Therapeutics and Clinical Risk Management最新文献

{"title":"Knowledge, Attitude, and Practice of Nurses in Preventing Complications in Patients with Nephrotic Syndrome: A Cross-Sectional Study.","authors":"Nannan Wang, Xueqin Deng, Ting Zhang, Yonglin Tao, Qing Feng","doi":"10.2147/TCRM.S538455","DOIUrl":"10.2147/TCRM.S538455","url":null,"abstract":"<p><strong>Background and aim: </strong>Nephrotic syndrome (NS) is frequently accompanied by serious complications such as edema-related infections, thromboembolism, and acute kidney injury, which can significantly impact prognosis. Nurses are essential in early identification, patient education, and implementation of preventive measures. This study explores the knowledge, attitude, and practice (KAP) levels of nurses concerning complication prevention in nephrotic syndrome and identifies relevant influencing factors.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted from January to December 2023 across Ruijin Hospital affiliated with Shanghai Jiao Tong University School of Medicine and Shanghai Baoshan Medical Emergency Center in China, targeting nurses working in nephrology-related units. A total of 246 valid responses were obtained using a structured and pre-validated KAP questionnaire. The instrument included domains assessing factual understanding, behavioral attitudes, and routine clinical practices. Data were analyzed using descriptive statistics, Pearson's correlation, and logistic regression to determine relationships between demographic variables and KAP outcomes.</p><p><strong>Results: </strong>The mean knowledge score among respondents was 5.12±2.67, attitude score was 18.76±5.02, and practice score was 30.45±11.07. Correlational analysis revealed significant positive associations between knowledge and practice (r = 0.421, p < 0.001), and between attitude and practice (r = 0.336, p = 0.015). Regression analysis identified prior nephrology education, years of clinical experience, and academic qualifications as independent predictors of higher practice scores.</p><p><strong>Conclusion: </strong>While nurses generally hold positive attitudes towards complication prevention in nephrotic syndrome (NS), there are significant gaps in their knowledge and inconsistencies in the application of preventive practices. These findings emphasize the need for targeted training programs to enhance nurses' practical competencies in managing NS complications. By improving nurses' knowledge and clinical practices, especially in early detection and prevention, patient outcomes can be significantly improved, leading to more effective management of NS-related complications.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"1295-1305"},"PeriodicalIF":2.8,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12399088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970127","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":"Neoadjuvant Therapy for Organ Preservation in Locally Advanced Rectal Cancer: A Review.","authors":"Liangting Qiu, Jianjun Li","doi":"10.2147/TCRM.S518959","DOIUrl":"10.2147/TCRM.S518959","url":null,"abstract":"<p><p>Preoperative chemoradiotherapy (CRT) and sphincter-preserving total mesorectal excision (TME) effectively control tumor growth in locally advanced rectal cancer (LARC). However, associated complications can impair the quality of life (QoL) of the patients. Neoadjuvant therapies, such as consolidation neoadjuvant therapy and total neoadjuvant therapy (TNT), can improve tumor regression, potentially achieving a complete response and allowing organ preservation. Emerging clinical data suggest that these approaches can promote long-term cancer control in patients with LARC.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"1289-1293"},"PeriodicalIF":2.8,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12375309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970132","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":"Erratum: Impact of Isotretinoin on Blood Lipids and Liver Enzymes: A Retrospective Cohort Study in Saudi Arabia [Corrigendum].","authors":"","doi":"10.2147/TCRM.S561428","DOIUrl":"10.2147/TCRM.S561428","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.2147/TCRM.S466113.].</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"1287-1288"},"PeriodicalIF":2.8,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12375507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970337","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 Predictive Value of the Combination of Serum RBP4, ALP, IL-1β for Postoperative Recurrence of Intrahepatic Bile Duct Stones.","authors":"Wenjie Tang, Xin Kang, Changhong Zhou, Chao Chen","doi":"10.2147/TCRM.S529277","DOIUrl":"10.2147/TCRM.S529277","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the predictive value of serum retinol-binding protein (RBP4), alkaline phosphatase (ALP), and interleukin (IL)-1β for postoperative recurrence of intrahepatic bile duct stones (IBDS).