International Braz J Urol最新文献

{"title":"Focal Cryotherapy in Prostate Cancer. Does Gleason Impact Results?","authors":"Kinga Mate, Pedro de Pablos-Rodríguez, Marta Burbano Herraiz, Mario Hassi Román, Paula Pelechano Gómez, Ana Calatrava Fons, Maria Isabel Martín García, Jessica Patiño Aliaga, Manel Beamud Cortés, Álvaro Gómez-Ferrer Lozano, Jose Luis Dominguez Escrig S, Cristina Gutierrez Castañé, Victor Rodríguez Part, Juan Luis Casanova Ramón Borja","doi":"10.1590/S1677-5538.IBJU.2025.0289","DOIUrl":"10.1590/S1677-5538.IBJU.2025.0289","url":null,"abstract":"<p><strong>Purpose: </strong>Focal cryotherapy is a minimally invasive treatment for localized prostate cancer (PCa), but its oncological outcomes, particularly in relation to baseline Gleason Grade Group (GG), remain understudied. This study evaluates its efficacy and the impact while radical of baseline Gleason score on recurrence-free survival.</p><p><strong>Materials and methods: </strong>A retrospective analysis included 111 patients with localized PCa treated with focal cryotherapy between 2014 and January 2024. Patients with prior treatments or follow-up < 12 months were excluded. All patients underwent MRI and transperineal biopsy, and cryotherapy was performed using the Visual ICE Cryoablation System. Confirmatory biopsies were recommended at 12-24 months post-treatment. Recurrence was classified as either in-field (treated or adjacent areas) or out-field (non-adjacent areas). Any recurrence-free survival was defined as the absence of positive biopsy or additional treatment. Radical treatment-free survival was defined as the absence of whole-gland treatment (e.g., radical prostatectomy, radiotherapy), androgen deprivation therapy, metastasis, or death. Outcomes were compared between patients with baseline GG 1 and GG >1.</p><p><strong>Results: </strong>Median follow-up was 35 months (IQR 24-49). Confirmatory biopsies were performed in 78% of patients (n=87), revealing in-field recurrence in 10% and out-field recurrence in 23%. There were no statistically significant differences between ISUP 1 and ISUP >1 groups in terms of protocol biopsy positivity for either in-field recurrence (HR 0.41; 95% CI 0.09-1.9) or out-field recurrence (HR 0.77; 95% CI 0.3-1.98). At three-years, the rates of any recurrence-free and radical treatment-free survival were 63% and 85%, respectively, with no significant variation by baseline GG.</p><p><strong>Conclusion: </strong>Focal cryotherapy provides favorable short-term oncological outcomes in localized PCa, with no significant differences in recurrence-free survival based on baseline Gleason score.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"52 2","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146042054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robot-assisted Repair of Rectovesical Fistula after Radical Prostatectomy using the Hugo™ RAS System.","authors":"Lara Herrero López, Andrea Noya Mourullo, Sara Tamburini, Edoardo Beatrici, Nicola Frego, Simone Morra, Florencio Manuel Marin Martinez, Geert De Naeyer, Ruben De Groote, Edward Lambert, Frederiek D'Hondt, Alexandre Mottrie","doi":"10.1590/S1677-5538.IBJU.2025.0405","DOIUrl":"10.1590/S1677-5538.IBJU.2025.0405","url":null,"abstract":"<p><strong>Introduction: </strong>Rectovesical fistula (RVF) is a rare complication after robot-assisted radical prostatectomy (RARP) (1), often requiring complex surgery (2). Robotic systems provide dexterity and visualization for deep pelvic procedures (3, 4). We report the first RVF repair using the Hugo™ RAS System.</p><p><strong>Materials and methods: </strong>A 76-year-old male developed fecaluria one week after catheter removal following RARP. MRI revealed a 1.3 cm fistulous tract between the bladder and rectum. Initial management included transurethral and suprapubic catheters, plus a loop colostomy. Robotic repair was performed five months later. Trocar placement, adapted to the stoma, included four robotic and two assistant ports. Posterior bladder wall dissection allowed removal of two joined catheters. The posterior bladder wall, urethrovesical anastomosis dehiscence, and a 1 cm anterior rectal defect were repaired. Fibrotic tissue and residual clip were removed. A peritoneal flap was interposed between the bladder and rectum, and a new bladder neck and vesicourethral anastomosis were created using barbed sutures. Intraoperative testing confirmed integrity, and a bladder catheter was placed.</p><p><strong>Results: </strong>The postoperative course was uneventful, with patient discharge on day 4. The bladder catheter was removed after 3 weeks. At the 2-month follow-up, urinary function was normal with good continence. Ultrasound confirmed good bladder filling and no post-void residual. Cystoscopy showed a well-healed urethrovesical anastomosis without fistula. Colostomy reversal is pending.