Indian Journal of Critical Care Medicine最新文献

{"title":"Controlling Glycemic Variability in Non-diabetic Sepsis Patients: A Step toward Precision in Critical Care.","authors":"","doi":"10.5005/jp-journals-10071-24909","DOIUrl":"10.5005/jp-journals-10071-24909","url":null,"abstract":"","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"29 2","pages":"197"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11915435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665037","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":"Intubation during Uninterrupted Chest Compressions: How Easy?","authors":"Asif Ahmed, Anu Prasad, Sujeet Ashok Joshi","doi":"10.5005/jp-journals-10071-24915","DOIUrl":"10.5005/jp-journals-10071-24915","url":null,"abstract":"<p><p><b>How to cite this article:</b> Ahmed A, Prasad A, Joshi SA. Intubation during Uninterrupted Chest Compressions: How Easy? Indian J Crit Care Med 2025;29(2):98-100.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"29 2","pages":"98-100"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11915428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665098","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":"Prognostic Significance of Driving Pressure for Initiation and Maintenance of ECMO in Patients with Severe ARDS: A Systematic Review and Meta-analysis.","authors":"Pratibha Todur, Anitha Nileshwar, Souvik Chaudhuri, Danavath Nagendra, Vishal Shanbhag, J Vennila","doi":"10.5005/jp-journals-10071-24893","DOIUrl":"10.5005/jp-journals-10071-24893","url":null,"abstract":"<p><strong>Introduction: </strong>In life-threatening conditions like severe acute respiratory distress syndrome (ARDS), rescue interventions like extracorporeal membrane oxygenation (ECMO) should be initiated urgently to resolve an otherwise potentially adverse clinical outcome. Driving pressure (DP) is an independent prognosticator of the survival of ARDS during mechanical ventilation. We conducted this review with the objective to identify the optimal DP for initiating ECMO in severe ARDS and to study the change in DP during ECMO strategy in survivors and non-survivors.</p><p><strong>Materials and methods: </strong>A systematic search of EMBASE, PubMed, Cochrane Library, and SCOPUS databases was conducted from their inception to January 2024. Two investigators independently carried out the processes of literature search, study selection, data extraction, and quality assessment. The analysis was conducted using comprehensive meta-analysis software (CMA).</p><p><strong>Results: </strong>For meta-analysis, six studies comprising 668 patients were included. In survivors, the DP at ECMO initiation was lower (mean DP = 14.56 cm H₂O, 95% CI: [11.060-18.060]) than non-survivors (mean DP = 17.77 cm H₂O, 95% CI: [12.935-22.607]). During ECMO, the survivors had lower DP (mean DP = 11.63 cm H₂O, 95% CI: [10.070-13.195]) than non-survivors (mean DP = 14.67 cm H₂O, 95% CI: [12.810-15.831]).</p><p><strong>Conclusion: </strong>The optimum DP to initiate ECMO in severe ARDS patients on MV is 15 cm H₂O. Extracorporeal membrane oxygenation reduces the intensity of MV, as reflected by a reduction in DP in both survivors and non-survivors during the ECMO by 3 cm H₂O. The DP ≤ 12 cm H₂O during ECMO strategy is a predictor of survival, and DP persisting ≥ 15 cm H₂O on ECMO prompts the search for strategies to reduce DP.</p><p><strong>Trial registration: </strong>PROSPERO CRD42022327846.</p><p><strong>How to cite this article: </strong>Todur P, Nileshwar A, Chaudhuri S, Nagendra D, Shanbhag V, Vennila J. Prognostic Significance of Driving Pressure for Initiation and Maintenance of ECMO in Patients with Severe ARDS: A Systematic Review and Meta-analysis. Indian J Crit Care Med 2025;29(2):177-185.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"29 2","pages":"177-185"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11915431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665111","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":"Biomarkers in Snakebite: Will This be a Reality in Near Future?","authors":"Mradul Kumar Daga, Naresh Kumar, Harpreet Singh","doi":"10.5005/jp-journals-10071-24917","DOIUrl":"10.5005/jp-journals-10071-24917","url":null,"abstract":"<p><p><b>How to cite this article:</b> Daga MK, Kumar N, Singh H. Biomarkers in Snakebite: Will This be a Reality in Near Future? Indian J Crit Care Med 2025;29(2):104-105.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"29 2","pages":"104-105"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11915434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665064","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":"Combined Effect of the Timing of Initiation of Nutrition and Nutrition Risk on Outcomes in a Mixed Intensive Care Unit of a Tertiary Hospital in a Middle-income Country.","authors":"Moses Siaw-Frimpong, Pritish J Korula, Reka Karuppusami, Nana F Gyapon, Kandasamy Subramani, Rajendran U Chander, Shoma Rao, William Addison","doi":"10.5005/jp-journals-10071-24891","DOIUrl":"10.5005/jp-journals-10071-24891","url":null,"abstract":"<p><strong>Background: </strong>The importance of nutrition in the critically ill is well known but its practice is varied globally. Determining the nutrition risk is important to help improve outcomes.