Medicine最新文献

{"title":"Laryngeal non-Hodgkin lymphoma presenting as throat foreign body sensation: A case report.","authors":"Hongming Liao, Ai He, Fengbo Yan, Benchao He","doi":"10.1097/MD.0000000000043132","DOIUrl":"10.1097/MD.0000000000043132","url":null,"abstract":"<p><strong>Rationale: </strong>Laryngeal lymphoma is an extremely rare malignancy, representing <1% of all laryngeal tumors. Diffuse large B-cell lymphoma (DLBCL) is the most common histologic subtype. Due to its rarity and nonspecific symptoms, early diagnosis and timely treatment are critical.</p><p><strong>Patient concerns: </strong>A 67-year-old male presented with progressive hoarseness and a persistent sensation of a foreign body in the throat that had developed over several weeks.</p><p><strong>Diagnoses: </strong>Laryngoscopy revealed a submucosal mass involving the glottis. Contrast-enhanced computed tomography demonstrated soft tissue infiltration. Surgical excision was performed, and histopathological evaluation confirmed the diagnosis of diffuse large B-cell lymphoma of the larynx.</p><p><strong>Interventions: </strong>The patient received systemic chemotherapy tailored to the staging and anatomical location of the lymphoma, following current DLBCL treatment guidelines.</p><p><strong>Outcomes: </strong>The patient experienced significant symptom relief after chemotherapy, with resolution of hoarseness and foreign body sensation. No recurrence was observed during the 2-month follow-up period.</p><p><strong>Lessons: </strong>This case highlights the importance of considering lymphoma in the differential diagnosis of persistent hoarseness and throat discomfort. Early biopsy and multidisciplinary intervention are essential to achieve favorable outcomes in patients with rare laryngeal DLBCL.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 26","pages":"e43132"},"PeriodicalIF":1.3,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528774","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":"Successful outcome of assisted reproductive technology in women with polycystic ovary syndrome combined with empty follicle syndrome: A case report.","authors":"Danyang Guo, Lin Zhang, Xiaoxia Lin, Sha Tang, Bin Zhang, Linlin Ni","doi":"10.1097/MD.0000000000043001","DOIUrl":"10.1097/MD.0000000000043001","url":null,"abstract":"<p><strong>Rationale: </strong>Empty follicle syndrome (EFS) is a rare and difficult-to-treat condition. Obese polycystic ovary syndrome (PCOS) is considered an independent risk factor for it. In this study, we report a case of successful pregnancy in an obese patient with PCOS combined with EFS and discuss the pathogenesis of EFS and optimal treatment strategies.</p><p><strong>Patient concerns: </strong>A 25-year-old woman presents with \"6 years of infertility without contraception.\"</p><p><strong>Diagnoses: </strong>Primary infertility, bilateral fallopian tube obstruction, PCOS, and EFS.</p><p><strong>Interventions: </strong>The patient underwent 2 cycles of controlled ovarian stimulation. In the first cycle, despite adequate ovarian stimulation, oocytes were not obtained and a diagnosis of EFS was made. In the second cycle, the following optimization measures were taken: the use of beinaglutide to help the patient lose weight and improve her blood glucose levels, supplementation with luteinizing hormone-active medications (e.g., Menotropins for injection), an increase in the dose of human chorionic gonadotropin, and the addition of growth hormone to improve the outcome of oocytes retrieval once the patient's blood glucose levels had stabilized.</p><p><strong>Outcomes: </strong>In the second cycle, 15 oocytes were successfully obtained, 13 oocytes of which were Metaphase II, resulting in the culture of 5 high-quality embryos. The patient had a successful pregnancy after frozen embryo transfer and was followed up to late-term pregnancy without abnormalities.</p><p><strong>Lessons: </strong>Multiple complex mechanisms may be involved in the development of EFS, and preconditioning and individualized treatment protocols are essential for improving outcomes in patients with EFS. Our treatment protocol provides some reference basis for the treatment of EFS.