Medical Science Monitor最新文献

{"title":"Time-Sensitive Antibiotic Adjustments in Gram-Negative Bacteremia: A Survival Perspective.","authors":"Yunwei Zheng, Chuwen Zhao, Bo Liao, Fuxing Li, Yaping Hang, Junqi Zhu, Youling Fang, Yanhua Liu, Longhua Hu","doi":"10.12659/MSM.945569","DOIUrl":"https://doi.org/10.12659/MSM.945569","url":null,"abstract":"<p><p>BACKGROUND This retrospective study was designed to assess risk factors for increased 30-day mortality from bacteremia caused by Escherichia coli or Klebsiella pneumoniae and to calculate the optimal point of time for patients to move from inappropriate empirical antimicrobial therapy to appropriate treatment. MATERIAL AND METHODS This retrospective study analyzed data from 610 patients with a diagnosis of E. coli- and K. pneumoniae-induced bacteremia collected between 2020 and 2023, including population-based information, infection bacteria, comorbidities, and treatment duration. Patients were categorized into 2 groups based on whether they received appropriate empirical antibiotic therapy (AEAT) or inappropriate empirical antibiotic therapy (IEAT). Propensity score-matched (PSM) analysis was performed using 1: 1 nearest neighbor matching. Receiver operating characteristic (ROC) curve analysis determined the time point for patients in the IEAT group to transition to appropriate therapy. RESULTS The study found that 30-day mortality was higher in the IEAT group than in the AEAT group (P=0.043). Multifactorial Cox regression analysis after PSM indicated that Pitt score (P<0.001), age-adjusted Charlson comorbidity index score (P<0.001), and inappropriate treatment days (P=0.018) were independent risk factors for increased 30-day mortality. The area under the ROC curve value was 0.613, and the maximum Youden index corresponded to a time turning point of 8 days. CONCLUSIONS Pitt and aCCI scores and inappropriate treatment days are significant risk factors for increased 30-day mortality in patients with E. coli or K. pneumoniae. Timely transition from inappropriate antibiotic to appropriate antibiotic therapy within 8 days was found to improve survival.</p>","PeriodicalId":48888,"journal":{"name":"Medical Science Monitor","volume":"31 ","pages":"e945569"},"PeriodicalIF":3.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143532052","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":"Editorial: The World Health Organization (WHO) Updated List of Emerging and Potentially Pandemic Pathogens Includes Yersinia pestis as Plague Vaccines Await Clinical Trials.","authors":"Dinah V Parums","doi":"10.12659/MSM.948672","DOIUrl":"https://doi.org/10.12659/MSM.948672","url":null,"abstract":"<p><p>The importance of rapidly developing and distributing safe and effective vaccines was a major lesson from the COVID-19 pandemic, which drove new vaccine development technologies. In May 2024, the World Health Organization (WHO) updated the identification of bacterial pathogens of importance to public health as guidance for research and development of strategies to prevent and overcome global antimicrobial resistance (AMR). In June 2024, the WHO updated the 2017-18 list of priority pathogens to provide a scientific framework for epidemic and pandemic preparedness. The 2024 updated WHO list of priority pathogens also recognizes emerging infections and historical former pandemic infections, including Yersinia pestis, the cause of bubonic, pneumonic, and septicemic plague. Between 2010 and 2019, the six countries with the most reported human cases of Yersinia pestis infection (from highest to lowest) were Madagascar, the Congo, Uganda, Peru, Tanzania, and the USA, with a total of 4,547 cases with a mortality rate of 17% (786 cases). More than 20 candidate plague vaccines are in the preclinical phase, with few in early (phase 1) clinical trials. This editorial highlights the need for continued review of potential pandemic pathogens and the re-emergence of plague, which awaits a vaccine.</p>","PeriodicalId":48888,"journal":{"name":"Medical Science Monitor","volume":"31 ","pages":"e948672"},"PeriodicalIF":3.