</p><p><strong>Methods: </strong>This retrospective study included 320 patients with intrahepatic bile duct stones (IBDS) admitted to our hospital from May 2020 to May 2022, all of whom underwent laparoscopic choledocholithotomy combined with choledochoscopy. Patients were divided into a recurrence group and a non-recurrence group based on their postoperative status. Serum levels of RBP4 and IL-1β were measured by ELISA; liver function indicators including ALP were analyzed using a biochemical analyzer; levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were also detected by ELISA; toll-like receptor 4 (TLR4) and thyroid-stimulating hormone (TSH) were measured by radioimmunoassay.Pearson correlation analysis was performed to assess the relationships between serum RBP4, ALP, IL-1β and laboratory indicators. Multivariate logistic regression analysis was used to identify factors influencing postoperative recurrence of IBDS. Receiver operating characteristic (ROC) curves were plotted to evaluate the predictive value of serum RBP4, ALP, and IL-1β for IBDS recurrence after surgery.</p><p><strong>Results: </strong>The levels of serum RBP4, ALP, IL-1β, TNF-α, TLR4, and TSH in the recurrence group were significantly higher than those in the non-recurrence group (P < 0.05). Pearson correlation analysis showed that serum RBP4, ALP, and IL-1β were all positively correlated with TNF-α, TLR4, and TSH (P < 0.05). Multivariate logistic regression analysis identified RBP4, ALP, IL-1β, TNF-α, TLR4, and TSH as independent risk factors for postoperative recurrence of IBDS (P < 0.05).According to ROC curve analysis showed that the area under the curve (AUC) for serum RBP4 in predicting postoperative recurrence of IBDS was 0.844, for serum ALP was 0.822, and for serum IL-1β was 0.732. The combined detection of RBP4, ALP, and IL-1β yielded an AUC of 0.892, which was superior to the predictive performance of each marker alone (Z = 2.654, Z = 2.668, Z = 2.650; all P < 0.05).</p><p><strong>Conclusion: </strong>Serum levels of RBP4, ALP, and IL-1β are significantly elevated in patients with IBDS, and their combined detection can enhance the predictive value for postoperative recurrence of IBDS.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"1277-1285"},"PeriodicalIF":2.8,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12363549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970085","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":"Causal Associations of the Alterations in Peripheral Blood Immune Cell Characteristics on the Incidence of Osteoporosis: A Bidirectional Mendelian Randomization Study.","authors":"Qunhui Yin, Kai Li, Rong Chen, Xin Li, Wai Leung Ambrose Lo, Qiuhua Yu, Minghui Ding, Siyun Zhang, Chuhuai Wang","doi":"10.2147/TCRM.S518164","DOIUrl":"10.2147/TCRM.S518164","url":null,"abstract":"<p><strong>Purpose: </strong>Osteoporosis is closely related to specific immune cell, yet the causal mechanism has not been clarified. Previous studies mostly adopted traditional unidirectional Mendelian randomization (MR) for analysis, failing to fully clarify their relationship. This study is the first to analyze the bidirectional causal relationship between the characteristics of peripheral immune cells and the risk of osteoporosis.</p><p><strong>Methods: </strong>A bilateral two-sample MR was performed, with immune cells serving as instrumental variables and the incidence of osteoporosis as the outcome. We used five algorithms to evaluate the causal relationship between immune cells and the incidence of osteoporosis (inverse-variance weighted [IVW], MR-Egger, simple mode, weight median, and weight mode). The Cochran Q and leave-one-out tests were used to evaluate heterogeneity and stability, and the MR-Egger intercept test was used to evaluate horizontal pleiotropy.</p><p><strong>Results: </strong>The eosinophil percentage of granulocytes (odds ratio [OR] = 1.25, 95% confidence interval [CI] = 1.08-1.44, P = 0.002), eosinophil percentage of white cells (OR = 1.17, 95% CI = 1.02-1.35, P = 0.027), and sum eosinophil basophil counts (OR = 1.16, 95% CI = 1.02-1.32, P = 0.027) had positive causal associations with the incidence of osteoporosis. The lymphocyte counts (OR = 0.83, 95% CI = 0.71-0.97, P = 0.016), neutrophil percentage of granulocytes (OR = 0.78, 95% CI = 0.67-0.90, P < 0.001) played negative effect on osteoporosis. The reverse direction showed that osteoporosis had no causal effect on the characteristics of the immune cells. Non-significant heterogeneity and horizontal pleiotropy indicated the results were robust.