Therapeutics and Clinical Risk Management最新文献

{"title":"Health and Economic Advantages Associated With the Use of TachoSil: An Update of Systematic Review.","authors":"Giorgio Lorenzo Colombo, Andrea Droghetti, Sergio Di Matteo, Henrike Ottenjann, Giacomo Matteo Bruno","doi":"10.2147/TCRM.S476650","DOIUrl":"10.2147/TCRM.S476650","url":null,"abstract":"<p><strong>Background: </strong>The international scientific literature is systematically analyzed in this review over a period of nearly 10 years with respect to the use of the active hemostat and surgical sealant patch TachoSil, considering its economic effects. It`s an update of the first review published in 2014.</p><p><strong>Methods: </strong>A PubMed systematic literature review was done from Nov 2013 up to December 2022. Based on the criteria used to select, the papers were grouped in terms of study design, surgery type, reduction in the time to hemostasis, shorter hospital stay, fewer number of post-operative complications, and the impact of TachoSil to operative procedures.</p><p><strong>Results: </strong>Medical evidence of TachoSil is well documented, in different clinical studies and for several indications. In this second review 18 scientific papers were screened. In total data from 3.375 patients were analyzed, of whom 1.748 were treated with TachoSil. Nine of the 18 papers (50%) were classified as randomized clinical trials (RCTs). The time required for hemostasis following the administration of TachoSil was significantly shorter than that observed with other surgical treatment techniques, with a median time of up to four minutes. The reduction in post-operative complications was evaluated in 15 studies that were conducted on patients in a variety of surgical specialties. When using TachoSil the hospitalization duration was briefer, as observed in the past review.</p><p><strong>Conclusion: </strong>The second analysis of scientific papers demonstrates that TachoSil plays a supporting role in surgical procedures, enhancing hemostasis and facilitating tissue sealing when conventional techniques are inadequate.This approach has been linked to a reduction in post-operative complications, length of hospital stay, and consequently, hospital cost.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"257-271"},"PeriodicalIF":2.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chinese Expert Consensus on Preventing and Managing Chyle Fistula in Cervical Lymph Node Dissection for Thyroid Cancer (2024).","authors":"Qingqing He, Wen Tian, Jingqiang Zhu, Ping Wang, Hao Zhang","doi":"10.2147/TCRM.S493007","DOIUrl":"10.2147/TCRM.S493007","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of thyroid carcinoma is on the rise, with cervical lymph node metastasis being a frequent occurrence necessitating surgical intervention. Chyle fistula, a significant postoperative complication, can have a substantial impact on recovery.</p><p><strong>Objective: </strong>To reduce the incidence of chyle fistula, enhance the effectiveness of postoperative treatment, and assist thyroid surgeons in performing cervical lymph node dissection, the consensus was compiled in a standardized and secure manner.</p><p><strong>Methods: </strong>Drawing from the expertise of Chinese specialists in managing chyle fistula and the latest international advancements in this field following cervical lymph node dissection, the thyroid tumor experts group of Chinese Thyroid Association, Chinese College of Surgeons, Chinese Medical Doctor Association and Thyroid Disease Professional Committee of Chinese Research Association have developed innovative approaches to address this issue. An evidence-based approach was employed, integrating the knowledge and practical experience of the panelists.</p><p><strong>Results: </strong>We developed twelve expert consensus recommendations, addressing the prevention, diagnosis, and treatment of postoperative chyle fistula. These recommendations included the dietary management and nutritional support, continuous negative pressure suction, local adhesive treatment, application of local compression methods, the use of somatostatin and its analogs, and surgery treatment.