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143532047","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":"Prevalence and Demographic Insights in Public Dental Clinics in Jazan, Saudi Arabia.","authors":"Ahmed M Bokhari, Mosa Ali Shubayr, Rawan Alfaifi, Aeshah M Abuhashem, Hashima Alhazmi, Nourah Y Salawi, Aalaa I Mughals, Bashayr M Zubayni, Raghad A Houmady","doi":"10.12659/MSM.947100","DOIUrl":"https://doi.org/10.12659/MSM.947100","url":null,"abstract":"<p><p>BACKGROUND In Saudi Arabia, particularly the Jazan region, a high prevalence of caries is reported among children, while adult data remain limited. This study aimed to assess the sex, age, and prevalence distribution of dental caries among adults in the Jazan region, Saudi Arabia. MATERIAL AND METHODS A cross-sectional study assessed dental caries among walk-in patients from 4 dental centers in Jazan region, using the WHO Oral Health Assessment Form (2013). Seven trained dentists conducted examinations, ensuring interrater reliability (Cronbach alpha=0.7). Sociodemographic data and Decayed, Missing, and Filled Permanent Teeth (DMFT) scores were collected and analyzed by tooth type, dental arches, and sides of arches. Data were analyzed using STATA/SE 15.1, using descriptive statistics, ANOVA, and t tests. Statistical significance was set at P≤0.05. RESULTS Of 312 participants, 94.6% were women. Caries prevalence was highest in the 26-30 year age group (24.4%), and overall was 94.6%. Maxillary arch had higher caries prevalence (91.3%) than mandibular arch (84.9%), with molars most affected. DMFT scores were lowest in the 19-25 age group (9.33±5.23) and highest in 36-40 group (13.42±4.94). Participants over 50 years showed significant tooth loss (6.09±5.51). There was a significant difference and association between the presence of caries and arch type with age groups (P=0.005, P=0.002 with ANOVA). CONCLUSIONS Widespread prevalence of dental caries in the Jazan region was found, affecting diverse demographics. Findings stress the need for preventive care, early intervention, and tailored treatments to address age-specific and sex-related differences, to improve overall oral health outcomes.</p>","PeriodicalId":48888,"journal":{"name":"Medical Science Monitor","volume":"31 ","pages":"e947100"},"PeriodicalIF":3.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524641","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":"Review of the Interactions Between Anesthetic Agents and Chemotherapeutic Agents in Cancer Cell Lines Studied In Vitro.","authors":"Paweł Radkowski, Hubert Oniszczuk, Justyna Opolska, Mateusz Pawluczuk, Marek Gowkielewicz, Łukasz Grabarczyk","doi":"10.12659/MSM.947071","DOIUrl":"https://doi.org/10.12659/MSM.947071","url":null,"abstract":"<p><p>Cancer remains the second leading cause of death worldwide, second to cardiovascular diseases. A significant number of patients with cancer require surgical interventions, highlighting the need to understand the interactions between popular agents used in general anesthesia and in chemotherapy, to provide safe anesthesia and effective anticancer treatment. Given that, for many clinicians, interactions between these 2 broad groups of drugs are not well known; therefore, this topic requires special attention. We have prepared this overview by presenting the actual findings in this field in order to introduce clinicians to this issue. The article considers commonly used drug groups in anesthesiology, such as intravenous and inhaled anesthetics, benzodiazepines, muscle relaxants, and opioids. Their interactions with commonly used antineoplastic drugs, described so far in the literature, are presented. These occurrences highlight the necessity of careful monitoring and control during perioperative care, to not interfere with chemotherapy targets and to prevent the severity of pharmacological adverse effects. To introduce these complex mechanisms, we prepared this article based on the most recent publications possible, considering the many studies carried out in vitro and in vivo, as well as clinical trials. This review was prepared on the basis of 73 articles published from 1989 to 2024, as well as on the authors' knowledge and clinical experience. This article aims to review the interaction between anesthetics and chemotherapeutic agents, based on clinical studies and studies conducted on in vitro cancer cell lines and in vivo animal models.