</p><p><strong>Conclusion: </strong>This study identified a unidirectional causal link between five immune cell traits and osteoporosis, providing new insights into osteoporosis pathogenesis and potential targeted immunotherapy.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"1259-1275"},"PeriodicalIF":2.8,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12360385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144883777","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 Relationship Between the Time Until Penile Fracture Repair and Post-Operative Erectile Dysfunction.","authors":"Yekta Bıçak, Onur Dede","doi":"10.2147/TCRM.S527293","DOIUrl":"10.2147/TCRM.S527293","url":null,"abstract":"<p><strong>Aim: </strong>Although penile fracture is a rare condition, the damage it may cause afterwards is challenging for patients. We aimed to investigate the relationship between late presentation to the hospital and the frequency of erectile dysfunction (ED) in patients with penile fractures.</p><p><strong>Methods: </strong>In our cross-sectional, retrospective study, the frequency and severity of ED were calculated according to the International Index of Erectile Function (IIEF) scoring in patients with penile fracture admitted to Dicle University Hospital in the inter-operative period between the event and the operation and the subsequent controls. The relationship between these two conditions was analysed.</p><p><strong>Results: </strong>Forty-six patients who met the inclusion criteria were included in our study. The mean age was 37 (28-46) years. The mean preoperative IIEF was 25 (20-28), and the mean postoperative IIEF was 21.3 (15-27). The mean event-operation time was 9 (6-15) hours. The rate of sexual intercourse was 50%, trauma was 30%, development after masturbation was 11%, and other causes were 9%.</p><p><strong>Conclusion: </strong>Penile fracture is a real urological emergency, and as urologists, we need to intervene as early as possible in patients experiencing this condition. We found that patients who presented to the hospital more than 12.5 hours after penile fracture had a significantly higher risk of developing ED or worsening ED in the subsequent period.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"1249-1258"},"PeriodicalIF":2.8,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12356205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875373","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":"Factors Influencing Prolonged Hospital Stay in Surgically Treated Children and Adolescents with Left-to-Right Shunt Congenital Heart Disease: Evidence From a Hospital in Southern China.","authors":"Liudan Huang, Yuhua Zhang, Shaobo Jiang","doi":"10.2147/TCRM.S533273","DOIUrl":"10.2147/TCRM.S533273","url":null,"abstract":"<p><strong>Background: </strong>Congenital heart disease(CHD) is a congenital malformation caused by abnormal development of the heart and large blood vessels, and left-to-right shunt CHD is a relatively common type. Surgical treatment has the problem of prolonged hospital stay in CHD patients. It is of great significance to explore the influencing factors of prolonged hospital stay after surgery therapy for children and adolescents with left-to-right shunt CHD.</p><p><strong>Methods: </strong>A total of 463 children and adolescents with left-to-right shunt CHD who received surgery therapy were retrospectively analyzed. Medical records (gender, CHD types, echocardiography, invasive mechanical ventilation, blood transfusion, tracheal intubation, intraoperative blood loss, and length of hospital stay) were collected. The threshold for prolonged hospital stay was defined based on the third quartile (75th percentile) of length of hospital stay in all patients. The relationship between clinical features and prolonged hospital stay was analyzed.