Medicina-Lithuania最新文献

{"title":"Prognostic Value of Neutrophil, Monocyte, Lymphocyte, and Platelet/High-Density Lipoprotein Ratios in Ischemic Heart Disease: An NHANES Analysis.","authors":"Chia-Chen Wu, Chia-Hui Wu, Chien-Ho Lee, Tien-Yu Chen, Cheng-I Cheng","doi":"10.3390/medicina60122084","DOIUrl":"https://doi.org/10.3390/medicina60122084","url":null,"abstract":"<p><p>The prognostic value of easily accessible hematologic biomarkers, such as the neutrophil-to-HDL ratio, as well as the monocyte-to-HDL, lymphocyte-to-HDL, and platelet-to-HDL ratios, remains underexplored in patients with established ischemic heart disease (IHD). Community-dwelling adults aged ≥ 20 with established IHD from the National Health and Nutrition Examination Survey (NHANES) 1999-2018 were eligible. Mortality was tracked through linkage to the National Death Index (NDI) until the end of 2019. Cox regressions examined the associations between these hematologic ratios and all-cause mortality. Receiver operating characteristic (ROC) curve analysis assessed the predictive accuracy of these ratios for mortality. A total of 2265 patients were analyzed, with a median follow-up period of 80 months. After adjusting for demographic factors, lifestyle variables, and comorbidities, patients in the highest quartile of the neutrophil/HDL had a significantly increased all-cause mortality risk (aHR = 1.41, 95% CI: 1.13-1.77) compared to those in the lowest quartile. No significant associations were found between the other ratios and mortality. In conclusion, this study found that among the hematologic ratios analyzed, an elevated neutrophil-to-HDL ratio has the strongest potential for mortality risk stratification in community-dwelling patients with ischemic heart disease in the US, offering important guidance for both patients and clinicians.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"60 12","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11678046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958044","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":"Uric Acid Correlates with Serum Levels of Mineral Bone Metabolism and Inflammation Biomarkers in Patients with Stage 3a-5 Chronic Kidney Disease.","authors":"Francisco Mendoza Carrera, Gloria Elizabeth Vázquez Rivera, Caridad A Leal Cortés, Lourdes Del Carmen Rizo De la Torre, Renato Parra Michel, Rosalba Orozco Sandoval, Mariana Pérez Coria","doi":"10.3390/medicina60122081","DOIUrl":"https://doi.org/10.3390/medicina60122081","url":null,"abstract":"<p><p><i>Background and Objectives</i>: Uric acid (UA) and the markers of mineral bone metabolism and inflammation are commonly altered in patients with chronic kidney disease (CKD) and are associated with the risk of cardiovascular complications and death. Studies point to a link between high serum UA and mineral bone homeostasis and inflammation, but controversy remains. The aim of this study was to evaluate the relationship between UA levels and mineral bone metabolism and inflammation biomarkers in a sample of Mexican patients with CKD 3a-5. <i>Materials and Methods</i>: This cross-sectional study included 146 Mexican patients with CKD 3a-5. In addition, 25 healthy subjects were included in the study with the aim of generating reference data for comparisons. Metabolic parameters including UA serum concentrations, mineral bone metabolism (parathormone (PTH), fibroblast growth factor 23 (FGF23), calcium, and phosphate), and inflammation (interleukin (IL)-1β, IL-6, and tumor necrosis factor-alpha (TNF-α)) biomarkers were measured in all of the samples and compared as a function of the estimated glomerular function rate (eGFR) or UA levels. <i>Results</i>: Intact PTH, FGF23, and cytokines were higher in advanced CKD stages. Patients with hyperuricemia had significantly higher values of FGF23 and TNF-α compared with those without hyperuricemia. The eGFR was found to be significantly and negatively correlated with all markers. Uric acid was significantly correlated with phosphate, iPTH, FGF23, and TNF-α, whereas iPTH was significantly correlated with FGF23, TNF-α, and FGF23. Finally, a multivariate analysis confirmed the relationship of eGFR with all the tested biomarkers, as well as other relationships of iPTH with UA and TNF-α and of FGF23 with UA and TNF-α. <i>Conclusions</i>: This study supports the relationship between uric acid and levels of mineral bone metabolism and inflammation biomarkers in patients with CKD at middle to advanced stages. In the follow-up of patients with CKD, monitoring and controlling UA levels through nutritional or pharmacological interventions could help in the prevention of alterations related to mineral bone metabolism.