</p>","PeriodicalId":48888,"journal":{"name":"Medical Science Monitor","volume":"31 ","pages":"e947071"},"PeriodicalIF":3.1,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517148","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":"A Review of the Diagnosis, Risk Factors, and Role of Angiogenetic Factors in Hypertensive Disorders of Pregnancy.","authors":"Joanna Zielińska, Dorota Darmochwał-Kolarz","doi":"10.12659/MSM.945628","DOIUrl":"10.12659/MSM.945628","url":null,"abstract":"<p><p>Hypertensive disorders in pregnancy (HDPs) include chronic hypertension, gestational hypertension, preeclampsia, and chronic hypertension with superimposed preeclampsia and are major causes of maternal and fetal complications. Preeclampsia, in particular, poses significant risks, yet prevention and management remain challenging despite extensive research. Various risk factors have been identified, with obesity being a key contributor to preeclampsia. The role of angiogenic factors, specifically soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF), has gained more attention in hopes of better understanding the pathogenesis of preeclampsia. Imbalances in these factors - increased sFlt-1 and decreased PlGF levels - can be observed before the clinical onset of the disease. The sFlt-1/PlGF ratio has been demonstrated to have strong predictive value in ruling out preeclampsia within the next 7 days for women with suspected cases, enhancing early diagnosis and screening mechanisms. Furthermore, women with a history of hypertensive disorders during pregnancy face a significantly higher risk of developing postpartum hypertension, especially within the first 2 years following childbirth. This article aims to provide a comprehensive review of HDPs, focusing on risk factors, diagnostic criteria, and the emerging role of angiogenic biomarkers. Specifically, it highlights the potential of the sFlt-1/PlGF ratio as a noninvasive tool to improve the early detection and diagnosis of preeclampsia.</p>","PeriodicalId":48888,"journal":{"name":"Medical Science Monitor","volume":"31 ","pages":"e945628"},"PeriodicalIF":3.1,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143505252","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":"Comparative Outcomes of Surgical Techniques for Pilonidal Sinus: A Turkish Retrospective Study.","authors":"Afig Gojayev, Murathan Erkent, Huseyin Onur Aydin, Cem Aydoğan, Tevfik Avci, İsmail Tırnova, Paşa Doğan, Ramazan Gündoğdu, Sedat Yıldırım","doi":"10.12659/MSM.947466","DOIUrl":"10.12659/MSM.947466","url":null,"abstract":"<p><p>BACKGROUND Pilonidal sinus is a chronic or acute infectious disease in the intergluteal cleft. Various surgical treatments exist, but optimal management remains debated. This study compares outcomes of primary midline closure (PMC), Karydakis flap (KF), Limberg flap (LF), and laser pilonidotomy (LP) in adult patients with pilonidal sinus disease. MATERIAL AND METHODS The data of 476 patients who underwent surgery for pilonidal sinus disease in our clinic between January 2011 and September 2022 were retrospectively evaluated. After 54 patients were excluded, the remaining patients were divided into 4 groups: PMC (n=228), LF (n=82), KF (n=53), and LP (n=59). Patient characteristics, surgical findings, and quality of life outcomes were compared between the groups. RESULTS The operation time was significantly shorter in the LP group (P<0.001). Seroma (P=0.006), wound dehiscence (P<0.001), and postoperative recurrence (P=0.017) rates were significantly higher in the PMC group. Hospital stay was significantly shorter in the LP group (mean, 8 h; P<0.001). Pain-free toilet sitting time, pain-free walking time, and return to work time were statistically significantly shorter in the LP group (all P<0.001). According to the Likert scale, the satisfaction rate of the LP group was significantly higher (P<0.001). CONCLUSIONS The PMC method has a higher postoperative complication rate and a slower return to normal physical activity. The KF method appears to be more advantageous in terms of postoperative recurrence rate. Although the LP method seems to be more advantageous in terms of quality of life in selected patients, studies with larger samples and longer follow-up periods are needed.