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 26","pages":"e43001"},"PeriodicalIF":1.3,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528780","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":"The expression and relationship of VEGF and MVD in type I endometrial cancer.","authors":"Suning Bai, Qi Wu, Liyun Song","doi":"10.1097/MD.0000000000042945","DOIUrl":"10.1097/MD.0000000000042945","url":null,"abstract":"<p><strong>Background: </strong>In recent years, with the improvement of people's living standards, the incidence rate of endometrial cancer shows a rising and younger trend in the world. Early stage endometrial cancer patients have a good prognosis after surgical treatment, but late stage patients have a poor prognosis. Therefore, if biological indicators related to the occurrence and development of endometrial cancer with high sensitivity and specificity can be found, it will provide clinical reference for predicting the prognosis of endometrial cancer and evaluating treatment effectiveness. Vascular endothelial growth factor (VEGF) is a positive regulator of angiogenesis, while microvascular density (MVD) is a quantitative indicator of angiogenesis. This study investigates the expression of VEGF and MVD in endometrial cancer and normal endometrial tissue, and explores their roles in the formation and development of endometrial cancer.</p><p><strong>Method: </strong>Immunohistochemical technique (SP method) was used to detect the expression of VEGF and MVD in paraffin sections of 38 cases of endometrial cancer and 20 cases of normal endometrium. Statistical analysis was conducted using statistical software SPSS 17.0.</p><p><strong>Results: </strong>The positivity of VEGF in the endometrial cancer group was significantly higher than that in the normal endometrial group. The expression level of MVD in the endometrial cancer group was significantly higher than that in the normal endometrial group. In endometrial cancer, the expression of VEGF is positively correlated with MVD (R = 0.811, P < .001).</p><p><strong>Conclusion: </strong>The expression levels of VEGF and MVD are significantly increased in endometrial cancer, and both are positively correlated in endometrial cancer. MVD is related to the surgical pathological staging, lymph node metastasis, and depth of muscle wall infiltration of endometrial cancer, indicating that local neovascularization and rich blood supply play an important role in the occurrence and development of endometrial cancer. VEGF is related to the depth of muscle wall infiltration in endometrial cancer, but not to surgical pathological staging and lymph node metastasis. It is considered that other angiogenic factors besides VEGF play a role in regulating angiogenesis during surgical pathological staging and lymph node metastasis of endometrial cancer.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 26","pages":"e42945"},"PeriodicalIF":1.3,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528784","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":"Pharmacists' knowledge of medication errors and their attitudes toward reporting them in Saudi Arabia.","authors":"Abdullah Alahmari, Nehad Ahmed, Abdulaziz Alkheran, Abdullah Alotaibi, Moayad Alhamdani, Rashed Alhrbi, Sarah Fatani","doi":"10.1097/MD.0000000000043035","DOIUrl":"10.1097/MD.0000000000043035","url":null,"abstract":"<p><p>Medication errors result in negative outcomes such as increased mortality, morbidity, length of hospital stays and medical costs. Assessing pharmacists' knowledge of medication errors and their attitudes toward reporting them is crucial for identifying gaps in awareness and practice. This study aims to evaluate pharmacists' knowledge of medication errors and their attitudes toward reporting them in Saudi Arabia. The present study was a cross-sectional study that included an online survey. Descriptive statistical analysis was conducted for all study variables, and linear regression analyses were performed to identify factors influencing pharmacists' knowledge of medication errors and their attitudes toward reporting them. The analysis was carried out using Jamovi software. A total of 527 pharmacists completed the survey. Over half of the participants were male (52.37%), and 59.39% were between the ages of 20 and 25. Over 25% of the pharmacists worked in hospitals, and 22.39% were employed in community pharmacies. Additionally, more than 56% of pharmacists have 8 or more years of work experience. The majority of pharmacists (90.13%) had limited knowledge about medication errors, but they maintained a positive attitude toward reporting these errors (96.39%). Pharmacists' attitudes toward medication error reporting were not significantly associated with the pharmacists' demographic data. However, pharmacists' knowledge of medication errors was significantly related to gender and age. To enhance medication safety and minimize errors, targeted educational programs should be introduced, with an emphasis on improving pharmacists' knowledge. Workplace-specific interventions are essential, alongside fostering a \"just culture\" to encourage transparent reporting without fear of blame. Policymakers and institutions must strengthen medication safety protocols, implement digital reporting tools, and promote interprofessional collaboration to reduce preventable errors and improve patient care.