Medicina-Lithuania最新文献

{"title":"Endoscopic Ultrasound-Guided Pancreatic Tissue Sampling: Lesion Assessment, Needles, and Techniques.","authors":"Jahnvi Dhar, Jayanta Samanta, Zaheer Nabi, Manik Aggarwal, Maria Cristina Conti Bellocchi, Antonio Facciorusso, Luca Frulloni, Stefano Francesco Crinò","doi":"10.3390/medicina60122021","DOIUrl":"https://doi.org/10.3390/medicina60122021","url":null,"abstract":"<p><p>Endoscopic ultrasound (EUS)-guided tissue sampling includes the techniques of fine needle aspiration (FNA) and fine needle biopsy (FNB), and both procedures have revolutionized specimen collection from the gastrointestinal tract, especially from remote/inaccessible organs. EUS-FNB has replaced FNA as the procedure of choice for tissue acquisition in solid pancreatic lesions (SPLs) across various society guidelines. FNB specimens provide a larger histological tissue core (preserving tissue architecture) with fewer needle passes, and this is extremely relevant in today's era of precision and personalized molecular medicine. Innovations in needle tip design are constantly under development to maximize diagnostic accuracy by enhancing histological sampling capabilities. But, apart from the basic framework of the needle, various other factors play a role that influence diagnostic outcomes, namely, sampling techniques (fanning, aspiration or suction, and number of passes), collection methods, on-site evaluation (rapid, macroscopic, or visual), and specimen processing. The choice taken depends strongly on the endoscopist's preference, available resources at the disposal, and procedure objectives. Hence, in this review, we explicate in detail the concepts and available literature at our disposal on the topic of EUS-guided pancreatic tissue sampling to best guide any practicing gastroenterologist/endoscopist in a not-to-ideal set-up, which EUS-guided tissue acquisition technique is the \"best\" for their case to augment their diagnostic outcomes.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"60 12","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Exercise on Physiological, Biochemical, and Analytical Parameters in Patients with Heart Failure with Reduced Ejection Fraction.","authors":"Francisco Epelde","doi":"10.3390/medicina60122017","DOIUrl":"https://doi.org/10.3390/medicina60122017","url":null,"abstract":"<p><p>Heart failure with reduced ejection fraction (HFrEF) is a condition marked by diminished cardiac output and impaired oxygen delivery to tissues. Exercise, once avoided in HFrEF patients due to safety concerns, is now recognized as an important therapeutic intervention. Structured exercise improves various physiological, biochemical, and analytical parameters, including cardiac output, endothelial function, skeletal muscle performance, and autonomic regulation. Biochemically, exercise induces favorable changes in inflammatory markers, lipid profiles, glucose metabolism, and renal function. This paper reviews these changes, highlighting how exercise can be safely incorporated into HFrEF management. Further research is needed to tailor exercise interventions for individual patients to optimize outcomes.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"60 12","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Point-of-Care Ultrasound on the Diagnosis and Management of Small Bowel Obstruction in the Emergency Department: A Retrospective Observational Single-Center Study.","authors":"Carmine Cristiano Di Gioia, Alice Alame, Daniele Orso","doi":"10.3390/medicina60122006","DOIUrl":"https://doi.org/10.3390/medicina60122006","url":null,"abstract":"<p><p><i>Background and Objectives</i>: Small bowel obstruction (SBO) requires prompt diagnosis and management. Due to its advantages, POCUS can be beneficial when assessing SBO. However, it is still doubtful whether POCUS performed by an emergency doctor can prolong the time of patients with SBO in the emergency department (ED). The primary outcome was time to diagnosis when using POCUS compared to not using it. Secondary outcomes included the processing time in the ED, ED length of stay (LOS), rates of abdominal radiography, hospital LOS, and mortality. <i>Materials and Methods</i>: We conducted a retrospective, observational study in our ED from 1 November 2021 to 31 December 2023, including patients aged 18 and older diagnosed with SBO. Both groups received confirmation of their diagnosis through contrast-enhanced computed tomography. The two groups of patients (POCUS group vs. non-POCUS