</p><p><strong>Conclusion: </strong>This evidence-based consensus would be valuable to assist front-line surgeons and medical specialists in the management of chyle fistula.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"229-237"},"PeriodicalIF":2.8,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11880616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nomogram-Based Prediction of 3-Month Unfavorable Outcome and Early Neurological Deterioration After Endovascular Thrombectomy in Acute Ischemic Stroke.","authors":"Yixuan Wu, Jiaxin Han, Yawen Cheng, Meng Wei, Fude Liu, Chen Chen, Ying Tan, Wenlong Ma, Jia Yu, Jianfeng Han, Guogang Luo, Kang Huo","doi":"10.2147/TCRM.S505897","DOIUrl":"10.2147/TCRM.S505897","url":null,"abstract":"<p><strong>Background: </strong>Some acute ischemic stroke (AIS) patients due to large-vessel occlusion, who underwent endovascular thrombectomy (EVT), continue to experience unfavorable outcomes. Furthermore, the impact of internal carotid artery (ICA) tortuosity remains uncertain. This study aimed to determine the value of ICA tortuosity and clinical features in predicting 3-month unfavorable outcome and early neurological deterioration (END) after EVT in AIS patients through nomograms.</p><p><strong>Methods: </strong>A total of 313 AIS patients treated with EVT at the First Affiliated Hospital of Xi'an Jiaotong University were retrospectively analyzed and randomized into two cohorts: training cohort (n=219) and validation cohort (n=94). After the selection of relevant features, nomograms for predicting the 3-month unfavorable outcome (mRS > 2) and END (an increase in NIHSS score of ≥4 within 24 hours) were established. The predictive accuracy of the nomograms was evaluated using ROC curves, calibration plots, and decision curve analysis (DCA).</p><p><strong>Results: </strong>Among 313 patients, ICA tortuosity was observed in 19.50% (extracranial) and 21.10% (cavernous) of patients. Furthermore, 53.30% of patients experienced a 3-month unfavorable outcome, while END occurred in 15.70%. The independent predictors for the 3-month unfavorable outcome included age, NIHSS score, puncture-to-recanalization time, eTICI score, and blood glucose. The addition of two tortuosity features (extracranial and cavernous ICA tortuosity) resulted in a significant improvement in model differentiation. The nomogram that included ICA tortuosity achieved an AUC of 0.826 and 0.803 in the training and validation cohorts. ASPECT score, occlusion site, number of retriever passes, and blood glucose were identified as factors associated with END. The AUC was 0.770 and 0.772 in the training and validation cohorts. However, the incorporation of ICA tortuosity did not significantly enhance the model for predicting END.</p><p><strong>Conclusion: </strong>ICA tortuosity characteristics significantly improve the discrimination of the nomogram model in predicting the 3-month unfavorable outcome. This can be used as guidance in clinical decision-making.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"239-256"},"PeriodicalIF":2.8,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing Heart Valve Replacement: Risk Mitigation of Decellularized Pulmonary Valve Preparation for Its Implementation in Public Tissue Banks.","authors":"Jose Ignacio Rodríguez Martínez, Cristina Castells-Sala, Ana Rita Baptista Piteira, Giulia Montagner, Diletta Trojan, Pablo Martinez-Legazpi, Alejandra Acosta Ocampo, Maria Eugenia Fernández-Santos, Javier Bermejo, Ramadan Jashari, Maria Luisa Pérez, Elba Agustí, Jaime Tabera, Anna Vilarrodona","doi":"10.2147/TCRM.S486508","DOIUrl":"10.2147/TCRM.S486508","url":null,"abstract":"<p><strong>Purpose: </strong>Cryopreserved homografts for valve replacement surgeries face a major problem regarding their durability after implantation and decellularized pulmonary heart valves have raised as potential new generation substitute for these surgeries. The present study aims to document the work performed for the safe implementation in public tissue banks of a new decellularization method for human pulmonary heart valves, based on previous risk evaluation.