Therapeutics and Clinical Risk Management最新文献

{"title":"Prognostic Value of Spontaneous Potential in Left Atrial Posterior Wall Isolation and Radiofrequency Ablation for Non-Paroxysmal Atrial Fibrillation.","authors":"Zhi-Yang Chen, Yu-Hong Zhong, Ke-Zeng Gong, Xue-Hai Chen, Zhe Xu, Fei-Long Zhang","doi":"10.2147/TCRM.S525135","DOIUrl":"10.2147/TCRM.S525135","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to examine the long-term effects of left atrial posterior wall spontaneous potential (SP) in patients with non-paroxysmal atrial fibrillation (AF) who underwent pulmonary vein isolation (PVI) combined with left atrial posterior wall isolation (PVI+BOX) ablation.</p><p><strong>Methods: </strong>Clinical data were retrospectively collected from 140 patients with symptomatic non-paroxysmal atrial fibrillation (NPAF) who underwent first-time radiofrequency ablation between 2022 and 2023. Based on the surgical procedure, patients were categorized into the pulmonary vein isolation group (PVI group) and the pulmonary vein isolation + left atrial posterior wall isolation group (PVI+BOX group). The PVI+BOX group was further subdivided into the spontaneous potential group (SP group) and the no-spontaneous potential group (no-SP group) based on the presence of SP after left atrial posterior wall isolation. Patients underwent monthly follow-ups in the clinic or via telephone and received 72-hour dynamic electrocardiography (ECG) at 3 and 12 months postoperatively. AF recurrence was compared among the groups, and factors associated with recurrence following AF ablation were analyzed.</p><p><strong>Results: </strong>The PVI+BOX group included 78 cases, with 45 in the no-SP group and 33 in the SP group, while the PVI group comprised 62 cases. No significant difference was observed in the postoperative recurrence-free rate between the PVI+BOX and PVI groups. However, the SP group exhibited a higher postoperative recurrence-free rate compared to both the no-SP group (<i>p</i> = 0.039) and the PVI group (<i>p</i> = 0.020). No significant difference was found in the late recurrence-free rate between the no-SP and PVI groups. Multivariate logistic regression analysis indicated that the duration of AF and the presence of left atrial posterior wall SP were independent risk factors for post-ablation recurrence in patients with NPAF.</p><p><strong>Conclusion: </strong>The presence of SP post-left atrial posterior wall isolation suggests a better long-term outcome in patients with NPAF following PVI+BOX catheter ablation.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"1021-1031"},"PeriodicalIF":2.8,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601693","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":"Comparative Impact of Intravenous Iron Sucrose and Ferric Carboxymaltose on Hypophosphatemia and Anemia Parameters in Iron Deficiency Anemia: A Retrospective Study.","authors":"Sefer Aslan, Serhat Doğan, Mehmet Sarıaydın, Aşkı Vural, Ersin Kuloglu, Ali Muhtaroğlu","doi":"10.2147/TCRM.S529064","DOIUrl":"10.2147/TCRM.S529064","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to determine the incidence of hypophosphatemia and evaluate anemia parameters following intravenous iron sucrose (IS) and iron carboxymaltose (FCM) therapy in patients diagnosed with iron deficiency anemia (IDA).</p><p><strong>Methods: </strong>This retrospective study included 108 patients aged 18-67 who were diagnosed with IDA and received either FCM or IS therapy. The patients were divided into two groups: iron sucrose (n=55, 51%) and ferric carboxymaltose (n=53, 49%). We collected and analysed data on patient demographics, doses of FCM and IS, and laboratory parameters including serum phosphorus, ferritin, total iron-binding capacity (TIBC), iron, and haemoglobin (Hg) values.</p><p><strong>Results: </strong>The pre-treatment blood phosphorus levels were significantly lower in the IS group than in the FCM group (p = 0.029). Following intravenous iron treatment, the TIBC and phosphorus levels were higher in the IS group compared to the FCM group (p = 0.011 and p <0.001, respectively). The ferritin levels were significantly higher in the FCM group compared to the IS group (p = 0.002).</p><p><strong>Conclusion: </strong>It is important to be aware that hypophosphatemia may occur after intravenous iron therapy for iron deficiency anemia. Therefore, phosphate levels should be monitored closely following treatment. Furthermore, it would appear that hypophosphatemia is more prevalent following FCM therapy compared to IS.