</p><p><strong>Conclusions: </strong>This case demonstrates the feasibility and effectiveness of the Hugo™ RAS System for RVF repair post-RARP. Robotic surgery can manage complex defects with favorable outcomes (5). Robotic platforms may expand telesurgery, allowing patients to undergo procedures locally with expert surgeons operating remotely (6).</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"52 2","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robot-assisted Reduction Pyeloplasty with 3D Image Navigation for Adult Giant Hydro-nephrosis: Technique and Clinical Outcomes.","authors":"Hao Dong, Pan Song, Zhihua Li, Xiang Wang, Kunlin Yang, Xuesong Li","doi":"10.1590/S1677-5538.IBJU.2025.0525","DOIUrl":"10.1590/S1677-5538.IBJU.2025.0525","url":null,"abstract":"<p><strong>Purpose: </strong>To perform a systematic review and meta-analysis evaluating the efficacy and safety of preoperative silodosin in improving ureteroscopy (URS) outcomes for ureterolithiasis.</p><p><strong>Materials and methods: </strong>PubMed, EMBASE and Cochrane Central were systematically searched for studies comparing preoperative silodosin with placebo or 'no preoperative silodosin' in patients undergoing URS for ureteral stones. Primary outcomes included ureteral wall injury, analgesia use, fever, haematuria, stone-free rate (SFR), operative time, and complications. Statistical analysis was performed using Review Manager 5.1.7. Study quality and risk of bias were assessed per Cochrane guidelines.</p><p><strong>Results: </strong>Nine studies, including eight randomized clinical trials, including 960 patients were analysed; 450 (46.8%) received silodosin. Compared to controls, silodosin significantly reduced ureteral injuries (RR 0.30; 95% CI: 0.18-0.49; p < 0.00001) and operative time (MD -17.72 minutes; 95% CI: -24.72 to -10.72; p < 0.00001). It also lowered analgesia needs (RR 0.35; 95% CI: 0.16-0.75; p = 0.007), with trends toward reduced fever (RR 0.67; 95% CI: 0.36-1.22; p = 0.19) and haematuria (RR 0.57; 95% CI: 0.32-1.02; p = 0.06). In studies with ≥10 days of preoperative use, silodosin significantly improved SFR (RR 1.17; 95% CI: 1.10-1.26; p < 0.00001).</p><p><strong>Conclusions: </strong>Preoperative silodosin reduces ureteral injuries, operative time, and complications, supporting its use to improve safety and efficiency of URS for ureterolithiasis.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"52 2","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146042026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Comment: Safety and efficacy of vibegron in pediatric patients with treatment-resistant nocturnal enuresis: a multicenter retrospective study","authors":"Luciano A Favorito","doi":"10.1590/S1677-5538.IBJU.2025.9923","DOIUrl":"10.1590/S1677-5538.IBJU.2025.9923","url":null,"abstract":"","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"52 2","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146042006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Large Language Models and the \"Centaur Model\" in Urological Training in Latin America.","authors":"Juan Martín Montoya Osorio","doi":"10.1590/S1677-5538.IBJU.2025.0632","DOIUrl":"10.1590/S1677-5538.IBJU.2025.0632","url":null,"abstract":"","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"52 2","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146042057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the Brazilian Version of the Cambridge Renal Stone Patient-Reported Out-come Measure (Br-CReSP) versus a Generic Questionnaire for Assessing Health-Related Quality of Life in Nephrolithiasis.","authors":"Alexandre Danilovic, Daniel Gabriele Sucupira, Oliver Wiseman, Elaine Brasil, Fabio Cesar Miranda Torricelli, Giovanni Scala Marchini, Carlos Batagello, Rodrigo Perrela, Fabio Carvalho Vicentini, William C Nahas, Eduardo Mazzucchi","doi":"10.1590/S1677-5538.IBJU.2025.0553","DOIUrl":"10.1590/S1677-5538.IBJU.2025.0553","url":null,"abstract":"<p><strong>Purpose: </strong>No validated tool specifically assesses health-related quality of life (HRQoL) in Brazilian patients with kidney stones. The Cambridge Renal Stone Patient-Reported Outcome Measure (CReSP) is a self-administered questionnaire that evaluates the impact of kidney stones on patients' QoL over the preceding seven days. This study aimed to translate the CReSP into Portuguese, validate it, and compare it with the validated generic SF-12 questionnaire.</p><p><strong>Materials and methods: </strong>The CReSP questionnaire was translated into Portuguese following Guillemin's guidelines. Patients with and without kidney stones completed the Brazilian version of the CReSP (Br-CReSP) and SF-12 questionnaires. Internal consistency, test-retest reliability, discriminant validity, and convergent validity with SF-12 components were evaluated. Logistic regression assessed the discriminant capacity of Br-CReSP and SF-12 components for nephrolithiasis.