Medicine最新文献

{"title":"The cardiometabolic index as a predictor of sleep disorders and mortality: A cross-sectional study.","authors":"Zhisen Xu, Xuanfang Qian, Junyao Xu","doi":"10.1097/MD.0000000000042029","DOIUrl":"10.1097/MD.0000000000042029","url":null,"abstract":"<p><p>The cardiometabolic index (CMI) reflects an individual's cardiometabolic health and is linked to the risk of dyslipidemia, obesity, hyperglycemia, and hypertension. These risk factors not only increase the likelihood of cardiovascular disease but are also strongly associated with sleep issues such as sleep apnea and insomnia. However, the relationship between CMI and the risk of sleep disorders remains unclear. This study aimed to investigate the association between CMI and sleep disorder-related morbidity and mortality. This cross-sectional study utilized data from 6220 adults aged ≥ 20 years from the National Health and Nutrition Examination Survey (2007-2014). The CMI was calculated as [waist circumference (cm)/height (cm)] × [triglycerides (mmol/L)/high-density lipoprotein-C (mmol/L)], reflecting metabolic risk. Participants were categorized into 3 CMI tertiles (Q1-Q3). Based on survey data, participants were classified into sleep disorder and non-sleep disorder groups. The analysis included logistic regression, subgroup analysis, forest plots, and survival analysis. The average age of participants was 49 ± 18.00 years; 49% were male. The high-CMI group had older participants, more males, higher body mass index, higher triglycerides, and more hypertension (P < .001). Higher CMI was significantly associated with an increased risk of sleep disorders (odds ratio [OR] = 1.11, 95% CI: 1.02 to 1.21, P = .017), with the prevalence being greater in Q3 than in Q1 (OR = 1.46, 95% CI: 1.27 to 1.68, P ≤ .001). After adjusting for demographics, the association persisted (OR = 1.13, 95% CI: 1.03-1.24, P = .014). The mortality rate was also higher in the high-CMI group (P≤.001), with a 34% increased risk of death (OR = 1.34, 95% CI: 1.08-1.67, P = .021). The study found that a higher CMI is associated with increased risks of sleep disorders and mortality. Understanding this relationship may help in monitoring cardiometabolic health and assessing sleep disorder severity. CMI could serve as a cost-effective indicator for sleep disorder assessment.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 14","pages":"e42029"},"PeriodicalIF":1.3,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803878","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":"The role of resistive index in the diagnosis of Hashimoto thyroiditis: A cross-sectional study.","authors":"Kiarash Soltani, Elham Keshavarz, Ensi Khalili Pouya, Razieh Jamali, Taraneh Faghihi Langroudi, Sara Haseli","doi":"10.1097/MD.0000000000041933","DOIUrl":"10.1097/MD.0000000000041933","url":null,"abstract":"<p><p>The diagnostic role of Doppler ultrasonography regarding Hashimoto thyroiditis (HT) is not fully established. We examined intraparenchymal resistive index (RI) as a Doppler parameter, thyroidal vascularity and other Gray-Scale findings in adults with HT in order to evaluate the clinical feasibility of RI in the diagnosis of this disease. The study included 48 women aged 20 to 50 years who had recently been diagnosed with HT. These participants, who were either euthyroid or sub-clinically hypothyroid during the study period, underwent sonographic examination. Thyroid glands were classified into 4 distinct patterns, using the Color Doppler Scale introduced by Schultz et al and also based on Sostre and Reyes Gray-Scale Grading System they were classified into 4 Grades. Intraparenchymal RIs were obtained in 2 locations within each lobe of the thyroid gland. Gray-Scale findings were compared to Doppler findings (RI). Also, intraparenchymal RIs were obtained in 45 healthy adults as a control group. The mean RI values were determined by calculating the mean of the RI measurements obtained from both lobes of each participant in the patient and control groups. The mean RI value was found to be 0.57 ± 0.05 (range 0.5-0.7) cm/s in patient group and 0.54 ± 0.05 (range 0.47-0.7) cm/s in control group. The results were distributed as follows: pattern 0 was observed in 22 cases, pattern I in 15 cases, pattern II in 6 cases, and pattern III in 5 cases. The mean RI values for patients with normal or nearly normal Gray-Scale findings (n = 13) and those with more pronounced Gray-Scale changes (n = 35) showed no significant difference. However, both groups exhibited higher mean RI values compared to the normal adults in the control group. The results highlight that the RI could be an effective and sensitive tool for diagnosing HT through Doppler ultrasonography.