Journal of Research in Medical Sciences最新文献

{"title":"Survival outcomes correlate with the level of cell-free circulating DNA in ST-elevation myocardial infarction.","authors":"Ai-Ai Chu, Han-Xiang Gao, Ting-Ting Wu, Zheng Zhang","doi":"10.4103/jrms.jrms_335_22","DOIUrl":"10.4103/jrms.jrms_335_22","url":null,"abstract":"<p><strong>Background: </strong>Myocardial infarction (MI) can lead to higher cellular damage, making cell-free DNA (cfDNA) a potential biomarker for assessing disease severity. The aim of this study is to evaluate survival predictions using cfDNA measurements and assess its correlation with MI.</p><p><strong>Materials and methods: </strong>A direct fluorescence assay was employed to measure cfDNA content in the blood samples of participants. The inclusion criteria included patients who gave informed consent, suffering from ST-elevation myocardial infraction (STEMI) based on established diagnostic criteria (joint ESC/ACC guidelines), between the age of 18 and 80 years old, and had elevated troponin biomarker levels. The study included 150 patients diagnosed with STEMI and 50 healthy volunteers as controls. Serial monitoring of patients was conducted to track their postdisease status. The rate of change of cfDNA was calculated and daily measurements for 7 days were recorded.</p><p><strong>Results: </strong>Mean levels of cfDNA were found to be 5.93 times higher in patients with STEMI compared to healthy controls, providing clear evidence of a clinical correlation between cfDNA and STEMI. Patients were further categorized based on their survival status within a 90-day period. The study observed a strong predictive relationship between the rate of change of cfDNA during daily measurements and survival outcomes. To assess its predictive capability, a receiver operating characteristics (ROC) curve analysis was performed. The ROC analysis identified an optimal cutoff value of 2.50 for cfDNA, with a sensitivity of 81.5% and specificity of 74.0% in predicting disease outcomes.</p><p><strong>Conclusion: </strong>This study demonstrates a robust association between cfDNA and STEMI, indicating that cfDNA levels can be a valuable early prognostic factor for patients. Serial measurements of cfDNA during early disease onset hold promise as an effective approach for predicting survival outcomes in MI patients.</p>","PeriodicalId":50062,"journal":{"name":"Journal of Research in Medical Sciences","volume":"29 ","pages":"8"},"PeriodicalIF":1.6,"publicationDate":"2024-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10956566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140208154","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":"Influence of endotracheal tube and laryngeal mask airway for general anesthesia on perioperative adverse events in patients undergoing laparoscopic hysterectomy: A propensity score-matched analysis.","authors":"Yanan Jia, Yu Zhang, Zihan Wang, Wei Pan, Haifeng Fu, Wenwen Du","doi":"10.4103/jrms.jrms_384_22","DOIUrl":"10.4103/jrms.jrms_384_22","url":null,"abstract":"<p><strong>Background: </strong>To compare perioperative adverse events between general anesthesia with endotracheal tube (ETT) and general anesthesia with laryngeal mask airway (LMA) in patients undergoing laparoscopic hysterectomy.</p><p><strong>Materials and methods: </strong>This was a large sample retrospective, propensity score-matched (PSM) study. We collected the data of 6739 female patients who underwent laparoscopic hysterectomy between January 2016 and June 2021 in our hospital, China. Patients were divided into two groups (ETT group and LMA group) according to different airway management modes. Data on all perioperative adverse events were collected. PSM analysis was performed to control confounding factors and differences in baseline values between the two groups. Finally, 4150 female patients were recruited after PSM.</p><p><strong>Results: </strong>The total number of patients taking intraoperative vasoactive drugs during surgery was higher in the ETT group than in the LMA group (<i>P</i> = 0.04). The LMA group had a higher incidence of vomiting (51 [2.46%]) and somnolence (165 [7.95]) in the postanesthesia care unit (PACU) than the ETT group (71 [3.42%] and 102 [4.92%], respectively) (<i>P</i> = 0.02 and <i>P</i> < 0.001). Hypothermia was significantly higher in the LMA group (183 [10.36%]) than in the ETT group (173 [8.34%]) in the PACU (<i>P</i> = 0.03). The number of patients with sore throat was significantly higher in the ETT group (434 [20.02%]) than in the LMA group (299 [14.41%]) in the ward (<i>P</i> < 0.001). Other variables such as hypoxemia, moderate to severe pain, abdominal distension, diarrhea, sleep disorders, wound bleeding, and skin itch were not significantly different between the two groups (<i>P</i> > 0.05).</p><p><strong>Conclusion: </strong>The ETT group had more incidences of vomiting, sore throat, and cough complications and needed more drug treatment than the LMA group. LMA is a better airway management mode and LMA general anesthesia can be safely used in patients undergoing laparoscopic nonemergency hysterectomy.</p>","PeriodicalId":50062,"journal":{"name":"Journal of Research in Medical Sciences","volume":"28 ","pages":"88"},"PeriodicalIF":1.5,"publicationDate":"2024-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10953732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140177467","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":"Lifestyle factors on the long-term survival of gastric cancer patients after radical resection: A cohort study.","authors":"Huadong Wu, Jinjia Zhang, Baojun Zhou","doi":"10.4103/jrms.jrms_375_22","DOIUrl":"10.4103/jrms.jrms_375_22","url":null,"abstract":"<p><strong>Background: </strong>This retrospective cohort study aimed to evaluate the effect of lifestyle factors (e.g., smoking, drinking, physical exercise, and sleep duration) on the long-term survival of gastric cancer (GC) patients after radical resection.