Therapeutics and Clinical Risk Management最新文献

{"title":"Ultrasound Assessment of Preoperative Gastric Contents for Predicting Aspiration Risk in Surgical Patients: A Scoping Review and Future Directions.","authors":"Yuzhou Li, Li Tang, Shuying Zou, Xiangnan Zhu, Bo Zhang, Caixia Xie","doi":"10.2147/TCRM.S570929","DOIUrl":"10.2147/TCRM.S570929","url":null,"abstract":"<p><strong>Introduction: </strong>This scoping review aims to summarise studies evaluating gastric contents in surgical patients using preoperative ultrasound, discuss current challenges, and propose future directions.</p><p><strong>Methods: </strong>The system retrieved data from 8 databases, including PubMed, with a search period spanning from the inception to May 11, 2025. The scoping review follows the JBI scoping review framework and the PRISMA-ScR reporting guidelines.</p><p><strong>Results: </strong>A total of 44 studies were included. The research involved various perioperative populations and surgical procedures, with a \"full stomach\" rate ranging from 0% to 57.7%. Ultrasound operators included anesthesiologists, sonographers, and medical consultants. Assessment methods comprised qualitative, quantitative, or combined approaches. Evaluation metrics included gastric contents nature, Perlas 3-point grading system, gastric antral cross-sectional area (CSA), and gastric volume.</p><p><strong>Conclusion: </strong>Preoperative gastric ultrasound can provide information about gastric contents, thereby aiding in the identification of aspiration risk and enabling the adoption of appropriate anaesthesia strategies. However, existing studies still face limitations, including restricted study populations and sample sizes, variations in operator training, a lack of consensus on an evaluation metric threshold value, and diverse gastric volume calculation models. Future studies should expand their scale, enhance training for clinicians in gastric ultrasound, and standardise assessment positions, threshold values, and selection criteria for calculation models. Furthermore, we believe that integrating artificial intelligence with gastric ultrasound can overcome the limitations of manual measurement, offering a direction for precise and convenient preoperative assessment of gastric contents.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"22 ","pages":"570929"},"PeriodicalIF":2.6,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12998681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147487314","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":"Clinical Outcomes and Safety of Ureteral Catheter-Assisted Antegrade Guidewire Intubation in the Laparoscopic-Endoscopic Rendezvous Procedure for Cholelithiasis with Choledocholithiasis: A Retrospective Cohort Study.","authors":"Binyao Shi, Jiayuan Feng, Peng Hu, Shangdong Lv, Binfeng Wang, Qi Wang, Zheping Fang, Aidong Wang, Wenlong Zhang, Fabiao Zhang","doi":"10.2147/TCRM.S569440","DOIUrl":"10.2147/TCRM.S569440","url":null,"abstract":"<p><strong>Background and purpose: </strong>The laparoscopic-endoscopic rendezvous procedure, which integrates laparoscopic cholecystectomy with intraoperative endoscopic retrograde cholangiopancreatography (ERCP), is an established therapeutic strategy for patients with cholelithiasis and concomitant choledocholithiasis. This study evaluated the impact of ureteral catheter-assisted antegrade guidewire intubation on the procedural success rate and duration of the rendezvous technique, with additional assessment of safety and clinical efficacy.</p><p><strong>Methods: </strong>Clinical data were retrospectively analyzed from patients with cholelithiasis and concomitant choledocholithiasis who underwent laparoscopic cholecystectomy at the South Campus of Taizhou Hospital (Enze Hospital), Zhejiang Province, between May 2019 and December 2022. A total of 116 patients were assigned to either a control group or an intervention group in which ureteral catheter-assisted guidewire insertion was employed.</p><p><strong>Results: </strong>The success rate of antegrade guidewire intubation was 98.3% in the intervention group, compared to 91.2% in the control group. The intervention group demonstrated a statistically significant reduction in guidewire insertion time (<i>p</i> < 0.05). No statistically significant differences were observed between groups in terms of intraoperative hospitalization costs, total hospitalization duration, postoperative serum amylase levels or postoperative hospitalization duration (<i>p</i> > 0.05). The total operative duration tended to be lower but did not reach statistical significance in the intervention group compared to the control group, with a p-value of 0.054. No cases of postoperative bile leakage were reported. In the control group, the incidence of acute pancreatitis was 2%, and the incidence of hyperamylasemia was 28.8%. In the intervention group, hyperamylasemia occurred in 25.9% of cases, with no reported instances of acute pancreatitis. Additionally, one patient in the control group developed a pulmonary embolism, and two patients developed ascites accompanied by fever.