</p><p><strong>Materials and methods: </strong>A prospective observational study involved patients admitted to the intensive care unit (ICU) who stayed for at least 48 hours. The demographics of participants modified the NUTRIC score, and comorbidities were assessed. The timing of nutrition initiation was noted to get two main cohorts: Early (within 48 hours of admission) and delayed (after 48 hours of admission). All the patients were followed for a maximum of 30 days in the hospital to determine outcome variables such as mortality and length of hospital stay. The ICU-free days (30 minus days in ICU) and 30-day hospital-free days were calculated and recorded for each patient.</p><p><strong>Results: </strong>A total of 489 patients, 59.9% were males, 75.5% were mechanically ventilated and total parenteral nutrition utilization was 13.2%. The prevalence of nutrition risk was 21.1%. The patients who had early nutrition constituted 36.6%. There was no difference in the primary outcome of ICU-free days between the two groups; 24 (19-25.5) and 24 (16-25) days, respectively; <i>p</i> = 0.591. The high modified NUTRIC score cohort had lower ICU-free days (<i>p</i> < 0.001), 30-day hospital-free days, and higher mortality; 18 (0-24) vs 25 days (20-26), <i>p</i> < 0.001.</p><p><strong>Conclusion: </strong>The timing of the initiation of nutrition does not affect ICU-free days and 30-day hospital-free days irrespective of the nutrition risk on admission. A high modified NUTRIC score is associated with reduced ICU-free days and 30-day hospital-free days and increased mortality.</p><p><strong>How to cite this article: </strong>Siaw-Frimpong M, Korula PJ, Karuppusami R, Gyapon NF, Subramani K, Chander RU, <i>et al</i>. Combined Effect of the Timing of Initiation of Nutrition and Nutrition Risk on Outcomes in a Mixed Intensive Care Unit of a Tertiary Hospital in a Middle-income Country. Indian J Crit Care Med 2025;29(2):137-142.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"29 2","pages":"137-142"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11915452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665074","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":"Nucleotidase as a Clinical Prognostic Marker in Snakebites: A Prospective Study.","authors":"Ram S Kaulgud, Tousif Hasan, Muragendraswami Astagimath, Gulamnabi L Vanti, S Veeresh, Mahantesh M Kurjogi, Shivakumar Belur","doi":"10.5005/jp-journals-10071-24901","DOIUrl":"10.5005/jp-journals-10071-24901","url":null,"abstract":"<p><strong>Background: </strong>Snakebite envenomation is a critical global health issue, causing substantial mortality and morbidity. Snake venom includes various enzymes, such as nucleotidase, phosphatases, etc. which impact physiological functions. However, research on the role of serum 5'-nucleotidase levels in assessing the severity and outcomes of snakebites is limited. This study aims to measure serum 5'-nucleotidase levels and explore their correlation with the severity of envenomation, to better understand its role in predicting patient prognosis.</p><p><strong>Methods: </strong>This is a single-center, prospective observational analysis involving 82 snakebite patients. Serum 5'-nucleotidase levels were measured using enzyme-linked immunosorbent assay, and clinical severity was evaluated using the snakebite severity score (SSS). Statistical analyses were performed to determine the correlation between 5'-nucleotidase levels and SSS, as well as various complications.</p><p><strong>Results: </strong>Among the 82 snakebite patients, 71.9% were male and 28.1% were female. Most bites (62.2%) occurred during the day, and 83% involved the lower limbs. Recovery was high, with 93.9% discharged, 3.7% deceased, and 2.4% lost to follow-up. A positive correlation was observed between 5'-nucleotidase levels and SSS at both 0 and 24 hours, with correlation coefficients of 0.55 and 0.61, respectively (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Serum 5'-nucleotidase serves as an effective biomarker for assessing the severity of snakebite envenomation and predicting patient outcomes. Its strong correlation with clinical severity scores makes it a valuable tool for improving the prognostication and management of snakebite cases when used in conjunction with clinical assessments.</p><p><strong>How to cite this article: </strong>Kaulgud RS, Hasan T, Astagimath M, Vanti GL, Veeresh S, Kurjogi MM, <i>et al</i>. Nucleotidase as a Clinical Prognostic Marker in Snakebites: A Prospective Study. Indian J Crit Care Med 2025;29(2):125-129.