Medicine最新文献

{"title":"Improved injection site reactions after switching from adalimumab reference to adalimumab biosimilar LBAL for ulcerative colitis: A case report.","authors":"Yudai Hirakawa, Toshihiko Kakiuchi, Masato Yoshiura, Nao Kikkawa","doi":"10.1097/MD.0000000000040400","DOIUrl":"10.1097/MD.0000000000040400","url":null,"abstract":"<p><strong>Rationale: </strong>Adalimumab (ADA) is an antitumor necrosis factor agent that is used for the treatment of inflammatory bowel disease. However, its cost has resulted in varying degrees of restricted access across global healthcare economies. Biosimilars are agents that contain a similar version of the active substance of an already approved original biologic agent and are intended to be used for the same indication as the reference product. In general, biosimilars follow the originator; therefore, information on its efficacy and safety had been few. Some studies have reported on replacement of the originator with a biosimilar of the same efficacy because of medical reasons.</p><p><strong>Patient concerns: </strong>A 15-year-old girl with steroid-dependent ulcerative colitis that relapsed after vedolizumab was treated with ADA reference. Six weeks after starting ADA reference, her gastrointestinal symptoms had completely resolved, however, immediately after the eighth dose of ADA reference, redness, swelling, and pruritus were noted at the injection site on the left thigh.</p><p><strong>Diagnosis: </strong>Allergic reaction caused by the ADA reference.</p><p><strong>Intervention: </strong>ADA reference was changed to ADA biosimilar LBAL.</p><p><strong>Outcomes: </strong>ADA biosimilar LBAL was continued without any symptoms, such as local swelling, redness, or itching. In addition, there was no deterioration of gastrointestinal symptoms.</p><p><strong>Lessons: </strong>We showed the efficacy and safety of ADA biosimilar LBAL as an alternative to ADA reference, which caused injection site reactions. Changing from ADA reference to ADA biosimilar because of adverse events may be an option that needs careful observation, considering that the originator and the biosimilar are not exactly the same.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A deep dive into neonatal well-being and anesthesia in cesarean sections: From procedure to outcome.","authors":"Rahul Kumar Chaudhary, Sajjad Ahmed Khan, Kanak Khanal, Siddhartha Kumar Yadav, Surya Bahadur Parajuli, Laleet Kumar Rajbanshi, Chandra Bhushan Jha","doi":"10.1097/MD.0000000000040404","DOIUrl":"10.1097/MD.0000000000040404","url":null,"abstract":"<p><p>This observational study analyzed data from 502 participants undergoing cesarean section (CS) procedures at an obstetrics and gynecology department, aiming to explore anesthesia practices, neonatal outcomes, and demographic characteristics within the cohort. Participants, aged 17 to 59 years with a mean age of 32.23 years, were enrolled based on the clinical necessity for cesarean delivery during the study period. Informed consent was obtained from each participant or their guardians before data collection, which included detailed demographic information, medical histories, specifics of the cesarean section procedure, and APGAR scores of neonates immediately postbirth (at 0 and 5 minutes). Primary outcomes focused on APGAR scores, critical indicators of neonatal health, while secondary outcomes included the distribution of patient ages, reasons for cesarean sections, and the administration of Bupivacaine during anesthesia. Data were rigorously analyzed using descriptive and inferential statistics to summarize participant demographics, anesthesia practices, and neonatal outcomes. Statistical methods included measures of central tendency and dispersion, correlation analyzes to explore associations between variables, and regression models to identify predictors of neonatal APGAR scores. The study identified a range of indications for cesarean sections, with common reasons including fetal distress and maternal health complications. Findings indicated an average APGAR score of 7.02 at 0 minutes and 7.84 at 5 minutes, reflecting generally favorable immediate neonatal outcomes. Anesthesia protocols predominantly involved Bupivacaine, with doses ranging from 1.8 to 2.2 mL, administered based on clinical requirements. In conclusion, this study underscores the importance of comprehensive data collection and rigorous statistical analysis in evaluating cesarean section procedures. Future research could further explore long-term neonatal outcomes and refine anesthesia protocols to optimize maternal and neonatal health during cesarean deliveries.