</p><p><strong>Conclusion: </strong>The use of ureteral catheter-assisted antegrade guidewire intubation during the laparoscopic-endoscopic rendezvous procedure appears to be a safe and clinically effective approach for managing cholelithiasis and concomitant choledocholithiasis. This technique is associated with a high success rate of guidewire realignment, reduced procedural duration, and a lower incidence of procedure-related complications.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"22 ","pages":"569440"},"PeriodicalIF":2.6,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12998649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147487382","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 Narrative Review and Risk-Stratification Framework for Preventing LNG-IUS Expulsion in Adenomyosis.","authors":"Jin Zhao, Jianliang Chen, Xiaoe Wang, Huabin Wang","doi":"10.2147/TCRM.S566786","DOIUrl":"10.2147/TCRM.S566786","url":null,"abstract":"<p><p>Levonorgestrel-releasing intrauterine system (LNG-IUS) expulsion rates are markedly elevated (15-37.5%) in patients with adenomyosis compared to those with normal uteri (3-10%), significantly compromising treatment efficacy and adherence. Existing evidence on risk factor mitigation is fragmented, lacking a structured management framework. This narrative review synthesizes current literature to identify key determinants of expulsion-including uterine enlargement, intracavitary lesions, and insertion techniques-and evaluates preventive strategies such as GnRH-agonist pretreatment and imaging-guided placement. Its primary aim is to propose a novel, three-tiered risk-stratification model that tailors management (conventional, augmented, or advanced fixation approaches) to individual patient profiles based on anatomical, procedural, and clinical factors. This structured approach seeks to optimize LNG-IUS retention and resource allocation. Prospective validation through randomized controlled trials remains essential to establish evidence-based, personalized protocols.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"22 ","pages":"566786"},"PeriodicalIF":2.6,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12998664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147487354","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":"Prehospital Tranexamic Acid Combined with Blood Transfusion Reduced the Short-Term Mortality Risk in Trauma Patients at Risk for Hemorrhage.","authors":"Zheng Qian, Bining Yang","doi":"10.2147/TCRM.S564232","DOIUrl":"10.2147/TCRM.S564232","url":null,"abstract":"<p><strong>Background: </strong>Hemorrhage is a leading cause of preventable death in trauma. While both blood transfusion and tranexamic acid (TXA) improve outcomes, the combined effect of prehospital TXA and transfusion remains uncertain. This study aims to evaluate the impact of prehospital TXA combined with blood transfusion on short-term mortality in trauma patients at risk for hemorrhage.</p><p><strong>Methods: </strong>We performed a retrospective cohort study of 408 adult trauma patients at risk for hemorrhage admitted between 2018 and 2023. Patients were grouped into transfusion only (n=240) or prehospital TXA plus transfusion (n=168). The primary outcome was 30-day mortality. Secondary outcomes included 24-hour mortality, transfusion requirements, multiple organ failure (MOF), and venous thromboembolism (VTE).</p><p><strong>Results: </strong>Compared with transfusion alone, prehospital TXA plus transfusion significantly reduced 30-day mortality (14.3% vs 31.3%, p<0.01) and 24-hour mortality (6.0% vs 19.6%, p<0.01). The TXA group also had lower MOF incidence (14.3% vs 28.7%, p<0.01) and required less plasma and crystalloid resuscitation, without an increase in VTE (p=0.17). Kaplan-Meier analysis confirmed a survival advantage (log-rank p<0.01), and multivariate Cox regression identified combination therapy as an independent predictor of reduced 30-day mortality (HR=2.16, 95% CI: 1.35-3.46, p<0.01).</p><p><strong>Conclusion: </strong>Prehospital TXA combined with transfusion significantly improves short-term survival and reduces organ failure in bleeding trauma patients, without increasing thromboembolic risk. These findings support early integration of TXA into prehospital transfusion protocols.