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"29 2","pages":"125-129"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11915441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665101","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":"Stuck Suction Catheters in Reinforced Endotracheal Tube: Hypotheses on Friction and Adhesive Forces.","authors":"Varun Singla, Sarthak Pal, Pramod Avti, Parul Gupta","doi":"10.5005/jp-journals-10071-24892","DOIUrl":"10.5005/jp-journals-10071-24892","url":null,"abstract":"<p><p><b>How to cite this article:</b> Singla V, Pal S, Avti P, Gupta P. Stuck Suction Catheters in Reinforced Endotracheal Tube: Hypotheses on Friction and Adhesive Forces. Indian J Crit Care Med 2025;29(2):189-190.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"29 2","pages":"189-190"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11915449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665117","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":"ADAMTS-13 Behavior in Thrombocytopenia of Infectious Origin in ICU Patients.","authors":"V Dinesh K Gontla, Srinivas Samavedam, Narmada Aluru, Radhika Rudravarapu, Shravani Pabba, Mohammad N Shaik","doi":"10.5005/jp-journals-10071-24890","DOIUrl":"10.5005/jp-journals-10071-24890","url":null,"abstract":"<p><strong>Introduction: </strong>Thrombocytopenia is a common hematological abnormality in intensive care unit (ICU) patients, with varying incidence across populations. A disintegrin-like metalloproteinase and thrombospondin-like activity motif 13 (ADAMTS-13), a plasma serine protease, plays a crucial role in modulating von Willebrand factor (vWF) activity by cleaving its ultra-large (UL) multimers and preventing excess platelet aggregation. This study aimed to evaluate the association between ADAMTS-13 levels, viral and non-viral (NV) infections, and thrombocytopenia severity.</p><p><strong>Materials and methods: </strong>This Prospective observational study included adult ICU patients with thrombocytopenia, categorized into viral and non-viral groups. Thrombocytopenia severity was assessed by absolute platelet count on diagnosis day. Statistical analyses evaluated correlations between ADAMTS-13 levels, thrombocytopenia severity, and clinical outcomes, including bleeding episodes, transfusion needs, and overall patient outcomes.</p><p><strong>Results: </strong>Among 72 patients (30 viral, 42 non-viral), lower ADAMTS-13 activity correlated significantly with thrombocytopenia severity in both groups (<i>p</i> < 0.05), with a greater deficiency observed in NV cases. A disintegrin-like metalloproteinase and thrombospondin-like activity motif 13 levels were associated with bleeding episodes, transfusion requirements, and thrombocytopenia progression in both groups but did not predict increased transfusion needs despite lower platelet counts.</p><p><strong>Conclusion: </strong>This study highlights an association between reduced ADAMTS-13 activity, infection type, and thrombocytopenia severity, especially in NV infections. A disintegrin-like metalloproteinase and thrombospondin-like activity motif 13 (ADAMTS-13) depletion and increased vWF activity may contribute to infection-related thrombocytopenia pathogenesis. These findings suggest that ADAMTS-13 levels could aid in assessing thrombocytopenia severity and prognosis, informing early management strategies and transfusion guidelines.</p><p><strong>Clinical significance: </strong>This study found that low ADAMTS-13 activity is associated with higher disease severity in both viral and non-viral infections, particularly in NV cases. While thrombocytopenia correlated with reduced ADAMTS-13 activity, it did not lead to increased platelet transfusions.</p><p><strong>How to cite this article: </strong>Gontla VDK, Samavedam S, Aluru N, Rudravarapu R, Pabba S, Shaik MN. ADAMTS-13 Behavior in Thrombocytopenia of Infectious Origin in ICU Patients. Indian J Crit Care Med 2025;29(2):143-147.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"29 2","pages":"143-147"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11915448/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665014","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":"Comparison of Macintosh Direct Laryngoscope with the C-MAC and Tuoren Videolaryngoscopes in Facilitating Endotracheal Intubation during Uninterrupted Manual Chest Compression: A Randomized Crossover Manikin Study.","authors":"Rajender Kumar, Rakesh Kumar, Naveen Kumar","doi":"10.5005/jp-journals-10071-24897","DOIUrl":"10.5005/jp-journals-10071-24897","url":null,"abstract":"<p><strong>Background: </strong>Videolaryngoscopes (VLS) frequently provide superior views of the glottis compared with traditional direct laryngoscopy (DL), especially during unexpected difficult airways. Chest compressions during attempts to intubate the trachea make it a difficult situation. Although VLS have been compared with DL for intubation during resuscitation, there is a paucity of literature comparing VLS with integrated screen and distant screen with DL during continued manual chest compressions.