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"987-993"},"PeriodicalIF":2.8,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12206423/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529578","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 Higher Incidence of Liver Injury in HCC Patients Compared to Other Malignancies During Immune-Checkpoint Inhibitor Therapy is Primarily Due to Tumor Progression.","authors":"Yan Wang, Liwei Liu, Mengyu Zhao, Wei Chen, Yu Chen, Xinyan Zhao","doi":"10.2147/TCRM.S514868","DOIUrl":"10.2147/TCRM.S514868","url":null,"abstract":"<p><strong>Background: </strong>The study explores the incidence and clinical features of immune-related liver injury (irLI) in hepatocellular carcinoma (HCC) patients compared to those with other malignancies receiving immune checkpoint inhibitors (ICIs).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on patients treated with ICIs at Beijing Friendship Hospital. Individuals who experienced liver injury consistent with the criteria specified in the Common Terminology Criteria for Advanced Event version 5.0 for irLI were included in the study. The cohort was divided into an HCC group and a non-HCC malignancy group. HCC patients were further classified into three subgroups based on liver injury: no injury, irLI, or non-immune-related liver injury. Data on demographics, laboratory results, and mortality rates were compared.</p><p><strong>Results: </strong>The study included 292 hCC patients and 1248 patients with other malignancies. Both groups underwent a similar number of ICIs cycles (p=0.237). Liver injury was more common in HCC patients [98 (33.6%) vs 288 (23.1%), p<0.001], but the irLI incidence was comparable between the groups [17 (5.8%) vs 62 (5.0%), p=0.556]. Tumor progression-related liver injury was higher in HCC patients (12.0%) compared to other malignancies (4.6%). Mortality rates showed no significant differences between groups.</p><p><strong>Conclusion: </strong>HCC patients with underlying liver disease are more prone to liver injury during ICIs therapy, mainly due to tumor progression rather than irLI.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"963-974"},"PeriodicalIF":2.8,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12206408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529579","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":"Impact of Hypertension and Antihypertensive Treatment on COVID-19 Severity: A Retrospective Observational Study in Ternopil Region, Ukraine.","authors":"Marian Hrebenyk, Sofia Maslii, Oksana Shevchuk, Roman Komorovsky, Mykhaylo Korda","doi":"10.2147/TCRM.S527151","DOIUrl":"10.2147/TCRM.S527151","url":null,"abstract":"<p><strong>Background: </strong>Hypertension (HP) may significantly affect the prognosis of COVID-19 illness. Understanding the epidemiological and clinical characteristics of post-COVID-19 patients with HP and other comorbidities is important for improving outcomes.</p><p><strong>Methods: </strong>We conducted a retrospective observational study in the Ternopil region of Ukraine involving 926 subjects: 848 individuals in the post-COVID period (0-90 days after a negative SARS-CoV-2 PCR test) and 78 (8.4%) in a control group. Data on medical history, clinical manifestations, treatment modalities, and pathomorphological findings were collected. Patients were categorized into four groups based on COVID-19 severity: mild, moderate, severe, and critical.</p><p><strong>Results: </strong>HP was present in 46.2% of patients, with a prevalence of 75.0% among fatal cases (p<0.001). Diabetes mellitus (DM) was diagnosed in 17.6%. HP was not associated with increased susceptibility to SARS-CoV-2 infection. In-hospital mortality risk significantly correlated with age (r=0.306, p<0.001), HP (r=0.145, p=0.001), DM (r=0.144, p=0.001), combined HP and DM (r=0.159, p<0.001), and irregular antihypertensive treatment (r=-0.118, p=0.037). However, regular use of ACE inhibitors or ARBs did not significantly affect prognosis. Multivariable logistic regression identified age and irregular antihypertensive treatment as independent predictors of in-hospital mortality.</p><p><strong>Conclusion: </strong>HP was not associated with increased susceptibility to SARS-CoV-2 infection, based on similar prevalence rates in patients and controls, but was linked to worse outcomes when combined with other risk factors. Age and irregular antihypertensive treatment emerged as independent predictors of in-hospital mortality. These findings highlight the importance of regular blood pressure management in reducing the severity and improving the prognosis of COVID-19 in hypertensive patients.