</p><p><strong>Methods: </strong>After assessing new preparation method associated risks, using EuroGTP-II methodologies, an extensive array of in vitro <i>studies</i> were defined to validate the new technique, mitigate the risks and provide quality and safety data.</p><p><strong>Results: </strong>Initial evaluation of risks using EuroGTP II tool, showed Final Risk Score of 23 (high risk), and four studies were devised to mitigate identified risks: (i) tissue structure integrity; (ii) cell content; (iii) microbiological safety; and (iv) cytotoxicity evaluation in final tissue preparation. Protein quantification, mechanical properties, and histological evaluation indicated no tissue damage, reducing implant failure probability, while cellular content removal demonstrated a 99% DNA removal and microbiological control ensured contamination absence. Moreover, in vitro results showed no cytotoxicity. Risk re-evaluation indicated a risk reduction to moderate risk (Final Risk Score = 10), suggesting that further evidence for safe clinical use would be needed at pre-clinical in vivo evaluation to mitigate remaining risks.</p><p><strong>Conclusions: </strong>The studies performed and reviewed bibliography were able to significantly reduce the original level of risk associated with the clinical application of this homograft's preparation. However, additional in vivo studies and tissue stability tests are still necessary to address the remaining risks associated with reagents' effect on extracellular matrix and storage conditions, which could influence implant failure, before the clinical evaluation procedures can be implemented to determine the efficacy and safety of the new decellularized heart valves.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"209-228"},"PeriodicalIF":2.8,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11873323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outperforming Traditional Staging: A Novel Nomogram for HR-Positive Breast Cancer.","authors":"Chaoxing Liu, Jiabin Ding, Jinbiao Xu, Chen Fang, GuoHua Zhang, Chao Shi, Feng Qiu","doi":"10.2147/TCRM.S485685","DOIUrl":"https://doi.org/10.2147/TCRM.S485685","url":null,"abstract":"<p><strong>Background: </strong>Hormone receptor-positive breast cancer (HR-positive BC), the most prevalent subtype, typically has a favorable prognosis. However, treatment decision-making and survival prediction remain challenging due to the limitations of traditional staging systems like AJCC. Improved prognostic tools are needed to enhance individualized risk stratification.</p><p><strong>Materials and methods: </strong>Clinical information from the Surveillance, Epidemiology, and End Results (SEER) database and the First Affiliated Hospital of Nanchang University were analyzed to evaluate outcomes across HR-positive BC subtypes. Patients were divided into training and validation cohorts. A prognostic nomogram was developed using factors identified by univariate and multivariate Cox regression analyses and evaluated through C-index, Receiver Operating Characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA).</p><p><strong>Results: </strong>The study included 156,378 patients (training) and 67,016 (validation) for breast cancer-specific survival (BCSS) and 165,047 (training) and 70,732 (validation) for overall survival (OS), along with 232 external validation cases. Multivariate Cox regression analysis revealed that the ER-positive/PR-negative (HR=2.317 (2.219-2.419)) and ER-negative/PR-positive (HR=3.498 (3.143-3.894)) subtypes had worse prognosis than ER-positive/PR-positive patients. The prognosis of ER-negative/PR-positive subtype (HR=1.511 (1.686-1.351)) was also worse than that of ER-positive/PR-negative subtype. A nomogram integrating age, race, tumor size, grade, histology, bone, brain, lung, and liver metastases, tumor stage, HER2, marital status, positive lymph node numbers, and radiation therapy. The nomogram had a good C-index values and area under curve values for predicting OS and BCSS in both the training and validation set. Moreover, the DCA revealed that the nomogram performed better than the AJCC (TNM) staging system in predicting the three- and five-year OS and BCSS in both the groups.