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"60 12","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11677754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957145","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":"A Novel Reconstruction Approach After Skin Cancer Ablation Using Lateral Arm Free Flap: A Serial Case Report.","authors":"Soyeon Jung, Seungjun Lee, Seokchan Eun","doi":"10.3390/medicina60122082","DOIUrl":"https://doi.org/10.3390/medicina60122082","url":null,"abstract":"<p><p><i>Background and Objectives</i>: The lateral arm flap has been a very useful choice for the reconstruction of small to medium-sized defects, such as in the hands, extremities, and oral head and neck area. Its versatile characteristics and surgical feasibility allow this flap to be widely applied, but its reconstructive potential in the facial subunit after tumor ablation procedures has never been reported. In this study, we aimed to utilize the advantages of this flap to carry out facial temple subunit defect reconstruction. <i>Materials and Methods</i>: Between 2020 and 2023, 12 patients underwent temple reconstruction with lateral arm free flaps after wide malignant tumor excisions. There were seven women and five men, and the mean patient age was 60.6 years. Among the patients with cancer, six had squamous cell carcinoma, five had basal cell carcinoma, and one had myxofibrosarcoma. All flaps were elevated under general anesthesia. Alprostadil (PGE1, Eglandin^®, Mitsubishi Tanabe Korea, Seoul, Republic of Korea) was administered postoperatively. <i>Results</i>: All flaps were the fasciocutaneous type, with sizes that varied from 3 cm × 4 cm to 5 cm × 7 cm (average size: 22.7 cm²). The average pedicle length was 6.1 cm. The versatility of the lateral arm flap enabled successful coverage in all cases, with no specific complications. Good functional outcomes and good ranges of motion in the donor arms were observed after surgery. <i>Conclusions</i>: The authors successfully verified the advantages of lateral arm flaps in the treatment of medium-sized facial temple subunit defects.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"60 12","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11680044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957860","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":"Gamified Health Promotion in Schools: The Integration of Neuropsychological Aspects and CBT-A Systematic Review.","authors":"Evgenia Gkintoni, Fedra Vantaraki, Charitini Skoulidi, Panagiotis Anastassopoulos, Apostolos Vantarakis","doi":"10.3390/medicina60122085","DOIUrl":"https://doi.org/10.3390/medicina60122085","url":null,"abstract":"<p><p><i>Background and Objectives:</i> This systematic review examines the integration of gamified health promotion strategies in school settings, with a focus on their potential to positively influence health behaviors and promote well-being among adolescents. This study explores the incorporation of cognitive behavioral therapy (CBT), artificial intelligence, and neuropsychological principles in gamified interventions, aiming to enhance engagement and effectiveness. <i>Materials and Methods:</i> A narrative synthesis of 56 studies, following PRISMA guidelines, underscores the significant impact of these gamified interventions on mental health outcomes, emphasizing reductions in anxiety, depression, and burnout while improving coping skills and lifestyle habits. The focus of key areas in mental health outcomes, emotional regulation, cognitive flexibility, and adherence mechanisms is explored through quantitative and qualitative syntheses to underscore intervention effectiveness and design principles. <i>Results:</i> This review highlights the high-quality evidence supporting the use of gamification in educational settings and calls for further research to optimize design elements and address implementation barriers. The findings propose that well-designed gamified health interventions can effectively engage students, promote healthy behaviors, and improve mental well-being while acknowledging the need for further studies to explore underlying mechanisms and long-term effects. <i>Conclusions:</i> Gamified health interventions that embed CBT and neuropsychological principles are promising for promoting the mental well-being of schoolchildren. Although the evidence indicates that they are effective in improving psychological and behavioral outcomes, further research is needed to optimize design features and overcome implementation challenges to ensure wider and more sustainable application.