Medicina-Lithuania最新文献

{"title":"Analyzing Clinical Parameters and Bacterial Profiles to Uncover the COPD Exacerbations: A Focus on Intensive Care Unit Challenges.","authors":"Dragoș Huțanu, Hédi-Katalin Sárközi, Mara Andreea Vultur, Adrian-Horațiu Sabău, Iuliu Gabriel Cocuz, Corina Mărginean, Andra-Maria Chelemen, Corina Eugenia Budin","doi":"10.3390/medicina61040669","DOIUrl":"https://doi.org/10.3390/medicina61040669","url":null,"abstract":"<p><p><i>Background and Objectives:</i> Chronic obstructive pulmonary disease (COPD) poses a significant healthcare challenge worldwide, frequently leading to exacerbations necessitating intensive care unit admissions for potentially life-threatening complications. We aimed to investigate correlations between laboratory parameters, bacteriological agents, ventilation mode, and survival rates among COPD patients admitted to the ICU. <i>Materials and Methods:</i> Data were collected from the Pulmonology Department of Mures Clinical County Hospital, Romania, from 1 January 2022 to 30 October 2023. Eighty-four COPD patients required ICU transfer, except for concurrent SARS-CoV-2 infections. <i>Results:</i> Ventilation modes exhibited a significant correlation with specific bacteriological agents, orotracheal intubation being more prevalent in infections with <i>Acinetobacter baumanii</i>, <i>Staphylococcus aureus</i>, and <i>Streptococcus pneumoniae</i> (<i>p</i> < 0.001). Negative cultures were predominantly found in patients managed with non-invasive ventilation. Laboratory parameters revealed an association between elevated white blood cell counts and bacteriological superinfection, particularly with <i>Escherichia coli</i> (<i>p</i> < 0.001). Different bacteriological agents had different survival rates. Patients infected with <i>Acinetobacter baumanii</i> exhibited the highest mortality rate, while those with Staphylococcus aureus had the lowest (<i>p</i> < 0.01). <i>Conclusions:</i> The importance of prompt evaluation of laboratory parameters and bacteriological findings is underscored by these findings, particularly in ICU settings where ventilation and bacteriological profiles influence patient outcomes. The identification of elevated WBC counts is a marker of bacterial superinfection. The association between specific bacterial agents and ventilation modes highlights the importance of tailored treatment based on microbial profiles. These insights can be applied to refine treatment protocols and enhance survival rates in severe COPD exacerbations that require ICU management.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"61 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12029107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990328","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":"Evaluation of Prefrontal Cortex Activation and Static Balance Mechanisms in Adolescent Idiopathic Scoliosis Using fNIRS.","authors":"Esra Suzen, Kadriye Tombak, Buket Simsek, Omer Halil Colak, Sukru Ozen","doi":"10.3390/medicina61040667","DOIUrl":"https://doi.org/10.3390/medicina61040667","url":null,"abstract":"<p><p><i>Background and Objectives:</i> In this study, the role of oxyhemoglobin (HbO) in subregions of the prefrontal cortex during a static balance task under eyes-open and eyes-closed conditions was investigated in adolescent idiopathic scoliosis (AIS) using functional near-infrared spectroscopy (fNIRS), a powerful neuroimaging tool that enables more natural and flexible measurement in the analysis of balance mechanisms and motor tasks. <i>Materials and Methods:</i> Hemodynamic changes in the right and left dorsolateral cortex (DLPFC), frontopolar prefrontal cortex, and orbitofrontal cortex were analyzed in 16 healthy controls and 15 individuals with AIS. The statistical results were supported by HbO contrast maps. <i>Results:</i> Significant differences were found in the cortical activity patterns between the AIS and control groups. The AIS group had lower HbO concentrations than the control group in the eyes-closed condition and completely differed from the control group by showing more active HbO concentrations in the DLPFC regions than in the frontopolar regions. In the eyes-open condition, it was found that the maximum HbO value was reached in the frontopolar regions, and this value was weakened and observed throughout the left frontopolar region. Discriminative differences were also found in the orbitofrontal region in the eyes-closed static balance condition. <i>Conclusions:</i> The results obtained were evaluated and discussed in terms of postural balance compensation, differences in neural pathways, and the conscious balance mechanism. It was determined that the AIS group tended to utilize a conscious balance mechanism in the eyes-closed static balance condition and developed its own balance compensation mechanism in the eyes-open static balance condition. This study concludes that fNIRS is a powerful tool in the evaluation of balance and control mechanisms and can be used effectively in the evaluation of rehabilitation-oriented development in AIS.