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"African-Colombian woman with preeclampsia and high-risk APOL1 genotype: A case report.","authors":"Carlos E Duran, Juan David Gutierrez-Medina, Jacobo Triviño Arias, Lina M Sandoval-Calle, Mario Barbosa, Elena Useche, Lorena Diaz-Ordoñez, Harry Pachajoa","doi":"10.1097/MD.0000000000040284","DOIUrl":"10.1097/MD.0000000000040284","url":null,"abstract":"<p><strong>Rationale: </strong>Preeclampsia is one of the main causes of maternal morbidity and mortality worldwide. Even though preeclampsia is the most prevalent medical complication of pregnancy, it predominantly affects Black women when compared with other ethnicities. APOL1 G1 and G2 risk alleles are genetic risk factors for hypertension and more recently have been associated to the risk of developing preeclampsia.</p><p><strong>Patient concerns: </strong>A 17-year-old African Colombian primigravid patient from the Colombian Pacific Coast with preeclampsia, grade 1 obesity, convulsive episodes and psychomotor agitation.</p><p><strong>Diagnoses: </strong>The patient exhibited elevated blood pressure readings concomitant with 4 tonic-clonic episodes, tachycardia, Grade I edema, irregular uterine activity and recurrent convulsive episodes. A head computed tomography revealed posterior reversible encephalopathy syndrome along with cytotoxic edema. Genetic testing unveiled a high risk APOL1 genotype (G1/G2) and a confirmed matrilineal African genetic ancestry (haplogroup L3b).</p><p><strong>Interventions: </strong>Initial management involved administration of labetalol and sodium nitroprusside infusions alongside neuroprotective management utilizing magnesium sulfate. Due to the diagnosis of eclampsia, pregnancy termination was performed via cesarean section. The additional antihypertensive therapeutic protocol with nitroprusside, labetalol, carvedilol, and diltiazem finally controlled the hypertensive crisis.</p><p><strong>Outcomes: </strong>Discharge was provided with family planning via subdermal implant contraception and established antihypertensive management.</p><p><strong>Lessons: </strong>This is the first Latin American report of an underage patient with a hypertensive crisis of pregnancy associated with a G1/G2 high risk genotype and a verified matrilineal genetic ancestry represented by a haplogroup L3b. This case reflects the importance of considering genetic predisposition in the context of preeclampsia. A stratified approach to preeclampsia management that acknowledges genetic factors harbors the potential to significantly diminish the maternal morbidity and mortality entwined with this condition.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of Sini Decoction at acupoint on gastrointestinal dysfunction in patients with sepsis: A clinical study.","authors":"Yuteng Du, Jingjing Hu, Pingping Zhang, Ting'ai Ge, Yidan Zhou","doi":"10.1097/MD.0000000000040464","DOIUrl":"10.1097/MD.0000000000040464","url":null,"abstract":"<p><p>The occurrence of gastrointestinal dysfunction is widely recognized as a prevalent complication in patients with sepsis. To investigate clinical effect of Sini Decoction at acupoint on gastrointestinal dysfunction in sepsis patients. Seventy-five patients with gastrointestinal dysfunction caused by sepsis were randomly divided into 2 groups. Treatment group received routine Western medicine treatment combined with Sini Decoction at acupoint, while control group treated with talcum powder at acupoint. Treatments in both groups lasted 7 days. Changes in the acute physiology and chronic health evaluation II score, sequential organ failure assessment score, mechanical ventilation duration, the length of Intensive Care Unit (ICU) stay, enteral nutrition tolerance scores, abdominal circumference, gastric residual volume, bowel sounds, and serum index were observed. After treatment, the enteral nutrition tolerance score, abdominal circumference, gastric residual volume, and levels of lactate and interleukin-6 were significantly lower in the treatment group compared to the control group. Bowel sounds were more active and motilin levels were higher in the treatment group. Additionally, the length of ICU stay was significantly shorter in the treatment group than in the control group. Our findings demonstrated that the application of Sini Decoction at acupoints in sepsis patients with gastrointestinal dysfunction can effectively enhance gastrointestinal function, leading to a reduction in ICU stay duration and an improvement in patients' prognosis.