</p><p><strong>Results: </strong>One hundred patients completed both questionnaires. Internal consistency was high across all domains and the total score (Cronbach's α = 0.92). Test-retest reliability demonstrated strong correlations for all domains and the total score (ICC = 0.94). Discriminant validity was evidenced by significant differences between patients with and without kidney stones, with large effect sizes. Convergent validity was shown by significant inverse correlations between the Br-CReSP and SF-12 (p < 0.001). The Br-CReSP outperformed PCS-12 and MCS-12 in predicting nephrolithiasis (AUC = 0.91 vs. 0.84 and 0.73, respectively).</p><p><strong>Conclusions: </strong>The validated Br-CReSP outperforms SF-12 in assessing HRQoL in Brazilian patients with kidney stones.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"52 2","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146041878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scrotal Ultrasound in the Infertile Male-A Practical Compass for the Urologist.","authors":"Sandro C Esteves","doi":"10.1590/S1677-5538.IBJU.2025.9920.1","DOIUrl":"10.1590/S1677-5538.IBJU.2025.9920.1","url":null,"abstract":"","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"52 2","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146042070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Standardizing Suction Ureteral Access Sheath Technique in Retrograde Intrarenal Surgery (RIRS): Tips, Tricks & Troubleshooting.","authors":"Giovanni Scala Marchini, Alexandre Danilovic, Fábio Cesar Miranda Torricelli, Fábio Carvalho Vicentini, Carlos Alfredo Batagello, Rodrigo Perrella, Pedro Antonio Araújo Simões, Alexandre Gilberto Silva, William Carlos Nahas, Eduardo Mazzucchi","doi":"10.1590/S1677-5538.IBJU.2025.0535","DOIUrl":"10.1590/S1677-5538.IBJU.2025.0535","url":null,"abstract":"<p><strong>Introduction: </strong>Suction ureteral access sheaths (FANS, S-UAS) are reshaping retrograde intrarenal surgery (RIRS) by improving stone-free rates and reducing complications compared to traditional UAS (1-5). Since their use requires significant technical adjustments with limited standardization, we present an instructional video detailing setup, operative choreography, and troubleshooting.</p><p><strong>Methods: </strong>Single-center instructional case from a tertiary unit. Index patient: 67-year-old man with a 25-mm right pelvic stone (1560 HU; ~3500 mm³). Preoperative considerations included selective prior stenting and off-label α-blockers. We typically use 10/12 or 11/13 Fr suction UAS with 7.5-8.5 Fr flexible ureteroscopes. Setup: pressurized irrigation to the ureteroscope; lateral suction port connected to a labeled collector cup via a vacuum regulator, creating a closed-loop, pressure-aware system. Under fluoroscopy, the sheath is positioned above the ureteropelvic junction (UPJ) with careful advancement into the target calyx. Laser strategy combines dusting and fragmentation with suction. Fragments are evacuated through coordinated suction bursts and slow scope withdrawal. Final inspection defines stent placement and dwell.</p><p><strong>Results: </strong>Operative time was 115 min, with 25 min of laser use. POD-1 CT confirmed stone-free status. The patient was discharged after 24 h, and the double-J stent with string was removed on day 5. The high-definition video illustrates connections, target pressures, inflow/outflow rules, and provides concise troubleshooting algorithms for common issues: impassable UPJ (use as conventional UAS), friction/kinks, clogging, and system collapse (increase inflow, reduce suction, or reopen outflow).</p><p><strong>Conclusion: </strong>A standardized suction-UAS technique is feasible and reproducible, optimizing visualization, fragment clearance, pressure control, and safety during RIRS for large stones (6-8). Standardization videos such as this may enhance training, support wider adoption, and improve consistency of outcomes.