Open Medicine最新文献

{"title":"Early outcomes after focal high-dose-rate brachytherapy in low- and favorable intermediate-risk prostate cancer: promising early results from a prospective randomized trial.","authors":"Justinas Jonusas, Ausvydas Patasius, Mantas Trakymas, Kestutis Akelaitis, Mindaugas Dziugelis, Marius Burkanas, Jonas Venius, Giedre Smailyte, Marius Kincius","doi":"10.1515/med-2026-1450","DOIUrl":"10.1515/med-2026-1450","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the QoL of patients diagnosed with low- or favorable-intermediate-risk PCa after focal HDR brachytherapy and active surveillance. Our secondary objectives were to compare progression-free survival (PFS) between patients who underwent focal treatment and those who were actively surveilled and to assess early and late GU and GI adverse effects after the focal HDR brachytherapy.</p><p><strong>Methods: </strong>This prospective randomized controlled trial was conducted at the National Cancer Center located in Vilnius, Lithuania. The study was initiated after approval from the Vilnius Regional Biomedical Research Ethics Committee was obtained (Approval ID 2022/6-1438-911). Twenty-seven patients were assigned to the AS group and 28 to the focal HDR group.</p><p><strong>Results: </strong>During the median follow-up time of 14 and 17 months for AS and HDR groups, respectively, the QoL, evaluated by the EORTC QLQ-30 and PR25 instruments, showed no statistically significant differences in functional scores between the groups after baseline adjustment. Additionally, patients in the HDR group reported better urinary outcomes as measured by EORTC PR25 and IPSS scores at 6, 12, and 18 months. There were no statistically significant differences in erectile function between the groups as measured by the IIEF. Early toxicity was low (no Grade ≥3 events), and only two cases (7.1 %) of Grade 2 GU toxicity were reported in the HDR group within the first 3 months, with one case persisting for 6 months. Late toxicity was not assessed during this interim follow-up. The HDR group demonstrated a non-significant trend toward better oncological outcomes, with fewer PSA-based recurrences and a higher mean PFS than the AS. At the time of last follow-up, 49/55 (89 %) patients were censored (22/27 in the AS and 27/28 in the HDR group).</p><p><strong>Conclusions: </strong>A current study shows comparable QoL and early toxicity results between AS and HDR groups. Any domain-level signals were below MCID and did not persist after baseline adjustment. Results of PFS are underpowered at this interim analysis due to short follow-up and high censoring, and should be considered hypothesis-generating only. However, as current results are only exploratory and insufficient to assess durable disease control or late toxicity, a longer follow-up, larger cohorts, and a multicenter approach are needed to provide definitive outcomes to demonstrate the benefit of focal brachytherapy.</p>","PeriodicalId":19715,"journal":{"name":"Open Medicine","volume":"21 1","pages":"20261450"},"PeriodicalIF":1.8,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13382696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148605994","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":"Subtyping and risk model construction based on taurine metabolism-related genes for predicting prognosis and immune response in lung adenocarcinoma.","authors":"Lei Wu, Minzhe Li, Jia Zhang","doi":"10.1515/med-2026-1389","DOIUrl":"10.1515/med-2026-1389","url":null,"abstract":"<p><strong>Objectives: </strong>Lung adenocarcinoma (LUAD) remains a major cause of cancer-related deaths worldwide. While taurine has been shown to suppress tumor growth in laboratory models, its relationship with LUAD patient survival remains unclear. This study constructs a taurine metabolism-based prognostic model for LUAD to predict survival and immunotherapy response, supporting personalized treatment.</p><p><strong>Methods: </strong>Using transcriptomic and clinical data from public databases (TCGA and GEO), we identified prognostic genes linked to taurine metabolism in LUAD. Patients were classified into two molecular subtypes using clustering analysis. Key genes were verified experimentally (qRT-PCR), and a 9-gene risk model was developed using machine learning approaches. We then analyzed immune infiltration, tumor mutations, immunotherapy response, and drug sensitivity across subtypes and risk groups. Regulatory networks involving transcription factors and miRNAs were also constructed.</p><p><strong>Results: </strong>A 9-gene signature effectively stratified LUAD patients into high- and low-risk groups. High-risk patients showed activated tumor growth pathways and an immune-suppressive microenvironment, resulting in poorer survival and limited response to immunotherapy. In contrast, low-risk patients exhibited favorable outcomes and enhanced immune activity. We also identified STAT3/GATA2 and hsa-miR-98-5p as key regulatory factors.