</p><p><strong>Results: </strong>The mean length of hospital stay was 13.00 (7.00, 18.00) days, there were 330 (71.3%) patients with non-prolonged hospital stay (<18.0 days) and 133 (28.7%) with prolonged stay (≥18.0 days). There were statistically significant differences in the distributions of types of CHD (χ²=67.959, <i>p</i><0.001), severity of mitral insufficiency (χ²=14.171, <i>p</i>=0.002) and pulmonary hypertension (χ²=49.611, <i>p</i><0.001), and the proportion of treated with invasive mechanical ventilation (χ²=104.657, <i>p</i><0.001), blood transfusion (χ²=117.649, <i>p</i><0.001), and tracheal intubation (χ²=67.752, <i>p</i><0.001) between CHD patients with prolonged and non-prolonged hospital stay. Multivariate logistic regression analysis showed that male (odds ratio(OR): 2.137, 95% confidence interval(CI): 1.278-3.574, <i>p</i>=0.004), compound types CHD (OR: 2.021, 95% CI: 1.178-3.469, <i>p</i>=0.011), pulmonary hypertension (OR: 3.179, 95% CI: 1.537-6.572, <i>p</i>=0.002), invasive mechanical ventilation (OR: 4.069, 95% CI: 1.567-10.564, <i>p</i>=0.004), and blood transfusion (OR: 5.128, 95% CI: 2.421-10.862, <i>p</i><0.001) were independently associated with prolonged hospital stay.</p><p><strong>Conclusion: </strong>Male, compound types CHD, pulmonary hypertension, invasive mechanical ventilation, and blood transfusion were independently associated with prolonged hospital stay in CHD patients. It provides valuable information to guide the hospitalization management of CHD.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"1237-1247"},"PeriodicalIF":2.8,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12355004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875372","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 Continuous Cardiac Rehabilitation on the Psychological and Physiological Prognosis of Patients with Heart Failure-A Retrospective Study.","authors":"Li-Hua Yan, Yun Ge, Fei Wang, Yu-Ling Zhu, Li Lu","doi":"10.2147/TCRM.S529282","DOIUrl":"10.2147/TCRM.S529282","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the impact of continued cardiac rehabilitation on cardiac function, psychological well-being, and prognostic outcomes in patients diagnosed with heart failure and improved ejection fraction (HFimpEF).</p><p><strong>Methods: </strong>This study adopted a retrospective design, and a total of 150 patients with HFimpEF who experienced reduced ejection fraction after the first acute myocardial infarction were included. All patients underwent emergency percutaneous coronary intervention (PCI). Participants were categorized into a control group (n = 70) or an observation group (n = 80) based on their participation in ongoing cardiac rehabilitation. The follow-up period extended for one year. Comparative analyses were conducted to assess differences between the two groups in baseline characteristics, cardiac function, anxiety and depression scores, and the incidence of cardiovascular events.</p><p><strong>Results: </strong>No statistically significant differences were observed between the groups in terms of sex, age, past medical history, blood lipid levels, blood glucose levels, or renal function. Similarly, pre-treatment assessments of cardiac function, six-minute walk test results, Self-Rating Anxiety Scale (SAS) scores, Self-Rating Depression Scale (SDS) scores, or the incidence of cardiovascular events showed no significant differences. Compared to the control group, the observation group demonstrated significantly better cardiac function and six-minute walk test performance, along with significantly lower SAS and SDS scores. Furthermore, the incidence of heart failure and rehospitalization was significantly lower in the observation group than in the control group.</p><p><strong>Conclusion: </strong>Sustained cardiac rehabilitation in patients with HFimpEF was associated with significant improvements in cardiac function, enhanced six-minute walk test performance, reduced anxiety and depression levels, and a lower incidence of heart failure and rehospitalization. These findings highlight the key role of sustained cardiac rehabilitation in improving clinical outcomes for patients with HFimpEF.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"1227-1236"},"PeriodicalIF":2.8,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12341564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144837792","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":"Risk Factors for Sigmoid Colonic Anastomosis: A Comparative and Cross-Sectional Analysis.","authors":"Tutkun Talih, Gokhan Sonmez, Erdogan M Sozuer, Sevket Tolga Tombul, Mahmut O Kulturoglu, Dogan G Islam, Hızır Y Akyıldız, Abdullah Demirtas, Mustafa Karaagac, Fatih Dal","doi":"10.2147/TCRM.S521002","DOIUrl":"10.2147/TCRM.S521002","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the anastomotic leakage (AL) rates in cancerous and non-cancerous intestinal anastomoses and analyze the general risk factors for AL.</p><p><strong>Methods: </strong>The primary endpoint of this study is to investigate whether there is a difference in terms of AL between patients who underwent sigmoid colon resection + colorectal anastomosis due to primary colon cancer (Group 1) and patients with a completely healthy colorectal region who underwent sigmoid colon resection + colorectal anastomosis for use in the orthotopic bladder during radical cystoprostatectomy (Group 2). The secondary endpoint, considering all the patients, is to evaluate and investigate the risk factors affecting the AL rates.