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"60 12","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11678321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957943","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 in Patients with Rheumatoid Arthritis in Bahrain.","authors":"Adla B Hassan, Amer Almarabheh, Abdulaziz Almekhyal, Danya Abdulhameed AlAwadhi, Haitham Jahrami","doi":"10.3390/medicina60122078","DOIUrl":"https://doi.org/10.3390/medicina60122078","url":null,"abstract":"<p><p><i>Background and Objectives</i>: Compared to the general population, rheumatoid arthritis (RA) patients have additional disease-specific risk factors for osteoporosis that include chronic exposure to systemic inflammation. The current study aimed to investigate the prevalence of osteoporosis and its associated risk factors, such as age, sex, body mass index (BMI), uric acid (UA), and vitamin D status, but also the coexistence of type 2 diabetes mellitus (DMT2) and breast cancer (Ca breast) in patients with RA in Bahrain. <i>Material and Methods</i>: Data from DEXA scans were collected retrospectively from the patient's electronic health records. All patients who had BMD data and at least one single comorbidity, including RA, were included in the current study. The collected data were analyzed by using SPSS, version 28. <i>Results</i>: A total of 4396 patients were included in the current study. The comorbidities among this cohort were as follows: 3434 patients had endocrinological diseases, among them 63.6% had DMT2; 1870 patients had rheumatological diseases, among them 15.1% had rheumatoid arthritis; and 941 patients had malignancies, among them 75.6% had breast cancer. Our results indicated that patients with RA had a high prevalence of low BMD (72.30%, <i>p</i> < 0.001) and low vitamin D levels (63.10%, <i>p</i> < 0.001) but high serum UA (20.85%). Comparing RA with non-RA patients, our results showed a statistically significant association between RA and each of BMD and UA (<i>p</i> = 0.017 and <i>p</i> = 0.004, respectively), but also between RA and each of age (<i>p</i> = 0.001) and Ca breast (<i>p</i> < 0.001). However, no association was found between RA and BMI, DMT2, or vitamin D status. <i>Conclusions</i>: RA patients had a high prevalence of low BMD (72.3%) and low vitamin D (63.10%) but high serum UA (20.85%). The risk of osteoporosis, hypovitaminosis, and gout must be kept in mind during the evaluation of any case with RA.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"60 12","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11678244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957913","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":"The Role of Complete Blood Count-Derived Inflammatory Biomarkers as Predictors of Infection After Acute Ischemic Stroke: A Single-Center Retrospective Study.","authors":"Weny Rinawati, Abdulloh Machin, Aryati Aryati","doi":"10.3390/medicina60122076","DOIUrl":"https://doi.org/10.3390/medicina60122076","url":null,"abstract":"<p><p><i>Background and Objectives</i>: Although a wide range of hematological parameters are used as blood-based inflammatory biomarkers, the role of complete blood count-derived inflammatory biomarkers in infection after acute ischemic stroke (AIS) is modest. Therefore, this study aimed to explore complete blood count-derived inflammatory biomarkers as predictors of infection after AIS. <i>Materials and Methods</i>: A single-center retrospective cross-sectional study was carried out at the National Brain Center Hospital Prof. Dr. dr. Mahar Mardjono, Jakarta, Indonesia, between 1 October 2023, and 31 March 2024, using medical records of hospitalized first-ever ischemic stroke patients who underwent a complete blood count within 24 h of admission. Based on complete blood count-derived inflammatory biomarkers, this study included absolute numbers and related ratios or indices. <i>Results</i>: In total, 163 patients met the study criteria. The diagnosis of infection after AIS was established using reliable clinical symptoms and/or guidelines of the disease. According to the status of infection after AIS, the subjects were categorized into two groups, including 24 patients in the infection group and 139 patients in the non-infection group. Biomarkers that had significant accuracy (higher sensitivity and specificity, respectively) in predicting infection were the leukocyte count (LC; 70.8%, 74.1%, <i>p</i> < 0.001), absolute neutrophil count (ANC; 66.7%, 79.9%, <i>p</i> < 0.001), absolute monocyte count (AMC; 75.0%, 63.3%, <i>p</i> = 0.001), neutrophil to lymphocyte ratio (NLR; 62.5%, 71.9%, <i>p</i> = 0.003), derivative NLR (dNLR; 50.0%, 78.4%, <i>p</i> = 0.003), monocyte-granulocyte to lymphocyte ratio (MGLR; 62.5%, 73.0%, <i>p</i> = 0.003), systemic inflammatory response index (SIRI; 62.5%, 79.0%, <i>p</i> = 0.001), and systemic immune inflammation index (SII; 87.5%, 44.0%, <i>p</i> = 0.012) with chances of 74.4%, 75.4%, 71.0%, 69.0%, 68.7%, 69.3%, 73.4%, and 66.2%, respectively. <i>Conclusions</i>: Considering the overall ROC curve used to evaluate the complete blood count-derived inflammatory biomarkers, ANC has a better ability to predict infection in AIS patients, as denoted by the highest AUC, suggesting a 75.4% chance of correctly discriminating patients with infection after stroke.