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 26","pages":"e43035"},"PeriodicalIF":1.3,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528792","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":"Risk factors for lower extremity deep vein thrombosis after intertrochanteric fracture of the femur and its response.","authors":"Feng-Li Wen, Yu-Chen Xiao, Ayidan Ailihemaiti, Jiangannuer Zheyiken","doi":"10.1097/MD.0000000000042997","DOIUrl":"10.1097/MD.0000000000042997","url":null,"abstract":"<p><p>The aim was to investigate the independent risk factors affecting the formation of lower extremity deep vein thrombosis (DVT) after intertrochanteric fracture of the femur, and to propose corresponding preventive measures. Data were collected from patients who underwent intertrochanteric femur fracture surgery in our hospital during the period from January 2020 to December 2023, and the independent risk factors for the formation of postoperative lower limb DVT were determined by univariate and multivariate logistic regression analyses, which led to the construction of the corresponding Nomogram model. The performance of the model was assessed by plotting the subjects' work characteristic curve and its corresponding area under the curve, as well as calibration curve and decision curve analysis. A total of 627 patients with intertrochanteric femoral fractures were included in the study, of whom 156 had postoperative thrombosis, with an incidence rate of 24.88%. By univariate and multivariate logistic regression analyses, 5 independent risk factors associated with lower extremity DVT formation after intertrochanteric femur fracture were identified, including age >75 years (OR: 1.719; 95% CI: 1.094-4.105), body mass index >24 (OR: 2.190; 95% CI: 1.610-2.899), history of preoperative diabetes mellitus (OR: 1.511; 95% CI: 1.079-2.115), high-energy injury (OR: 4.184; 95% CI: 1.977-8.858), and fracture-to-operation time of more than 48 hours (OR: 2.666; 95% CI: 1.964-4.342). The Nomogram model constructed in this study for DVT formation in the lower limb after femoral intertrochanteric fracture showed high predictive accuracy, which can help orthopedic surgeons to identify high-risk patients and intervene early to reduce the occurrence of postoperative DVT.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 26","pages":"e42997"},"PeriodicalIF":1.3,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528801","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":"Assessment of inflammation levels through the modified systemic inflammation score in patients with nonneovascular and neovascular age-related macular degeneration.","authors":"Burcu Polat Gültekin, Sebile Çomçali, Elif Şahin","doi":"10.1097/MD.0000000000043047","DOIUrl":"10.1097/MD.0000000000043047","url":null,"abstract":"<p><p>This study assesses the inflammation levels through the modified systemic inflammation score (mSIS) in patients with nonneovascular and neovascular age-related macular degeneration (AMD). A total of 90 participants were categorized into 3 groups: a control group, individuals with nonneovascular AMD under follow-up, and individuals with neovascular AMD who had not yet started injection treatment. Demographic and clinical parameters, including body mass index, were analyzed. The mSIS, based on serum albumin levels and the lymphocyte-to-monocyte ratio, was used to determine the level of systemic inflammation. There were no significant differences between the groups in terms of age (P = .08) or gender (P = .06). Regarding body mass index, no significant differences were observed between the groups (P = .06). When comparing mSIS scores between the groups, no significant differences were found for mSIS scores 0 and 1 across the groups. However, for mSIS 2, the proportion of participants with an mSIS score of 2 was significantly higher in the neovascular AMD group compared with the control group (P = .01). These findings suggest that mSIS may be a valuable tool for assessing systemic inflammation in AMD. The higher mSIS scores in the neovascular AMD group may indicate that disease severity is associated with increased inflammation. Further large-scale studies are needed to confirm the utility and clinical relevance.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 26","pages":"e43047"},"PeriodicalIF":1.3,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528699","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":"Causal relationship between inflammatory factors and inflammatory bowel disease: A bidirectional Mendelian randomization study combined with meta-analysis.","authors":"Xiang Ji, Afen Wu, Dehua Zha, Ming Li","doi":"10.1097/MD.0000000000042988","DOIUrl":"10.1097/MD.0000000000042988","url":null,"abstract":"<p><p>Due to the limitations of traditional observational studies, investigating the association between inflammatory factors and inflammatory bowel disease (IBD) remains challenging. In this study, we employed Mendelian randomization (MR) combined