Brazilian Journal of Anesthesiology最新文献

{"title":"Evolution of patients with chronic pain undergoing standard treatment: a prospective longitudinal follow-up study","authors":"Camila Cavalcante Castro ,&nbsp;Sandro Max C. Silva ,&nbsp;Martha Moreira C. Castro ,&nbsp;Durval Campos Kraychete ,&nbsp;Carla Daltro","doi":"10.1016/j.bjane.2025.844700","DOIUrl":"10.1016/j.bjane.2025.844700","url":null,"abstract":"<div><h3>Introduction</h3><div>Chronic pain greatly affects quality of life and, consequently, impacts the psychological state, a condition that needs to be addressed. A 30% reduction in pain intensity is clinically significant. The objective of this study was to describe the clinical and psychological aspects of individuals with chronic pain undergoing standard treatment.</div></div><div><h3>Methods</h3><div>Descriptive longitudinal study involving individuals with chronic pain undergoing treatment at the Pain Outpatient Clinic of the Federal University of Bahia, in Salvador, Bahia, between June 2016 and December 2017. The variables studied were pain intensity, quality of life, sleep disorders, stress level, and the presence of anxiety and depression symptoms. Descriptive statistics were performed, and Student's t-test, and Fisher's Chi-Square test were used to compare the groups.</div></div><div><h3>Results</h3><div>We studied 134 individuals with a mean (standard deviation) age of 50 (10) years, 89.6% of whom were female. There was an improvement in quality of life and sleep, anxiety and depressive symptoms, and 58.2% of patients showed a 30% reduction in pain intensity. Among the factors associated with pain reduction, having a partner was a significant factor (73.7% vs. 52.1%; p = 0.030). However, symptoms of anxiety (81.6% vs. 75.0%; p = 0.436), symptoms of depression (63.2% vs. 58.3%; p = 0.718), and stress (92.1% vs. 87.5%; p = 0.846) were not associated with pain reduction.</div></div><div><h3>Conclusion</h3><div>This study suggests that multidisciplinary treatment can reduce pain intensity in chronically affected patients, as most patients exhibited a clinically significant response, accompanied by global improvement.</div></div>","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":"76 1","pages":"Article 844700"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145440271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of intravenous dexmedetomidine on sensory block duration in spinal anesthesia for lower limb surgery: a randomized controlled trial","authors":"Simran Chahal,&nbsp;Anju R. Bhalotra,&nbsp;Rahil Singh,&nbsp;Shweta Dhiman,&nbsp;Snigdha Singh","doi":"10.1016/j.bjane.2025.844672","DOIUrl":"10.1016/j.bjane.2025.844672","url":null,"abstract":"<div><h3>Study objective</h3><div>To study the effect of Intravenous (IV) dexmedetomidine during spinal anesthesia on duration of sensory block and postoperative analgesia in patients undergoing lower limb orthopedic surgery.</div></div><div><h3>Design</h3><div>Prospective randomized double blind controlled trial.</div></div><div><h3>Intervention</h3><div>Patients in intervention (DX) group received 0.5 mcg.kg^-1 IV dexmedetomidine over 10 min. Spinal anesthesia was administered and an infusion of dexmedetomidine 0.5 mcg.kg^-1.h^-1 was given throughout surgery.</div></div><div><h3>Measurements</h3><div>Onset time of sensory and motor block, maximum height of sensory block and duration of sensory and motor block were assessed. Intraoperative Heart Rate (HR), Blood Pressure (BP), Peripheral Oxygen Saturation (SpO₂), sedation scores, postoperative pain scores, time to requirement of first analgesic and analgesic consumption over first 24h were noted.</div></div><div><h3>Results</h3><div>Data of 58 ASA I/II adults was analyzed. Duration of sensory block, defined as time to two-dermatome regression, was 137.03 ± 25.02 min in DX group and 79.45 ± 11.27 min in the NS group (p = 0.000). Onset of sensory and motor block and maximum height of sensory block were similar. Postoperative VAS scores were lower in the DX group at 4h and 24h (p = 0.001, p 0.0001) and comparable at 0h, 8h and 12h. Time to requirement of postoperative analgesia was longer in the DX group (p &lt; 0.001) and requirement of postoperative analgesics was higher in the NS group. Sedation scores and incidence of bradycardia were higher in the DX group, but hypotension was similar.</div></div><div><h3>Conclusion</h3><div>IV dexmedetomidine (0.5 mcg.kg^-1 followed by 0.5 mcg.kg^-1.h^-1) resulted in extended sensory and motor block, prolonged postoperative analgesia and reduced postoperative analgesic consumption with minimal side effects.