</p>","PeriodicalId":48888,"journal":{"name":"Medical Science Monitor","volume":"31 ","pages":"e947466"},"PeriodicalIF":3.1,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494309","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":"Predictive Value of Wells, Geneva, Bova, and PESI Scores in Elderly Pulmonary Embolism Patients.","authors":"Miray Tümer","doi":"10.12659/MSM.947238","DOIUrl":"10.12659/MSM.947238","url":null,"abstract":"<p><p>BACKGROUND This retrospective study aimed to compare the Wells score, Geneva score, Bova score, and Pulmonary Embolism Severity Index (PESI) in the prediction of 30-day mortality and survival outcomes in 200 geriatric patients with a diagnosis of pulmonary embolism (PE). MATERIAL AND METHODS We reviewed the records of 200 patients (≥65 years old) admitted to the Emergency Department between May 2019 and December 2019 with a diagnosis of PE confirmed by computed tomography pulmonary angiography. Demographic variables, comorbidities, mental status, and laboratory data were collected. The Wells score, Geneva score, Bova score, and PESI were calculated for each patient. Primary outcome was 30-day mortality. RESULTS Among these 200 elderly patients, the presence of malignancy (P<0.05) and altered mental status (P<0.05) were significantly associated with 30-day mortality. When analyzed categorically, only the PESI score showed a significant relationship with mortality (P<0.05). However, when considering numeric values, the Bova (P<0.001), Geneva (P=0.028), and PESI (P<0.001) scores all significantly predicted 30-day mortality. CONCLUSIONS The findings suggest that PESI alone is a strong predictor of short-term mortality when evaluated categorically, while Bova, Geneva, and PESI scores provide significant prognostic information in numeric form. This underscores the importance of detailed scoring in identifying high-risk older patients with PE, which can guide treatment decisions and potentially improve clinical outcomes.</p>","PeriodicalId":48888,"journal":{"name":"Medical Science Monitor","volume":"31 ","pages":"e947238"},"PeriodicalIF":3.1,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of King's Combined Uterine Suture in Managing Placenta Accreta: A Retrospective Analysis.","authors":"Wenqiang You, JinXiao Lin, LiPing Hu","doi":"10.12659/MSM.945826","DOIUrl":"10.12659/MSM.945826","url":null,"abstract":"<p><p>BACKGROUND Placenta accreta is a spectrum disorder that can include an abnormally adherent placenta to placental tissue that invades the endometrium and myometrium and results in hemorrhage during or after delivery. King's combined uterine suture is a combination of parauterine vascular ligation with longitudinal suturing of the lower uterine segment. This retrospective study aimed to evaluate outcomes from using King's combined uterine suture for hemostasis in 49 parturient women with placenta accreta spectrum (PAS). MATERIAL AND METHODS Clinical data of parturient women with placenta accreta in Fujian Maternal and Child Health Hospital from January 2020 to January 2023 were retrospectively collected. King's combined uterine suture ligation surgery was performed in these patients who had placenta accreta. Placenta accreta was diagnosed by the criteria for PAS. The outcomes of surgery and prognosis of newborns were analyzed. RESULTS A total of 49 parturient women were included and underwent successful intraoperative hemostasis without hysterectomy or ureteral injury. There were 4 cases of bladder rupture and 17 cases of uterine plastic surgery. The average intraoperative bleeding volume of the 49 patients was (507±162) mL. Patients had no long-term complications during postoperative follow-up. Apgar score of newborns was 9.67±0.77, and there was no asphyxia or neonatal death. CONCLUSIONS King's combined uterine suture ligation surgery is applied to placenta accreta, which not only has a definite and fast hemostatic effect, but can also effectively preserve the uterus.