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"61 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12028968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056799","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":"Anatomical Variants in Pancreatic Irrigation and Their Clinical Considerations for the Pancreatic Approach and Surrounding Structures: A Systematic Review with Meta-Analysis.","authors":"Juan José Valenzuela-Fuenzalida, Camila Ignacia Núñez-Castro, Valeria Belén Morán-Durán, Pablo Nova-Baeza, Mathias Orellana-Donoso, Alejandra Suazo-Santibáñez, Alvaro Becerra-Farfan, Gustavo Oyanedel-Amaro, Alejandro Bruna-Mejias, Guinevere Granite, Daniel Casanova-Martinez, Juan Sanchis-Gimeno","doi":"10.3390/medicina61040666","DOIUrl":"10.3390/medicina61040666","url":null,"abstract":"<p><p><i>Background and Objectives</i>: The pancreas receives blood through a complex network of multiple branches, primarily originating from the celiac trunk (CeT) and the superior mesenteric artery (SMA). This blood supply is structured into three main arterial groups, each serving different regions of the pancreas to effectively support its endocrine and exocrine functions. <i>Materials and Methods</i>: The databases Medline, Scopus, Web of Science, Google Scholar, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Latin American and the Caribbean Literature in Health Sciences (LILACS) were searched until January 2025. Methodological quality was evaluated using an assurance tool for anatomical studies (AQUA). Pooled prevalence was estimated using a random effects model. <i>Results</i>: A total of sixteen studies met the established selection criteria in this study for meta-analysis. Pancreatic irrigation variants presented a prevalence of 11.2% (CI: 7-14%) and a heterogeneity of 88.2%. The other studies were analyzed by subgroups, showing statistically significant differences in the following subgroups: (1) sample type-a larger sample of images analyzed in the included studies (<i>p</i> = 0.312), which did not show statistically significant differences; (2) geographical region (<i>p</i> = 0.041), which showed a greater presence in the Asian population studied, and this was statistically significant; and (3) sex (male or female) (<i>p</i> = 0.12), where there were no statistically significant differences. <i>Conclusions</i>: The discovery of variations in pancreatic irrigation is common due to the numerous blood vessels involved in supplying this vital organ. Understanding different vascular patterns (such as those from the splenic and mesenteric arteries) is crucial for surgical interventions on the pancreas. For transplant patients, a thorough vascular analysis of both the donor and recipient is essential. Variations can impact blood flow and compatibility, potentially leading to transplant rejection if not addressed. To enhance outcomes, it is recommended to develop more accurate imaging tools for pre-surgical analysis, necessitating ongoing research in this area.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"61 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12028877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040676","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":"Comparative Analysis of Cardiac SPECT Myocardial Perfusion Imaging: Full-Ring Solid-State Detectors Versus Dedicated Cardiac Fixed-Angle Gamma Camera.","authors":"Gytis Aleksa, Paulius Jaruševičius, Andrė Pacaitytė, Donatas Vajauskas","doi":"10.3390/medicina61040665","DOIUrl":"https://doi.org/10.3390/medicina61040665","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;i&gt;Background and Objectives:&lt;/i&gt; Single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) is a well-established technique for evaluating myocardial perfusion and function in patients with suspected or known coronary artery disease. While conventional dual-detector SPECT scanners have limitations in spatial resolution and photon detection sensitivity, recent advancements, including full-ring solid-state cadmium zinc telluride (CZT) detectors, offer enhanced image quality and improved diagnostic accuracy. This study aimed to compare the performance of Veriton-CT, a full-ring CZT SPECT system, with GE Discovery 530c, a dedicated cardiac fixed-angle gamma camera, in myocardial perfusion imaging and their correlation with coronary angiography findings. &lt;i&gt;Materials and Methods:&lt;/i&gt; This was a prospective study that analyzed 21 patients who underwent MPI at the Department of Nuclear Medicine, Lithuanian University of Health Sciences, Kauno Klinikos. A one-day stress-rest protocol using 99mTc-Sestamibi was employed, with stress testing performed via bicycle ergometry or pharmacological induction. MPI was