Clinics and Practice最新文献

{"title":"A Quantitative Systematic Review on the Analgesic Efficacy and Adverse Effects of Ketorolac in Third Molar Surgery.","authors":"Mario Alberto Isiordia-Espinoza, Othoniel Hugo Aragon-Martinez, Nicolás Addiel Serafín-Higuera, Sandra López-Verdín, Eduardo Gómez-Sánchez, Nelly Molina-Frechero, Ronell Bologna-Molina, Juan Manuel Guzmán-Flores, Itzel Joselyn Mora-Falcón","doi":"10.3390/clinpract15040081","DOIUrl":"https://doi.org/10.3390/clinpract15040081","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to determine the number needed to treat (NNT) of ketorolac in comparison to placebo after third molar surgery.</p><p><strong>Methods: </strong>Studies located in PubMed, Scopus, and Web of Science were evaluated with the Cochrane Risk of Bias assessment tool. Data on the onset of analgesia, the number of patients requiring rescue medication, the global or general evaluation of the study medication, and adverse effects were extracted. Data analysis was performed using Review Manager 5.3 software for Windows.</p><p><strong>Results: </strong>The qualitative assessment of the included studies showed that ketorolac was more effective than a placebo and the quantitative evaluation on the onset of analgesia (NNT = 1.6 (95%CIs = 1.4, 1.9), n = 301), the number of patients who took rescue analgesics (NNT = 3.6 (95%CIs = 2.8 to 4.9), n = 563), and the global evaluation of the treatments (NNT = 1.7 (95%CIs = 1.5 to 1.9), n = 475) showed estimates of analgesic efficacy with a statistical difference in favor of ketorolac when compared with a placebo. No statistical difference was observed in adverse effects between ketorolac and placebo (n = 739).</p><p><strong>Conclusions: </strong>There is scientific evidence of moderate quality that allows estimators of the analgesic efficacy of ketorolac to be calculated, which will significantly help the clinician who performs pharmacological treatment after third molar surgery.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12025813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Overview of the Etiopathogenic Mechanisms Involved in the Expression of the Oral Microbiota.","authors":"Ion Alexandru Popovici, Cristian Ionut Orasanu, Georgeta-Camelia Cozaru, Anita-Cristina Ionescu, Lidia Kajanto, Bogdan Cimpineanu, Anca Chisoi, Adrian Nelutu Mitroi, Ionut Poinareanu, Raluca Ioana Voda, Oana Andreea Ursica, Mihaela Butcaru Pundiche","doi":"10.3390/clinpract15040080","DOIUrl":"https://doi.org/10.3390/clinpract15040080","url":null,"abstract":"<p><p><b>Background/Objectives</b>: The diversity of the oral microbiota exerts its effects in maintaining dental and overall health. The unique genetic profile of each individual influences the composition of the oral microbiota, determining susceptibility to certain diseases. The aim is to observe its role by highlighting the pathogenic mechanisms involved in oral dysbiosis and identify genetic determinism's influence in maintaining balance. <b>Methods</b>: This study was designed as a narrative review of the oral microbiota, utilizing some of the principles and guidelines of systematic review to increase methodological rigor. We examined 121 articles such as reviews, meta-analyses, editorials, and observational studies, which met the inclusion and exclusion criteria. The inclusion criteria for studies were as follows: (1) studies that evaluated the impact of the microbiota in oral or/and systemic diseases; (2) studies that observed pathogenic mechanisms in the oral microbiota; (3) studies that evaluated the interaction of the microbiota with the immune system (4); studies that evaluated genetic implications in the microbiota. <b>Results</b>: Host genes regulate inflammatory and immunological reactions that play a role in microbiological balance. This explains the increased resistance of some to diseases, including gingivitis or periodontitis. Also, the implications of oral dysbiosis are reflected not only locally, but also generally, being associated with various systemic conditions. <b>Conclusions</b>: Understanding the pathogenic mechanisms and genetic determinants involved in oral dysbiosis may help create individualized therapies for preventing and managing oral and systemic disorders. A healthy lifestyle and adequate oral hygiene can facilitate a diverse and balanced microbiome, crucial for overall health.