Medical Science Monitor最新文献

{"title":"Contrast-Associated Acute Kidney Injury in Oncology Patients During Active Chemotherapy: A Saudi Arabian Retrospective Study.","authors":"Abdulmalek Alzahrani, Mohammad Alsayed, Salah Shihata, Wgoud Mohamed, Mohammed S Alqarni, Rahaf Almoallim, Abdulaziz Khiyami, Abdullah Felemban, Majed Ashour, Zergham Zia","doi":"10.12659/MSM.953198","DOIUrl":"https://doi.org/10.12659/MSM.953198","url":null,"abstract":"<p><p>BACKGROUND Contrast-associated acute kidney injury (CA-AKI) is a recognized complication in oncology patients undergoing contrast-enhanced computed tomography (CECT) during chemotherapy. Limited data exist on CA-AKI incidence in patients with preserved baseline renal function, particularly in Middle Eastern populations. MATERIAL AND METHODS We conducted a retrospective analysis of 146 adult oncology patients with baseline estimated glomerular filtration rate (eGFR) greater than 50 mL/min/1.73 m² who underwent CECT within 45 days of chemotherapy at a tertiary cancer center in Saudi Arabia (January 2017-December 2018). CA-AKI was defined as an absolute serum creatinine increase of 0.3 mg/dL or more, or as a relative increase of more than 50% within 48 to 72 hours of contrast administration. Given the small number of events (n=2), descriptive statistics and exploratory univariate analyses were performed. RESULTS CA-AKI occurred in 2 of 146 patients (1.4%; 95% CI: 0.2%-5.0%). Mean age was 51.5±16.2 years; 58% were women. Cancer types included solid tumors (81.5%) and hematological malignancies (17.8%). The chemotherapy-to-CECT interval was shorter in patients with CA-AKI (mean: 2 days) than in patients without CA-AKI (mean: 23.3±12.8 days; P=0.02). This association is exploratory and hypothesis-generating given the extremely limited number of events. CONCLUSIONS CA-AKI incidence was relatively low (1.4%) in oncology patients with preserved baseline renal function undergoing CECT during active chemotherapy. The observed association between shorter chemotherapy-to-imaging intervals and CA-AKI requires prospective validation and should not be interpreted as a definitive causal relationship. These findings provide preliminary regional data from Saudi Arabia and underscore the need for larger, well-designed prospective studies to better characterize CA-AKI risk in this population.</p>","PeriodicalId":48888,"journal":{"name":"Medical Science Monitor","volume":"32 ","pages":"e953198"},"PeriodicalIF":2.5,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149228988","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":"Distribution of Needlestick Injuries in Hand Parts: A Retrospective Cohort Study‌.","authors":"Hong Mo, Zeyou Dong, Qingquan Liu, Junqi Liu, Siheng Wang, Depei Kong, Jingjing An","doi":"10.12659/MSM.953148","DOIUrl":"https://doi.org/10.12659/MSM.953148","url":null,"abstract":"<p><p>BACKGROUND A large number of healthcare workers worldwide experience needlestick injuries (NSIs), placing them at risk of infection. This study aimed to analyze the incidence of NSIs involving the hand, particularly focusing on the high incidence of NSIs in operating room staff, to provide a reference for the prevention of NSIs. MATERIAL AND METHODS We investigated the incidence of NSIs and the hand regions most frequently affected among operating room staff at a hospital in China from 2015 to 2023 using self-reported NSI data. Differences in NCI incidence across hand regions were analyzed using the chi-square test. RESULTS Among the 139 NSI cases, 98 (70.5%) were attributed to the unsafe operation of medical devices, 128 (92.09%) occurred during procedures not involving surgical instruments, 87 (62.6%) were caused by swaged needles, and 46 (33.1%) occurred among staff involved in hepatobiliary and pancreatic surgeries. Of the 139 cases, 110 (79.1%) resulted in bleeding after NSIs. Regarding source infection status, 87 cases involved confirmed infections, 24 involved suspected infections, 9 had unknown infection status, and 14 had no infectious diseases. Regarding the effect of protective equipment, no statistically significant difference was found in the bleeding outcomes between individuals wearing single-layer and dual-layer gloves (P>0.05), nor in the distribution of injury sites across different hand regions (P>0.05). CONCLUSIONS Using local protective measures, such as medical gloves with stab-resistant or thickened materials in the index fingers and dorsal hand regions, may be an effective preventative measure against NSIs.