Medicina-Lithuania最新文献

{"title":"Continuous Non-Invasive Hemodynamic Monitoring in Cirrhotic Patients-Friend or Foe?","authors":"Mirela Crihan, Alexandru Leonard Alexa, Dan Valean, Daniela Ionescu","doi":"10.3390/medicina61030536","DOIUrl":"10.3390/medicina61030536","url":null,"abstract":"<p><p><i>Background and Objectives</i>: Liver cirrhosis leads to significant hemodynamic changes, particularly portal hypertension and a hyperdynamic circulatory state. Traditional invasive methods for hemodynamic monitoring, while accurate, carry risks such as infection and hemorrhage in a patient predisposed to these conditions. This study evaluates the accuracy of non-invasive continuous hemodynamic monitoring compared to a minimally invasive method in patients with decompensated liver cirrhosis. <i>Materials and Materials and Methods</i>: The study enrolled 51 patients with decompensated liver cirrhosis requiring continuous hemodynamic monitoring in the ICU. Patients underwent simultaneous monitoring via the minimally invasive FloTrac system and continuous non-invasive ClearSight sensor over 24 h, with measurements registered at 6 h intervals. Hemodynamic parameters measured included cardiac output (CO), cardiac index (CI), stroke volume (SV), stroke volume variation (SVV), systemic vascular resistance (SVR), and mean arterial pressure (MAP). <i>Results</i>: Significant discrepancies were observed between the two monitoring methods for most parameters, particularly CO, CI, and MAP, at most time intervals. However, SVV measurements showed no significant differences, indicating similar efficacy in assessing fluid responsiveness between the devices. <i>Conclusions</i>: The ClearSight system, although a valuable non-invasive alternative, demonstrated lower accuracy compared to the FloTrac system for hemodynamic measurements in patients with decompensated liver cirrhosis. Its effectiveness in assessing fluid responsiveness, particularly by SVV, suggests it could play a role in the monitoring of these patients, especially when invasive techniques have increased risks.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"61 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722076","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":"Racquet Mammoplasty as an Oncoplastic Technique in the Management of Lateral Quadrant Breast Cancer: A Prospective Controlled Study of Oncologic and Cosmetic Outcomes.","authors":"Amr G Mohamed, Emad M Abdelrahman, Sherief M Mohsen, Mostafa S Abdeen, Mohamed A Elsayed, Zizi M Ibrahim, Osama R Abdelraouf, Ebtesam N D Attia","doi":"10.3390/medicina61030539","DOIUrl":"10.3390/medicina61030539","url":null,"abstract":"<p><p><i>Background and Objectives</i>: The incorporation of oncoplastic surgery techniques into the management of breast cancer has become more popular and offers both oncological safety and good cosmetic results. However, it is challenging for surgeons to obtain good oncological control and acceptable cosmetic results. This study aims to evaluate racquet mammoplasty in patients managing lateral quadrant breast tumors. <i>Materials and Methods</i>: In total, 59 female patients with lesions in their lateral breast quadrants were operated upon using the racquet mammoplasty technique. Their intraoperative data and postoperative outcomes were assessed and analyzed. Follow-up was planned for at least 1 year later. <i>Results</i>: In the current study, 59 females were enrolled, with a mean age of 38.6 ± 4.3 years. Tumors were located in the lateral upper quadrant in most of the patients (74.4%). The mean size of the tumors was 2.7 ± 1.8. The surgical margins were free of malignancy in all cases. A total of 5.1% of cases reported a wound infection. A single patient developed loco-regional recurrence. Concerning the cosmetic outcomes, 89.8% of patients reported excellent outcomes and none reported poor or bad results. <i>Conclusions</i>: The racquet mammoplasty technique, when used as an oncoplastic technique, provides oncological safety as well as good cosmetic results for tumors in the lateral breast quadrants.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"61 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721751","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":"Comparison of Margin Quality for Intersegmental Plan Identification in Pulmonary Segmentectomy.","authors":"Selcuk Gurz, Yurdanur Sullu, Leman Tomak, Necmiye Gul Temel, Aysen Sengul","doi":"10.3390/medicina61030535","DOIUrl":"10.3390/medicina61030535","url":null,"abstract":"<p><p><i>Background and Objectives:</i> Insufficient margin in lung cancer is associated with an increased locoregional recurrence rate. In pulmonary segmentectomy, two commonly used methods for identifying the intersegmental plane are inflation-deflation and indocyanine green dyeing. The aim of this study was to compare these two methods in terms of quality margins and to evaluate their superiority. <i>Materials and Methods:</i> A total of 63 patients who underwent