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12026067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Influencing Adherence to Non-Invasive Telemedicine in Heart Failure: A Systematic Review.","authors":"George Koulaouzidis, Lamprini Tsigkriki, Orestis Grammenos, Sotiria Iliopoulou, Maria Kalaitzoglou, Panagiotis Theodorou, Ioannis Bostanitis, Karolina Skonieczna-Żydecka, Dafni Charisopoulou","doi":"10.3390/clinpract15040079","DOIUrl":"https://doi.org/10.3390/clinpract15040079","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Telemedicine (TM) has emerged as a promising tool for improving heart failure (HF) management by allowing non-invasive, remote patient monitoring. However, patient adherence to TM plays a critical role in its effectiveness. This systematic review aims to assess adherence levels to non-invasive TM interventions and explore factors influencing compliance. <b>Methods:</b> This systematic review followed the PRISMA guidelines. A literature search was conducted across the PubMed, Medline, Web of Science, and Google Scholar databases to identify prospective randomized controlled trials published between January 2010 and June 2024. The inclusion criteria included studies focused on non-invasive TM in HF patients with a follow-up period longer than three months. Adherence rates were categorized as high (≥80%), moderate (60-79%), or low (<60%). <b>Results:</b> Of the 136 identified studies, 6 met the inclusion criteria. Three studies reported high adherence (>80%), and three moderate adherence (60-79%). Older patients (≥65 years) showed higher adherence, with two studies exceeding 85% adherence. Studies with higher female participation (>30%) reported better adherence, with two exceeding 88%. Across studies, a lack of racial diversity was especially notable, apart from a study that included a population with 69% black and 31% Hispanic participants, where adherence was 50% for ≥10 uploads over a 90-day period. Seasonal variations affected adherence, with December being the lowest (47-69%) and August the highest (>85%). Monitoring multiple health parameters correlated with better adherence (>85%) compared to single-parameter tracking (50-74%). <b>Conclusions:</b> TM is a promising tool for HF management, but adherence differs by age, sex, and the complexity of monitoring. To optimize TM use, standardized adherence measures and tailored strategies are needed.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12025463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time Capsule Medicine: A Mixed-Methods Pilot Study on Immersive Simulation for Chronic Disease Education in Medical Students.","authors":"Andreas Conte, Waseem Jerjes","doi":"10.3390/clinpract15040078","DOIUrl":"https://doi.org/10.3390/clinpract15040078","url":null,"abstract":"<p><p><b>Background</b>: Chronic diseases require long-term and multidimensional care, but traditional medical education has emphasised acute care and episodic interventions. This gap limits the understanding of future clinicians about the complexity of managing chronic conditions over decades. This mix-methods quantitative-qualitative pilot study describes \"Time Capsule Medicine\", an innovative educational framework in which medical students acted out the progressive challenges that patients with chronic illnesses might face over a continuous period of 20 years. This paper aims to report the outcomes of this innovative educational technique. <b>Methods</b>: Thirty final-year medical students were engaged in the three-phase programme which included preparation, immersive simulation, and reflection and evaluation. The preparation consisted of online workshops in chronic disease progression, age-related changes, and continuity of care, while the immersive simulation featured appropriate role-play exercises in small groups that simulated the chronic disease process across four five-year increments. The reflection and evaluation consisted of debriefing sessions and reflective journals, while pre- and post-simulation questionnaires tested learning outcomes. The physical constraints included weighted garments with visual impairments simulating the age-related limitations. <b>Results</b>: A gender- and ethnically diverse cohort of thirty final-year medical students from three medical schools in North London participated in the programme. The simulation significantly enhanced students' confidence in managing long-term disease trajectories (pre-simulation score: 2.8 ± 0.9; post-simulation score: 4.3 ± 0.6; <i>p</i> < 0.01) and understanding of age-related challenges (from 3.1 ± 1.0 to 