with meta-analysis to assess the causal relationship between 91 inflammatory factors and IBD. We selected genome-wide association study (GWAS) data for inflammatory factors and IBD from GWAS databases and conducted 2-sample MR analyses using the inverse-variance weighted (IVW) method, MR-Egger regression, and weighted median estimator. The MR analyses were performed for 91 inflammatory factors with IBD outcome data from 2 different databases. Subsequently, a meta-analysis of the main IVW results was conducted, followed by multiple corrections of the meta-analysis results. Conduct MR analysis between inflammatory factors and subtypes of IBD (Crohn disease and ulcerative colitis [UC]), followed by reverse causality validation of positive inflammatory factors with IBD and its subtype outcome data. In the IVW analysis of the 91 inflammatory factors with IBD outcome data from the GWAS catalog database, C-X-C motif chemokine 9 (CXCL9) was found to be positively associated with the risk of IBD (OR = 1.24, 95% CI = 1.09-1.41, P = .001). Similarly, in the IVW analysis with IBD outcome data from the IEU database, CXCL9 was also positively associated with the risk of IBD (OR = 1.76, 95% CI = 1.12-2.76, P = .015). Meta-analysis and multiple corrections showed a significant association between CXCL9 and IBD (OR = 1.27, 95% CI = 1.12-1.44, P = .001). In the MR analysis of IBD subtypes, the inflammatory factor CXCL9 showed a significant causal association with UC using the IVW method (OR = 1.77, 95% CI = 1.39-2.44, P = .0004), with a P-value of .038 after multiple testing correction. However, no significant causal association was observed between CXCL9 and Crohn disease = 3.28). In the reverse MR analysis, no causal effect of IBD and UC on CXCL9 was found. CXCL9 exhibits a causal relationship with IBD, functioning as a disease-progression risk factor that elevates UC risk, suggesting potential therapeutic targets for alleviating symptoms and slowing progression in UC patients.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 26","pages":"e42988"},"PeriodicalIF":1.3,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528704","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":"Comparison of neonatal COVID-19 clinical features based on onset timing.","authors":"Ting Yang, Rui Li, You Chen, Yan Huang, Zhen-Chao Jin, Xiaoqin Liang, Jing Feng, Cheng Chen, Ping Zhou","doi":"10.1097/MD.0000000000043100","DOIUrl":"10.1097/MD.0000000000043100","url":null,"abstract":"<p><p>The clinical features of neonatal sepsis that develop early and late differ, and it is unclear whether neonatal coronavirus disease 19 (COVID-19) varies depending on the day of onset. Based on whether the onset occurred within the first 5 days of life, all neonatal COVID-19 cases were divided into the early-onset group (EOG) and late-onset group (LOG). Clinical data of these cases diagnosed between December 14, 2022, and January 9, 2023, were gathered and analyzed retrospectively. Of the 212 neonates with COVID-19 included, 36 were in EOG and 176 were in EOG. The percentages of asymptomatic, mild, moderate, and severe cases were 9.4%, 76.9%, 11.3%, and 2.4%, respectively, and there were no critical cases. While 82.4% of mild cases and 15.4% of moderate or severe cases were in LOG, the EOG had a considerably larger proportion of asymptomatic infections (44.4% vs 2.3%) and only 1 moderate or severe case. The most common symptom (87.3%) was fever, which was more prevalent and lasted longer in LOG (93.8% vs 55.6%). The LOG also had higher rates of coughing (43.8% vs 5.6%) and poor appetite (70.5% vs 13.9%). Except for increased C-reactive protein in EOG and decreased white blood cells in LOG, there were no appreciable variations in liver enzymes, cardiac enzymes, or other infection biomarkers between the groups. Most pneumonia cases (96.8%) diagnosed by chest radiography occurred in LOG. Steroids and antiviral medications were not administered to any of infected infants, who only received symptomatic treatment. Five critical patients received neonatal intensive care. All the patients were cured and discharged. COVID-19 often manifests only weakly. Although the general prognosis was good for all groups, the LOG was more likely to experience fever, respiratory and gastrointestinal symptoms, and a small percentage of patients with moderate or severe disease.