segmentectomy via video-assisted thoracoscopic surgery (VATS) for pulmonary nodules and underwent preoperative planning with 3D modeling between October 2020 and February 2024 were included in this study. The location of the nodule and the distance to the intersegmental margins were virtually measured preoperatively using an open-source 3D modeling system. Patients were grouped according to the method of identifying the intersegmental margins. Group 1 included segmentectomies performed by the inflation-deflation method (n = 42), and Group 2 included segmentectomies performed by systemic indocyanine green (ICG) injection (n = 21). The area where the histopathological nodule was measured closest to the intersegmental margin was recorded. Values within (+/-10 mm) compared to the value measured in the three-dimensional model were considered successful. The obtained data were statistically compared between the groups. <i>Results:</i> There was no difference between the groups in terms of virtual and pathological margins. However, in terms of margin quality, the rate of deviation detected in the pathological margin compared to the measured virtual margin was significantly different between the groups (<i>p</i> = 0.04). Accordingly, the success rate was 64.3% in Group 1 and 90.5% in Group 2 (<i>p</i> = 0.05). In Group 1, the failure rate was highly against the adjacent parenchyma. There was no significant difference between the groups in the analysis of simple and complex segmentectomies. <i>Conclusions:</i> Intersegmental plane identification with indocyanine green increases the margin quality by defining resection margins closer to the virtual margins. In the inflation-deflation method, unnecessary parenchymal loss occurs due to disadvantages in identifying intersegmental margins.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"61 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721927","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":"Vaping-Associated Pneumothorax: A Systematic Review of Case Reports and Case Series.","authors":"Moneeb Al-Taj, Alameen Alsabbah, Tariq Ma'ali, Mohammad Abu Suilik, Jehad Feras AlSamhori, Ahmad Alloubani, Ali Madha, Anita V Goyal, Abeer Gharaibeh","doi":"10.3390/medicina61030537","DOIUrl":"10.3390/medicina61030537","url":null,"abstract":"<p><p><i>Background and Objectives</i>: Pneumothorax is a medical condition characterized by the accumulation of air in the pleural cavity, leading to lung collapse. While cigarette smoking is a well-known risk factor, the role of electronic cigarettes is less understood. This systematic review aimed to evaluate the outcomes of vaping-associated pneumothorax, in addition to its clinical features and management strategies, by compiling published case reports and case series. <i>Materials and Methods</i>: The choice to use case reports and case series was due to the limited availability of other types of studies on this emerging condition, as vaping-associated pneumothorax is relatively rare and primarily reported in isolated cases. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we conducted a systematic search of six databases for case reports and case series. Data extraction and quality assessment were performed independently by multiple reviewers. <i>Results</i>: Seven case reports and four case series with a total number of 16 patients were included. Most patients were young, underweight men who presented with chest pain and shortness of breath. Conventional cigarette and cannabis use were commonly reported alongside vaping. The main treatment was the insertion of a chest tube, with surgical interventions reserved for severe cases. Patients who were treated non-surgically exhibited a higher recurrence rate. Additionally, specific symptoms such as chest pain radiating to the ipsilateral shoulder were associated with a higher recurrence rate. <i>Conclusions</i>: Clinicians should be vigilant for pneumothorax in at-risk individuals, consider targeted screening for symptomatic vapers, and prioritize early surgical intervention in recurrent cases to reduce complications. Further research is needed to understand the pathophysiology of vaping-associated spontaneous pneumothorax and optimal management strategies.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"61 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722024","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":"Association of Inflammatory and Metabolic Markers with Mortality in Patients with Postoperative Femur Fractures in the Intensive Care Unit.","authors":"Metin Kilinc, Enes Çelik, Ibrahim Demir, Semih Aydemir, Hakan Akelma","doi":"10.3390/medicina61030538","DOIUrl":"10.3390/medicina61030538","url":null,"abstract":"<p><p><i>Background and Objectives</i>: Postoperative femur fracture in elderly patients is associated with high morbidity and mortality, especially in the intensive care unit (ICU). Various factors, including demographic and laboratory parameters, may influence mortality in this