first conducted using GE Discovery 530c (GE Health Care, Boston, MA, USA), followed by imaging on Veriton-CT, which included low-dose CT for attenuation correction. The summed stress score (SSS), summed rest score (SRS), and summed difference score (SDS) were analyzed and compared between both imaging modalities. Coronary angiography results were retrospectively collected, and lesion-based analysis was performed to assess the correlation between imaging results and the presence of significant coronary artery stenosis (≥35% and ≥70% narrowing). Image quality and the certainty of distinguishing the inferior myocardial wall from extracardiac structures were also evaluated by two independent researchers with differing levels of experience. &lt;i&gt;Results&lt;/i&gt;: Among the 14 patients included in the final analysis, Veriton-CT was more likely to classify MPI scans as normal (64.3%) compared to GE Discovery 530c (28.6%). Additionally, Veriton-CT provided a better assessment of the right coronary artery (RCA) basin, showing greater agreement with coronary angiography findings than GE Discovery 530c, although the difference was not statistically significant. No significant differences in lesion overlap were observed for the left anterior descending artery (LAD) or left circumflex artery (LCx) basins. Furthermore, the image quality assessment revealed slightly better delineation of extracardiac structures using Veriton-CT (Spectrum Dynamics Medical, Caesarea, Israel), particularly when evaluated by an experienced researcher. However, no significant difference was observed when assessed by a less experienced observer. &lt;i&gt;Conclusions:&lt;/i&gt; Our findings suggest that Veriton-CT, with its full-ring CZT detector system, may offer advantages over fixed-angle gamma cameras in improving image quality and reducing attenuation artifacts in MPI. ","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"61 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12028854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040907","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":"Editorial to the Special Issue \"Retinopathies: A Challenge for Early Diagnosis, Innovative Treatments, and Reliable Follow-Up\".","authors":"Dario Rusciano, Stefania Marsili","doi":"10.3390/medicina61040662","DOIUrl":"https://doi.org/10.3390/medicina61040662","url":null,"abstract":"<p><p>The Special Issue \"Retinopathies: A Challenge for Early Diagnosis, Innovative Treatments, and Reliable Follow-Up\" brings together a diverse yet interconnected collection of research papers that collectively address the multifaceted challenges of retinal diseases [...].</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"61 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12028691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024881","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":"Significance of <i>Demodex folliculorum</i> and <i>Demodex brevis</i> in Pathogenesis of Dermatological Diseases-Current State of Knowledge.","authors":"Katarzyna Rychlik, Julia Sternicka, Roman J Nowicki, Leszek Bieniaszewski, Dorota Purzycka-Bohdan","doi":"10.3390/medicina61040660","DOIUrl":"https://doi.org/10.3390/medicina61040660","url":null,"abstract":"<p><p><i>Demodex folliculorum</i> and <i>Demodex brevis</i> are external parasites that reside in human hair follicles and sebaceous glands, most commonly on the cheeks, chin, nose, and eyelids, inhabiting the eyelash follicles. The prevalence of <i>Demodex</i> spp. varies with age. The highest concentration of mites is observed in older people, being almost 100%, and the lowest is found in children. Although the presence of parasites does not directly lead to the development of pathological symptoms, their high density is associated with diseases such as rosacea or blepharitis. This manuscript delves into the biological characteristics of <i>Demodex folliculorum</i> and <i>Demodex brevis</i> with consideration of current diagnostic techniques for detecting <i>Demodex</i> mites. It also aims to provide an in-depth analysis of the role <i>Demodex</i> mites play in the development of various dermatological conditions, with a review of the current therapeutic approaches for managing <i>Demodex</i>-related diseases.