</p><p><strong>Materials and methods: </strong>This was a prospective, randomized, crossover observational manikin study. A total of 20 participants performed intubation, while manual chest compression was continuing, with each of the three devices on six occasions, but in different, randomized order. The primary outcome parameter was the total time taken for successful intubation. The secondary outcome criteria included the number of attempts, ease of intubation, and the device preference.</p><p><strong>Results: </strong>Time taken for successful intubation and ease of intubation were significantly better with C-MAC VLS and DL as compared with Tuoren VLS (C-Mac vs Tuoren <i>p</i> < 0.000 for both; DL vs Tuoren <i>p</i> < 0.001 for time and <i>p</i> = 0.021 for ease). There was no significant difference between C-MAC and DL (<i>p</i> = 1.0 for time and <i>p</i> = 0.69 for ease). There was no significant difference with regard to the number of attempts for successful intubation with any of these devices (<i>p</i> = 0.310). C-Mac was the most and Tuoren was the least preferred device.</p><p><strong>Conclusion: </strong>C-MAC VLS and Macintosh DL are significantly easier to use and require significantly less time to achieve successful intubation as compared with the Tuoren VLS during continued manual chest compression. Among the devices tested, C-MAC VLS was the most preferred for endotracheal intubation during uninterrupted manual chest compressions.</p><p><strong>How to cite this article: </strong>Kumar R, Kumar R, Kumar N. Comparison of Macintosh Direct Laryngoscope with the C-MAC and Tuoren Videolaryngoscopes in Facilitating Endotracheal Intubation during Uninterrupted Manual Chest Compression: A Randomized Crossover Manikin Study. Indian J Crit Care Med 2025;29(2):113-116.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"29 2","pages":"113-116"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11915440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665085","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":"Hemoadsorption Therapy for Calcium Channel Blocker Overdose at a Tertiary-level Intensive Care Unit: A Retrospective Study.","authors":"Shahed Omar, Varadaben Shukla, Ayesha B Khan, Ziyaad Dangor","doi":"10.5005/jp-journals-10071-24906","DOIUrl":"10.5005/jp-journals-10071-24906","url":null,"abstract":"<p><strong>Objective: </strong>To describe the burden of calcium channel blocker (CCB) overdose at a tertiary intensive care unit (ICU).</p><p><strong>Design and setting: </strong>Retrospective study of patients admitted to the ICU with CCB overdose from 2020 to 2022.</p><p><strong>Participants: </strong>Adult participants with clinically confirmed CCB overdose.</p><p><strong>Main outcome: </strong>Admission frequency, management strategies, and patient outcomes.</p><p><strong>Results: </strong>A total of 1719 ICU admissions over the study period, 24 (1.4%) had CCB overdose with a case fatality rate of 12.5% (3/24). Interventions included mechanical ventilation (MV) (71%), vasopressors (92%), high-dose insulin euglycemic therapy (HIET) (71%), calcium (42%), methylene blue (4%), and fluid therapy (100%). Thirteen patients (54%) received hemoadsorption therapy (HA), and eleven received standard of care (SoC) based on current guidelines. The resin hemoadsorption group had a higher SAPS II score (<i>p</i> = 0.002), and a greater total maximal vasopressor dose (<i>p</i> = 0.001) than SoC group. The HA group also had a lower admission mean arterial pressure (MAP), (<i>p</i> = 0.014), a greater MAP increase at 48 hours (<i>p</i> = 0.044), and a longer ICU length of stay (LOS) (<i>p</i> = 0.004) compared to the SoC group. There was one death in the HA group (7.7%) and two in the SoC group (18.2%).</p><p><strong>Conclusion: </strong>Calcium channel blocker overdose is an important and life-threatening cause of toxicology admissions in the ICU. Modern resin HA may contribute to improved hemodynamic stability providing a safe and important rescue therapy in cases with refractory shock. Well-designed studies are required to confirm its role in enhancing drug clearance thereby improving the hemodynamic state and clinical outcomes.</p><p><strong>How to cite this article: </strong>Omar S, Shukla V, Khan AB, Dangor Z. Hemoadsorption Therapy for Calcium Channel Blocker Overdose at a Tertiary-level Intensive Care Unit: A Retrospective Study. Indian J Crit Care Med 2025;29(2):130-136.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"29 2","pages":"130-136"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11915437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665091","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}