</p>","PeriodicalId":48888,"journal":{"name":"Medical Science Monitor","volume":"32 ","pages":"e953148"},"PeriodicalIF":2.5,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149225162","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":"Evaluation of the Caval-Aortic Index During Early Fluid Resuscitation in Patients With Acute Pancreatitis.","authors":"Tuba Şafak, Ahmet Burak Erdem, Nur Vahapoğlu Vural, Emre Çakar","doi":"10.12659/MSM.954804","DOIUrl":"https://doi.org/10.12659/MSM.954804","url":null,"abstract":"<p><p>BACKGROUND Early fluid resuscitation is a cornerstone of acute pancreatitis management; however, bedside assessment of the early hemodynamic response remains challenging. We prospectively evaluated serial ultrasonographic parameters and peripheral venous pressure (PVP) during initial fluid resuscitation in patients with acute pancreatitis. MATERIAL AND METHODS Patients with confirmed acute pancreatitis underwent serial measurements of inferior vena cava (IVC) diameter, aortic diameter, caval-aortic (IVC/Ao) index, PVP, and mean arterial pressure (MAP) before and 2 hours after fluid resuscitation. Early hemodynamic response was defined as an increase of at least 10% in MAP from baseline. Correlation and receiver operating characteristic (ROC) analyses with DeLong's test were performed. RESULTS Sixty patients were included. After fluid resuscitation, IVC diameter, IVC/Ao index, PVP, and MAP significantly increased, whereas aortic diameter remained unchanged. Changes in IVC diameter (ΔIVC) were positively correlated with changes in MAP (ΔMAP); changes in aortic diameter (ΔAorta) showed a significant inverse correlation. The ΔIVC/Ao index showed a similar positive trend, but this correlation was not statistically significant. ΔAorta demonstrated the highest discriminatory performance for identifying MAP-defined early hemodynamic response (area under the curve, 0.680; 95% confidence interval, 0.535-0.824), although pairwise ROC analysis revealed no significant superiority over the other ultrasonographic parameters. CONCLUSIONS Serial ultrasonographic assessment may provide clinically relevant information during early fluid resuscitation in acute pancreatitis. No ultrasonographic parameter demonstrated clear superiority. ΔAorta showed the numerically highest, although modest, discriminatory performance in this cohort. These findings should be considered hypothesis-generating and warrant further investigation before any comparative advantage of arterial ultrasonographic assessment can be inferred.</p>","PeriodicalId":48888,"journal":{"name":"Medical Science Monitor","volume":"32 ","pages":"e954804"},"PeriodicalIF":2.5,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220995","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":"Association of Visual Impairment With Medication Adherence and Unintentional Nonadherence Behaviors in Older Adults With Chronic Diseases: A Cross-Sectional Observational Study.","authors":"Qi Shen, Xianhong Zeng, Li Yu","doi":"10.12659/MSM.954346","DOIUrl":"https://doi.org/10.12659/MSM.954346","url":null,"abstract":"<p><p>BACKGROUND Visual impairment can hinder medication self-management in older adults, but severity-specific associations with adherence across chronic disease regimens are not well characterized. MATERIAL AND METHODS This single-center cross-sectional observational study included 100 consecutive outpatients older than 60 years with at least 1 chronic disease and long-term medication use at a tertiary geriatric clinic in 2024. Data were obtained through medical-record abstraction, nurse-administered interviews, and task-based observation at the index visit. Better-eye