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"60 12","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11679367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958057","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":"Prognostic Implications and Predictors of Mitral Regurgitancy Reduction After Transcatheter Aortic Valve Implantation.","authors":"Murat Can Güney, Hakan Süygün, Melike Polat, Hüseyin Ayhan, Telat Keleş, Zeynep Şeyma Turinay Ertop, Engin Bozkurt","doi":"10.3390/medicina60122077","DOIUrl":"https://doi.org/10.3390/medicina60122077","url":null,"abstract":"<p><p><i>Background</i>: Mitral regurgitation (MR) is a common condition observed in patients undergoing transcatheter aortic valve implantation (TAVI) for the treatment of aortic stenosis (AS). However, the impact of TAVI on MR outcomes and the factors predicting MR improvement remains uncertain. Understanding these predictors can enhance patient management and guide clinical decisions. <i>Methods</i>: This retrospective cohort study included 156 patients with moderate to severe MR undergoing TAVI. MR severity was assessed via echocardiography at baseline, as well as 6 months and 1 year after TAVI. Patients were divided into groups based on MR reduction: no improvement or worsening, one-degree improvement, and at least two-degree improvement. Clinical, echocardiographic, and procedural characteristics were evaluated as predictive factors for MR improvement after TAVI. <i>Results</i>: MR reduction occurred in 68% of patients at 6 months and 81% at 1 year. Factors predicting a reduction of two grades or more in MR severity included lower baseline LVEDD (OR = 1.345, 95% CI: 1.112-1.628, <i>p</i> = 0.002) lower baseline LA (OR = 1.121, 95% CI: 1.015-1.237, <i>p</i> = 0.024), lower baseline LVMI (OR = 1.109, 95% CI: 1.020-1.207, <i>p</i> = 0.024), and higher baseline EF levels (OR = 1.701, 95% CI: 1.007-2.871, <i>p</i> = 0.047). No significant association was found between MR reduction at 6 months and one-year mortality. (<i>p</i> = 0.65). <i>Conclusions</i>: Baseline echocardiographic parameters are valuable in predicting MR improvement post-TAVI, with LVMI emerging as a novel predictor. However, MR reduction did not independently predict survival, underscoring the need for further research to optimize patient selection and management strategies in TAVI candidates.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"60 12","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11676227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958021","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":"The Effect of Muscle Cramps During Hemodialysis on Quality of Life and Habitual Physical Activity.","authors":"Gabriela Kot, Agata Wróbel, Kasper Kuna, Agnieszka Makówka, Michał Nowicki","doi":"10.3390/medicina60122075","DOIUrl":"https://doi.org/10.3390/medicina60122075","url":null,"abstract":"<p><p><i>Background and Objectives</i>: This study aimed to evaluate the association between QoL, self-assessed physical activity, and the presence and severity of muscle spasms in chronic hemodialysis patients. Patients undergoing regular in-center hemodialysis (HD) have much lower quality of life (QoL) than healthy individuals. However, there is limited knowledge about the impact of specific common complications of hemodialysis, particularly muscle spasms on the overall well-being of patients. <i>Materials and Methods</i>: In this prospective, single-center study, 67 chronic HD patients were surveyed regarding the prevalence of muscle spasms using a validated 9-multiple-choice-question survey, alongside the Physical Activity Questionnaire (IPAQ) and The Short Form (36) Health Survey (SF-36). Based on the muscle spasms survey answers, patients were divided into two subgroups: with (<i>n</i> = 39) and without muscle spasms (<i>n</i> = 28). <i>Results</i>: The findings revealed that patients with muscle spasms had a higher body mass index (BMI) (<i>p</i> = 0.005), a shorter dialysis vintage (<i>p</i> = 0.063), and significantly longer sitting times (<i>p</i> = 0.017). Multivariate analysis identified BMI (<i>p</i> = 0.034), sitting time (<i>p</i> = 0.009), physical functioning scores (<i>p</i> = 0.032), and dialysis vintage (<i>p</i> = 0.040) as significant predictors of muscle spasms. <i>Conclusions:</i> This study concluded that muscle spasms are associated with lower QoL among HD patients. The contributing factors to this dependance are BMI, dialysis vintage, physical functioning, and sitting time.