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"61 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12028426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993788","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":"Unipedicular vs. Bipedicular Balloon Kyphoplasty in the Treatment of Osteoporotic Vertebral Compression Fractures: Single-Institute 3-Year Follow-Up Results.","authors":"Tolga Ege, Uğur Yüzügüldü, Ali Murat Başak, Mustafa Aydın, Ömer Erşen, Tuluhan Yunus Emre","doi":"10.3390/medicina61040663","DOIUrl":"https://doi.org/10.3390/medicina61040663","url":null,"abstract":"<p><p><i>Background and Objectives:</i> Balloon kyphoplasty is one of the most commonly performed minimally invasive surgical procedures for the treatment of osteoporotic vertebral fractures, with the bipedicular technique being the conventional approach. However, the use of both pedicles may present certain disadvantages, including higher costs, longer operative times, increased radiation exposure, and a greater risk of bone cement leakage. This study aims to report the 3-year follow-up outcomes of double-pedicle and single-pedicle kyphoplasty performed at our institution. <i>Materials and Methods:</i> Between June 2016 and May 2019, a total of 136 patients who presented to our clinic with osteoporotic vertebral fractures and underwent balloon kyphoplasty were included in this retrospective study. Pain relief and quality of life indices were assessed preoperatively and postoperatively. During follow-up examinations, radiographs, VAS (Visual Analog Scale) scores, and ODI (Oswestry Disability Index) scores were evaluated. Radiation exposure was assessed using fluoroscopy time and dose area product (DAP) values. Additionally, total injected cement volume, operative time, and procedural complications were retrieved from patient records. <i>Results:</i> The procedure was successful in all patients. The mean bone cement volume used was 3.4 ± 1.4 mL in the unipedicular group and 5.3 ± 2.1 mL in the bipedicular group. Fluoroscopy time and DAP values were significantly higher in the bipedicular technique compared to the unipedicular technique. At the final follow-up, the average kyphosis correction and mean vertebral height correction ratio were greater in the bipedicular group. The mean reduction in VAS and ODI scores was superior in the bipedicular group at the 1-, 2-, and 6-month follow-ups. However, at the 1-, 2-, and 3-year follow-ups, there was no significant difference in VAS and ODI scores between the two groups. <i>Conclusions:</i> The unipedicular balloon kyphoplasty technique offers several advantages, including shorter operative time, lower cement leakage risk, reduced radiation exposure, and comparable pain score reductions at 1- to 3-year follow-ups. However, the bipedicular technique provides superior short-term pain relief and demonstrates better sagittal alignment correction in long-term follow-ups compared to the unipedicular approach.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"61 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12029024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025056","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 Management of Ischemic Priapism Due to Sickle Cell Disease and Other Etiologies: Treatment Strategies and Indications for Penile Prosthesis Implantation in an Endemic Region.","authors":"Eser Ördek, Sadık Görür, Fatih Gökalp, Duran Kuru, Ferhat Uçurmak","doi":"10.3390/medicina61040658","DOIUrl":"https://doi.org/10.3390/medicina61040658","url":null,"abstract":"<p><p><i>Background and Objectives</i>: Priapism is a condition characterized by a prolonged erection lasting over four hours, either independent of or following sexual stimulation. The primary treatment goal for ischemic and non-ischemic priapism is timely and appropriate intervention in order to preserve erectile function and penile length. This study aims to evaluate the management of recurrent ischemic priapism in sickle cell disease (SCD) patients in an endemic region and compare it with ischemic priapism of other etiologies. <i>Materials and Methods</i>: Patients admitted to our hospital with a diagnosis of priapism between January 2010 and June 2024 were retrospectively reviewed. The patients were divided into two groups: ischemic priapism due to SCD and ischemic priapism due to other etiologies. Patient characteristics, treatment management, and the need for penile prosthesis (PP) were compared. <i>Results</i>: A total of 40 ischemic priapism patients were included in the study; 20 of them had SCD and the other 20 had priapism cases due to different etiologies. In the SCD priapism group, the rate of comorbidity and previous history of priapism were significantly (<i>p</i> < 0.05) higher than in the other etiologies of priapism group. Similarly, in the SCD priapism group, the hospital admission time and the rate of fibrosis findings in MRI (magnetic resonance imaging) were significantly (<i>p</i> < 0.05) higher than in the other priapism groups. The PP implantation rate in the SCD priapism group was found to be significantly (<i>p</i> < 0.05) higher than in the other priapism group. <i>Conclusions</i>: This study highlights the importance of early intervention and patient awareness in SCD-related ischemic priapism, recommending educational programs to improve symptom recognition and prevent complications.