4.5 ± 0.5; <i>p</i> < 0.01). Empathy scores increased from 3.0 ± 0.9 to 4.7 ± 0.5 <i>p</i> < 0.01. The qualitative analysis showed an increased appreciation of the continuity of care, recognition of systemic barriers, and insights into the emotional burdens of chronic conditions. For many students, the simulation was transformative, changing the way they approached holistic, patient-centred care. <b>Conclusions</b>: This experiential learning approach has succeeded in effectively addressing one of the most important gaps known in traditional medical education in developing empathy, understanding, and confidence in the long-term management of chronic diseases. The integration of similar simulations into medical curricula may adequately arm future clinicians with the complexities of continuity of care and patient management. Further studies need to be performed exploring scalability and its impact on long-term clinical practice.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12025795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cutaneous Leishmaniasis in the Context of Global Travel, Migration, Refugee Populations, and Humanitarian Crises.","authors":"Janice Kim, Tarek Zieneldien, Sophia Ma, Bernard A Cohen","doi":"10.3390/clinpract15040077","DOIUrl":"https://doi.org/10.3390/clinpract15040077","url":null,"abstract":"<p><p>Cutaneous leishmaniasis (CL) is a vector-borne infection caused by protozoan parasites belonging to the genus <i>Leishmania</i>. CL is an emerging global health concern due to increasing migration, travel, and climate change. Traditionally, it was confined to endemic regions such as the Americas, the Middle East, and Central Asia; however, it is now spreading to non-endemic areas. Climate change has further contributed to the expansion of sandfly habitats, increasing CL transmission risk in previously unaffected areas. Healthcare providers in non-endemic regions often misdiagnose CL, delaying treatment and morbidity. Diagnosis remains challenging due to the need for species-specific identification, while treatment is limited by cost, availability, and personnel expertise. This review explores the epidemiology, clinical presentation, diagnostic challenges, and management of CL in the context of global mobility. It highlights rising CL cases in refugee settlements, particularly in Lebanon and Jordan, due to poor living conditions, inadequate vector control, and healthcare barriers. While there have been advances in systemic and topical therapies, access in refugee and resource-poor settings remains a barrier. Addressing the global burden of CL requires improved surveillance, healthcare provider training, and increased awareness. By enhancing global collaboration and policy changes, public health efforts can mitigate the expanding impact of CL.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12025697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Cohort Study on the Impact of Oral Health on the Quality of Life of Adolescents and Young Adults.","authors":"Iva Klarić Puđa, Kristina Goršeta, Hrvoje Jurić, Mirko Soldo, Luc A M Marks, Martina Majstorović","doi":"10.3390/clinpract15040076","DOIUrl":"https://doi.org/10.3390/clinpract15040076","url":null,"abstract":"<p><p><b>Objectives:</b> This cohort study examines the relationship between quality of life and oral health in adolescents and young adults in the Zagreb area. <b>Methods:</b> The research involved 250 participants aged 14 to 25 from Zagreb. Each participant was examined by an oral medicine doctor using a probe and mirror in a dental unit, and their DMFT (Decayed, Missing, and Filled Teeth) status was determined. Participants also completed questionnaires on their socio-economic status (SES) and the impact of their oral health on quality of life (OHIP-14, Oral Health Impact Profile). <b>Results:</b> Caries was the most common dental issue among adolescents (2.23 ± 2.58), with restoration being the most frequent treatment (54%). Endodontic treatment and tooth extraction were more prevalent among individuals with lower SES (24.1%), who also had worse DMFT scores (8.09 ± 5.56). Prophylaxis was equally distributed across SES and gender. Male patients had more carious teeth (2.75 ± 3.07) than female patients (1.85 ± 2.08), while female patients scored worse on the OHIP-14 scale (10.97 ± 8.77) compared to males (8.81 ± 8.11). Age positively correlated with both OHIP-14 and DMFT scores. <b>Conclusions:</b> Adolescents and young adults in Zagreb, Croatia, exhibited high DMFT and OHIP-14 scores, reflecting significant oral health issues and reduced quality of life, particularly among older individuals and those with lower SES. The association between invasive treatments (e.g., endodontic procedures and extractions) and diminished quality of life underscores the necessity for early preventive measures, including regular dental check-ups and targeted oral health education.