group) were compared regarding the time needed to reach the final diagnosis (i.e., time to diagnosis), the ED LOS, the hospital LOS, and in-hospital mortality. <i>Results</i>: A total of 106 patients were included. The median time to diagnosis was 121 min for the POCUS group vs. 217 min for the non-POCUS group (<i>p</i> < 0.001). Median ED processing time was 276 min in the POCUS group compared to 376 min in the non-POCUS group (<i>p</i> = 0.006). ED LOS was also shorter in the POCUS group (333 vs. 436 min, <i>p</i> = 0.010). Abdominal X-ray rates were lower in the POCUS group (49% vs. 78%, <i>p</i> = 0.004). Hospital LOS was similar between the two groups (<i>p</i> = 1.000). Five non-POCUS patients died during hospitalization; none died in the POCUS group, but the difference was not statistically significant (<i>p</i> = 0.063). <i>Conclusions</i>: POCUS significantly reduced time to diagnosis and ED LOS. Further exploration is needed to assess long-term outcomes and the cost-effectiveness of integrating POCUS into ED practice.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"60 12","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Manual Therapy and Home Exercise Treatment on Pain, Stress, Sleep, and Life Quality in Patients with Bruxism: A Randomized Clinical Trial.","authors":"Merve Berika Kadıoğlu, Miraç Sezer, Bülent Elbasan","doi":"10.3390/medicina60122007","DOIUrl":"https://doi.org/10.3390/medicina60122007","url":null,"abstract":"<p><p><i>Background and Objectives</i>: This study aimed to examine the effects of manual therapy (MT) and home exercise (HE) treatments on pain, sleep quality, stress level, and quality of life in patients with bruxism. <i>Materials and Methods</i>: The study included 30 bruxism patients ages 18-25 years who were randomly divided into the manual therapy group (MTG) and home exercise group (HEG). Before treatment (T1), all patients were asked to fill out the Pittsburgh Sleep Quality Index (PSQI), Perceived Stress Scale (PSS), Fonseca Anamnestic Index (FAI), and Quality of Life Scale/Short Form-36 (SF-36), and additionally, the number of trigger points (NTP) and pain levels were determined. MT and HE were applied for 8 weeks, and all tests were repeated at the end of treatment (T2). A paired-samples <i>t</i> test was used for intra-group comparisons at T1 and T2, and an independent <i>t</i> test was used for inter-group comparisons. The statistical significance level was accepted as <i>p</i> < 0.05. <i>Results</i>: When the results obtained with MT and HE were examined after 8 weeks of treatment, a significant difference was found for all parameters (FAI, PSQI, PSS, SF-36, NTP, activity pain, and night pain levels, <i>p</i> < 0.05) except rest pain in HEG. According to the inter-group comparison, a significant difference was found in PSQI, FAI, and NTP (<i>p</i> < 0.05). However, it was determined that both groups showed statistically similar effects in terms of pain, perceived stress, and quality of life (<i>p</i> > 0.05). <i>Conclusions</i>: MT and HE reduce perceived stress and pain intensity and also improve quality of life and sleep in patients with bruxism. HE is as effective as MT in terms of pain, stress quality of life. MT is more effective than HE in improving sleep quality and TMD symptoms. Both manual therapy and home exercise applications can be applied as alternative treatment methods in the treatment of bruxism.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"60 12","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effectiveness of a Specific Exercise Program in Alleviating Work-Related Neck and Upper Back Pain and Improving Mood State in Various Occupational Populations-A Randomized Controlled Trial.","authors":"Anastasia Beneka, Paraskevi Sakellari, Katerina Daskalaki, Paraskevi Malliou, Theodoros Konstantinidis","doi":"10.3390/medicina60122002","DOIUrl":"https://doi.org/10.3390/medicina60122002","url":null,"abstract":"<p><p><i>Background and Objectives:</i> The COVID-19 pandemic brought significant challenges across governmental, industrial, and social systems. Additionally, numerous studies have reported a sharp increase in both mental health issues and musculoskeletal disorders worldwide. This study aimed to investigate whether a specific exercise program could alleviate neck and upper back pain symptoms and improve mood state among healthcare and office employees during the post-COVID-19 period. <i>Materials and Methods</i>: This was an unblinded (open label) randomized controlled