</p><p><strong>Conclusion: </strong>This study introduces and validates a novel prognostic nomogram for HR-positive BC, providing enhanced risk stratification, particularly in regions with limited access to comprehensive genetic testing. Further validation through multicenter clinical studies is recommended to confirm its clinical utility.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"191-208"},"PeriodicalIF":2.8,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11871874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Early Protein Advancement in Critically Ill Patients with COVID-19: A Multicenter Cardinality Matching Study.","authors":"Abdulrahman Alissa, Ghazwa B Korayem, Ohoud Aljuhani, Mashael AlFaifi, Lina I Alnajjar, Noura A L Souaan, Meshal Albassam, Aljoharah Alrayes, Sara Albishi, Reem Abdullah Alqahtani, Abdullah F Alharthi, Nasser Alkhushaym, Mohammed A Alhammad, Ramesh Vishwakarma, Aisha Alharbi, Samiah Alsohimi, Abdalmohsen Ababtain, Hasan M Al-Dorzi, Rahaf Alqahtani, Ghadah Almuaither, Layan A Alarifi, Ahlam Almutairi, Mada B Alharbi, Abeer A Alghamdi, Munirah F Alhmoud, Khalid Al Sulaiman","doi":"10.2147/TCRM.S487662","DOIUrl":"10.2147/TCRM.S487662","url":null,"abstract":"<p><strong>Background: </strong>Limited evidence is available regarding the safety and effectiveness of early high protein intake in critically ill patients with COVID-19. Therefore, this study aims to assess the safety of early protein advancement during nutritional support in these patients.</p><p><strong>Methods: </strong>A multi-center retrospective cohort study included adult critically ill patients with COVID-19 admitted to Intensive Care Units (ICUs) at three centers in Saudi Arabia. Patients were grouped into two groups based on the protein intake at day three of feeding initiation into low protein (≤0.8 mg/kg/day) versus high protein (>0.8 mg/kg/day) groups. Acute kidney injury (AKI) during the ICU stay was the primary endpoint, while the remaining were considered secondary endpoints.</p><p><strong>Results: </strong>The study included 466 patients, but after cardinality matching with a 2:1 ratio, 192 were in the lower protein group compared with 96 patients in the high protein group. The rate of AKI was low in the highprotein group compared with the low protein group on day three of feeding initiation (19.9% versus 12.7%); however, this was not statistically significant (OR 0.54; 95% CI 0.26, 1.33; p=0.2). Additionally, patients in the high protein group had a higher rate of atrial fibrillation than those in the low protein group (OR 2.33; 95% CI 1.18, 4.62; p=0.02). No differences were observed in 30-day and in-hospital mortality (HR1.33, 95% CI 0.91, 1.96; p=0.14 and HR 1.21, 95% CI: 0.85, 1.72; p=0.29, respectively).</p><p><strong>Conclusion: </strong>The advancement of protein in critically ill patients with COVID-19 was not associated with significant differences in the incidence of AKI. In contrast, the early advancement of protein in nutritional feeding within the first three days was associated with a higher incidence of atrial fibrillation.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"177-189"},"PeriodicalIF":2.8,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11853109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brain Frailty on Neuroimaging Beyond Chronological Age Is Associated with Functional Outcome After Endovascular Thrombectomy in Patients with Anterior Large Vessel Occlusion.","authors":"Jinrui Li, Junting Chen, Kailin Cheng, Jianxia Ke, Jintao Li, Jia Wen, Xiaoli Fu, Zhu Shi","doi":"10.2147/TCRM.S498094","DOIUrl":"10.2147/TCRM.S498094","url":null,"abstract":"<p><strong>Background: </strong>Current guidelines have not recommended an upper age limit for endovascular thrombectomy (EVT) in patients with large vessel occlusion (LVO) stroke. However, elder age links to an increased risk of poor outcome. This study aimed to investigate the efficacy of EVT in elderly versus non-elderly patients and determine the respective factors of poor outcome.</p><p><strong>Methods: </strong>Three hundred and two consecutive patients with LVO-stroke who underwent EVT were included, and we used sensitivity analysis with restricted cubic spline to define 75 years as the inflexion point. Participants were thus dichotomized into elderly (≥75 years) and non-elderly (<75 years) groups. Brain frailty on neuroimaging was evaluated using the global cortical atrophy (GCA) scale and the Fazekas scale for white matter lesions (WML). The primary outcome was 3-month functional outcome, and the secondary outcomes were EVT efficacy and safety.