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"61 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12028485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022728","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":"Hemodynamic Performance of a Self-Expanding Transcatheter Aortic Valve with an Intra-Annular Leaflet Position in Patients with a Small Aortic Annulus.","authors":"Matjaž Bunc, Gregor Verček, Ole De Backer","doi":"10.3390/medicina61040661","DOIUrl":"https://doi.org/10.3390/medicina61040661","url":null,"abstract":"<p><p><i>Background and Objectives</i>: Transcatheter aortic valve implantation is associated with a higher risk for elevated trans-prosthetic gradients and prosthesis-patient mismatch in patients with a small aortic annulus. We aimed to assess the short-term hemodynamic performance of self-expanding transcatheter aortic valves with an intra-annular leaflet position in patients with small aortic anatomies. <i>Materials and Methods</i>: Consecutive patients with small aortic annuli (annular area < 430 mm²), who underwent transcatheter aortic valve implantation with a self-expanding Portico or Navitor (Abbott Medical, St. Paul, MN, USA) transcatheter aortic valve between October 2017 and August 2024 at the University Medical Centre Ljubljana, Slovenia, were analyzed. The main endpoints were the post-procedural mean trans-prosthetic gradient, the presence of moderate or severe prosthesis-patient mismatch or paravalvular regurgitation. <i>Results</i>: Overall, 37 patients were included in the study (29 patients with a native aortic valve and 8 patients undergoing valve-in-valve transcatheter aortic valve implantation). The mean age was 81.6 ± 4.3 years, 32 patients (86.5%) were female. The median annular perimeter was 70.8 mm (interquartile range 67.3-74.1 mm) and the median annular area was 379 mm² (interquartile range 355-412 mm²). The post-procedural mean trans-prosthetic gradient was 9.0 ± 3.5 mmHg, with no cases with a mean gradient > 20 mmHg. Moderate and severe prosthesis-patient mismatch was observed in 21.2% and 3.0% of patients, respectively. Mild paravalvular regurgitation was noted in 44.1% of patients, there were no cases of moderate or severe paravalvular regurgitation. One patient (3.0%) had moderate valvular regurgitation. <i>Conclusions</i>: Self-expanding transcatheter aortic valves with an intra-annular leaflet position are associated with favorable hemodynamic performance in patients with a small aortic annulus.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"61 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12028768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042324","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":"Systematic Review and Meta-Analysis of Transcendental Meditation for Post-Traumatic Stress Disorder.","authors":"David W Orme-Johnson, Vernon A Barnes, Brian Rees, Jean Tobin","doi":"10.3390/medicina61040659","DOIUrl":"https://doi.org/10.3390/medicina61040659","url":null,"abstract":"<p><p><i>Background and Objectives.</i> Our recent systematic review and meta-analysis of all studies on meditation as treatment for PTSD (61 studies) found a moderate effect size of Hedges's g = -0.67 for post-minus-pre change in symptom scores. Separate tests of the four meditation categories found a large effect size of g = -1.13 for the Transcendental Meditation (TM) technique that is significantly greater than for each other category. The present follow-up used a different method, calculating effects relative to internal controls, to better characterize the effects of this meditation technique. <i>Materials and Methods</i>. Our study followed Prisma guidelines. Major databases, research anthologies, and bibliographies were searched for studies that used TM for treating PTSD, all military and civilian populations, and all age groups. <i>Results.</i> The searches located 15 controlled trials on TM that met the inclusion criteria (longitudinal and reporting sufficient statistics to calculate effect sizes), 1248 subjects total, mean age 40.5 years (range 20.6 to 54.4 years), and 46.9% males (range 0% to 100%). Using the random effects model, the pooled effect across all studies of TM compared to other treatments was g = -1.01, 95% CI = -1.29 to -0.74, <i>p</i> < 0.000000001. One-study removed analysis found that no study reduced the pooled effect to less than -1.0. Funnel plots indicated no risk of bias. TM was non-inferior to prolonged exposure therapy, <i>p</i> = 0.0001, and it worked significantly faster (<i>p</i> = 0.04 at week six). <i>Conclusions.</i> TM produced clinically meaningful reductions in PTSD for civilian and military personnel, young and older adults, and for both men and women. We recommend phase-III multisite studies comparing TM with known first-line treatments for PTSD.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"61 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12028398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005800","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}