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"995-1007"},"PeriodicalIF":2.8,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12231102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584955","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":"Airway Organoid Models as Pivotal Tools for Unraveling Molecular Mechanisms and Therapeutic Targets in Respiratory Diseases: A Literature Review.","authors":"Shu-Ping Jiang, Bing-Qi Lin, Xing-Qiang Zhou, Min-Hua Li, Zhen-Cheng Feng, Yue-Ying Qin, Shi-Qi Lin, Zi-Qing Zhou, Yang Peng, Lian Li","doi":"10.2147/TCRM.S526727","DOIUrl":"10.2147/TCRM.S526727","url":null,"abstract":"<p><p>Respiratory inflammatory and infectious diseases continue to impose a substantial global health burden, compounded by persistent gaps in understanding their pathogenic mechanisms and limited therapeutic advancements. To address these challenges, this review systematically analyzed literature from PubMed, Web of Science, and Scopus databases (2005-2025) to evaluate the evolution and applications of airway organoid models in respiratory disease research. Key findings include: (1) the convergence of traditional culture techniques with advanced methodologies - including 3D matrix embedding, bioprinting and organoids-on-chips technologies - has enabled unprecedented recapitulation of human airway architecture and multicellular interactions; (2) these novel models provide unique insights into disease pathogenesis, host-microbe dynamics, and drug response variability; (3) the inherent capacity to maintain native cellular diversity and disease-associated phenotypes positions airway organoids as crucial platforms for personalized medicine approaches. Collectively, these advances establish airway organoids as transformative tools that bridge conventional in vitro models and clinical reality. Looking ahead, coupling organs-on-chips platforms with microgravity culture and single-cell lineage tracing will catalyze fundamental breakthroughs in respiratory disease research.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"975-986"},"PeriodicalIF":2.8,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12205757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529577","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":"Tranexamic Acid Demonstrated a Trend Toward Decreased Perioperative Blood Loss in Posterior Decompression Surgery of Patient with Metastatic Spinal Tumor.","authors":"Yunpeng Cui, Huaijin Li, Chuan Mi, Bing Wang, Yuanxing Pan, Wei Yu, Xuedong Shi","doi":"10.2147/TCRM.S516261","DOIUrl":"10.2147/TCRM.S516261","url":null,"abstract":"<p><strong>Background: </strong>To explore the effect of tranexamic acid (TXA) on perioperative blood loss in posterior decompression surgery of patient with metastatic spinal tumor.</p><p><strong>Methods: </strong>Three hundred sixty-eight consecutive patients between May 2011 and Aug 2022 were retrospectively reviewed. One hundred eighty patients (182 surgeries) met the criteria and were included in the study. Sixty-two surgeries received preoperative intravenous TXA (TXA group), and 120 did not (non-TXA group). The primary outcome was total blood loss. <i>T</i>-test, Mann-Whitney U, and chi-square tests were used to evaluate the difference in baseline data, total blood loss, and other outcome measures between the two groups.</p><p><strong>Results: </strong>Patients with hyper vascular tumors had significantly more blood loss compared with non-hyper vascular tumors (2002(1531,2792) mL vs 1469(1036,1962) mL, p=0.001). There was no significant different in the postoperative venous thromboembolism of the lower limb between the two groups. For patients with non-hyper vascular tumors, the blood loss (1216(827, 1709) mL vs 1561(1146, 2019) mL, p = 0.012) and postoperative drainage (1-day post-operation: 240(150,290) mL vs 280(150,395) mL, p=0.040; 3-days post-operation: 450(348,630) mL vs 613(398,799) mL, p=0.025) of TXA group were significantly less compared with that of the non-TXA group. Meanwhile, the TXA group had significantly less postoperative hospitalization compared with the non-TXA group (11.0(9.0, 13.3) days vs 12.5(9.0, 16.3) days, p=0.023). For patients with hyper vascular tumors, there were no significant differences in the blood loss and amount of postoperative drainage between the two groups.</p><p><strong>Conclusion: </strong>Preoperative intravenous TXA demonstrated a trend toward decreased perioperative blood loss in posterior decompression surgery of spinal metastases with non-hyper vascular tumors.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"951-962"},"PeriodicalIF":2.8,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508384","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":"Retrospective Analysis of Prognostic Factors and Pregnancy Outcomes in Patients with Moderate-to-Severe Intrauterine Adhesions Following Hysteroscopic Adhesiolysis and Modified Intrauterine Stent Intervention.","authors":"Qiao Peng, Chao-Xia Cao, Yi-Nan Chen, Wei-Chu Liu, Rui-Kun Zhao, Quan-Jia Jiang, Qin Zhou","doi":"10.2147/TCRM.S511425","DOIUrl":"10.2147/TCRM.S511425","url":null,"abstract":"<p><strong>Objective: </strong>To assess the clinical prognosis and reproductive outcomes in individuals presenting with moderate-to-severe intrauterine adhesion (IUA) following the administration of hysteroscopic adhesiolysis (HA) in conjunction with modified intrauterine stents.