</p>","PeriodicalId":48888,"journal":{"name":"Medical Science Monitor","volume":"31 ","pages":"e945826"},"PeriodicalIF":3.1,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Linear Dimensional Accuracy in Maxillomandibular Records: A Comparative Study of Scannable and Transparent Materials.","authors":"Mohammed E Sayed, Bandar M A Al-Makramani, Praveen Gangadharappa, Mohammed M Al Moaleem, Loay E Najmi, Faisal A A Daghreeri, Rayan A Nahari, Mohammad Alamri, Nisreen Nabiel Hassan, Mai Almarzouki, Saad Saleh AlResayes, Ahid Amer Alshahrani, Saeed M Alqahtani, Khurshid Mattoo","doi":"10.12659/MSM.947265","DOIUrl":"10.12659/MSM.947265","url":null,"abstract":"<p><p>BACKGROUND Maxillomandibular relationship records facilitate patient stomatognathic information transfer to dental laboratories, but new bite registration materials (BRMs) lack scientific evidence on linear dimensional accuracy. This in vitro investigation compared linear dimensional accuracy of 6 commercial scannable and transparent BRMs with a typical BRM at 1 h. MATERIAL AND METHODS Seven American Dental Association (ADA)-approved BRMs were categorized into 1 control and 2 experimental groups: control: Occlufast Rock; scannable group: Occlufast CAD, Virtual CADBite, and Flexitime Bite; and transparent group: Maxill Bite, Charmflex Bite, and Defend ClearBite. The study used modified ADA specification no. 19 to standardize bite registration record samples, which were examined using a stereomicroscope to compare with control group and standard die measurements. Median, interquartile range, and median rank scores were used for statistical interpretation. One-way ANOVA (Kruskal-Wallis rank test) and multiple-comparison Dunn test with Bonferroni correction compared between and within group differences at the probability P value ≤0.05. RESULTS The median linear differences varied in scannable, -0.06 (0.24%) to -0.11mm (0.44%), and transparent, -0.06 (0.24%) to -0.07 (0.28%), BRMs, with transparent BRMs showing more linear accuracy than scannable BRMs. A statistically significant difference from control at 1 h was observed for 3 different commercial brands. All transparent BRMs exhibited markedly reduced linear discrepancies, compared with the standard BRM (P<0.05). CONCLUSIONS All BRMs at 1 h showed a reduced linear dimensions, indicating shrinkage. All investigated BRMs demonstrated clinically acceptable linear discrepancies, with transparent BRMs exhibiting less change than scannable BRMs.</p>","PeriodicalId":48888,"journal":{"name":"Medical Science Monitor","volume":"31 ","pages":"e947265"},"PeriodicalIF":3.1,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Outcomes of Implanon in Managing Adenomyosis: A 3-Year Prospective Study.","authors":"Na Jiao, Jie Wang, Hongxin Mu, Qiwei Qi","doi":"10.12659/MSM.945972","DOIUrl":"10.12659/MSM.945972","url":null,"abstract":"<p><p>BACKGROUND Adenomyosis, which involves the presence of endometrial tissue within the uterine muscle, leads to chronic pelvic pain and heavy menstrual bleeding, creating challenges for contraception. The subdermal contraceptive implant Implanon presents a potential solution due to its long-acting properties. This study evaluates the efficacy, safety, and user satisfaction of Implanon in patients with adenomyosis, aiming to enhance understanding of its clinical benefits in this demographic. MATERIAL AND METHODS A prospective study over three years at Qingdao Women and Children's Hospital followed 124 women with and without adenomyosis after they received Implanon implants. Follow-up visits at 10 days, 3 months, 6 months, 1 year, 2 years, and 3 years post-implantation assessed adverse events, implant removals, and patient satisfaction. A survival analysis was conducted to investigate the influence of adenomyosis on the continuation of the implant. RESULTS All 124 patients completed the study with a 100% follow-up and contraception rate. Bleeding disorders, excluding amenorrhea, were the most common adverse events, affecting 52.42% of participants at 3 months and decreasing to 8.43% at 36 months. The incidence was notably lower in those with adenomyosis, with a significant decline seen from 6 to 12 months after implantation. The implant continuation rates at 1 year, 2 years, and 3 years were 75.81%, 66.94% and 54.84%, respectively. Women with adenomyosis had a lower risk of removal (hazard ratio=0.62) and higher satisfaction and were more inclined to opt for reimplantation upon expiration. CONCLUSIONS Implanon is a relatively effective and safe contraceptive, particularly for women with adenomyosis. Counseling on possible bleeding-related side effects is crucial for maintaining satisfaction and optimizing implant use.</p>","PeriodicalId":48888,"journal":{"name":"Medical Science Monitor","volume":"31 ","pages":"e945972"},"PeriodicalIF":3.1,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11853391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}