population. The aim of this study was to evaluate the association of inflammatory and metabolic markers with mortality in ICU patients with postoperative femur fractures and to identify key predictors to enhance risk stratification and improve patient outcomes. <i>Materials and Methods</i>: In this retrospective single-center study, we analyzed 121 patients aged over 65 years with postoperative femur fractures who were admitted to the ICU between January 2023 and January 2024. Demographic and clinical data, including comorbidities, Charlson Comorbidity Index (CCI), and Acute Physiology and Chronic Health Evaluation (APACHE II) score, were collected. Laboratory parameters such as white blood cell count (WBC), albumin, C-reactive protein (CRP), D-dimer, Pan-Immune-Inflammation Value (PIV), CRP-to-albumin ratio (CAR), neutrophil-to-lymphocyte ratio (NLR), and others were analyzed. Linear regression, logistic regression, and Receiver Operating Characteristic (ROC) analyses were performed to determine the predictive value of these markers for ICU mortality. <i>Results</i>: The mean age of the patients was 76.3 ± 9.6 years, and 52.1% were female. The most common comorbidities were hypertension (67.8%) and diabetes (49.6%). ICU mortality occurred in 24 patients (20%). Significant predictors of mortality included higher CRP (>62.8 mg/L), NLR (>10.0), PIV (>450), and APACHE II scores (>23) (<i>p</i> < 0.001 for all). Lower albumin levels (<2.5 g/dL) were strongly associated with increased mortality (<i>p</i> < 0.001). ROC analysis demonstrated that the APACHE II score had the highest predictive accuracy for mortality (AUC = 0.83), followed by albumin (AUC = 0.79) and PIV (AUC = 0.76). Extended ICU stay (>10 days) was also significantly correlated with increased mortality (<i>p</i> < 0.001). <i>Conclusions</i>: This study successfully demonstrates the utility of combining traditional clinical markers, such as APACHE II score, with novel inflammatory markers, such as PIV, CAR, and NLR, in predicting mortality in ICU patients following femur fracture surgery. The integration of emerging biomarkers with well-established scoring systems offers enhanced predictive accuracy and provides valuable insights into patient management.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"61 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722170","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":"Relationship Between Dyspnoea Scales and Quality of Life in Stroke Survivors: A Retrospective Analysis.","authors":"Abdurrahim Yildiz, Rustem Mustafaoglu, Ayse Nur Bardak","doi":"10.3390/medicina61030540","DOIUrl":"10.3390/medicina61030540","url":null,"abstract":"<p><p><i>Background and Objectives</i>: The purpose of the study was to evaluate the relationship between different dyspnoea scales and clinical and physical parameters of stroke patients and to identify the most appropriate scale for stroke patients. <i>Materials and Methods:</i> This study, designed as a retrospective analysis, involved 203 patients diagnosed with stroke. Dyspnoea intensity was evaluated using four different scales: Oxygen Cost Diagram (OCD), Basic Dyspnoea Index (BDI), Modified Medical Research Council (mMRC), and Visual Analogue Scale (VAS). Respiratory muscle strength (maximal inspiratory pressure (MIP) and quality of life (Stroke Impact Scale 3.0 (SIS)) were also assessed. <i>Results:</i> The regression model explained only 20.2% of the variance in SIS total scores (R² = 0.202), indicating that key predictors might be missing. Additionally, dyspnoea scales showed statistically significant but modest correlations with SIS total scores (r = 0.248-0.397), suggesting limited clinical significance. There was a statistically significant relationship between age and dyspnoea scales, except for OCD (r = -0.153, <i>p</i> = 0.056). A statistically significant relationship was found between the MIP and OCD scales (r = 0.290, <i>p</i> < 0.001) and BDI scale (r = 0.195, <i>p</i> = 0.014). However, only the BDI showed a statistically significant relationship with the other three dyspnoea scales in stroke patients. <i>Conclusions:</i> The OCD and BDI can evaluate dyspnoea ratings during day-to-day activities; therefore, these scales were significantly correlated with inspiratory muscle strength in stroke patients. Our findings suggest that while BDI and OCD are valuable tools for dyspnoea assessment in stroke patients, the overall predictive power of dyspnoea scales for quality of life is limited. Future studies should consider additional variables, such as comorbidities and rehabilitation intensity, to improve predictive accuracy and clinical relevance.