</div></div>","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":"75 6","pages":"Article 844672"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of pectoserratus plane block versus erector spinae plane block on acute and chronic pain after mastectomy: randomized clinical trial","authors":"Fabrício T. Mendonça,&nbsp;Marcus Alexandre B. de Aviz,&nbsp;Ana Paula S. Bezerra,&nbsp;Lucas G. Silva,&nbsp;Estefane E. Gaspar,&nbsp;Bárbara N. Terol,&nbsp;Lucianna R. e Silva,&nbsp;Liliana M. Andrade","doi":"10.1016/j.bjane.2025.844691","DOIUrl":"10.1016/j.bjane.2025.844691","url":null,"abstract":"<div><h3>Objectives</h3><div>To compare Pectoserratus Plane Block (PSPB) and Erector Spinae Plane (ESP) block regarding perioperative opioid consumption and chronic pain risk among women undergoing elective mastectomy.</div></div><div><h3>Methods</h3><div>Single-blind (patients), randomized (1:1) trial. The primary outcome was the composite measure defined as the use of fentanyl intraoperatively or tramadol postoperatively. Secondary outcomes encompassed intraoperative hemodynamics, short (24h), medium (3 months) and long-term (6 months) postoperative pain intensity and complications.</div></div><div><h3>Results</h3><div>99 patients were randomized (50 in the PSPB group and 49 in the ESP block group). Of these, 93 patients had complete data for the primary outcome. Use of either fentanyl or tramadol was required for 20 of 47 patients (43%) in the PSPB group and 28 of 46 patients (61%) in the ESP block group (Relative Risk [RR] 0.70, 95% Confidence interval [95% CI] 0.47‒1.05, p = 0.09). PSPB-treated patients had a lower risk of tramadol (RR = 0.31, 95% CI 0.12-0.77, p = 0.01) and dipyrone (RR = 0.60, 95% CI 0.39‒0.92, p = 0.02) consumption than ESP block-treated patients. PSPB lowered chronic pain risk at 3 months (RR = 0.66, 95% CI 0.47‒0.92, p = 0.02), with lower scores for the Short-Form McGill Pain Questionnaire (Mean Difference [MD] -2.55, 95% CI -4.31 to -0.78, p = 0.005) and the Douleur Neuropathique 4 Questions questionnaire (MD = -1.08, 95% CI -2.05 to -0.11, p = 0.03). By 6 months, pain outcomes were statistically comparable between groups. Hemodynamic variables and complications were comparable between groups.</div></div><div><h3>Conclusion</h3><div>PSPB and ESP block resulted in similar overall opioid consumption among women undergoing mastectomy. However, PSPB was associated with lower postoperative tramadol consumption.</div></div>","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":"75 6","pages":"Article 844691"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145474134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lateral versus posterior quadratus lumborum block in children undergoing open orchiopexy: a double-blind randomized clinical trial","authors":"Ozgecan P. Zanbak Mutlu,&nbsp;Pinar Kendigelen,&nbsp;Ayse C. Tutuncu","doi":"10.1016/j.bjane.2025.844661","DOIUrl":"10.1016/j.bjane.2025.844661","url":null,"abstract":"<div><h3>Background</h3><div>Quadratus Lumborum Block (QLB) has recently become an effective analgesic regional technique frequently used in abdominal surgeries. However, due to the heterogeneity in studies regarding block approaches, a direct comparison of QLB types is needed. In this double-blind prospective randomized trial, we aimed to compare the effects of lateral and posterior approaches of QLB on pain and analgesic use in children undergoing orchiopexy.</div></div><div><h3>Methods</h3><div>Patients aged 6 months – 12 years undergoing elective unilateral open orchiopexy were included in the study. Patients were randomized into two groups using the closed-envelope method. Lateral or posterior QLB was applied under ultrasonography with 0.4 mL/kg 0.25% bupivacaine for both groups before the surgery. The primary outcome was the assessment of postoperative pain for 24 hours. Analgesic usage, parental satisfaction, and complications were recorded as secondary outcomes.</div></div><div><h3>Results</h3><div>Analyses were conducted on 80 patients. Both study groups achieved clinically adequate analgesia, and no significant pain score distinctions were observed within 24 hours (Total mean scores: FLACC [lateral QLB: 2.86 ± 4.69 vs. posterior QLB: 2.87 ± 3.71, p = 0.466], Wong-Baker [lateral QLB: 0.86 ± 2.03 vs. posterior QLB: 1.24 ± 1.85, p = 0.151]). No significant interaction effect between groups and postoperative time intervals on pain scores was observed (FLACC score p-interaction: 0.425, Wong-Baker score p-interaction: 0.451). There were no statistical differences in the number of patients necessitating intraoperative and postoperative analgesics. Parental satisfaction exhibited similarity between the groups, and no perioperative complications were observed in either group.