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 14","pages":"e41933"},"PeriodicalIF":1.3,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803335","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":"Eye acupuncture therapy for insomnia: A systematic review and meta-analysis.","authors":"Shuxuan Wang, Zhenyu Shi, Sheng Li, Mengjiao Li, Yaqun Wang","doi":"10.1097/MD.0000000000041767","DOIUrl":"10.1097/MD.0000000000041767","url":null,"abstract":"<p><strong>Background: </strong>Insomnia is a common sleep disorder, and this meta-analysis aimed to systematically evaluate the effectiveness of eye acupuncture combined with other therapies in treating insomnia.</p><p><strong>Methods: </strong>In this comprehensive meta-analysis, we conducted a systematic evaluation of the effectiveness of eye acupuncture as a treatment for insomnia, a widespread sleep disorder. Our literature search spanned multiple databases, including Wanfang, Chinese National Knowledge Infrastructure, Wipo Information Chinese Periodicals Service Platform, China Biology Medicine, PubMed, Cochrane Library, Web of Science, and Embase, covering the period from their inception to February 1, 2024, and including both Chinese and English publications. The article included randomized controlled trials comparing eye acupuncture combined with other treatments versus non-eye acupuncture treatments for insomnia. Data extraction was independently conducted by 2 evaluators, and the risk of bias was rigorously assessed using the Cochrane Risk of Bias Tool. The synthesis of data involved a meta-analysis using RevMan 5.3 software, complemented by sensitivity analysis comparing fixed and random effects models to enhance the robustness of our findings.</p><p><strong>Results: </strong>This study involved 13 clinical studies involving 856 patients with insomnia.The meta-analysis findings indicated that the combined eye acupuncture treatment exhibited significantly superior clinical efficacy compared to either drug treatment or non-drug treatment alone (odds ratio = 3.71, 95% confidence interval [CI]: 2.18-6.32, Z = 4.82, P < .00001). Compared with the control group, the intervention group exhibited a lower Pittsburgh Sleep Quality Index score (PSQI; mean difference [MD] = -2.46, 95% CI [-3.07, -1.85], Z = 7.87, P < .00001). Moreover, the Traditional Chinese Medicine Symptom Score (TCMSS) of the intervention group decreased more than that of the control group (MD = -1.51, 95% CI [-2.80, -0.22], Z = 2.29, P = .02). In the documentation of adverse reactions, a single study reported that 2 patients experienced mild subcutaneous hemorrhage following eye acupuncture treatment, which resolved spontaneously post-treatment.</p><p><strong>Conclusion: </strong>The combination of eye acupuncture with other therapies in the treatment of insomnia can enhance clinical efficacy, reduce the TCMSS and the PSQI score, and effectively improve insomnia outcomes.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 14","pages":"e41767"},"PeriodicalIF":1.3,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803440","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":"Gastroesophageal reflux disease and osteoporosis: A bidirectional Mendelian randomization study.","authors":"Qinghua Yang, Longao Huang, Hongyuan Xu, Junfei Feng, Dun Liu, Shengwang Wei, Hua Jiang","doi":"10.1097/MD.0000000000042083","DOIUrl":"10.1097/MD.0000000000042083","url":null,"abstract":"<p><p>In observational studies, associations between osteoporosis (OP) and gastroesophageal reflux disease (GERD) have been found. We conducted a 2-way, 2-sample Mendelian randomization (MR) analysis to determine whether these associations have a causal relationship. Data on GERD at the summary-level were sourced from extensive genome-wide association studies encompassing 129,080 cases and 473,524 control subjects. Bone mineral density (BMD) served as the phenotypic indicator for OP. BMD metrics were compiled from a cohort of 537,750 individuals, encompassing total body BMD (TB-BMD) and stratified TB-BMD across age groups, along with BMD measurements at 4 anatomical locations: lumbar spine, femoral neck, heel, and ultra-distal forearm. Multiple MR approaches, such as the inverse-variance weighted (IVW) method, MR-Egger regression, and the MR-PRESSO test, were employed, among which findings obtained by IVW method were designated as the primary outcomes. For quality assurance, sensitivity analyses were conducted using the MR-Egger intercept, Cochran Q, and leave-one-out test. There were no significant causal links between genetic inclination towards GERD and reduced BMD levels. Nonetheless, the genetic evidence suggests a causal link between higher BMD levels and lower incidence of GERD [TB-BMD: OR = 0.941, 95% confidence intervals (CI) = 0.910-0.972, P < .001; TB-BMD-1: OR = 0.919, 95% CI = 0.885-0.954, P < .001; TB-BMD-3: OR = 0.945, 95% CI = 0.915-0.977, P = .001; TB-BMD-4: OR = 0.926, 95% CI = 0.896-0.957, P < .001]. Sensitivity analyses corroborate our findings. The MR analysis indicates no significant causal link between genetic inclination towards GERD and OP or reduced BMD within the European demographic. In addition, the study suggests that lower BMD or OP, as predicted by genetics, may contribute to the development of GERD.