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"61 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721753","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":"Granulomatosis with Polyangiitis: A Focus on Differences and Similarities Between Child and Adult Patients.","authors":"Vincenzo Calabrese, Romina Gallizzi, Alessandra Spagnolo, Mariateresa Zicarelli, Diana Sutera, Alessandra Farina, Valeria Cernaro, Domenico Santoro","doi":"10.3390/medicina61030534","DOIUrl":"10.3390/medicina61030534","url":null,"abstract":"<p><p>Wegener's granulomatosis (WG), or granulomatosis with polyangiitis (GPA), is a rare autoimmune disease that can cause inflammation in various organs, including the kidneys. Renal involvement in GPA is a major cause of morbidity and mortality in both adults and children, and early detection and effective treatment are essential for preventing renal failure. This review aims to summarize the current evidence on the incidence, clinical features, treatment, and outcomes of renal involvement in children with Wegener's granulomatosis. The incidence of renal involvement in children with GPA ranged from 26% to 56%. Renal involvement is a common and serious complication of GPA in children, and early detection and effective treatment are crucial for preventing renal failure. The most common clinical features were proteinuria, hematuria, and reduced glomerular filtration rate. The majority of children with renal involvement in GPA required treatment with corticosteroids and immunosuppressive agents. The treatment outcomes varied among the studies, with some children achieving remission of renal involvement while others developed end-stage renal disease. Although most features are the same in children and adult patients, this review summed up some important differences between these two different populations. Further studies are needed to identify the most effective treatment strategies for renal involvement in children with GPA.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"61 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722133","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":"Effect of Autologous Skin Cell Suspensions Versus Standard Treatment on Re-Epithelialization in Burn Injuries: A Meta-Analysis of RCTs.","authors":"Faisal M Obeid","doi":"10.3390/medicina61030529","DOIUrl":"10.3390/medicina61030529","url":null,"abstract":"<p><p><i>Background and Objectives</i>: Burn injuries, particularly partial-thickness burns, often require advanced therapies to improve re-epithelialization and scar quality. This study aims to evaluate the efficacy of autologous skin cell suspensions, such as Recell, compared to standard treatments in promoting faster and better-quality skin healing. Our goal is to provide evidence-based conclusions on the effectiveness of these regenerative approaches in burn treatment. <i>Materials and Methods</i>: During our comprehensive investigation, we systematically examined several databases for the period to November 2024, including PubMed, Scopus, Web of Science, and the Cochrane Central Register of Controlled Trials. Our primary objective was to assess the efficacy of autologous cell suspension in treatment for burn injuries. We employed the ROB2 method to assess the quality of evidence to ensure the validity of the conclusions derived from these studies. The gathered data were systematically organized in a standardized online format and analyzed with RevMan 5.4. <i>Results</i>: Our systematic literature search identified nine studies (n = 358 patients) evaluating the efficacy of autologous skin cell suspensions in promoting re-epithelialization in burn injuries. The meta-analysis revealed a statistically significant reduction in time to re-epithelialization in the autologous skin cell suspension group compared to the control group (MD = -1.71 days, 95% CI [-2.73, -0.70], <i>p</i> = 0.001), with moderate heterogeneity among the studies (I² = 58%). However, no significant differences were found in secondary outcomes, including postoperative pain (SMD = -0.71, 95% CI [-2.42, 1.00], <i>p</i> = 0.42), POSAS scores (MD = -0.35, 95% CI [-2.12, 1.42], <i>p</i> = 0.69), Vancouver Scar Scale (MD = -0.76, 95% CI [-2.86, 1.33], <i>p</i> = 0.48), or the incidence of complete healing by the 4th week (RR = 0.98, 95% CI [0.94, 1.02], <i>p</i> = 0.24). Similarly, no significant differences were found in postoperative infection rates (RR = 0.85, 95% CI [0.28, 2.60], <i>p</i> = 0.78) or the need for further interventions (RR = 0.15, 95% CI [0.02, 1.16], <i>p</i> = 0.07). <i>Conclusions</i>: autologous skin cell suspension significantly reduces the time to re-epithelialization in burn injuries compared to standard treatments. However, no significant differences were found in secondary outcomes, such as postoperative pain, scar quality (POSAS, Vancouver Scar Scale), complete healing rates, infection rates, or the need for additional interventions. While autologous skin cell suspension shows promise in accelerating re-epithelialization, it does not provide significant advantages over conventional methods in other clinical aspects. The results underscore the need for further research with larger, more robust studies to assess the long-term benefits of autologous skin cell suspension in burns carefully.