trial (both the participants and the researchers knew which treatment or intervention was being administered). In total, 40 healthcare employees from a public hospital and 98 remote office employees, all of whom reported neck and upper back pain, were randomly assigned to an experimental (EG) and control group (CG). The experimental groups underwent the same exercise protocol, while their corresponding control groups underwent the assessments only. Pain assessment using the Visual Analogue Scale (VAS) and mood state using the Feeling Scale (FS) questionnaires of the participants were recorded at baseline (pre-intervention) and immediately following the exercise intervention period of 6 weeks (post-intervention). The intervention consisted of 18 exercise sessions conducted over a 6-week period, with remote office workers participating online and healthcare workers attending exercise sessions on site (at the hospital). Statistical analysis was performed using non-parametric Mann-Whitney and Wilcoxon tests, as appropriate. <i>Results</i>: Following the six-week intervention, the percentage of workers in the EG reporting pain decreased significantly (from 75% to 45% for healthcare workers and from 54% to 25% for office employees), whereas no change was observed for their corresponding control groups. Similarly, the mood state of the EGs significantly improved compared with the control groups, as measured between pre- and post-intervention sessions. <i>Conclusions</i>: The COVID-19 period exacerbated stress and musculoskeletal strain, particularly for workers in demanding occupational roles. To mitigate these effects, exercise programs that can be applied while at work should be implemented, as they are effective in enhancing mood and managing neck pain in employees with physical exertion.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"60 12","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Age Predicts Nasal Septal Deviation in Orthognathic Surgery: A Non-Randomized Clinical Trial of 102 Participants.","authors":"Juergen Taxis, Henrik-Robert Florian, Gerardo Napodano, Maximilian Rink, Felix Nieberle, Katja Himmelstoß, Sophia R Lindner, Tobias Ettl, Torsten E Reichert, Waltraud Waiss","doi":"10.3390/medicina60122000","DOIUrl":"https://doi.org/10.3390/medicina60122000","url":null,"abstract":"<p><p><i>Background and Objectives</i>: Orthognathic surgery is used to restore a correct anatomical and functional relationship between the jaws, with postoperative nasal septal deviation (NSD) being a common complication of Le Fort I osteotomy (LF-IO). The aim of this study was to evaluate the occurrence of NSD after LF-IO and to identify possible risk factors. <i>Materials and Methods</i>: Pre- and postoperative cone beam computed tomography (CBCT) scans from 2018 to 2023 of 102 patients after LF-IO were analyzed. After categorizing the preoperative NSDs according to the Mladina classification, the next step was to measure the angle of deviation and classify the severity grades. Pre- and postoperative NSDs were compared using a paired Wilcoxon signed-rank test and postoperative changes in NSD were correlated with surgery-relevant characteristics by calculating Spearman's correlation coefficients. <i>Results</i>: Postoperatively, an increase in NSD was observed in 62 cases and 35 patients showed a decrease. In both cases with an increase and a decrease in NSD, the preoperatively measured deviations showed a highly significant difference compared to postoperative NSDs (both <i>p</i> < 0.001). Age correlated significantly with increases in deviation (<i>r</i> = 0.28, <i>p</i> = 0.014, CI: -1.0--0.068) and anterior maxillary displacement showed a significant correlation with a decrease in NSD (<i>r</i> = 0.296, <i>p</i> = 0.042, CI: 0.006-1.0). Gender, cranial and caudal movements of the maxilla had no influence on the results of the NSDs. <i>Conclusions</i>: LF-IO has an influence on NSD and can both intensify and attenuate it. In addition, the risk of an increase in nasal deviation after this surgical procedure rises with the patient's age and decreases with anterior displacement of the maxilla.