best-corrected visual acuity was categorized as normal vision or mild, moderate, or severe visual impairment. Adherence was assessed with the Chinese 8-item Morisky Medication Adherence Scale (MMAS-8). Study-specific unintentional nonadherence behaviors were analyzed descriptively. RESULTS Mean MMAS-8 scores declined from 7.32 (SD, 0.74) in normal vision to 6.09 (SD, 0.79), 5.21 (SD, 1.12), and 4.29 (SD, 1.52) in mild, moderate, and severe visual impairment, respectively (F=34.96, P<0.001). Conversely, low adherence increased from 3.7% in the normal-vision group to 45.0%, 71.4%, and 88.9% in the mild, moderate, and severe visual impairment groups, respectively. Adjusted odds ratios for low adherence were 3.45 (95% CI, 1.18-10.13), 8.72 (95% CI, 2.94-25.83), and 16.45 (95% CI, 4.21-64.23) for mild, moderate, and severe visual impairment versus normal vision. CONCLUSIONS Greater visual impairment severity was associated with lower adherence and more frequent exploratory indicators of unintentional medication-use difficulty. These cross-sectional, single-center findings are hypothesis-generating and require prospective validation.</p>","PeriodicalId":48888,"journal":{"name":"Medical Science Monitor","volume":"32 ","pages":"e954346"},"PeriodicalIF":2.5,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217192","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":"Metabolic Dysfunction-Associated Fatty Liver Disease-Cardiovascular-Kidney-Metabolic (MAFLD-CKM): A Modified Framework to Predict Long-Term Mortality.","authors":"Alaa M Mostafa, Yasser Fouad, Eman Abdelsameea, Reem Ezzat Mahdy, Ziayn Pan, Nahum Méndez-Sánchez, Mohammed Eslam","doi":"10.12659/MSM.954116","DOIUrl":"https://doi.org/10.12659/MSM.954116","url":null,"abstract":"<p><p>BACKGROUND Cardiovascular-kidney-metabolic (CKM) syndrome reframes cardio-renal-metabolic risk but omits hepatic dysfunction, particularly metabolic dysfunction-associated fatty liver disease (MAFLD). This study assesses whether integrating MAFLD into the CKM framework improves mortality risk discrimination compared with the original CKM framework. MATERIAL AND METHODS We used data of 10 335 adults aged 20 to 74 years from the third National Health and Nutrition Examination Survey (NHANES III) with mortality follow-up through 2019. CKM was classified based on the American Heart Association framework, and MAFLD was identified based on hepatic steatosis and metabolic dysfunction according to established criteria. A modified CKM score was proposed, incorporating MAFLD into CKM staging. We compared the association of each staging system with all-cause and cardiovascular mortality using Cox regression. RESULTS While both staging systems are significantly associated with mortality, the proposed modified CKM staging showed superior risk stratification than the original definition, particularly in stage 3. The modified CKM system showed a notably higher hazard ratio than the original CKM system in all-cause mortality (3.84, 95% CI: 3.38-4.37 vs 3.49, 95% CI: 3.07-3.95) and CVD-related mortality (6.38, 95% CI: 4.80-8.48 vs 5.41, 95% CI: 4.12-7.12). CONCLUSIONS Integrating MAFLD into the CKM framework (modified CKM) provided an incremental improvement in prognostic discrimination for allcause and cardiovascular mortality, with stronger risk stratification observed in stage 3, highlighting the key role of the liver in the cardio-renal-metabolic axis. These findings underscore the need for a broader, multi-organ approach to provide incremental refinement for defining and managing metabolic risk.