</p><p><strong>Results: </strong>Elderly patients had significantly higher incidences of hypertension, diabetes mellitus, atrial fibrillation, and more severe GCA and WML. The rate of good outcome in elderly patients was 32%, significantly lower than non-elderly patients (54%, <i>p</i><0.001). There was no difference in terms of reperfusion (89% vs 93%, <i>p</i>=0.363) and intracranial hemorrhage (38% vs 41%, <i>p</i>=0.826) between two groups. In elderly patients, high degree of GCA (OR 1.15, 95% CI 1.02-1.30, <i>p</i>=0.012) and moderate/severe WML (OR 5.88, 95% CI 1.47-23.50, <i>p</i>=0.015) independently predicted 3-month poor outcomes.</p><p><strong>Conclusion: </strong>GCA and WML play pivotal roles for the functional outcomes in elderly patients undergoing EVT for LVO-stroke, providing valuable and practical information for early prediction of long-term prognosis.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"149-159"},"PeriodicalIF":2.8,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11846514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum Periostin as a Novel Biomarker for Predicting 30-Day Major Adverse Cardiac Events After Off-Pump Coronary Artery Bypass Grafting.","authors":"Qian Su, Zhipeng Deng, Xiangqing Wei, Lu Li, Boxiang Du, Fei Guo, Yi Gu, Jie Song, Lei Yao","doi":"10.2147/TCRM.S507435","DOIUrl":"10.2147/TCRM.S507435","url":null,"abstract":"<p><strong>Background: </strong>The identification of predictors for major adverse cardiovascular events (MACEs) is essential for reducing mortality associated with off-pump coronary artery bypass grafting (OPCAB). The objective of this study is to assess serum periostin levels as a novel predictor of MACEs in patients undergoing OPCAB.</p><p><strong>Methods: </strong>This prospective study included 79 patients diagnosed with coronary artery disease (CAD) who underwent OPCAB between May 2022 and May 2023. The changes in periostin levels (ΔPOSTN) were calculated using the formula: postoperative POSTN levels minus preoperative POSTN levels. Based on the optimal cut-off value determined from the receiver operating characteristic (ROC) curve, patients were categorized into Low POSTN Change (LPC) and High POSTN Change (HPC) groups for subgroup analysis. The primary outcomes assessed were MACEs, including cardiac death, myocardial infarction (MI), heart failure, and stroke.</p><p><strong>Results: </strong>Follow up for the patients was conducted for 30 days, with 71 patients ultimately being included in the final analysis. During this period, 13 MACEs were recorded, representing an incidence rate of 18.3%. The events included 2 cases of cardiac death (2.8%), 5 cases of MI (7.0%), 5 cases of heart failure (7.0%), and 1 case of stroke (1.4%). The risk of MACEs increased by 4% for each unit increase in the ΔPOSTN (Odds Ratio [OR]: 1.04, 95% Confidence Interval [CI]: 1.01-1.06; p = 0.005). The area under the ROC curve was 0.869 (95% CI: 0.768-0.938; p < 0.001). Based on the Youden index (J = 0.683), the optimal threshold for ΔPOSTN was determined to be 16.6 µg/L, with a sensitivity of 76.9% and a specificity of 91.4%.</p><p><strong>Conclusion: </strong>Changes in serum periostin levels during the perioperative period may serve as an independent predictor of 30-day MACEs in patients undergoing OPCAB.</p><p><strong>Trial registration: </strong>Link of the registry: https://www.chictr.org.cn. Date of registration: 2022/05/22. Trial registration number: ChiCTR2200060220.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"161-176"},"PeriodicalIF":2.8,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11846488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Development of Publications on Catheter-Related Bladder Discomfort: A Bibliometric Analysis.","authors":"Wencai Jiang, Xuemeng Chen, Yanhua Peng, Wenhu Zhai, Xianjie Zhang, Yukai Zhou, Rui Zhou","doi":"10.2147/TCRM.S493703","DOIUrl":"10.2147/TCRM.S493703","url":null,"abstract":"<p><strong>Background: </strong>Catheter-related bladder discomfort (CRBD) is a risk factor that impacts postoperative recovery and still troubles patients and healthcare staff. The present study is a bibliometric analysis of CRBD.