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 14","pages":"e42083"},"PeriodicalIF":1.3,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803504","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":"Impact of multidisciplinary collaborative jejunal nutrition care on nutritional status and quality of life in severely burned patients.","authors":"Fang Zou, Dan Sun, Jiang Chang, Chonggen Huang, Qing Zhou, Lingtao Ding","doi":"10.1097/MD.0000000000041965","DOIUrl":"10.1097/MD.0000000000041965","url":null,"abstract":"<p><p>To access the impact of multidisciplinary collaborative jejunal nutrition care on the nutritional status, pain level, wound healing, and quality of life in severely burned cases. A total of 120 cases with severe burns who visited our hospital from January 2021 to May 2023 were enrolled. Inclusion criteria: ① severe burn diagnosis; ② admission within 18 hours; ③ normal heart, liver, kidney, and cognitive function; ④ informed consent signed. Exclusion criteria: ① consumptive/metabolic diseases; ② malignant tumors; ③ midway death; ④ pregnant or lactating women. Patients were divided into 2 groups: control (n = 60) receiving parenteral nutrition and observation (n = 60) receiving multidisciplinary collaborative jejunal nutrition care. The latter included a multidisciplinary team (burns, endocrinology, cardiology, nephrology) and professionally trained caregivers. The jejunal nutrition care included the placement of a nasojejunal tube, individualized nutrition infusion protocols, close monitoring of vital signs, psychological counseling, and regular consultations with the multidisciplinary team. Outcomes assessed included hemoglobin, transferrin, albumin levels, pain (Visual Analogue Scale), wound healing, complications, SF-36 quality of life, and nursing satisfaction. After management, the observation group indicated significantly higher levels of hemoglobin (mean difference: 16.28 g/L, 95% CI: 12.5-20.1; Cohen d: 2.0, 95% CI: 1.7-2.3), transferrin (mean difference: 0.67 g/L, 95% CI: 0.5-0.9; Cohen d: 2.5, 95% CI: 2.1-3.0), and albumin (mean difference: 5.26 g/L, 95% CI: 4.2-6.3; Cohen d: 3.5, 95% CI: 3.0-4.0) compared to the control group (P < .05). The Visual Analogue Scale scores in the observation group were significantly lower (mean difference: 3.18 points, 95% CI: 2.8-3.5; Cohen d: 6.5, 95% CI: 5.9-7.2), and the wound healing time was significantly shorter (mean difference: 7.41 days, 95% CI: 4.5-10.3; Cohen d: 0.8, 95% CI: 0.6-1.0, P < .05). The observation group showed a lower complication rate (P = .02). Additionally, the observation group demonstrated significant improvements in SF-36 quality of life scores and higher nursing satisfaction (96.67% vs 80.00%, P = .0001). Multidisciplinary collaborative jejunal nutrition care effectively improves nutritional status, reduces pain, accelerates wound healing, and enhances quality of life and satisfaction in severely burned patients.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 14","pages":"e41965"},"PeriodicalIF":1.3,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803739","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":"Analysis of risk factors for gastrointestinal bleeding in percutaneous coronary intervention patients treated with dual antiplatelet therapy after surgery.","authors":"Caiping Chen, Huimin Fan, Renya Shuai","doi":"10.1097/MD.0000000000041935","DOIUrl":"10.1097/MD.0000000000041935","url":null,"abstract":"<p><p>Following percutaneous coronary intervention (PCI), dual antiplatelet therapy (DAPT) is key to preventing thrombosis. However, the use of DAPT is strongly associated with an increased risk of Gastrointestinal Bleeding, which not only affects patient recovery but also increases the healthcare burden. This study aims to determine the influence of past medical history and factors during hospitalization on the development of postoperative GIB in patients undergoing PCI with DAPT. A total of 380 patients were collected in this study. A total of 42 patients developed GIB during the 1-year follow-up period. Preoperative and postoperative clinical data and past medical history of patients were collected to study the correlates affecting the occurrence of GIB in the postoperative period in patients undergoing PCI with DAPT and to establish a prediction model. Single-factor logistic regression analysis showed: gender, age, past history of bleeding, past history of cancer or tumor, smoking history, history of heart failure, history of PPI use, renal insufficiency, and