</p>","PeriodicalId":48888,"journal":{"name":"Medical Science Monitor","volume":"32 ","pages":"e954116"},"PeriodicalIF":2.5,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208118","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":"Comparison of Visual and Ocular Hemodynamic Outcomes Following Trifocal vs Bifocal Intraocular Lens Implantation in Patients With Cataract and Myopia.","authors":"Man Xu, Yan Shao, Xing Gao, Qilin Wu","doi":"10.12659/MSM.953476","DOIUrl":"https://doi.org/10.12659/MSM.953476","url":null,"abstract":"<p><p>BACKGROUND This retrospective study from a single center aimed to compare postoperative visual, structural, and ocular hemodynamic outcomes following implantation of a trifocal intraocular lens (IOL) in 67 patients and a bifocal IOL in 67 patients with combined cataract and myopia. MATERIAL AND METHODS A total of 134 patients (268 eyes) with cataract and myopia treated between June 2022 and June 2024 were retrospectively analyzed and divided into a bifocal IOL group (n=67; 134 eyes) and a trifocal IOL group (n=67; 134 eyes). All patients underwent standardized phacoemulsification with capsular bag IOL implantation and were evaluated 6 months postoperatively. Outcomes included visual acuity, intraocular pressure, anterior chamber depth, axial length, lens thickness, mean blood flow density, pulsatility index, and resistance index. Generalized estimating equation models were used to account for inter-eye correlation. RESULTS Compared with the bifocal IOL group, the trifocal IOL group showed lower postoperative intraocular pressure (P=0.003) and anterior chamber depth (P=0.004) and improved oculus dexter visual acuity (P=0.003). Lens thickness was lower postoperatively, whereas axial length remained stable between groups. Mean blood flow density increased (P=0.020), whereas pulsatility index (P=0.003) and resistance index (P=0.002) decreased. Adverse events were less frequent in the trifocal IOL group (P=0.029). However, the observed differences were modest, with uncertain clinical significance. CONCLUSIONS Trifocal IOL implantation was associated with limited postoperative differences in visual and hemodynamic outcomes compared with bifocal IOL implantation. These findings require cautious interpretation and validation in larger prospective studies with longer follow-up.</p>","PeriodicalId":48888,"journal":{"name":"Medical Science Monitor","volume":"32 ","pages":"e953476"},"PeriodicalIF":2.5,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196961","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":"Validation of the Children and Adolescents Physical Activity and Sedentary Questionnaire (CAPAS-Q) in Polish Children and Adolescents.","authors":"Rafał Baran, Joanna Baran, Justyna Leszczak, Alicia Fillon, David Thivel, Justyna Wyszyńska","doi":"10.12659/MSM.953567","DOIUrl":"https://doi.org/10.12659/MSM.953567","url":null,"abstract":"<p><p>BACKGROUND Global public health faces challenges related to low physical activity (PA) and excessive sedentary behavior (SB) among youth. This study aimed to validate the Polish version of the Children and Adolescents Physical Activity and Sedentary Questionnaire (CAPAS-Q). MATERIAL AND METHODS The study involved 206 participants (114 girls, 92 boys) aged 8 to 17 years. Participants completed the CAPAS-Q twice (7-day interval) to assess test-retest reliability. Objective PA and SB data were collected concurrently using ActiGraph wGT3X-BT accelerometers. Psychometric evaluation included internal consistency (Cronbach's alpha), test-retest reliability (intraclass correlation coefficient [ICC]), and criterion validity (Spearman's rank correlation [rs]). RESULTS Internal consistency was acceptable (Cronbach's alpha 0.674 for PA and 0.754 for SB). Test-retest reliability was good to excellent, with subscale ICCs of 0.7429 to 0.9375. For criterion validity, the SB dimension showed moderate correlations with accelerometer-derived total PA (rs=-0.41) and sedentary time (rs=0.41). PA subscale correlations were generally smaller, with the highest association found between sports/leisure PA and moderate to vigorous PA (rs=0.27). Psychometric properties varied by group, with lower PA validity in younger children and adolescent girls. CONCLUSIONS The Polish CAPAS-Q demonstrates good to excellent test-retest reliability, although its internal consistency varies across subgroups, being lower in younger children. While the tool shows moderate criterion validity for SBs, its validity for quantifying PA volume is weak. Nevertheless, the CAPAS-Q provides valuable contextual and qualitative data. It is recommended as a cost-effective instrument for contextual screening in epidemiological studies, but caution is advised when interpreting PA levels in younger children and adolescent girls.