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"60 12","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11676847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958046","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":"Evaluating Meniscus, Ligament and Soft Tissue Injury Using MRI in Tibial Plateau Fractures: A Tscherne Classification Approach.","authors":"Yong-Bum Joo, Young-Mo Kim, Young-Cheol Park, Soo-Hyeok Chae, Dong-Hwan Kim","doi":"10.3390/medicina60122073","DOIUrl":"https://doi.org/10.3390/medicina60122073","url":null,"abstract":"<p><p><i>Background and Objectives</i>: This study investigated associated meniscus and ligament injuries in tibial plateau fractures using magnetic resonance imaging (MRI) and assessed soft tissue injuries in relation to the Schatzker classification and Tscherne classification. <i>Materials and Methods</i>: The data of 185 patients who sustained tibial plateau fractures from January 2010 to April 2021 were retrospectively reviewed. Fractures were classified according to the Schatzker classification system. Soft-tissue injuries were assessed using the Tscherne classification. Menisci and ligaments were evaluated using preoperative MRI. Nerve injuries, compartment syndrome and wound problems were also assessed. The incidence of soft tissue injuries, as well as the relationship between the Schatzker and Tscherne classification systems, were analyzed. <i>Results</i>: Evidence of derangement of meniscus and ligament around the knee was found in 183 (98.9%) patients. The most common injury was a medial collateral ligament injury. The incidence of lateral collateral ligament injury, nerve injury, compartment syndrome and wound problem was higher in high-energy tibial plateau fractures. A tendency was observed between the Schatzker and the Tscherne classifications (<i>p</i> value < 0.001). Higher Tscherne grade was also associated with the incidence of posterior cruciate ligament injury, nerve injury and compartment syndrome. <i>Conclusions</i>: In tibial plateau fractures, soft tissue injuries were highly prevalent. High-energy fractures tended to exhibit higher Tscherne classification grades and showed an increased incidence of meniscus and ligament injuries. The Tscherne classification appears to be a helpful system for predicting soft tissue injuries in tibial plateau fractures. And preoperative MRI can be a helpful tool.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"60 12","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11678086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957870","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":"Surgery for an Uncommon Pathology: Pancreatic Metastases from Renal Cell Carcinoma-Indications, Type of Pancreatectomy, and Outcomes in a Single-Center Experience.","authors":"Emil Matei, Silviu Ciurea, Vlad Herlea, Traian Dumitrascu, Catalin Vasilescu","doi":"10.3390/medicina60122074","DOIUrl":"https://doi.org/10.3390/medicina60122074","url":null,"abstract":"<p><p><i>Background and Objectives</i>: The role of surgery in pancreatic metastases of renal cell carcinoma (PM_RCC) is highly controversial, particularly in the context of modern systemic therapies and the conflicting results of studies published so far. This study aims to explore a single surgical center experience (including mainly pancreatic resections) regarding the indications, the type of pancreatectomies, and early and long-term outcomes for PM_RCC. <i>Materials and Methods</i>: The data of all patients with surgery for PM_RCC (from 1 January 2002 to 31 December 2023) were retrospectively assessed, and potential predictors of survival were explored. <i>Results</i>: 20 patients underwent surgery for PM_RCC (pancreatectomies-95%). Metachronous PM_RCC was 90%, with a median interval between the initial nephrectomy and PM_RCC occurrence of 104 months. For elective pancreatectomies, the overall and severe morbidity and mortality rates were 24%, 12%, and 0%, respectively; 32% of patients underwent non-standardized pancreatic resections. The median survival of patients with negative resection margins was 128 months after pancreatectomies, with an 82% 5-year survival rate. Left kidney RCC and the body/tail PM_RCC were favorable prognostic factors for the overall survival after pancreatectomies for PM_RCC. Body/tail, asymptomatic PM_RCC, and an interval after initial nephrectomy > 2 were favorable prognostic factors for the overall survival after initial nephrectomy for RCC. <i>Conclusions</i>: Pancreatectomies for PM_RCC can achieve long-term survival whenever complete resection is feasible, with acceptable complication rates. Patients with left kidney RCC, body/tail, and asymptomatic PM_RCC and an interval of more than 2 years after nephrectomy exhibit the best survival rates.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"60 12","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11678890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958014","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}