</div></div><div><h3>Conclusion</h3><div>Lateral and posterior QLB provided similar perioperative analgesia in pediatric patients undergoing orchiopexy.</div></div><div><h3>Clinical trial registration number</h3><div>NCT05056038.</div></div><div><h3>Date of registration</h3><div>02 June 2021.</div></div>","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":"75 6","pages":"Article 844661"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use of ketamine on emergence agitation in children: a systematic review and meta-analysis","authors":"Ka Ting Ng ,&nbsp;Jun Chuen Hui ,&nbsp;Wan Yi Teoh ,&nbsp;Ina Ismiarti Shariffuddin ,&nbsp;Mohd Fitry Zainal Abidin","doi":"10.1016/j.bjane.2025.844675","DOIUrl":"10.1016/j.bjane.2025.844675","url":null,"abstract":"<div><h3>Background</h3><div>Ketamine is believed to reduce the incidence of emergence agitation in children after surgery. However, recent studies reported contradictory findings. Thus, the primary objective of this review and meta-analysis was to investigate the use of ketamine in the reduction of emergence agitation in children undergoing surgery or procedure.</div></div><div><h3>Methods</h3><div>MEDLINE, EMBASE and CENTRAL were systematically searched from their inception date until March 2024. Randomized controlled trials comparing intravenous ketamine and placebo in children were sought. Observational studies, editorial letters or case reports were excluded.</div></div><div><h3>Results</h3><div>Seventeen studies (1515 patients) were included. Children who received ketamine were reported to have a significantly lower incidence of emergence agitation (OR = 0.27, 95% Confidence Interval: 0.16 to 0.45, <em>p</em> &lt; 0.00001, I² = 61%, certainty of evidence: very low). As compared to placebo, the ketamine group had a significantly lower postoperative pain score (MD = -2.28, 95% Confidence Interval -3.68 to -0.87, <em>p</em> = 0.001, I² = 91%, certainty of evidence: very low). However, no significant differences were observed in the incidence of postoperative nausea and vomiting, desaturation, and laryngospasm.</div></div><div><h3>Conclusion</h3><div>This meta-analysis highlights the potential benefits of ketamine in the reduction of emergence agitation in children undergoing surgery or diagnostic procedures. However, high degrees of heterogeneity and low certainty of evidence limit the recommendations of the routine use of ketamine in the prevention of emergence agitation in children. Further high-quality randomized controlled trials are warranted before routine use can be recommended.</div></div><div><h3>PROSPERO registration</h3><div>CRD42024523680.</div></div>","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":"75 6","pages":"Article 844675"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The venous sympathetic block in chronic pain practice: absence of evidence, presence of use?","authors":"Hugo Muscelli Alecrim","doi":"10.1016/j.bjane.2025.844666","DOIUrl":"10.1016/j.bjane.2025.844666","url":null,"abstract":"","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":"75 6","pages":"Article 844666"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective review of spinal magnetic resonance images to determine the margin of safety for epidural analgesia in pediatric patients","authors":"Noah Letofsky ,&nbsp;Dana Archibald ,&nbsp;Anthony M.-H. Ho ,&nbsp;Lais Helena N. e Lima ,&nbsp;Rodrigo M. e Lima ,&nbsp;Vinicius C. Quintão ,&nbsp;Fernando B. Cançado ,&nbsp;Ricardo V. Carlos ,&nbsp;Leopoldo M. da Silva ,&nbsp;Fernando N. Bellicieri ,&nbsp;Saullo Q. Silveira ,&nbsp;Arvin Haghighat ,&nbsp;Rachel Phelan ,&nbsp;Glenio B. Mizubuti","doi":"10.1016/j.bjane.2025.844687","DOIUrl":"10.1016/j.bjane.2025.844687","url":null,"abstract":"<div><h3>Background</h3><div>Deeply sedated children cannot provide feedback if an epidural needle traumatizes the Spinal Cord (SC). Knowing relevant structure depths may, therefore, improve safety. We aimed to determine the epidural margin of safety, i.e., distances from the Ligamentum Flavum (LF) and from the dura mater to the SC in pediatric patients measured (i) Perpendicular to the SC and (ii) Parallel to the spinous process (to approximate needle trajectory).</div></div><div><h3>Methods</h3><div>Retrospective review of pediatric (0‒12 years-old) T2-weighted sagittal MRI spine scans without spinal pathology. Three investigators independently measured distances from the ventral edge of the LF, and from the ventral edge of the dura mater to the SC at T5/T6, T9/T10, and L1/L2. All measurements were taken perpendicular to the SC and parallel to the angle of the spinous process of the inferior vertebra.