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"61 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722243","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":"Bone Health for Gynaecologists.","authors":"Angel Yordanov, Mariela Vasileva-Slaveva, Eva Tsoneva, Stoyan Kostov, Vesselina Yanachkova","doi":"10.3390/medicina61030530","DOIUrl":"10.3390/medicina61030530","url":null,"abstract":"<p><p>Osteoporosis, the most common bone disorder, profoundly impacts women's health, especially during postmenopausal phases. Characterised by diminished bone mineral density (BMD), it increases the risk of fractures, affecting mobility, quality of life, and potentially mortality. The present review analyses the intricate interactions among physiological alterations, diseases, and medications that lead to bone mineral density reduction in women. It underscores the importance of gynaecologists in the prevention, diagnosis, and management of osteoporosis via early risk assessment, suitable hormone treatment, and lifestyle modifications. Essential considerations encompass the categorisation of osteoporosis into primary (age-related) and secondary (attributable to diseases or pharmacological treatments) types, with particular emphasis on predisposing conditions such as premature menopause, hormone deficits, and cancer therapies. The significance of diagnostic instruments such as DXA and novel methodologies like trabecular bone score and quantitative ultrasonography is emphasised for precise evaluation and surveillance. The review also addresses nutritional methods, physical exercise, and pharmaceutical interventions, including hormone replacement therapy (HRT), selective oestrogen receptor modulators (SERMs), and other anti-resorptive drugs, to preserve bone health. This review highlights the important role of gynaecologists in maintaining women's bone health, promoting a proactive strategy to avert osteoporosis-related complications and enhance long-term results.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"61 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11944197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722275","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":"Morphometric Measurement of Mean Cortical Curvature: Analysis of Alterations in Cognitive Impairment.","authors":"Renāte Rūta Apse, Nauris Zdanovskis, Kristīne Šneidere, Guntis Karelis, Ardis Platkājis, Ainārs Stepens","doi":"10.3390/medicina61030531","DOIUrl":"10.3390/medicina61030531","url":null,"abstract":"<p><p><i>Background and Objectives</i>: Cognitive impairment, including mild cognitive impairment (MCI) and Alzheimer's disease (AD), is a growing public health concern. Early detection and an understanding of structural changes are crucial for accurate diagnosis and timely intervention. Cortical curvature, a morphometric measure derived from structural magnetic resonance imaging (MRI), has emerged as a potential biomarker for neurodegenerative processes. This study investigates the relationship between mean cortical curvature and cognitive impairment. <i>Materials and Methods</i>: A cross-sectional study was conducted with 58 participants, categorized into, first, cognitively impaired (CI) and non-cognitively impaired (NC) groups and, second, a normal cognitive group (NC), a mild cognitive performance group (MPG), and a low cognitive performance group (LPG) based on the Montreal Cognitive Assessment (MoCA) score. MRI data were acquired using a 3.0 Tesla scanner, and cortical reconstruction was performed using FreeSurfer 7.2.0. Mean cortical curvature values were extracted for 34 brain regions per hemisphere. <i>Results</i>: Significant differences in mean cortical curvature were found between the CI and NC groups. In the right hemisphere, statistically significant changes in mean curvature were observed in the isthmus cingulate (U = 188.5, <i>p</i> = 0.006), lingual (U = 202.5, <i>p</i> = 0.013), pars orbitalis (U = 221.5, <i>p</i> = 0.031), and posterior cingulate regions (U = 224.5, <i>p</i> = 0.035). In the left hemisphere, significant differences were detected in the cuneus (U = 226.5, <i>p</i> = 0.038) and posterior cingulate (U = 231.5, <i>p</i> = 0.046) regions. Analysis across three cognitive performance groups (NC, MPG, and LPG) showed significant curvature differences in the right isthmus cingulate (H(2) = 7.492, <i>p</i> = 0.024) and lingual regions (H(2) = 6.250, <i>p</i> = 0.044). <i>Conclusions</i>: Decreased mean cortical curvature in brain regions associated with cognitive function could be indicative of cognitive impairment and may reflect early neurodegenerative changes. These results highlight cortical curvature as a potential structural sign for cognitive impairment, showing the need for further investigation in longitudinal studies.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"61 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11944146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721988","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}