</p><p><strong>Conclusions: </strong>This study highlights the important role of taurine metabolism in LUAD progression and immunity. The proposed gene signature offers a new tool for prognosis prediction and may help guide personalized treatment strategies.</p>","PeriodicalId":19715,"journal":{"name":"Open Medicine","volume":"21 1","pages":"20261389"},"PeriodicalIF":1.8,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13377578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148579607","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":"Sleep disturbances and their relationship with anxiety-depressive symptoms and quality of life in older adults: a retrospective observational study.","authors":"Huiqing Xuan, Lixiu Wu, Kunqiang Yu, Lu Yang, Xiaoyan Chen","doi":"10.1515/med-2026-1491","DOIUrl":"10.1515/med-2026-1491","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the prevalence of sleep disorders in the elderly and explore their relationships with anxiety, depressive symptoms, and quality of life.</p><p><strong>Methods: </strong>This single-center retrospective study included 120 elderly inpatients from the psychiatry department of our hospital between December 2020 and December 2025. Demographic and clinical data, along with Pittsburgh Sleep Quality Index (PSQI), Hospital Anxiety and Depression Scale (HADS), Patient Health Questionnaire-9 (PHQ-9), 12-Item Short Form Health Survey (SF-12) scores and the Chinese version of the Montreal Cognitive Assessment Scale (MoCA-C), were collected. Patients were categorized into sleep disturbance (SD, PSQI>5) and non-sleep disturbance (NSD, PSQI≤5) groups. Group differences were analyzed, and multivariate logistic regression and Spearman correlation were performed.</p><p><strong>Results: </strong>Of the 120 patients, 50 (41.7 %) had sleep disturbances. The SD group showed significantly higher anxiety and depression scores and lower SF-12 and MoCA scores than the NSD group (all p<0.05). The total PSQI score was strongly positively correlated with HADS anxiety, HADS depression, and PHQ-9 scores (r=0.413-0.514, p<0.001), and significantly negatively correlated with SF-12 PCS, SF-12 MCS, and MoCA-C scores (r=-0.683 to -0.476, p<0.001). Multivariate logistic regression identified chronic pain (OR=3.580, 95 % CI: 1.444-8.879, p=0.006), long-term sedative-hypnotic use (OR=2.860, 95 % CI: 1.136-7.200, p=0.026), and psychological loneliness (OR=5.261, 95 % CI: 2.006-13.798, p=0.001) as independent risk factors for sleep disorders in the elderly.</p><p><strong>Conclusions: </strong>In this hospital-based sample of older psychiatric patients, sleep disturbances in older adults are significantly associated with anxiety, depression, and reduced quality of life, particularly mental health. Early screening and targeted interventions are warranted.</p>","PeriodicalId":19715,"journal":{"name":"Open Medicine","volume":"21 1","pages":"20261491"},"PeriodicalIF":1.8,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13377504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148579577","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 treatment of acute organophosphorus pesticide poisoning complicated by intestinal necrosis with exploratory laparotomy: a case report.","authors":"Shuhong Wang, Lili Shi, Yin Tian, Jin Wu, Xiangui Zhou, Ruilie Wang, Yuanlan Lu, Anyong Yu","doi":"10.1515/med-2026-1458","DOIUrl":"10.1515/med-2026-1458","url":null,"abstract":"<p><strong>Objectives: </strong>Acute organophosphorus pesticide poisoning (AOPP) constitutes a common yet life-threatening emergency, particularly prevalent in rural regions of Asia. The condition results from inhibited cholinesterase activity, which induces acetylcholine accumulation at neural synapses. Clinically, its manifestations are categorized into muscarinic, nicotinic, and central types. Among these, mortality typically arises from respiratory paralysis, while neurological sequelae are frequently encountered. Nevertheless, reports of AOPP-induced intestinal necrosis remain exceedingly uncommon both domestically and internationally.</p><p><strong>Case presentation: </strong>In the present case, the patient experienced acute poisoning following oral ingestion of a high dose of dichlorvos. Despite initial standardized management, including atropine administration, pralidoxime therapy, and hemoperfusion, complications such as toxic encephalopathy and multiple organ dysfunction ensued. During hospitalization, acute peritonitis developed, and abdominal computed tomography revealed intestinal perforation accompanied by peritonitis. Exploratory laparotomy confirmed small intestinal necrosis and perforation of the ascending colon, necessitating resection of the necrotic segment and enterostomy. Postoperatively, the patient was transferred to the emergency intensive care unit for comprehensive supportive treatment and subsequently achieved full recovery before discharge.