</p><p><strong>Methods: </strong>The publications on CRBD were retrieved from the Web of Science Core Collection. VOSviewer and Excel were applied to present the current status and hot spots of CRBD research. We analyzed parameters such as the annual number of publications, countries/regions, organizations, authors, journals, and keywords of the articles in this area by generating visualization graphs.</p><p><strong>Results: </strong>A total of 127 articles were eligible, recorded by 78 journals, and drafted by 672 authors from 169 organizations in 26 countries/regions. The main type of these articles is randomized trial. Park Hee-Pyoung, Kim Hyun-Chang, and Cui Yuanshan are the most productive authors with 5 articles. Sichuan University, Seoul National University, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Capital Medical University, and Qingdao University published more articles on CRBD worldwide. China ranks No. 1 in terms of the number of publications, followed by South Korea and India. Journals specialized in anesthesiology, such as BMC Anesthesiology, Journal of Anesthesia, and British Journal of Anesthesia, are more popular with researchers in this area. The research hot spots of CRBD have concentrated on the prevention and treatment of CRBD.</p><p><strong>Conclusion: </strong>Though formal research on CRBD started late, there is a rising tendency for the number of publications. Authors and academic teams from Asia have made significant contribution to CRBD. Journals specialized in anesthesiology are priorities for publishing articles. Previous studies mainly focused on the pharmacological and pharmacological methods to CRBD. However, CRBD is not fully settled. Either clinical or experimental studies are still needed to further improve CRBD.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"137-147"},"PeriodicalIF":2.8,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11806727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics, Incidence, and Management of Immune Checkpoint Inhibitors Related Cardiovascular Adverse Events in Real-World Practice-A Retrospective Study in Chinese Han Population.","authors":"Rong-Hua Wang, Yin Chen, Ya-Ling Lou, Yu-Liang Lu, Hui-Min Xu","doi":"10.2147/TCRM.S477417","DOIUrl":"10.2147/TCRM.S477417","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to elaborate on the incidence, clinical features, and management of immune checkpoint inhibitors (ICIs) related cardiovascular adverse events (CVAEs) in real-world practice.</p><p><strong>Patients and methods: </strong>We performed a retrospective chart review study on patients receiving at least one dose of ICI therapy at a Chinese tertiary hospital from March 2020 to March 2021. CVAEs were identified through clinical assessment and the Naranjo algorithm. The management and outcomes of CVAEs were monitored over a median follow-up duration of 8 months.</p><p><strong>Results: </strong>Among the included 203 patients, 4.4% (9/203) developed CVAEs, including heart failure (n = 3), arrhythmia (n = 2), myocarditis (n = 2), and pericardial disease (n = 2), with a proportion (6/9) tending to be severe (grade 3 or grade 4). CVAEs were more common in older patients (mean age: 73.6 ± 9.2 years) and those with hypertension (p = 0.02) or heart failure (p = 0.01). Adherence to the American Society of Clinical Oncology (ASCO) guidelines for managing CVAEs was low (44%), with most cases showing partial resolution by the last follow-up.</p><p><strong>Conclusion: </strong>We reported that the incidence of ICI-related CVAEs in the Chinese institution was higher than that in some prior studies. Adherence to guidelines for managing ICI-related CVAEs is found to be suboptimal in real-world practice and highlighted as a needed improvement.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"125-135"},"PeriodicalIF":2.8,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11840335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}