</div></div><div><h3>Results</h3><div>111 MRI scans [52 females, 0.08‒12 (median 7) years-old] were analyzed. The conus medullaris was identified superior to the L1 vertebra in 47 scans, requiring L1/L2 measurement exclusion. When all ages were combined, the largest median (range) depth [dura-mater–SC = 4.87 (2.30‒10.30) mm, LF–SC = 8.10 (4.57‒12.53) mm, measured perpendicular to the SC; and dura-mater–SC = 8.20 (3.75‒19.57) mm; LF–SC = 13.40 (5.50‒39.77) mm, measured at the angle parallel to the inferior spinous process] was at T5/T6.</div></div><div><h3>Conclusion</h3><div>Our results suggest that the margin of safety (dura-mater–SC distance and LF–SC distance) for performing epidurals in children may be greatest at the mid-thoracic spinal region. The measured ranges were very wide. Further studies are warranted to validate these findings in pediatric patients with other relevant “epidural placement” positions.</div></div>","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":"75 6","pages":"Article 844687"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145330858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing pediatric surgical analgesia: recent trends in regional anesthesia","authors":"Mariana Fontes Lima Neville ,&nbsp;Vinícius Caldeira Quintão ,&nbsp;John Hagen ,&nbsp;Liana Maria Torres de Araújo Azi","doi":"10.1016/j.bjane.2025.844695","DOIUrl":"10.1016/j.bjane.2025.844695","url":null,"abstract":"","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":"75 6","pages":"Article 844695"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145473673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative microcirculatory monitoring using handheld video microscopy: a proof-of-concept observation","authors":"Rafael M. Linhares ,&nbsp;Eduardo Tibiriça","doi":"10.1016/j.bjane.2025.844660","DOIUrl":"10.1016/j.bjane.2025.844660","url":null,"abstract":"","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":"75 6","pages":"Article 844660"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Respiratory outcomes of adrenergic beta-antagonists in patients undergoing tracheal extubation: a systematic review and meta-analysis of randomized controlled trials","authors":"Lucas Cael Azevedo Ramos Bendaham ,&nbsp;Altair Pereira de Melo Neto ,&nbsp;Hilária Saugo Faria ,&nbsp;André Richard da Silva Oliveira Filho ,&nbsp;Carlos Henrique de Oliveira Ferreira ,&nbsp;Marcela da Silva Kazitani Cunha ,&nbsp;Victor Gonçalves Soares ,&nbsp;Ocílio Ribeiro Gonçalves ,&nbsp;Milene Vitória Sampaio Sobral ,&nbsp;Mohamed Doma ,&nbsp;Denis Maltz Grutcki ,&nbsp;Fabrício Tavares Mendonça","doi":"10.1016/j.bjane.2025.844659","DOIUrl":"10.1016/j.bjane.2025.844659","url":null,"abstract":"<div><h3>Background</h3><div>Tracheal extubation after general anesthesia may cause hemodynamic and respiratory complications, with no established strategies to prevent them. We conducted a meta-analysis to evaluate the safety and efficacy of beta-blockers in patients undergoing tracheal extubation.</div></div><div><h3>Methods</h3><div>We searched the MEDLINE, EMBASE and CENTRAL databases for randomized controlled trials up to 2024 comparing beta-blockers to placebo in patients undergoing tracheal extubation. Primary outcome: cough intensity; secondary: bronchospasm, bucking, hypertension. Risk Ratios (RR) with 95% Confidence Intervals (95% CI) were computed. Leave-one-out sensitivity and meta-regression analyses were performed for outcomes with high heterogeneity.</div></div><div><h3>Results</h3><div>We included 31 randomized studies, comprising 1,803 patients, of whom 965 received beta-blockers. The risk of moderate/severe cough (RR = 0.21; 95% CI 0.13 to 0.34; p &lt; 0.001; I² = 0%) and hypertension (RR = 0.28; 95% CI 0.13 to 0.58; p &lt; 0.001; I² = 45%) was significantly lower in the beta-blockers group compared with the placebo group. There were no statistically significant differences between groups in the risk of bronchospasm (RR = 0.58; 95% CI 0.17 to 1.94; p = 0.375; I² = 0%) or bucking (RR = 0.47; 95% CI 0.20 to 1.13; p = 0.093; I² = 72%). Sensitivity analysis identified Mendonça (2023) as the main heterogeneity source in bucking.</div></div><div><h3>Conclusion</h3><div>Our study demonstrates that beta-blockers reduced moderate/severe cough and hypertension in patients undergoing tracheal extubation compared with placebo with no significant difference in the risk of bronchospasm and bucking. These findings suggest beta-blockers may be a valuable strategy for preventing peri-extubation hemodynamic instability and airway hyperresponsiveness.</div></div><div><h3>Prospero register</h3><div>CRD42024542103.</div></div>","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":"75 6","pages":"Article 844659"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}