</p><p><strong>Conclusions: </strong>This case highlights that in patients with severe organophosphorus poisoning, any unexplained alteration in abdominal signs should prompt high clinical suspicion of gastrointestinal complications, and prompt surgical intervention may be lifesaving. However, as a single case report, this study carries inherent limitations, and future large-scale investigations remain essential to further substantiate these findings and develop more effective therapeutic strategies to enhance the overall management of AOPP.</p>","PeriodicalId":19715,"journal":{"name":"Open Medicine","volume":"21 1","pages":"20261458"},"PeriodicalIF":1.8,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13367200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148448480","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":"Psychiatric correlates of recurrent shoulder dislocations: the role of attention deficit hyperactivity disorder, impulsivity, and depression.","authors":"Sabri Kerem Diril, Orhun Celik, Yunus Elmas, Orhan Güneş, Hasan Gökçay, Soner Kocak, Cemil Ertürk","doi":"10.1515/med-2026-1471","DOIUrl":"10.1515/med-2026-1471","url":null,"abstract":"<p><strong>Objectives: </strong>One of the most common reasons for shoulder instability is recurrent shoulder instability. Arthroscopic repair is an option in the surgical treatment of Bankart lesions, and it is indicated if certain criteria are met. Recent evidence suggests that neurobehavioral traits may predispose individuals to orthopedic injuries. Therefore, we aimed to investigate the correlation between psychiatric parameters and recurrent dislocations in patients treated with arthroscopic Bankart repair.</p><p><strong>Methods: </strong>A total of 83 patients were included in the study, including 42 patients who underwent arthroscopic Bankart surgery due to recurrent shoulder dislocation (RSD) and 41 demographically matched healthy volunteers. The evaluated functional data included parameters such as Constant shoulder score and Rowe score for instability. Psychiatric parameters such as attention deficit hyperactivity disorder (ADHD), the Baratt impulsiveness Scale (BIS-11) and the Depression Anxiety and Stress Scale (DASS-21) were also evaluated.</p><p><strong>Results: </strong>The mean Constant shoulder score was 86.07 ± 12.07 (excellent) and the mean Rowe instability score was 81.26 ± 18.23 (good). The following psychiatric parameters were significantly greater in the patient group than in the control group.</p><p><strong>Conclusions: </strong>RSD patients were found to have significantly higher postoperative ADHD, BIS-11 and DASS-21 scores. Existing ADHD and impulsivity <b>may represent behavioral traits associated with</b> RSD. Higher DASS-21 scores in patients are associated with depression. We recommend that routine psychiatric evaluation for ADHD and impulsivity should be considered in the management of patients with RSD to improve outcomes and prevent recurrence.</p>","PeriodicalId":19715,"journal":{"name":"Open Medicine","volume":"21 1","pages":"20261471"},"PeriodicalIF":1.8,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13367199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148448431","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":"SMP30: a promising cancer biomarker with therapeutic potential.","authors":"Pei Chen, Yu-Ling Zhang, Ying Guo","doi":"10.1515/med-2026-1447","DOIUrl":"10.1515/med-2026-1447","url":null,"abstract":"<p><strong>Introduction: </strong>SMP30 is a calcium binding protein closely related to cellular senescence. Low expression of SMP30 is significantly associated with malignant progression and poor prognosis in tumors, suggesting it values as a potential diagnostic biomarker and therapeutic target.</p><p><strong>Content: </strong>We systematically review recent studies on SMP30 in human tumors, highlight its role in modulating tumor cells proliferation and apoptosis, and detail mechanism of its involvement in glycolipid metabolic reprogramming as well as its impact on the tumor microenvironment and metastasis.</p><p><strong>Summary: </strong>SMP30 is involved in regulating cell cycle, maintaining intracellular homeostasis, and protecting cells from external damage. It supports cellular homeostasis and resistance to apoptosis by modulating intracellular Ca²⁺ concentrations. The reduced expression of SMP30 elevates lipid peroxidation, accelerating cellular senescence and tissue damage. Furthermore, SMP30 affects macrophage polarization and modulates the tumor microenvironment by altering their cytokine secretion profiles.