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"1915-1921"},"PeriodicalIF":2.8,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12766115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145912740","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":"Safety and Efficacy of Intra-Osseous versus Intravenous Vascular Access for Out-of-Hospital Cardiac Arrest: A Systematic Review and Meta-Analysis.","authors":"Mengjie Cai, Yu Dai","doi":"10.2147/TCRM.S549510","DOIUrl":"10.2147/TCRM.S549510","url":null,"abstract":"<p><strong>Background: </strong>The immediate administration of drugs and fluids is critical for successful resuscitation in out-of-hospital cardiac arrest (OHCA). Vascular access selection plays a pivotal role in ensuring timely delivery of therapeutic interventions during OHCA management. This study aims to compare the safety and efficacy of intraosseous (IO) and intravenous (IV) access in OHCA management.</p><p><strong>Methods: </strong>We conducted a comprehensive search of PubMed, EMbase, Google Scholar, and the Cochrane Library databases to identify studies published up to February 20th, 2025, evaluating IO and IV access in OHCA patients. The outcomes of interest included return of spontaneous circulation (ROSC), survival from hospital admission to discharge, neurological outcome, comorbidities, and access time.</p><p><strong>Results: </strong>Twenty-three studies, comprising 48945 cases of IO access and 188966 cases of IV access for OHCA management, were included. Overall, the rate of favorable neurological outcome was similar between patients with IO and IV access (odds ratio [OR] = 0.73; 95% confidence interval [CI] = 0.37 to 1.45, I²=95.3%). IO access was associated with significantly lower odds of shockable rhythms in both adult (OR = 0.77; 95% CI = 0.70 to 0.85, I²=86%) and pediatric (OR = 0.20; 95% CI = 0.12 to 0.33) patients. Additionally, IO access was linked to a lower rate of ROSC in pediatric OHCA patients (OR = 0.30; 95% CI = 0.21 to 0.42). Prospective studies and those with unadjusted time to intervention analysis demonstrated markedly lower rates of survival at discharge, favorable neurological outcome, and ROSC in the IO group compared to the IV group. It should also be noted that the interpretation of the results should take into account the high heterogeneity and potential biases, despite the corresponding subgroup analyses we conducted.</p><p><strong>Conclusion: </strong>In OHCA management, IO access may be associated with less favorable outcomes in terms of survival, neurological function, and ROSC compared to IV access. Further research is needed to address limitations and provide more robust evidence regarding the comparative effectiveness of intraosseous and intravenous access in this clinical setting.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"1887-1903"},"PeriodicalIF":2.8,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12764207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145901088","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":"Safety and Efficacy Comparison of Ticagrelor versus Other P2Y12 Inhibitors in Combination with Oral Anticoagulants as a Part of DAPT/SAPT in Patients with Concomitant Atrial Fibrillation and Coronary Artery Disease: A Meta-Analysis.","authors":"Yang Li, Jing Gong, Naifeng Liu","doi":"10.2147/TCRM.S575007","DOIUrl":"10.2147/TCRM.S575007","url":null,"abstract":"<p><strong>Objective: </strong>We performed a meta-analysis of randomized controlled trials to assess the safety and efficacy of ticagrelor or other P2Y12 inhibitors in combination with oral anticoagulants as a part of DAPT/SAPT for the patients with atrial fibrillation (AF) and acute coronary disease (ACS) or undergoing percutaneous coronary intervention (PCI).</p><p><strong>Methods: </strong>We searched PubMed, Web of Science and ClinicalTrials.gov for randomized controlled trials (published from January 1, 1998, up to June 6, 2023; no language restrictions) comparing safety and efficacy of ticagrelor and DOACs or VKAs combination treatment arm with or without aspirin to other P2Y12 inhibitors treatment strategies. Main endpoints were clinically relevant bleeding as safety outcomes, all-cause mortality, and major adverse cardiovascular events (MACE) as efficacy outcomes.</p><p><strong>Results: </strong>Of 248 identified studies, 3 were eligible and were included in our analysis (N= 9463 participants). Ticagrelor and DOAC or VKA combination treatment with or without aspirin strategy was associated with an increased rate of bleeding compared with clopidogrel (odds ratio [OR] 1.39, 95% CI 1.15 to 1.67, I²=0%). MACE was similar between ticagrelor versus clopidogrel (OR 1.00, 95% CI 0.54 to 1.86, I²=68.1%) and between ticagrelor versus prasugrel (OR 0.86, 95% CI 0.28 to 2.65, I²=0%).</p><p><strong>Conclusion: </strong>The use of ticagrelor is associated with significantly higher rates of bleeding when compared with clopidogrel in patients with concomitant atrial fibrillation and coronary artery disease.