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 26","pages":"e43100"},"PeriodicalIF":1.3,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528727","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":"Evaluating the impact of COVID-19 infection and vaccination on the presentation and severity of idiopathic granulomatous mastitis: A retrospective cohort study.","authors":"Serkan Erkan, Hüseyin Ozgür Aytac, Hülya Ozdemir, Tevfik Avci, Ramazan Gundogdu, Murat Kus, Aylin Gunesli, Umur Anil Pehlivan, Çiğdem Yalçin Ulas","doi":"10.1097/MD.0000000000043151","DOIUrl":"10.1097/MD.0000000000043151","url":null,"abstract":"<p><p>This study aimed to investigate the differences in the occurrence, clinical course, and severity of Idiopathic granulomatous mastitis (IGM) before and after the COVID-19 pandemic. Additionally, we evaluated the potential relationship between the COVID-19 vaccine and infection in individuals diagnosed with granulomatous mastitis during the pandemic. The files of patients who applied to our breast care center between October 2011 and October 2023 were scanned via an electronic data system, and patients with a pathologically confirmed diagnosis of IGM were identified. Among these patients, those over 18 years of age and without missing data were included in the study. Patients under the age of 18, those with incomplete data, and those with a positive tuberculosis polymerase chain reaction test were excluded from the study. Demographic data, application dates and complaints, breastfeeding history, ultrasonography findings, polymerase chain reaction tests for tuberculosis, treatment data, COVID-19 vaccination status, and infection histories were recorded. There were 183 female patients who met the inclusion criteria. The patients were divided into 2 groups; pre-COVID (n = 132, mean age 34.02 ± 5.75 years) and post-COVID (n = 51, mean age 34.23 ± 5.2 years). There was no significant difference between the groups for the pre and post-COVID periods in terms of demographic data, presenting symptoms and imaging findings, BI-RADS classification, or maximal lesion diameter on ultrasound (P ≥ .05). The proportion of vaccinated patients in the post-pandemic group was greater than that of unvaccinated patients. While a significantly higher proportion of post-COVID patients received steroid therapy, the surgical rate was significantly lower. Although there was no significant difference in the occurrence of IGM during the pandemic period, there was an increase in IGM in those who received the mRNA vaccine. These findings, suggested a potential association between mRNA vaccine and IGM. Further investigations to understand the underlying mechanisms are needed. In this period, conservative treatment has become prominent in the treatment of the disease.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 26","pages":"e43151"},"PeriodicalIF":1.3,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528755","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":"Factors influencing the occurrence of postoperative kinesiophobia in patients with lumbar disc herniation.","authors":"Lin-Feng Zhou, Tao Jiang, Xiao-Qin Zhang, Zhi-Rong Li","doi":"10.1097/MD.0000000000043096","DOIUrl":"10.1097/MD.0000000000043096","url":null,"abstract":"<p><p>This study was intended to analyze the potential risk factors associated with postoperative onset of kinesiophobia in patients with lumbar disc herniation and to construct a predictive model using logistic regression and decision tree methods. We retrospectively evaluated the clinical data of 342 lumbar disc herniation patients who underwent surgical treatment between January 2021 and December 2023, grouped them according to the occurrence of postoperative kinesiophobia, applied multifactorial logistic regression to determine the main influencing factors, and constructed a prediction model with the help of SPSS Modeler software to further evaluate its predictive effect. The study found that the incidence of kinesiophobia was 37.46%; statistically significant differences were found between the kinesiophobia group and the nonkinesiophobia group in terms of education level, visual analog scale (VAS) score of pain, Hospital Anxiety and Depression Scale (HADS) score, self-efficacy, per capita monthly family income, and mode of payment of medical expenses (P < .05). Multifactorial Logistic regression suggested that all of the above factors were independent influencing variables of kinesiophobia (P < .05). Decision tree modeling revealed that self-efficacy was the first discriminant variable, followed by payment method, VAS, HADS score, and income level. Analysis of the subjects' job characteristic curve (receiver operating characteristic) showed that the predictive power of the decision tree model was significantly better than that of the logistic regression model (P < .05). Education level, VAS score, HADS score, self-efficacy, family financial status, and payment mode are all important risk factors for postoperative kinesiophobia, and the use of predictive modeling can be more effective in assessing the patient's condition and realizing early intervention.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 26","pages":"e43096"},"PeriodicalIF":1.3,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528762","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}