Therapeutics and Clinical Risk Management最新文献

{"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}

{"title":"Efficacy of Transcutaneous Electrical Acupoint Stimulation Applied During the Post-Anesthesia Recovery Period in Improving Postoperative Recovery Quality After Gynecological Laparoscopic Surgery: A Randomized Controlled Trial.","authors":"Zhihu Zhou, Xiang Yang, Min Shi, Liqiao Huang, Danping Wu, Huailong Yang, Xu Zhang","doi":"10.2147/TCRM.S507856","DOIUrl":"10.2147/TCRM.S507856","url":null,"abstract":"<p><strong>Purpose: </strong>Transcutaneous electrical acupoint stimulation (TEAS) has emerged as a promising non-pharmacological intervention to enhance postoperative recovery. However, its application during the post-anesthesia recovery period remains underexplored. This study investigated the impact of TEAS during the post-anesthesia recovery period on postoperative recovery quality in patients undergoing laparoscopic gynecological surgery.</p><p><strong>Patients and methods: </strong>In this single-center, randomized, double-blinded, sham-controlled trial, 100 patients undergoing elective gynecological laparoscopic surgery were randomly allocated to receive either TEAS or sham stimulation at bilateral Hegu (LI4), Neiguan (PC6), Zusanli (ST36), and Sanyinjiao (SP6) acupoints for 30 minutes during the post-anesthesia recovery period in the post-anesthesia care unit (PACU). The primary outcome was the Quality of Recovery-15 (QoR-15) score assessed on postoperative days (POD) 1, 2, and 3. Secondary outcomes included pain, postoperative nausea and vomiting (PONV), recovery times, and adverse events.</p><p><strong>Results: </strong>Ninety-seven patients completed the study, with 48 in the TEAS group and 49 in the Sham group. The TEAS group exhibited significantly higher QoR-15 scores on POD 1 compared to the Sham group, with improvements in emotional state, physical comfort, and pain dimensions. On POD 2, the TEAS group had significantly higher pain dimension scores. The TEAS group also reported lower resting VAS scores on POD 1 and lower exercise VAS scores on POD 1 and 2. The incidence of PONV was lower on POD 1, with fewer patients requiring rescue antiemetics. Additionally, the TEAS group experienced shorter times to first flatus and ambulation. Adverse events were comparable between the groups, with no local skin irritation noted in the TEAS group.</p><p><strong>Conclusion: </strong>TEAS applied during the post-anesthesia recovery period significantly improves early postoperative recovery quality, reduces pain and PONV, and accelerates functional recovery in patients undergoing gynecological laparoscopic surgery.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"1175-1186"},"PeriodicalIF":2.8,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12302977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733407","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 Pleural Reaction in CT-Guided Percutaneous Lung Nodule Localization: A Single-Center Retrospective Study.","authors":"Ning Zhou, Nan Feng, Zichen Jiao, Xiaoming Shi, Tao Wang, Gefei Zhao","doi":"10.2147/TCRM.S516329","DOIUrl":"10.2147/TCRM.S516329","url":null,"abstract":"<p><strong>Background: </strong>Pleural reaction (PR) frequently occurs during computed tomography (CT) -guided lung puncture procedures, and its development is influenced by various factors. This study aims to identify the risk factors associated with PR in CT-guided percutaneous lung nodule localization (CT-PLNL) procedures.</p><p><strong>Methods: </strong>This retrospective study included 467 patients who underwent video-assisted thoracic surgery (VATS) at Nanjing Drum Tower Hospital between January 2022 and December 2023, all of whom had received CT-PLNL. Clinical data, including medical records, imaging findings, and laboratory results, were collected. Univariate analysis and Least Absolute Shrinkage and Selection Operator (LASSO) regression identified independent risk factors for PR. Binary logistic regression was performed to further analyze these factors. Receiver Operating Characteristic (ROC) curves were plotted to assess model performance, and Bootstrap validation evaluated discriminative ability. Calibration curves and decision curve analysis (DCA) were conducted to compare predicted versus actual probabilities and assess clinical applicability.</p><p><strong>Results: </strong>The incidence of PR was 5.35% (25/467). Significant variables from univariate analysis and LASSO regression were analyzed by logistic regression. Age, intrapulmonary needle path adjustment, inadequate anesthesia, and a history of diabetes were identified as independent risk factors for PR. ROC curves showed Area Under the Curve (AUC) values indicating excellent discriminative ability. Calibration curves showed appropriate fit, and DCA demonstrated high clinical applicability.</p><p><strong>Conclusion: </strong>Younger age groups, intraprocedural needle adjustments, inadequate anesthesia, and diabetes were independent risk factors for PR after CT-PLNL. Optimizing anesthesia, avoiding unnecessary needle manipulations, and perioperative glucose monitoring in diabetic patients may mitigate PR risks and enhance procedural safety.