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study on the impact of refractive anisometropia on strabismus, stereopsis, and amblyopia in children.","authors":"Shanli Qiao, Jing Chen, Jianfei Zhang, Changfeng Sun","doi":"10.1097/MD.0000000000040205","DOIUrl":"10.1097/MD.0000000000040205","url":null,"abstract":"<p><p>To preliminarily explore the correlation between different types and degrees of refractive errors and strabismus, amblyopia, and stereopsis. A retrospective collection was conducted on a total of 145 patients with anisometropia who visited our hospital for strabismus and pediatric ophthalmology from January 2023 to August 2023.Based on the nature of anisometropia in both eyes, it was divided into 4 groups: Farsighted anisometropia (36 cases); myopic anisometropia (38 cases); astigmatic anisometropia (35 cases); mixed anisometropia (36 cases), and 30 children with normal vision were collected. Both groups of subjects underwent routine slit lamp and fundus examinations to exclude other organic eye diseases. The test indexes were: visual acuity, diopter, strabismus, far-stereoscopic vision, near-stereoscopic Titmus, and random static zero-order stereoscopic vision. The results of this study showed that compared with the normal control group, the incidence of strabismus was higher in the anisometropia group. When the refractive error was ≥1.00D, the far stereopsis and random dot static 0-order stereopsis in the anisometropia group decreased more significantly, and the difference between the groups was statistically significant (P < .05). Far-sighted and mixed astigmatism were more prone to amblyopia than myopia and regular astigmatism (P < .05). However, there was no statistical difference in near stereopsis Titmus between the anisometropia group and the control group (P > .05). Children with anisometropia are more likely to have strabismus, stereopsis and amblyopia than normal children.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Central role of hypoxia-inducible factor-1α in metabolic reprogramming of cancer cells: A review.","authors":"Bing Zhu, Lichao Cheng, Baosu Huang, Runzhi Liu, Bin Ren","doi":"10.1097/MD.0000000000040273","DOIUrl":"10.1097/MD.0000000000040273","url":null,"abstract":"<p><p>Metabolic reprogramming is one of the characteristics of tumor cell metabolism. In tumor cells, there are multiple metabolic enzymes and membrane proteins to regulate metabolic reprogramming, and hypoxia inducible factor-1α (HIF-1α) can be regulated in transcription, translation, posttranslational modification and other aspects through multiple pathways, and HIF-1α affects multiple metabolic enzymes and membrane proteins during metabolic reprogramming, thus playing a central role in the metabolic reprogramming process, and thus has some implications for tumor therapy and understanding chemotherapy drug resistance. HIF-1α affects a number of metabolic enzymes and membrane proteins in the metabolic reprogramming process, thus playing a central role in the metabolic reprogramming process, which has certain significance for the treatment of tumors and the understanding of chemotherapeutic drug resistance. In this paper, we review the central role of HIF-1α in metabolic reprogramming, chemotherapeutic agents targeting HIF-1α, and chemotherapeutic drug resistance.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Construction and validation of a risk prediction model for postoperative lung infection in elderly patients with lung cancer.","authors":"Xiaojie Chen, Lixin Wu, Gang Lan, Xiaofeng Li, Xuejing Wang, Ping Zhang, Weihu Huang","doi":"10.1097/MD.0000000000040337","DOIUrl":"10.1097/MD.0000000000040337","url":null,"abstract":"<p><p>This study aimed to analyze the risk factors for postoperative lung infection in elderly patients with lung cancer (LC) and construct a predictive model. A retrospective analysis was conducted on 192 elderly patients with LC who underwent surgical treatment in our hospital between February 2020 and May 2023. According to whether there is lung infection after surgery, they were divided into an infected group (n = 55) and a noninfected