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"60 12","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11676348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958002","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":"Establishing an Extracorporeal Cardiopulmonary Resuscitation Program.","authors":"Pietro Bertini, Fabio Sangalli, Paolo Meani, Alberto Marabotti, Antonio Rubino, Sabino Scolletta, Valentina Ajello, Tommaso Aloisio, Massimo Baiocchi, Fabrizio Monaco, Marco Ranucci, Cristina Santonocito, Simona Silvetti, Filippo Sanfilippo, Gianluca Paternoster","doi":"10.3390/medicina60121979","DOIUrl":"https://doi.org/10.3390/medicina60121979","url":null,"abstract":"<p><p>Extracorporeal cardiopulmonary resuscitation (ECPR) is a complex, life-saving procedure that uses mechanical support for patients with refractory cardiac arrest, representing the pinnacle of extracorporeal membrane oxygenation (ECMO) applications. Effective ECPR requires precise patient selection, rapid mobilization of a multidisciplinary team, and skilled cannulation techniques. Establishing a program necessitates a cohesive ECMO system that promotes interdisciplinary collaboration, which is essential for managing acute cardiogenic shock and severe pulmonary failure. ECPR is suited for selected patients, emphasizing the need to optimize every step of cardiac arrest management-from public education to advanced post-resuscitation care. The flexibility of ECMO teams allows them to manage various emergencies such as cardiogenic shock, massive pulmonary embolism, and severe asthma, showcasing the program's adaptability. Launching an ECPR program involves addressing logistical, financial, and organizational challenges. This includes gaining administrative approval, assembling a diverse team, and crafting detailed protocols and training regimens. The development process entails organizing teams, refining protocols, and training extensively to ensure operational readiness. A systematic approach to building an ECPR program involves establishing a team, defining patient selection criteria, and evaluating caseloads. Critical elements like patient transport protocols and anticoagulation management are vital for the program's success. In conclusion, initiating an ECPR program demands thorough planning, collaborative effort across specialties, and ongoing evaluation to improve outcomes in critical cardiac emergencies. This guide offers practical insights to support institutions in navigating the complexities of ECPR program development and maintenance.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"60 12","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11676360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957143","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":"Antimicrobial Susceptibility Patterns and Antimicrobial Therapy of Infections Caused by <i>Elizabethkingia</i> Species.","authors":"Chienhsiu Huang","doi":"10.3390/medicina60121990","DOIUrl":"https://doi.org/10.3390/medicina60121990","url":null,"abstract":"<p><p><i>Background and Objectives</i>: <i>Elizabethkingia</i> species have become significant sources of infections acquired in hospital settings and are commonly linked to high mortality rates. Antimicrobial resistance can be influenced by <i>Elizabethkingia</i> species, geographical location, antimicrobial susceptibility testing methods, and the time of bacterial isolation. There are distinct antimicrobial susceptibility patterns among species, and the investigation into potential antibiotic susceptibility variations among species is beneficial. There is no guidance on the treatment of <i>Elizabethkingia</i> species infections in the literature. Consequently, the purpose of this review was to elaborate on the antimicrobial susceptibility patterns of <i>Elizabethkingia</i> species through a scoping review of existing studies on the antibiograms of the <i>Elizabethkingia</i> species and on the illness caused by <i>Elizabethkingia</i> species. <i>Materials and Methods</i>: A comprehensive literature search in PubMed and Web of Science between 1 January 2000 and 30 April 2024 identified all studies, including those that examined antimicrobial susceptibility patterns and antimicrobial therapy of infections caused by <i>Elizabethkingia</i> species. I considered studies on antimicrobial susceptibility testing for <i>Elizabethkingia</i> species in which only broth microdilution methods and agar dilution methods were used. <i>Results</i>: The sensitivity levels of <i>Elizabethkingia meningoseptica</i> to piperacillin-tazobactam (5-100%), ciprofloxacin (0-43.4%), levofloxacin (30-81.8%), trimethoprim-sulfamethoxazole (0-100%), tigecycline (15-100%), minocycline (60-100%), and rifampicin (94-100%) varied. The sensitivity levels of <i>Elizabethkingia anophelis</i> to piperacillin-tazobactam (3.3-93.3%), ciprofloxacin (1-75%), levofloxacin (12-100%), trimethoprim-sulfamethoxazole (1.02-96.7%), tigecycline (0-52.2%), minocycline (97.5-100%), and rifampicin (20.5-96%) varied. The sensitivity levels of <i>Elizabethkingia miricola</i> to piperacillin-tazobactam (41.6-94.0%), ciprofloxacin (14-75%), levofloxacin (77.0-100%), trimethoprim-sulfamethoxazole (18.0-100%), tigecycline (50%), minocycline (100%), and rifampicin (66-85.7%) varied. <i>Conclusions</i>: The majority of the isolates of <i>Elizabethkingia</i> species were susceptible to minocycline and rifampin. This issue requires professional knowledge integration and treatment recommendations.