</p>","PeriodicalId":48888,"journal":{"name":"Medical Science Monitor","volume":"32 ","pages":"e953567"},"PeriodicalIF":2.5,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185421","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":"Hybrid Molecular Imaging Using PET/CT and PET/MRI in Inflammatory Bowel Disease: Current Applications, Challenges, and Future Perspectives.","authors":"Yuqin Li, Min Wang, Bin Liu, Zijun Yuan, Wenbo Yang, Wenchun Yao, Yongxin Yuan","doi":"10.12659/MSM.953971","DOIUrl":"https://doi.org/10.12659/MSM.953971","url":null,"abstract":"<p><p>Hybrid molecular imaging is increasingly recognized as a valuable tool for the precision management of inflammatory bowel disease (IBD). Driven by the treat-to-target paradigm, the noninvasive quantification of transmural inflammation and the accurate differentiation of stricture phenotypes remain key clinical challenges. Current evidence indicates that although 2-deoxy-2-¹⁸F-fluoro-D-glucose (¹⁸F-FDG) positron emission tomography (PET) can effectively quantify the overall inflammatory burden, the integration of fibroblast activation protein inhibitor (FAPI)-targeted PET imaging provides important complementary value for characterizing fibro-inflammatory remodeling and distinguishing fibrotic strictures. By combining high metabolic sensitivity with high-resolution multiparametric soft-tissue characterization, PET/magnetic resonance imaging (MRI) has demonstrated potential advantages in assessing penetrating complications and facilitating longitudinal therapeutic monitoring. Pediatric and young adult patients requiring long-term follow-up may derive substantial benefit from the reduced radiation exposure offered by integrated PET/MRI systems. To overcome conventional method limitations, including physiologic intestinal uptake and attenuation-correction artifacts, the field is actively exploring novel molecularly targeted tracers, ultra-low-dose long-axial-field-of-view whole-body systems, and artificial intelligence-based image reconstruction techniques. Given that substantial current evidence is derived from small, single-center cohorts and experimental studies, these advanced modalities currently serve as adjunctive, problem-solving tools rather than routine replacements for standard endoscopy or conventional cross-sectional imaging. This review comprehensively evaluates the clinical performance, applicability, and translational barriers of hybrid molecular imaging in IBD, underscoring the urgent need to establish standardized, multicenter consensus protocols that can guide its future implementation in individualized therapeutic strategies.</p>","PeriodicalId":48888,"journal":{"name":"Medical Science Monitor","volume":"32 ","pages":"e953971"},"PeriodicalIF":2.5,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185455","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":"Refining Home-Based Squat Training: The Role of Hip Adduction in Improving Neuromuscular Control for Clinically Diagnosed Patellofemoral Pain Syndrome.","authors":"Chia-Ling Chen, Sui-Foon Lo, Min-Chi Chiu, Chien-Chun Chang, Wei-Hsien Hong","doi":"10.12659/MSM.953994","DOIUrl":"10.12659/MSM.953994","url":null,"abstract":"<p><p>BACKGROUND Patellofemoral pain syndrome (PFPS) often stems from neuromuscular imbalances, particularly vastus medialis obliques (VMO) dysfunction impairing patellar tracking. Research is shifting toward integrated rehabilitation strategies, such as combining hip adduction with squats to enhance VMO recruitment. MATERIAL AND METHODS Thirty participants with PFPS were randomized to traditional squatting (SQU, n=15) or squatting with hip adduction (SQU-HA, n=15) for an 8-week home-based program with identical stretching. SQU-HA squeezed a Swiss ball during squats. Fifteen healthy individuals served as a reference group (RG). Outcome measures assessed before and after intervention included Q-angle, patellar tilt, clinical