group (n = 137). Binary logistic regression was used to analyze factors influencing postoperative lung infection in elderly patients with LC. Based on the logistic regression results, a predictive model for postoperative lung infection in LC patients was constructed. The receiver operating characteristic curve was used to analyze C-reactive protein (CRP), interleukin-6 (IL-6), insulin-like growth factor-1 (IGF-1), and their combination in predicting postoperative lung infection in patients with LC. There were significant differences between the infected group and the noninfected group in age, smoking history, diabetes, and perioperative antibiotic use were significantly different between the infected and noninfected groups (P < .05). The postoperative CRP, IL-6, and IGF-1 levels in the infected group were higher than those in the noninfected group on the 1st day (P < .05). Logistic regression analysis showed that age > 70 years, history of smoking, history of diabetes, prolonged use of perioperative antibiotics, and elevated CRP, IL-6, and IGF-1 levels on the 1st day after surgery were risk factors for postoperative lung infection in elderly patients with LC (P < .05). Receiver operating characteristic curve analysis showed that the area under curve values of CRP, IL-6, IGF-1, and their combination in predicting postoperative lung infection in elderly patients with LC were 0.701, 0.806, 0.737, and 0.871, P < .05), with sensitivity values of 0.443, 0.987, 0.456, and 0.835, respectively; the specificity was 0.978, 0.525, 0.991, and 0.821, respectively. Age > 70 years, smoking history, diabetes history, prolonged use of perioperative antibiotics, and elevated CRP, IL-6, and IGF-1 levels on the 1st day after surgery have an impact on postoperative lung infection in elderly patients with LC. Early postoperative monitoring of changes in CRP, IL-6, and IGF-1 levels can provide an important reference for predicting the occurrence of postoperative lung infections.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Different intensities of physical activity for amyotrophic lateral sclerosis and Parkinson disease: A Mendelian randomization study and meta-analysis.","authors":"Wenyuan Xu, Xianghu Zhao, Jiaying Wang, Yujie Guo, Zhihao Ren, Lian Cai, Shengbing Wu, Meiqi Zhou","doi":"10.1097/MD.0000000000040141","DOIUrl":"10.1097/MD.0000000000040141","url":null,"abstract":"<p><strong>Background: </strong>The causal relationships between amyotrophic lateral sclerosis (ALS), Parkinson disease and different intensities of physical activity (PA) are still inconclusive. To evaluate the causal impact of PA on ALS and Parkinson disease (PD), this study integrates evidence from Mendelian randomization (MR) using a meta-analysis approach.</p><p><strong>Methods: </strong>MR analyses on genetically predicted levels of PA (compose of self-reported moderate-to-vigorous physical activity [MVPA], self-reported vigorous physical activity [VPA], and strenuous sports or other exercises [SSOE]) regarding ALS and PD published up to July 27, 2024, were obtained from PubMed, Scopus, Web of Science, and Embase. De novo MR studies were analyzed utilizing publicly accessible datasets from genome-wide association studies and then meta-analyses were performed to pool the results.</p><p><strong>Results: </strong>Meta-analyses of results of 12 de novo MR studies analyses and 2 published MR studies indicated that genetic predicted levels of MVPA (odds ratio [OR]: 1.22, 95% confidence interval [CI]: 1.08-1.38), VPA (OR: 1.32, 95% CI: 1.08-1.60), and SSOE (OR: 1.35, 95% CI: 1.07-1.70) were related to a raised risk of ALS, but not causally with PD.</p><p><strong>Conclusion: </strong>Our findings showed no causal relationships between MVPA, VPA, SSOE, and PD, while MVPA, VPA, and SSOE were associated with increased ALS risk, highlighting the need for targeted PA recommendations for disease management.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of Qishen Yiqi dropping pills combined with modern medicine for coronary heart disease with ischemic heart failure: A systematic review and meta-analysis.","authors":"Qiushan Man, Shijian Chen, Xingyu Li","doi":"10.1097/MD.0000000000039927","DOIUrl":"10.1097/MD.0000000000039927","url":null,"abstract":"<p><strong>Background: </strong>Qishen Yiqi dropping pills combined with modern medicine have been widely used as a treatment for coronary heart disease with ischemic heart failure. Currently, there have been no robust studies addressing the efficacy and safety of Qishen Yiqi dropping pills combined with modern medicine for coronary heart disease with ischemic heart failure. Therefore, this systematic review and meta-analysis are conducted to fill in the gaps mentioned above.