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"52 2","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13127681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146042087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of Life in Patients with Ureteral Stones: Translation and Validation of the Brazilian Version of the Cambridge Ureteral Stone PROM (Br-CUSP).","authors":"Alexandre Danilovic, Daniel Gabriele Sucupira, Oliver Wiseman, Fabio Cesar Miranda Torricelli, Giovanni Scala Marchini, Carlos Batagello, Rodrigo Perrela, Fabio Carvalho Vicentini, William C Nahas, Eduardo Mazzucchi","doi":"10.1590/S1677-5538.IBJU.2025.0551","DOIUrl":"10.1590/S1677-5538.IBJU.2025.0551","url":null,"abstract":"<p><strong>Purpose: </strong>There is currently no validated instrument in Brazil specifically designed to assess the quality of life (QoL) of patients with ureteral stones. The Cambridge Ureteral Stone Patient-Reported Outcome Measure (CUSP) is a self-administered questionnaire that evaluates the QoL impact of ureteral stones over the preceding seven days. This study aimed to translate, culturally adapt, and validate the CUSP for Brazilian Portuguese (Br-CUSP) for clinical and research applications.</p><p><strong>Materials and methods: </strong>The CUSP questionnaire was translated into Portuguese according to Guillemin's cross-cultural adaption guidelines. Patients with and without ureterolithiasis completed both the Br-CUSP and SF-12 questionnaires. Psychometric validation included assessment of internal consistency, test-retest reliability, convergent validity, and discriminant validity.</p><p><strong>Results: </strong>A total of 156 participants completed both questionnaires. No inconsistencies emerged during univariate analysis. Confirmatory factor analysis supported the six-factor model with satisfactory fit indices. All factor loadings exceeded 0.50. Internal consistency was high across all domains (Cronbach's α = 0.72 - 0.98; McDonald's ω = 0.73 - 0.98). Test-retest reliability demonstrated strong temporal stability. Inter-domain correlations (Spearman's p = 0.45 - 0.82) supported structural coherence. Convergent validity was confirmed through inverse correlations with SF-12 scores. Discriminant validity was demonstrated by significant score differences between patients with and without ureteral stone, with large effect sizes.</p><p><strong>Conclusions: </strong>The Brazilian Cambridge Ureteral Stone Patient-Reported Outcome Measure is a valid, reliable tool for assessing health-related quality of life in Brazilian patients with ureteral stones. Its implementation can enhance both clinical assessment and research into patient-centered outcomes in urolithiasis.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"52 2","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146041998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Micropenis in Children and Adolescents: A Narrative Review.","authors":"Edson da Silva Salvador, Luciano A Favorito","doi":"10.1590/S1677-5538.IBJU.2025.0648","DOIUrl":"10.1590/S1677-5538.IBJU.2025.0648","url":null,"abstract":"<p><strong>Purpose: </strong> To summarize current evidence on the etiology, diagnostic approach, management strategies, and outcomes of micropenis in children and adolescents.</p><p><strong>Materials and methods: </strong>A narrative review was performed using PubMed/MEDLINE (October 2025) with the search terms (Micropenis OR Microphallus OR \"Small Penis\") AND (Children OR Youth OR Adolescents). From 707 records screened, 36 studies were selected based on methodological quality and relevance to clinical practice.</p><p><strong>Results: </strong>Micropenis is a clinical sign frequently associated with underlying endocrinopathies, particularly Congenital Hypogonadotropic Hypogonadism (CHH). Accurate diagnosis relies on standardized Stretched Penile Length (SPL) assessment, recently optimized by the Stretched Penile Length INdicator Technique (SPLINT). Use of population-specific SPL nomograms is critical for diagnostic reliability. Testosterone therapy remains the primary treatment modality and demonstrates greatest efficacy in early infancy, promoting significant penile growth and generally favorable functional outcomes. Spontaneous catch-up growth during puberty has been reported in select cases. Current evidence supporting surgical interventions in children and adolescents is limited, heterogeneous, and associated with inconsistent long-term results; thus, surgery should not be considered first-line therapy. High-quality long-term outcome data and randomized placebo-controlled trials are lacking.</p><p><strong>Conclusions: </strong> Standardized SPL measurement and appropriate nomogram use are essential for accurate diagnosis. Early hormonal therapy, especially in CHH-associated micropenis, appears to yield optimal functional and psychosocial outcomes. Expectant management may be appropriate in selected clinical scenarios. Surgical techniques remain controversial, with insufficient evidence to recommend routine use. Further well-designed prospective studies, including randomized placebo-controlled trials, are needed to define long-term outcomes and guide clinical decision-making.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"52 2","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146042046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}