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"60 12","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Frequent Use of Advanced Energy Devices Improve Hysterectomy Outcomes?","authors":"Hyunkyoung Seo, Seon-Mi Lee, Aeran Seol, Seongmin Kim, Sanghoon Lee, Jae-Yun Song","doi":"10.3390/medicina60121978","DOIUrl":"https://doi.org/10.3390/medicina60121978","url":null,"abstract":"<p><p><i>Background and Objectives</i>: The objective of this study was to assess the efficient use of advanced energy devices by examining the impact of their usage frequency on surgical outcomes of total laparoscopic hysterectomies. <i>Materials and Methods</i>: A retrospective study was conducted between 2020 and 2023 by a single surgeon. The patients' medical records and surgical videos were reviewed. Cases were categorized into three groups based on the frequency of usage of advanced energy devices: Group 1 (≤10 uses), Group 2 (11-20 uses), and Group 3 (≥21 uses). The differences in blood loss, surgery time, and surgical outcomes among these groups were analyzed. This study was conducted as a single-center retrospective analysis. It included 126 patients who underwent total laparoscopic hysterectomy and provided informed consent for video recording. To evaluate the usage of advanced energy devices, anonymized surgical videos were reviewed, and outcomes were analyzed based on the frequency of usage of advanced energy devices. <i>Results</i>: The time required for surgery differed significantly among the three groups (<i>p</i> = 0.006). However, no significant differences were observed in the changes in hemoglobin levels or estimated blood loss (<i>p</i> = 0.255 and 0.053, respectively). Additionally, the application of hemostatic agents, the need for intraoperative or postoperative transfusions, and the use of intravenous hemostatic agents postoperatively showed no notable variation. Complication rates, including rates of hematoma, urinary tract injury, gastrointestinal injury, and infections necessitating reoperation, were also comparable. <i>Conclusions</i>: The findings suggest that the prudent and strategic use of advanced energy devices, rather than their frequent application, may improve surgical efficiency without increasing the risk of complications.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"60 12","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11680009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957940","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":"Pediatric Nephrolithiasis: A Changing Landscape Through Time and Space.","authors":"Luca Pecoraro, Arianna Zuccato, Rebecca Vitella, Angelo Pietrobelli, Giorgio Piacentini, Milena Brugnara","doi":"10.3390/medicina60121993","DOIUrl":"https://doi.org/10.3390/medicina60121993","url":null,"abstract":"<p><p>Pediatric nephrolithiasis is an ancient and complex disorder that has seen a significant rise in recent decades and the underlying causes contributing to stone formation in children may also be shifting. Historically, kidney stones have been linked to factors such as metabolic disorders, congenital abnormalities, and family history. However, the recent increase in incidence appears to be associated with new risk factors, including changes in lifestyle and diet, the growing prevalence of obesity, metabolic syndrome, diabetes, and even climate change. Given this evolving landscape, performing a comprehensive metabolic evaluation during the diagnostic process is essential. A complete metabolic evaluation should thus be performed during the diagnostic assessment to identify any modifiable risk factors predisposing to stone recurrence and reduce the need for surgical management, extrarenal comorbidity, and the increased burden of care.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"60 12","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}