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12025447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clear Cell Renal Carcinoma in an Ulcerative Colitis Patient Under Short-Term Immunosuppressive Therapy: A Case Report.","authors":"Raffaele Pellegrino, Giuseppe Imperio, Michele Izzo, Ilaria De Costanzo, Fabio Landa, Paola Ciamarra, Marco Niosi, Antonietta Gerarda Gravina, Alessandro Federico","doi":"10.3390/clinpract15040075","DOIUrl":"https://doi.org/10.3390/clinpract15040075","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Renal cell cancer is a rare occurrence in patients with ulcerative colitis (UC), with no clearly demonstrated association between UC and an increased risk of renal malignancies. In this article, a case report concerning this relationship is presented. <b>Methods:</b> Our research group presented a case of clear cell renal carcinoma in a 56-year-old male with UC who had previously undergone ileorectal anastomosis and subtotal colectomy. <b>Results:</b> The patient developed a complex renal cyst that progressed to malignancy within one year while on immunosuppressive therapy with infliximab and then filgotinib. Previous ultrasound examinations of the kidney highlighted only simple cysts in the contralateral kidney in previous years. The neoplasm was promptly examined using contrast-enhanced ultrasound, confirming the diagnosis of a Bosniak IV cyst, which was corroborated by a subsequent computed tomography study. <b>Conclusions:</b> The patient underwent a nephrectomy and is currently scheduled for therapy with vedolizumab. Given the increasing use of biologics and small molecules in UC management, periodic ultrasound screening may be a valuable tool for the long-term monitoring of these patients.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12026009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuron-Specific Enolase and S100B as Biomarkers of Ischemic Brain Injury During Surgery.","authors":"Matej Makovec, Milan Skitek, Leja Šimnovec, Aleš Jerin","doi":"10.3390/clinpract15040074","DOIUrl":"https://doi.org/10.3390/clinpract15040074","url":null,"abstract":"<p><p>Biochemical markers can be used in addition to neuroimaging techniques to evaluate the extent of ischemic brain injuries and to enable earlier diagnosis and faster intervention following the ischemic event. Among the potential biomarkers of ischemic brain injuries during surgery, neuron-specific enolase (NSE) and S100B are the most frequently studied and were shown to be the most promising. The aim of this review was to summarize the role of NSE and S100B as biomarkers of ischemic brain injuries that occur during selected surgical procedures, predominantly carotid endarterectomy (CEA). Some other invasive interventions that cause ischemic brain injuries, like extracorporeal membrane oxygenation, were also included. We can conclude that these biomarkers can be useful for the evaluation of ischemic brain injuries that occur during various surgical procedures. They can help to determine the most optimal conditions for performing the surgery and therefore improve the procedures to consequently minimize brain damage caused during surgery. Because of a significant delay between sample collection and obtaining the results, they are not suitable for real-time assessment of brain injuries. Some improvement can be expected with the future development of laboratory methods. The association of the changes in NSE and S100B levels during surgery with potential consequences of ischemic brain injury have been described in numerous studies. However, even in a very homogenous group of surgical procedures like CEA, these findings cannot be summarized into a common final conclusion; therefore, the prognostic value of the two markers is not clearly supported at the present time.