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"1905-1913"},"PeriodicalIF":2.8,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12765707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145912690","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":"Electroacupuncture as a Non-Pharmacological Intervention for Nicotine Dependence: Evidence from a Randomized Clinical Trial.","authors":"Zhen Lai, Qian Fan, Ai Ling Lee, Xujing Yao, Ranran Dai, Yan Liang","doi":"10.2147/TCRM.S565463","DOIUrl":"10.2147/TCRM.S565463","url":null,"abstract":"<p><p>Nicotine dependence, a chronic addictive disorder characterized by high relapse rates, represents a significant global public health challenge. This study employed a randomized, single-blind, parallel-group controlled design to systematically evaluate the efficacy and safety of electroacupuncture compared with varenicline in the treatment of nicotine dependence. The results demonstrated that electroacupuncture achieved significantly superior outcomes across multiple key outcome measures relative to varenicline: the electroacupuncture group exhibited a greater mean daily reduction in Fagerström Test for Nicotine Dependence (FTND) scores (-1.11 points/day vs -0.33 points/day, P < 0.001) and a higher rate of sustained improvement at the 3-month follow-up (84.4% vs 69.5%). With respect to the Heaviness of Smoking Index (HSI), the electroacupuncture group showed a more rapid and sustained decline (sustained rate: 81.7% vs 63.9%, P = 0.002). Moreover, electroacupuncture demonstrated significant advantages in alleviating nicotine withdrawal symptoms (sustained rate: 75.3% vs 52.8%, P = 0.026) and reducing daily cigarette consumption (79.0% vs 56.2%, P < 0.001). The potential mechanism may involve modulation of the mesolimbic dopamine system. These findings support electroacupuncture as a safe, effective, and sustainable non-pharmacological intervention for smoking cessation, particularly suitable for individuals with high nicotine dependence who are sensitive to adverse drug reactions or exhibit poor medication adherence, and suggest its potential role as a complementary or alternative strategy in clinical smoking cessation programs. Future research should further validate its long-term efficacy and investigate the neurobiological mechanisms underlying its effects on relapse prevention.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"1869-1885"},"PeriodicalIF":2.8,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12764299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145901128","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":"Free Skin Anterolateral Thigh Flap and Vacuum-Assisted Closure Therapy for Reconstruction of Snakebite-Induced Complex Hand Defects.","authors":"Phan Tuấn Nghĩa, Trần Thiết Sơn, Tạ Thị Hồng Thúy, Nguyễn Hữu Trọng, Đặng Phương Nam","doi":"10.2147/TCRM.S560853","DOIUrl":"10.2147/TCRM.S560853","url":null,"abstract":"<p><strong>Introduction: </strong>Cobra (<i>Naja</i> species) envenomation in tropical regions like Vietnam frequently leads to severe hand tissue necrosis, creating complex defects that challenge conventional reconstruction. This study evaluates a staged approach combining vacuum-assisted closure (VAC) therapy with free anterolateral thigh (ALT) flap for these challenging injuries.</p><p><strong>Methods: </strong>Eleven patients with extensive hand defects involving skin and/or tendon due to cobra envenomation were included. Following surgical debridement, VAC therapy was applied to prepare the wound bed. Subsequently, definitive reconstruction was performed using tailored ALT flaps, which included fasciocutaneous or thinned configurations depending on defect complexity. Postoperative evaluation included flap viability, range of motion (ROM), and complication assessment.</p><p><strong>Results: </strong>The mean duration of VAC therapy was 11.5 ± 4.2 days. Eleven ALT flaps with an average dimension of 14.5×7.0 cm were harvested. Flap thinning was performed in eight cases (72.7%), achieving a mean final thickness of 4.6 ± 1.3 mm. Eight flaps (72.7%) were used to cover defects spanning both digital and dorsal or palmar subunits. Over a mean follow-up of 15.3 months, patients with digital reconstruction achieved a functional ROM at the metacarpophalangeal joint, with 0° of extension and up to 60° of flexion. The main issue was flap bulkiness; no donor-site morbidity was observed.</p><p><strong>Conclusion: </strong>A staged approach combining VAC therapy for wound bed preparation and subsequent reconstruction with a free ALT flap is a safe and effective strategy for managing complex hand defects resulting from cobra bites. This method facilitates optimal wound conditions and provides versatile, well-vascularized tissue coverage, thereby promoting functional hand recovery.