hypoproteinemia are potential risk factors that may influence the occurrence of GIB postoperatively in patients undergoing DAPT for PCI, P < .2. The data obtained were further included in multi-factor logistic regression analysis: gender (female), past history of bleeding, past history of cancer or tumor, smoking history, heart failure, renal insufficiency were independent risk factors influencing the occurrence of GIB postoperatively in PCI patients undergoing DAPT, P < .05. The findings of this study confirm that gender (female), past history of bleeding, past history of cancer or tumor, smoking history, heart failure and renal insufficiency are independent risk factors for the development of GIB postoperatively in PCI patients undergoing DAPT.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 14","pages":"e41935"},"PeriodicalIF":1.3,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803829","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":"Post-vitrectomy endophthalmitis complicated with orbital cellulitis treated with hyperbaric oxygen therapy: A case report.","authors":"Yi-Ju Shen, Li-Ching Liu, I-Chia Liang","doi":"10.1097/MD.0000000000042043","DOIUrl":"10.1097/MD.0000000000042043","url":null,"abstract":"<p><strong>Rationale: </strong>Infectious endophthalmitis developed in silicone oil (SO)-filled eyes after pars plana vitrectomy is a very rare but serious complication. Hyperbaric oxygen therapy (HBOT) has been reported to be effective in few studies of infectious endophthalmitis and orbital cellulitis.</p><p><strong>Patient concerns: </strong>This study reported a case of 71-year-old female with swelling of her left eye 1 week after pars plana vitrectomy and SO tamponade.</p><p><strong>Diagnoses: </strong>Acute infectious endophthalmitis complicated with orbital cellulitis and compartment syndrome in a postvitrectomy SO-filled eye.</p><p><strong>Interventions: </strong>Intravitreal injection of antibiotics and HBOT.</p><p><strong>Outcomes: </strong>The severe inflammatory condition of soft tissue with compartment syndrome and elevated intraocular pressure which could not be controlled ameliorated markedly after initiation of HBOT.</p><p><strong>Lessons: </strong>By taking advantages of the features of HBOT, it may be a good adjuvant treatment option for endophthalmitis cases along with antibiotics and surgical therapy.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 14","pages":"e42043"},"PeriodicalIF":1.3,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803744","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":"Ureteral orifice edema and stenting challenges in diabetic patients: Lessons from a case report.","authors":"Shuang Guo, Yunxi Hu, Zhongwei Liu, Denghui Huang, Wenjiang Yang","doi":"10.1097/MD.0000000000042069","DOIUrl":"10.1097/MD.0000000000042069","url":null,"abstract":"<p><strong>Rationale: </strong>Ureteral stones, particularly in elderly patients, pose significant clinical challenges due to their association with severe pain, infection, and urinary obstruction. While the introduction of minimally invasive techniques, such as ureteroscopy and ureteral stenting, has revolutionized treatment, gaps remain in understanding how comorbid conditions like diabetes affect patient outcomes.</p><p><strong>Patient concerns: </strong>A 68-year-old male patient was admitted to our hospital for 3 days due to left lumbar and abdominal pain accompanied by fever.</p><p><strong>Diagnoses: </strong>Abdominal computed tomography revealed sediment calculi in the left lower ureter and significant exudative changes in the left kidney. Through laboratory examination, procalcitonin and other inflammatory indicators were significantly elevated. The diagnosis was ureteral calculi with infection.</p><p><strong>Interventions: </strong>Transurethral ureteral stenting.</p><p><strong>Outcomes: </strong>The patient was discharged 3 days after surgery, and the inflammation index returned to normal. The ureteral stent was removed at a 2-week follow-up.</p><p><strong>Lessons: </strong>Key findings include the identification of significant challenges in locating the ureteral orifice, the successful use of stenting to manage both infection and obstruction, and the importance of minimally invasive interventions in diabetic patients. The case also emphasizes the role of diabetes in complicating ureteral stone management due to its impact on immune response and healing. This report contributes to the existing literature by providing insights into the complex anatomical and pathological factors that can complicate ureteral stent placement in diabetic and elderly patients.