</p><p><strong>Methods: </strong>This systematic review was conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Relevant studies published from inception to April 17, 2023, in the 5 electronic databases: PubMed, The Cochrane Library, EMBASE, CNKI, and the Wanfang database were comprehensively searched. Weighted mean difference was used as the effect size for the continuous variables. Pooled odd ratios are presented if the results are binary variables. Additionally, we performed subgroup and sensitivity analyses to examine the source of heterogeneity. The funnel plot and the Egger test were used to estimate publication bias.</p><p><strong>Results: </strong>This meta-analysis included 46 studies involving 5843 participants. There is a significant difference in clinical efficacy, the 6-minute walk test (weighted mean difference = 50.10; 95% CI 28.19 to 72.02; I2 = 98.9%, P = .000), the indexes of ultrasonic cardiogram, blood biochemical indexes, and adverse effects (odds ratios = 0.46; 95% CI 0.29 to 0.75; I2 = 35.9%, P = .142). The sensitivity analysis and publication bias have demonstrated the robustness of the results (P = .702).</p><p><strong>Conclusion: </strong>Qishen Yiqi dropping pills combined with modern medicine could significantly improve clinical efficacy without incasement adverse effects. Further studies are required to identify the more comprise efficacy and safety results.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exercise and physical activity for people with chronic kidney disease: A national survey of nephrologist practice patterns in Saudi Arabia.","authors":"Enad Alsolami, Sami Alobaidi","doi":"10.1097/MD.0000000000040394","DOIUrl":"10.1097/MD.0000000000040394","url":null,"abstract":"<p><p>A variety of health benefits are associated with physical activity (PA) in individuals with chronic kidney disease (CKD). The aim of this study was to examine nephrologist practice patterns concerning exercise and PA in CKD patients. This is an online cross-sectional survey study that was conducted between June 2023 and May 2024 in Saudi Arabia. Nephrology fellow, specialists, and consultants in Saudi Arabia formed the study population. A total of 96 physicians participated in this study. Only 9.4% of renal units have exercise programs available to patients. These programs are available mainly for advanced CKD (pre-dialysis) and in-center hemodialysis patients. The major barriers for initiating or expanding exercise programs at their centers are a lack of motivation/interest from front-line staff (55.2%), lack of interest from management (48.3%), and no funding (47.1). Around 56.2% of respondents ask patients about their level of PA. Additionally, 64.6% give patients specific advice on how to increase their level of PA. For the types of exercise most beneficial for people with CKD, 90.6% recommend walking. Around 34.4% of respondents believe that physiotherapists should take ownership in providing exercise counseling and resources to people with CKD. The majority agreed or strongly agreed to recommend exercise in patients with CKD (76.0%). The mean attitude score for the study participants was 32.1 (standard deviation: 3.9) out of 40 (equal to 80.3%); which demonstrates positive attitude towards recommending exercise for CKD patients. Binary logistic regression analysis identified that there is no statistically significant difference between physicians in term of their attitude towards recommending exercise for CKD patients (P > .05). This study highlights a critical gap in the availability of exercise programs for CKD patients. Key barriers include lack of interest by staff and management and funding issues. In spite of these barriers, a majority of physicians acknowledge the role of exercise in CKD patients and advice regarding PA on a frequent basis. It suggests recommendations in order to expand the programs, including increasing staff motivation, securing management support, and getting funding for exercise programs and identifying the role of physiotherapists in exercise counseling for CKD patients.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}