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"1847-1853"},"PeriodicalIF":2.8,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12751279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145879115","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 Evaluation of 11 Prognostic Scores for Atrial Fibrillation Recurrence After Pulmonary Vein Isolation in Non-Paroxysmal AF: A Retrospective Comparative Analysis.","authors":"Lin-Xin Guan, Xue-Hai Chen, Zhe Xu, Ke-Zeng Gong, Fei-Long Zhang","doi":"10.2147/TCRM.S563768","DOIUrl":"10.2147/TCRM.S563768","url":null,"abstract":"<p><strong>Objective: </strong>Pulmonary vein isolation (PVI) remains the cornerstone of catheter ablation for atrial fibrillation (AF); however, a substantial proportion of patients with non-paroxysmal AF (non-PAF) experience recurrence following ablation. With numerous prognostic models available to predict recurrence, the aim of this study is to compare the predictive performance of multiple scoring systems in patients with non-PAF undergoing PVI as a standalone procedure.</p><p><strong>Methods: </strong>A retrospective analysis was conducted involving 166 patients with non-PAF (22.3% female; mean age 60 ± 9 years) who underwent initial PVI alone. Clinical data, including transthoracic echocardiography and either cardiac computed tomography or transesophageal echocardiography, were collected. The evaluated prognostic scoring systems included APPLE, BASE-AF₂, C₂HEST, CAAP-AF, CHA₂DS₂-VASc, CHADS₂, DR-FLASH, HATCH, MB-LATER, PAT₂C₂H, and SCALE-CryoAF.</p><p><strong>Results: </strong>Recurrence of AF following a 90-day blanking period was observed in 41 individuals (24.7%), including 24 (51.8%) in the cryo-balloon ablation (CBA) subgroup and 17 (48.2%) in the radiofrequency catheter ablation (RFCA) subgroup. Among the evaluated models, BASE-AF₂ (AUC = 0.666, 95% CI: 0.572-0.759, <i>p</i> = 0.001), MB-LATER (AUC = 0.734, 95% CI: 0.646-0.821, <i>p</i> < 0.001), and SCALE-CryoAF (AUC = 0.702, 95% CI: 0.600-0.804, <i>p</i> < 0.001) demonstrated superior prognostic performance for recurrence. After propensity score matching, MB-LATER (AUC = 0.734, 95% CI: 0.570-0.899, <i>p</i> = 0.019) was identified as the most effective predictor of recurrence in the CBA subgroup, while BASE-AF₂ (AUC = 0.758, 95% CI: 0.578-0.937, <i>p</i> = 0.013) indicated superior predictive accuracy in the RFCA subgroup.</p><p><strong>Conclusion: </strong>The BASE-AF2, MB-LATER, and SCALE-CryoAF scoring systems demonstrated enhanced prognostic use for predicting AF recurrence following PVI alone in patients with non-PAF. MB-LATER exhibited superior performance in those treated with CBA, while BASE-AF2 was more predictive for those who underwent RFCA.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"1833-1845"},"PeriodicalIF":2.8,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12752111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145879152","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":"<i>Helicobacter pylori</i> Eradication: Why Recurrence Risk Should Not Dictate Treatment Decisions.","authors":"Xinglan Chen, Yuanyuan Wang, Yeze Dong, Jinxia Yang, Baoyuan Xie, Dekui Zhang","doi":"10.2147/TCRM.S566086","DOIUrl":"10.2147/TCRM.S566086","url":null,"abstract":"<p><p><i>Helicobacter pylori</i> infection is unequivocally associated with the development and progression of various digestive diseases. Clinical guidelines recommend eradication therapy for all eligible patients without contraindications. However, reports of high recurrence rates in earlier studies have raised concerns among clinicians and patients regarding the necessity of treatment, which has, to some extent, hindered the timely implementation of eradication strategies. This article provides a systematic review of the issue of <i>H. pylori</i> recurrence. A comprehensive analysis of literature retrieved from major databases such as PubMed, Web of Science, and Google Scholar, using keywords including \"Helicobacter pylori\", \"recurrence\", and \"reinfection\", indicates that the annual recurrence rate is significantly lower than previously thought, with modern epidemiological estimates ranging from 1.5% to 5.0%. The review further elucidates the underlying mechanisms of recurrence, identifies key modifiable risk factors, and highlights that optimizing eradication regimens and preventing intrafamilial transmission are central strategies for controlling recurrence. The conclusion emphasizes that concerns about recurrence should not preclude eradication therapy and offers a theoretical basis and practical directions for developing targeted prevention strategies in clinical practice.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"1855-1867"},"PeriodicalIF":2.6,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12751280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145879187","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}