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12026299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Continuous Positive Airway Pressure (CPAP) Mode on Lung Function, Exercise Tolerance, Vital Signs, and Dyspnea After Acute SARS-CoV-2 Infection.","authors":"Emilia Raposo Nascimento, Paloma Lopes Francisco Parazzi, Fernando Augusto Lima Marson, Maria Ângela Gonçalves Oliveira Ribeiro, Carla Cristina Sousa Gomez, Patrícia Blau Margosian Conti, Bianca Aparecida Siqueira, Edvane Aparecida Braz Araújo Silva, José Dirceu Ribeiro","doi":"10.3390/clinpract15040073","DOIUrl":"https://doi.org/10.3390/clinpract15040073","url":null,"abstract":"<p><p><b>Background/Objectives:</b> The coronavirus disease (COVID-19) pandemic was associated with an intense impact on health worldwide. Among the sequelae, it became necessary to clarify respiratory impairment related to lung function and aerobic capacity, as well as the treatment of curative and preventive measures of pulmonary involvement. In this context, this study aimed to compare vital signs, the sensation of dyspnea (Borg scale), lung function, and exercise tolerance before and after the use of non-invasive mechanical ventilation (NIV) in adults of both sexes after acute infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). <b>Methods:</b> A cross-sectional analytical clinical study was performed with the inclusion of individuals who had been diagnosed with COVID-19 at least three months before data collection. Individuals were evaluated for vital signs (heart rate and peripheral oxygen saturation), Borg scale, spirometry, and submaximal exercise protocol of two minutes of the step test before and after receiving NIV in ventilation mode by continuous positive airway pressure of 6 cm H₂O for 30 min. <b>Results:</b> A total of 50 participants were enrolled and grouped as a mild (N = 25) or severe (N = 25) clinical phenotype during SARS-CoV-2 infection according to the criteria of the World Health Organization. In our data, the forced vital capacity (<i>p</i> < 0.001), the ratio between the forced expiratory volume in the first one second to the forced vital capacity and the forced vital capacity (<i>p</i> = 0.020), and the two-minute submaximal step exercise protocol (number of steps-<i>p</i> = 0.001) showed a statistical improvement in the severe clinical phenotype group after NIV. In addition, forced expiratory volume in the first one second to the forced vital capacity (<i>p</i> = 0.032) and the two-minute submaximal step exercise protocol (number of steps-<i>p</i> < 0.001) showed a statistical improvement in the mild clinical phenotype group after NIV. No changes were described for vital signs and the Borg scale. <b>Conclusions:</b> This study allowed us to identify that NIV is a tool that promotes better exercise capacity by increasing the number of steps achieved in both clinical phenotype groups and improving lung function observed in the spirometry markers.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12025701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Acute Myocardial Infarction: A Machine Learning Analysis After a 7-Year Follow-Up.","authors":"Marco Casciaro, Pierpaolo Di Micco, Alessandro Tonacci, Marco Vatrano, Vincenzo Russo, Carmine Siniscalchi, Sebastiano Gangemi, Egidio Imbalzano","doi":"10.3390/clinpract15040072","DOIUrl":"https://doi.org/10.3390/clinpract15040072","url":null,"abstract":"<p><p><b>Background:</b> Ischemic heart disease is a major global health problem with significant morbidity and mortality. Several cardiometabolic variables play a key role in the incidence of adverse cardiovascular outcomes. <b>Objectives:</b> The aim of the present study was to apply a machine learning approach to investigate factors that can predict acute coronary syndrome in patients with a previous episode. <b>Methods:</b> We recruited 652 patients, admitted to the hospital for acute coronary syndrome, eligible if undergoing immediate coronary revascularization procedures for ST-segment-elevation myocardial infarction or coronary revascularization procedures within 24 h. <b>Results:</b> Baseline pulse wave velocity appears to be the most predictive variable overall, followed by the occurrence of left ventricular hypertrophy and left ventricular end-diastolic diameters. We found that the potential of machine learning to predict life-threatening events is significant. <b>Conclusions:</b> Machine learning algorithms can be used to create models to identify patients at risk for acute myocardial infarction. However, great care must be taken with data quality and ethical use of these algorithms.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12025629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}