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 14","pages":"e42069"},"PeriodicalIF":1.3,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803526","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":"Infectious disease-specific health literacy and its influencing factors: Research results based on a cross-sectional design study carried out in Shandong Province's rural areas.","authors":"Xin Wang, Xueli Zhang, Shuyu Chen, Keqing Shi, Wenhui Cui, Fuyan Shi, Suzhen Wang, Qiang Wang","doi":"10.1097/MD.0000000000042084","DOIUrl":"10.1097/MD.0000000000042084","url":null,"abstract":"<p><p>Rural residents face a higher risk of infectious diseases, and infectious disease-specific health literacy (IDSHL) is a crucial means of managing these risks. This study intended to survey the levels of IDSHL among rural residents in Shandong Province, China, and explore the influencing factors of IDSHL. In 2022, a cross-sectional design investigation was carried out in Shandong Province of China, involving 2283 participants recruited through a multistage sampling approach in rural regions. A cognitive questionnaire was used to assess participants' levels of IDSHL. Pearson χ2 test was performed to compare the differences in the distribution of categorical variables between the adequate and inadequate IDSHL groups. Multicollinearity diagnosis analysis was utilized to evaluate multicollinearity. Multiple logistic regression was used to detect the possible influencing factors of IDSHL. Among the participants, 31.80% had adequate IDSHL. Multiple logistic regression demonstrated that education (odds ratio (OR)junior high school = .71, 95% confidence interval (CI) of OR: 0.51-0.99, P = .04; ORuniversity or above = 2.62, 95% CI of OR: 1.67-4.11, P < .01), occupation (ORbusiness = 2.19, 95% CI of OR: 1.34-3.57, P < .01; ORothers = 1.46, 95% CI of OR: 1.02-2.10, P = .04), family income (OR1-3 10,000 RMB = 2.83, 95% CI of OR: 1.98-4.05, P < .01; OR3-6 10,000 RMB = 1.75, 95% CI of OR: 1.21-2.53, P < .01), \"whether the participant used a smartphone in daily life\" (OR = 2.02, 95% CI of OR: 1.32-3.09, P < .01) and \"whether knowledge of infectious disease prevention and control could be acquired\" (OR = 11.77, 95% CI of OR: 6.44-21.54, P < .01) were associated with adequate IDSHL. The rural residents' level of adequate IDSHL in China's Shandong Province, was unsatisfactory. Special health education is needed to be implemented to enhance rural residents' IDSHL and should target key populations with low levels of IDSHL.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 14","pages":"e42084"},"PeriodicalIF":1.3,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803742","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":"Esophageal magnetic anastomosis for long gap congenital esophageal atresia: A case report.","authors":"Hefeng Wang, Tingzhen Yuan, Jinliang Zhang, Fengyu Gao, Lifeng Liu","doi":"10.1097/MD.0000000000042041","DOIUrl":"10.1097/MD.0000000000042041","url":null,"abstract":"<p><strong>Rationale: </strong>Long gap esophageal atresia (LGEA) is a rare congenital malformation. Magnamosis represents a minimally invasive technique for LGEA to achieve esophageal recanalization for feeding. Few cases had been reported worldwide.</p><p><strong>Patient concerns: </strong>An infant was diagnosed as congenital esophageal atresia by using prenatal ultrasound imaging including the absence of gastric bubble and polyhydramnios.</p><p><strong>Diagnoses: </strong>LGEA was confirmed after birth by esophagography through the gastrostomy and esophagus simultaneously.</p><p><strong>Interventions: </strong>Laparoscopic gastrostomy was performed on the 3rd day after birth to obtain nutrition. The esophagus was prolonged from the proximal and distal blind end weekly starting from 2 weeks after gastrostomy. Magnamosis was achieved with the help of thoracoscopy. The proximal and distal esophagus were fully separated and released under thoracoscopy. Two magnets were introduced into the proximal and distal esophageal pouch respectively. Chest X-rays were performed to demonstrate a progressive reduction of inter magnetic space. The esophageal imaging confirmed that the esophagus is connected, and the magnets were removed from mouth. An anastomotic leak was found, and the leak healed within 2 weeks.</p><p><strong>Outcomes: </strong>The infant achieved esophageal recanalization through magnetic anastomosis, allowing for oral feeding and maintained her native esophagus. Esophageal stenosis occurred at 4 weeks after magnetic anastomosis without other complications. Endoscopic balloon dilation was performed. The infant was followed up for 6 months, and exhibited durable esophageal patency with a good nutrition.</p><p><strong>Lessons: </strong>This result suggests that magnetic anastomosis is a feasible and effective treatment for LGEA in infants.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 14","pages":"e42041"},"PeriodicalIF":1.3,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803326","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}