</p><p><strong>Results: </strong>A total of 178 patients, including 63 (35.4%) patients in Group 1 and 115 (64.6%) patients in Group 2, were included in the study. The mean age of all patients was 61.7 ± 9.9 years, and there was no statistical difference between the mean ages of the groups (62.8 ± 11.3 vs 60.7 ± 6.1, p = 0.106, respectively). Thirty-six (20.2%) of the patients were female, and 142 (79.8%) were male. There was no significant difference between the groups in terms of AL in the postoperative period. Postoperative AL was seen in three patients (4.8%) and six patients (5.2%) in Group 1 and Group 2, respectively (p = 0.642). According to univariate and multiple logistic regression analysis, the risk of AL increased in patients with comorbidities, in the presence of previous abdominal surgery, in patients with high neutrophil-to-lymphocyte ratio, and patients with postoperative ileus (p values are 0.042, 0.010, 0.029 and 0.048, respectively).</p><p><strong>Conclusion: </strong>Our data suggest that anastomosis due to colon cancer resection does not increase the risk of AL compared with healthy bowel anastomoses. In addition, some clinical factors have been found to compromise anastomotic safety and are risk factors for AL. In addition, some clinical factors have been found to endanger anastomotic safety and are risk factors for AL.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"1219-1226"},"PeriodicalIF":2.8,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12333642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817551","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":"Medicinal Plants for Chemotherapy-Induced Nausea and Vomiting: A Systematic Review of Antiemetic, Chemosensitizing, and Immunomodulatory Mechanisms.","authors":"Xue Sun, Fangfang Nie, Jizhuo Sun, Jingdong Zhang, Yuanhe Wang","doi":"10.2147/TCRM.S531645","DOIUrl":"10.2147/TCRM.S531645","url":null,"abstract":"<p><strong>Background: </strong>Chemotherapy-induced nausea and vomiting (CINV) is a major burden for cancer patients, often poorly managed by conventional antiemetics, prompting exploration of medicinal plant therapies for better supportive care.</p><p><strong>Objective: </strong>This systematic review critically evaluates medicinal plants for CINV, detailing bioactive compounds, diverse antiemetic mechanisms, and promising chemosensitizing and immunomodulatory properties.</p><p><strong>Methods: </strong>A comprehensive literature search and critical analysis of studies investigating medicinal plants for CINV were performed.</p><p><strong>Key findings: </strong>This review synthesizes evidence for 22 botanicals. Ginger (gingerols, shogaols) acts via 5-hydroxytryptamine 3 (5-HT₃) receptor antagonism and substance P/neurokinin-1 (NK-1) inhibition, and offers chemosensitization by downregulating P-glycoprotein. Cannabis (THC, CBD) modulates the endocannabinoid system and 5-HT₃ receptors for CINV relief and may enhance chemotherapy sensitivity. Mint (menthol, menthone) relaxes gastrointestinal smooth muscle and offers anti-inflammatory benefits. Chamomile (apigenin) has antispasmodic/anxiolytic effects; its apigenin also sensitizes cancer cells to chemotherapy. Turmeric (curcumin) acts on neurotransmitter systems, offers potent anti-inflammatory/antioxidant effects, and boosts chemosensitivity via NF-κB/P-gp modulation. Plants like <i>Pinellia ternata</i>, lemon, fennel, and licorice show varied mechanisms (gastrointestinal regulation, anti-inflammatory, neurotransmitter modulation). Many botanicals show chemosensitizing (inhibiting efflux pumps, promoting apoptosis) and immunomodulatory (affecting cytokines, immune cells) properties. Synergistic plant combinations (eg, ginger with P. ternata or turmeric) are noted for enhanced efficacy and safety.</p><p><strong>Conclusion: </strong>Medicinal plants offer a compelling, multi-targeted approach for CINV management, with potential beyond symptomatic relief via their antiemetic, chemosensitizing, and immunomodulatory actions. Rigorous clinical trials are needed to integrate these botanicals into evidence-based supportive cancer care.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"1187-1218"},"PeriodicalIF":2.8,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12325115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144795558","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}