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"1161-1173"},"PeriodicalIF":2.8,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12301428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733409","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":"Surgeons Knowledge, Attitude, and Practice Toward Preoperative Inflammatory Bowel Disease Medications and Post-Operative Complications.","authors":"Noura Alhassan, Abdullah Nasser Alnwdel, Mohammed Basem Beyari, Saleh Husam Aldeligan, Reem Alhassan, Maha Hamadien Abdulla, Thamer Bin Traiki","doi":"10.2147/TCRM.S527037","DOIUrl":"10.2147/TCRM.S527037","url":null,"abstract":"<p><strong>Background: </strong>Biologics, particularly anti-TNF agents, have transformed the management of inflammatory bowel disease (IBD), but concerns about their perioperative safety persist.</p><p><strong>Objective: </strong>This study evaluates the knowledge, attitudes, and practices of surgeons in Saudi Arabia regarding the preoperative management of IBD patients undergoing surgery while on biological treatments.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted among 115 surgeons. Participants included general and colorectal surgeons with extensive experience in IBD management. Data were analyzed to assess knowledge, attitudes, and practices related to the impact of biologics, corticosteroids, and immunomodulators on wound healing and postoperative complications.</p><p><strong>Results: </strong>The response rate of 67.8% and Most surgeons (74.4%) believed biologics negatively affect wound healing, despite evidence suggesting their safety. Corticosteroids were unanimously recognized for their adverse effects, while immunomodulators were widely perceived as safe. A majority preferred tapering biologics and corticosteroids 4 weeks preoperatively but continued immunomodulators. Differences between specialties were observed, with colorectal surgeons demonstrating greater adherence to evidence-based guidelines compared to general surgeons, who expressed more concerns about biologics' risks.</p><p><strong>Conclusion: </strong>This study identifies a persistent gap between evidence and practice in the perioperative management of IBD patients on biologics among Saudi surgeons, with general surgeons often stopping biologics due to safety concerns despite evidence of their safety, while colorectal surgeons are more likely to follow current guidelines. Unnecessary cessation may increase disease flare risk, highlighting the need for targeted education and multidisciplinary collaboration to optimize surgical outcomes.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"1149-1159"},"PeriodicalIF":2.8,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12301140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733410","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":"Adverse Event Management in Patients with Platinum-Resistant Ovarian Cancer Treated with Niraparib and Anlotinib: Updates from the Phase II, Multi-Center ANNIE Study.","authors":"Ting Deng, Lei Yan, Jing Li, Guochen Liu, Aijun Yin, Yanling Feng, Min Zheng, Chuyao Zhang, He Huang, Qidan Huang, An Lin, Jie Jiang, Beihua Kong, Jihong Liu","doi":"10.2147/TCRM.S526755","DOIUrl":"10.2147/TCRM.S526755","url":null,"abstract":"<p><strong>Background: </strong>The primary analysis of the ANNIE study demonstrated promising anti-tumor activity of the niraparib-anlotinib combination in platinum-resistant recurrent ovarian cancer (PROC). We report updated overall survival (OS) and safety data and the management of key treatment-emergent adverse event (TEAE) from the ANNIE study.</p><p><strong>Methods: </strong>In the multi-center, single-arm, Phase 2 ANNIE study, enrolled patients received oral niraparib 200 mg or 300 mg (baseline bodyweight-directed) once daily and anlotinib 10 mg (12 mg before protocol amendment) once daily on days 1-14 of each 21-day cycle. Safety management involved a multidisciplinary team comprising specialist physicians, who performed monitoring and intervention for key comorbidities and TEAEs.</p><p><strong>Results: </strong>Forty patients were enrolled. After a median follow-up of 19.0 months, the updated median OS was 18.2 months (95% confidence interval: 12.1-not evaluable). The most common TEAEs were hypertension (n=22, 55%), leukopenia (n=18, 45%), hand-foot syndrome (n=17, 43%), thrombocytopenia (n=15, 38%), neutropenia (n=14, 35%), and hypertriglyceridemia (n=12, 30%). Hypertension and cardiovascular events were mostly managed by early interventions using beta-blockers. Hypertriglyceridemia was mostly managed using atorvastatin and simvastatin. Hematological toxicities were consistent with prior studies and no severe hematologic events occurred. Protocol amendment was implemented to reduce the incidence of hand-foot syndrome, while topical glucocorticoids and non-steroidal anti-inflammatory drugs were used in patients with apparent symptoms.</p><p><strong>Conclusion: </strong>The updated OS analysis showed sustained long-term efficacy of niraparib-anlotinib in PROC patients. The safety data reflected satisfactory tolerability and adverse event management, supporting the involvement of a multidisciplinary disease management team in ovarian cancer care.</p><p><strong>Clinical trial registration: </strong>NCT04376073.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"1135-1147"},"PeriodicalIF":2.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12292356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733406","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}