scales (visual analog scale [VAS], patellofemoral pain severity scale [PSS]), and electromyographic parameters (VMO, vastus lateralis [VL], adductor [ADD] amplitudes, onset times, VMO/VL ratio, and VMO-VL onset difference). RESULTS Both PFPS groups showed significant improvements in VAS and PSS after intervention, with greater VAS improvement in the SQU-HA group (P<0.01). Within-group analysis showed reduced patellar tilt in the SQU-HA group (P=0.003); between-group comparison did not reach statistical significance (P=0.217). Muscle activation onset sequences shifted from an abnormal pattern, in which VL activation preceded VMO and ADD activation, to a more typical pattern, in which VMO activation preceded VL and ADD activation. This shift was particularly evident in the SQU-HA group, whose activation pattern resembled that of the RG after intervention. Only VMO-VL onset difference, VMO/VL ratio, and Q-angle were correlated with clinical outcomes (P<0.05). CONCLUSIONS An 8-week SQU-HA program demonstrates promising short-term improvements in VMO-related neuromuscular measures and pain reduction for patients with PFPS. This accessible motor re-education strategy serves as a practical, home-based approach to patellofemoral rehabilitation.</p>","PeriodicalId":48888,"journal":{"name":"Medical Science Monitor","volume":"32 ","pages":"e953994"},"PeriodicalIF":2.5,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168600","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":"Predictive Value of Preoperative Inflammatory and Nutritional Indices for Revision Surgery After Major Lower Extremity Amputation in Patients With Wagner Stage 5 Diabetic Foot.","authors":"Ümit Gök, Veysel Emre Çelik, Mehmet Akif Görgel, Nazlı Demir Gök, Çağdaş Pamuk, Özgür Selek, Beyzanur Işık, Ulaş Serarslan, Cengiz Erdemir, Ferat Çaboğlu","doi":"10.12659/MSM.953681","DOIUrl":"10.12659/MSM.953681","url":null,"abstract":"<p><p>BACKGROUND Major lower extremity amputation is a severe complication of diabetic foot disease, leading to high morbidity and repeat surgeries. Although systemic inflammatory and nutritional markers have been studied as prognostic factors in diabetic foot ulcers, their role in predicting revision surgery after major amputation is unclear. This study aims to evaluate the link between preoperative inflammatory and nutritional indices and revision surgery after major lower extremity amputation. MATERIAL AND METHODS This multicenter retrospective study reviewed medical records of patients with Wagner stage 5 diabetic foot disease who had major lower extremity amputation at 3 hospitals. Revision included stump shortening or re-amputation at a more proximal level. Patients were divided into revision and non-revision groups. Demographic characteristics, amputation side and level, and preoperative laboratory parameters were recorded. The Prognostic Nutritional Index, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio were evaluated. Intergroup comparisons were performed to evaluate the association between these indices and the risk of revision surgery. RESULTS A total of 89 patients were studied; 35 (39.3%) needed revision surgery, while 54 (60.7%) healed successfully without further surgery. There were no significant differences between groups in age, sex, preoperative revascularization, amputation levels, laboratory parameters, or inflammatory and nutritional indices. No link was found between these indices and revision surgery. CONCLUSIONS Systemic inflammatory and nutritional indices before major lower extremity amputation in patients with diabetic foot were not linked to postoperative revision surgery. Risks may be more affected by local factors such as residual infection, limb perfusion, and stump viability. Future studies combining systemic biomarkers with vascular assessment could better predict revision risk.</p>","PeriodicalId":48888,"journal":{"name":"Medical Science Monitor","volume":"32 ","pages":"e953681"},"PeriodicalIF":2.5,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170818","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}