</p><p><strong>Outlook: </strong>SMP30 is a key regulator of cellular senescence with significant implication in tumorigenesis. Low expression of SMP30 relates to multiple oncogenic mechanisms, including cell cycle, apoptosis, metabolic reprogramming, epithelial mesenchymal transition (EMT), and immune evasion, which shows promising potential for early diagnosis, prognostic evaluation, and targeted therapy of cancers.</p>","PeriodicalId":19715,"journal":{"name":"Open Medicine","volume":"21 1","pages":"20261447"},"PeriodicalIF":1.8,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13351293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148422910","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":"Computational and experimental evidence supports the modulation of inflammaging-related pathways by Sorghum bicolor 3-deoxyanthocyanidins.","authors":"Oluwafemi G Oluwole, Okubena Olajuwon","doi":"10.1515/med-2026-1489","DOIUrl":"10.1515/med-2026-1489","url":null,"abstract":"<p><strong>Objectives: </strong>Chronic inflammation, oxidative stress, and metabolic dysfunction are central drivers of biological aging. Polyphenolics from <i>Sorghum bicolor</i>, particularly 3-deoxyanthocyanidins, have the potential to modulate biological aging.</p><p><strong>Methods: </strong>We investigated <i>Sorghum bicolor</i> through integrative evidence synthesis. Then, utilised an integrated computational framework comprising network pharmacology, and molecular docking to identify key molecular targets of <i>Sorghum bicolor</i> polyphenols. The findings were validated by aligning findings with the data from <i>Sorghum bicolor</i> on high-fat diet/streptozotocin (HFD-STZ) induced type 2 diabetes with chronic stress using a polyphenol-rich <i>Sorghum bicolor</i> extract as treatment.</p><p><strong>Results: </strong>We observed a dose-dependent efficacy pattern that was strongly associated with anti-oxidant and anti-inflammation in <i>Sorghum bicolor</i> (Jobelyn^®). Computational analyses identified NF-κB, Keap1-Nrf2, and PPAR-γ as predicted high-confidence targets. The molecular docking suggests plausible interactions with the targets with the 3-deoxyanthocyanidins (Apigeninidin and Luteolinidin). The <i>in vivo</i> validation demonstrated the activation of Nrf2-mediated antioxidant pathway. These biological effects aligned with computational predictions and were achieved using the whole extract.</p><p><strong>Conclusions: </strong>The findings from this study supports the mechanistic plausibility of <i>Sorghum bicolor</i> polyphenols as modulators of inflammaging and metabolic dysfunction. This integrative framework provides the background for further translational and clinical investigation in aging-associated chronic diseases and treatments.</p>","PeriodicalId":19715,"journal":{"name":"Open Medicine","volume":"21 1","pages":"20261489"},"PeriodicalIF":1.8,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13351292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148422918","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":"Aloe emodin attenuates Aβ_1-42-Induced neurotoxicity in SH-SY5Y cells via downregulation of PPM1K.","authors":"Fang Huang, Mingxing Guo, Yiran Yang, Zhizhong Wang","doi":"10.1515/med-2026-1473","DOIUrl":"10.1515/med-2026-1473","url":null,"abstract":"<p><strong>Objectives: </strong>To study the role and underlying mechanism of aloe emodin, a natural anthraquinone compound known for antioxidant, and anti-inflammatory activities, in Alzheimer's disease (AD).</p><p><strong>Methods: </strong>Aβ_1-42-induced injury model was established using SH-SY5Y cells. A combination of CCK-8 assay, flow cytometry, ELISA, ROS fluorescence probe, RT-qPCR, and western blot assay was employed to systematically evaluate the effects of aloe emodin on cell viability, apoptosis, inflammation, and oxidative stress. Potential molecular targets were identified through bioinformatics analysis. The regulatory role of PPM1K in aloe emodin-mediated neuroprotection was further validated using PPM1K overexpression experiments.</p><p><strong>Results: </strong>Bioinformatics analysis revealed that PPM1K is significantly upregulated in AD and showed predicted in silico binding with aloe emodin. Aloe emodin markedly improved the viability of Aβ_1-42-treated SH-SY5Y cells, suppressed apoptosis, reduced the release of pro-inflammatory cytokines, and attenuated ROS generation, accompanied by the downregulation of PPM1K expression. In contrast, overexpression of PPM1K significantly weakened the neuroprotective effects of aloe emodin, as evidenced by decreased cell viability and increased levels of apoptosis and oxidative stress.</p><p><strong>Conclusions: </strong>Aloe emodin alleviates Aβ_1-42-induced neuronal injury by targeting and downregulating PPM1K expression, suggesting that PPM1K is a critical mediator of the neuroprotective effects of aloe emodin.