</p><p><strong>Methods: </strong>A cohort comprising 156 individuals diagnosed with IUA (105 with moderate severity and 51 with severe severity) was enrolled. Subsequent to hysteroscopic intervention, all participants received intrauterine stent placement during the immediate postoperative phase. A comprehensive follow-up period of 2 years post-stent removal was instituted.</p><p><strong>Results: </strong>The occurrence of adhesion recurrence increased progressively, demonstrating a recurrence rate of 11.54% at hysteroscopic reevaluation administrated in 3 months after surgery and surging to 32.69% during the 2-year follow-up period. Comparative analysis indicated a statistically significant reduction in recurrence rates among patients with moderate IUA compared to severe IUA (P < 0.05). The median duration of stent placement was determined to be 4 months. Postoperatively, patients exhibited a cumulative pregnancy rate of 71.79%, with a live birth rate of 79.28%. Significantly, patients with moderate IUA exhibited a significantly elevated pregnancy rate in comparison to those with severe IUA (P = 0.004). Multifactorial logistic regression analysis revealed that the severity of IUA was an independent risk factor for recurrence risk. Furthermore, the severity of IUA and postoperative re-adhesion emerged as contributory factors to the infertility observed in these patients.</p><p><strong>Conclusion: </strong>The combination of HA with a modified intrauterine stent demonstrates efficacy in the treatment of IUA; however, outcomes remain suboptimal for cases characterized by severity. The prognostic assessment of patients and the suggested criteria for the removal of intrauterine stents, as delineated in the study, are considered both feasible and recommendable for clinical practice. Furthermore, conscientious and attentive management is imperative for the mitigation of adverse pregnancy such as early pregnancy loss in individuals afflicted with IUA during pregnancy.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"929-939"},"PeriodicalIF":2.8,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12191175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498022","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":"A Retrospective Study on the Effect of STA Anesthesia Technique in the Extraction of Impacted Teeth in Dental Outpatients and Its Impact on Patient Anxiety Levels.","authors":"Jie Xu, Junsen Su, Guangfeng Liu, Wanggui Ying, Fang Yuan","doi":"10.2147/TCRM.S523718","DOIUrl":"10.2147/TCRM.S523718","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the effect of the Single Tooth Anesthesia (STA) technique in dental outpatient patients undergoing the extraction of impacted teeth and its impact on patient anxiety levels.</p><p><strong>Methods: </strong>This retrospective study included clinical data from 130 patients who underwent the extraction of a single mandibular impacted tooth in our dental outpatient department between April 2022 and June 2024. According to the anesthesia method, patients were divided into two groups: the Traditional Group (n = 65, receiving traditional local injection anesthesia) and the STA Group (n = 65, receiving Single Tooth Anesthesia). Parameters including intraoperative bleeding, duration of anesthesia, extent of anesthetic infiltration, blood pressure [systolic blood pressure (SBP), diastolic blood pressure (DBP)], heart rate (HR), pain [visual analog scale (VAS)], compliance (Frankl treatment compliance scale), tolerance (Houpt behavior scale), and anxiety level [modified dental anxiety scale (MDAS)] were compared between the two groups.</p><p><strong>Results: </strong>There were no significant differences in the amount of bleeding, anesthesia duration, or infiltration range between the two groups (P > 0.05). In the Traditional Group, SBP at 3 minutes after anesthesia and post-extraction was significantly higher than before anesthesia (P < 0.05), whereas DBP and HR showed no significant changes (P > 0.05). In the STA Group, SBP, DBP, and HR remained stable across the three time points (P > 0.05). Compared with the Traditional Group, the STA Group showed significantly lower pain scores, reduced anxiety, and higher rates of treatment compliance and tolerance (P < 0.05).</p><p><strong>Conclusion: </strong>Within the limitations of this retrospective study, the STA anesthesia technique showed advantages over traditional local injection anesthesia in reducing pain and anxiety, while improving compliance and tolerance during impacted tooth extraction in dental outpatients.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"941-950"},"PeriodicalIF":2.8,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12191143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498071","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":"Impact of Onset-to-Needle Time on the Risk of Early Neurological Deterioration in Patients with Acute Ischemic Stroke Receiving Intravenous Thrombolysis.","authors":"Bo Hu, Jiewei Hua","doi":"10.2147/TCRM.S515542","DOIUrl":"10.2147/TCRM.S515542","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the influence of onset-to-needle time (ONT) on early neurological deterioration (END) in patients with acute ischemic stroke (AIS) undergoing intravenous thrombolysis.