</p>","PeriodicalId":19715,"journal":{"name":"Open Medicine","volume":"21 1","pages":"20261473"},"PeriodicalIF":1.8,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13340830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148405421","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":"Impact of multimodal health education and preoperative ocular fixation training on psychological stress and postoperative complications in patients undergoing pterygium surgery.","authors":"Shi-Jie Zhang","doi":"10.1515/med-2026-1480","DOIUrl":"10.1515/med-2026-1480","url":null,"abstract":"<p><strong>Objectives: </strong>This study evaluated the effects of multimodal health education combined with preoperative ocular fixation training on patients undergoing pterygium surgery.</p><p><strong>Methods: </strong>A cohort of 88 patients who underwent pterygium surgery at Xining First People's Hospital from April 2025 to September 2025 were selected and randomly assigned to a control group (n=44) and an intervention group (n=44) using a random number table. The control group received routine high-quality nursing, and the intervention group received multimodal health education and preoperative ocular fixation training in addition to routine care. Disease uncertainty, psychological stress scores, and postoperative complications were compared between the two groups.</p><p><strong>Results: </strong>Following the intervention, patients in the intervention group had significantly lower Mishel Uncertainty in Illness Scale (MUIS) scores compared with the control group (p<0.05). Psychological resilience scores were significantly higher in the intervention group (p<0.05). The incidence rates of eye pain (11.36 %), infection (0), and dry eye (0) in the intervention group were lower than those observed in the control group (79.55 , 13.64, and 15.91 %, respectively) (p<0.05).</p><p><strong>Conclusions: </strong>Multimodal health education combined with preoperative ocular fixation training markedly reduced psychological stress and illness uncertainty in patients undergoing pterygium surgery and was associated with lower postoperative complication rates.</p>","PeriodicalId":19715,"journal":{"name":"Open Medicine","volume":"21 1","pages":"20261480"},"PeriodicalIF":1.8,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13340829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148405468","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":"Comparing outcomes of TAVI and SAVR in low or intermediate risk symptomatic severe aortic stenosis: a systematic review and meta-analysis.","authors":"Khalid Rashid, Ahmedyar Hasan, Mustafa Javaid, Farrukh Ansar, Yahya Khan, Muhammad Hazqeel Kazmi, Taimur Farid, Faraz Waheed, Leena Ali, Salah Ali Saleh, Raza Ali Akbar, Muhammad Aamir Waheed","doi":"10.1515/med-2026-1466","DOIUrl":"10.1515/med-2026-1466","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the mortality and clinical outcomes of transcatheter aortic valve implantation (TAVI) versus surgical aortic valve replacement (SAVR) in patients with low- or intermediate-risk symptomatic severe aortic stenosis through an updated systematic review and meta-analysis of randomized controlled trials.</p><p><strong>Methods: </strong>This systematic review was performed using PubMed, Medline, Embase, and Cochrane databases for RCTS between 2017 and 2024 which evaluated mortality outcomes in patients with low to intermediate risk AS who received TAVI vs. SAVR. Relative risks (RRs) with 95 % confidence intervals (CIs) were pooled using random effects models.</p><p><strong>Results: </strong>TAVI showed a numerically lower but statistically insignificant mortality risk compared to SAVR (RR: 0.88, 95 % CI: 0.62-1.25, p=0.49). TAVI was associated with a higher risk of PPM insertion (RR: 2.19, 95 % CI: 1.55-3.16, p<0.001, i2: 80 %), aortic valve re-intervention (RR: 2.51, 95 % CI: 1.40-4.51, p<0.001; I²=0 %), new-onset bundle branch block (RR: 2.10, 95 % CI: 1.21-3.67, p<0.01; I²=84 %), and vascular site complications (RR: 4.77, 95 % CI: 2.11-10.81, p<0.001; I²=62 %). Atrial fibrillation incidence was lower with TAVI (RR: 0.29, 95 % CI: 0.23-0.38, p<0.001; I²=73). There was no significant difference in the rates of post-procedural myocardial infarction, stroke and endocarditis between TAVI and SAVR.</p><p><strong>Conclusions: </strong>TAVI has mortality outcomes comparable to SAVR in low to intermediate risk patients. TAVI offers advantages in atrial fibrillation reduction, but is associated with increased risk of PPM insertion, vascular complications, new-onset bundle branch block, aortic valve re-intervention. Individualized treatment decisions remain important for optimizing outcomes in low to intermediate risk patients.</p><p><strong>Prospero registration number: </strong>CRD42024547882.</p>","PeriodicalId":19715,"journal":{"name":"Open Medicine","volume":"21 1","pages":"20261466"},"PeriodicalIF":1.8,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13340834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148405418","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}