</p><p><strong>Methods: </strong>Patients with AIS receiving intravenous thrombolysis at The Fifth Hospital of Wuhan between March 2021 and December 2023 were enrolled. Patients were divided into an END group (n=104) and a non-END group (n=317) based on a National Institutes of Health Stroke Scale (NIHSS) score increase of ≥4 points within 24 hours. Baseline and clinical data were analyzed using univariate, multivariable logistic regression, and subgroup analyses. A logistic regression model was developed to predict END, and its performance was assessed using receiver operating characteristic (ROC) curves.</p><p><strong>Results: </strong>Univariate analysis revealed significant differences between groups in age, total cholesterol, low-density lipoprotein cholesterol (LDL-C), lipoprotein-associated phospholipase A2 (Lp-PLA2), white blood cell count, activated partial thromboplastin time (APTT), pre-admission NIHSS score, and ONT (all P<0.05). Heart disease history, infarct location, and Trial of ORG 10172 in Acute Stroke Treatment (TOAST) classification also differed significantly (all P<0.05). Multivariable analysis identified age (Odds Ratio [OR]=1.098, 95% Confidence Interval [CI]: 1.031-1.169, P=0.003), LDL-C (OR=2.785, 95% CI: 1.360-5.710, P=0.005), Lp-PLA2 (OR=1.008, 95% CI: 1.001-1.015, P=0.045), complete anterior circulation infarction (vs lacunar; OR=8.050, 95% CI: 5.180-12.510, P=0.023), cardioembolic stroke (vs small vessel occlusion; OR=12.810, 95% CI: 8.420-19.530, P=0.002), and ONT (OR=1.015, 95% CI: 1.002-1.028, P=0.028) as independent risk factors for END. Subgroup analysis by admission NIHSS score showed that for moderate and severe strokes, each minute increase in ONT raised END risk by 1.5% (95% CI: 1.002-1.028, P=0.031) and 3.0% (95% CI: 1.009-1.052, P=0.005), respectively.</p><p><strong>Conclusion: </strong>Prolonged ONT is an independent risk factor for END in AIS patients, particularly those with moderate to severe strokes. Prompt thrombolysis is crucial for mitigating neurological decline.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"917-927"},"PeriodicalIF":2.8,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12184684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476755","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":"AI-Assisted 3D Planning of CT Parameters for Personalized Femoral Prosthesis Selection in Total Hip Arthroplasty.","authors":"Tian-Jiao Yang, Wei Qian","doi":"10.2147/TCRM.S521755","DOIUrl":"10.2147/TCRM.S521755","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the efficacy of CT measurement parameters combined with AI-assisted 3D planning for personalized femoral prosthesis selection in total hip arthroplasty (THA).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on clinical data from 247 patients with unilateral hip or knee joint disorders treated at Renmin Hospital of Hubei University of Medicine between April 2021 and February 2024. All patients underwent preoperative full-pelvis and bilateral full-length femoral CT scans. The raw CT data were imported into Mimics 19.0 software to reconstruct a three-dimensional (3D) model of the healthy femur. Using 3-matic Research 11.0 software, the femoral head rotation center was located, and parameters including femoral head diameter (FHD), femoral neck length (FNL), femoral neck-shaft angle (FNSA), femoral offset (FO), femoral neck anteversion angle (FNAA), tip-apex distance (TAD), and tip-apex angle (TAA) were measured. AI-assisted THA 3D planning system AIJOINT V1.0.0.0 software was used for preoperative planning and design, enabling personalized selection of femoral prostheses with varying neck-shaft angles and surgical simulation. Groups were compared by gender, age, and parameters. ROC curves evaluated prediction efficacy.</p><p><strong>Results: </strong>Females exhibited smaller FHD, FNL, FO, TAD, TAA but larger FNSA/FNAA vs males (P<0.05). Patients >65 years had higher FO, TAD, TAA (P<0.05). TAD-TAA correlation was strong (r=0.954), while FNSA negatively correlated with TAD/TAA (r=-0.773/-0.701). ROC analysis demonstrated high predictive accuracy: TAD (AUC=0.891, sensitivity=91.7%, specificity=87.6%) and TAA (AUC=0.882, sensitivity=100%, specificity=88.8%).</p><p><strong>Conclusion: </strong>CT parameters (TAA, TAD, FNSA, FO) are interrelated and effective predictors for femoral prosthesis selection. Integration with AI-assisted planning optimizes personalized THA, reducing biomechanical mismatch risks.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"905-916"},"PeriodicalIF":2.8,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476754","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}