</p><p><strong>Materials and methods: </strong>GC patients after radical resection were enrolled from January 2016 to December 2017. Their baseline clinical data, lifestyle factors, and prognosis were collected. The primary endpoint was all-cause death. The relationship between the variables and survival was examined using the Cox proportional hazards model.</p><p><strong>Results: </strong>A total of 309 patients were enrolled and 296 patients were followed up for a median of 54.0 months, with 130 confirmed deaths. Older age (>60 years) (hazard ratio [HR]: 1.307, 95% confidence interval [CI]: 1.056-2.161, <i>P</i> = 0.006), advanced tumor, node, and metastasis stage (<i>P</i> < 0.05), poorly pathological differentiation (HR: 1.765, 95% CI: 1.080-2.884, <i>P</i> = 0.023), history of smoking (<i>P</i> < 0.001), never physical exercise (HR: 2.057, 95% CI: 1.170-3.617, <i>P</i> = 0.012), long sleep duration (≥8 h) (HR: 4.160, 95% CI: 1.501-11.533, <i>P</i> = 0.006), and short sleep duration (<6 h) (HR: 3.417, 95% CI: 1.312-8.900, <i>P</i> = 0.012) were independent indicators of a poor overall survival in GC patients after radical resection.</p><p><strong>Conclusion: </strong>Smoking cessation, proper sleep duration, and regular physical exercise habits can improve the long-term survival of GC patients after radical resection.</p>","PeriodicalId":50062,"journal":{"name":"Journal of Research in Medical Sciences","volume":"29 ","pages":"11"},"PeriodicalIF":1.6,"publicationDate":"2024-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10956563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140208150","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 value of mitral annular calcification in coronary atherosclerotic disease assessed by coronary computed tomographic angiography.","authors":"Maryam Moradi, Amirabbas Shafiei Jahromi","doi":"10.4103/jrms.jrms_53_23","DOIUrl":"10.4103/jrms.jrms_53_23","url":null,"abstract":"<p><strong>Background: </strong>There is a lack of evidence on the link between mitral annular calcification (MAC) and coronary atherosclerotic diseases. The present investigation was undertaken to detect the clinical and prognostic value of MAC in coronary atherosclerotic diseases in patients who underwent coronary computed tomographic (CT) angiography.</p><p><strong>Materials and methods: </strong>Two hundred and five individuals with MAC and without it (<i>n</i> = 85 and 120, respectively) were included in the present cross-sectional study. Coronary artery disease-reporting and data system (CAD-RADS) at coronary CT angiography was used to define the severity of coronary atherosclerotic diseases. Patients were classified into no or non-significant CAD (CAD-RADS 0-2) and significant CAD (CAD-RADS 3-5) according to the severity of coronary atherosclerotic diseases. The association of MAC with two mentioned groups (no or non-significant CAD and significant CAD) was assessed using the Chi-squared test and logistic regression in crude and adjusted models.</p><p><strong>Results: </strong>Patients with MAC were significantly older (69.34 ± 8.20 vs. 60.64 ± 11.42, <i>P</i> < 0.001), had lower glomerular infiltration rate (69.67 ± 20.92 vs. 78.00 ± 20.23, <i>P</i> = 0.005), and higher coronary artery calcification score (352.87 ± 495.85 vs. 200.55 ± 426.13, <i>P</i> = 0.05) in comparison to those without MAC. However, the significant difference between the two groups regarding coronary artery calcification score disappeared after adjustment for confounders (<i>P</i> = 0.14). In addition, a statistically significant positive link between MAC and significant CAD was observed (odds ratio [OR] [95% confidence interval (CI)]: 1.96 [1.04-3.71], <i>P</i> = 0.04). Nevertheless, the association became statistically insignificant after adjustment for confounders (OR [95% CI]: 1.60 [0.78-3.28], <i>P</i> = 0.2).</p><p><strong>Conclusion: </strong>The findings of the study revealed that MAC has no independent prognostic value in coronary atherosclerotic diseases evaluated by coronary CT angiography.</p>","PeriodicalId":50062,"journal":{"name":"Journal of Research in Medical Sciences","volume":"29 ","pages":"3"},"PeriodicalIF":1.6,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10956555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140208151","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":"Secondary analysis: Graph analysis of brain connectivity network in autism spectrum disorder.","authors":"Fatemeh Pourmotahari, Nasrin Borumandnia, Seyyed Mohammad Tabatabaei, Hamid Alavimajd","doi":"10.4103/jrms.jrms_428_22","DOIUrl":"10.4103/jrms.jrms_428_22","url":null,"abstract":"<p><strong>Background: </strong>Autism spectrum disorder is a neurodevelopmental condition in which impaired connectivity of the brain network. The functional magnetic resonance imaging (fMRI) technique can provide information on the early diagnosis of autism by evaluating communication patterns in the brain. The present study aimed to assess functional connectivity (FC) variations in autism patients.</p><p><strong>Materials and methods: </strong>Resting-state fMRI data were obtained from the \"ABIDE\" website. These data include 294 autism patients with a mean (standard deviation) age of 16.49 (7.63) and 312 healthy individuals with a mean (standard deviation) age of 15.98 (6.31). In this study, changes in communication patterns across different brain regions in autism patients were investigated using graph-based models.</p><p><strong>Results: </strong>The FC cluster of 17 regions in the brain, such as the hippocampus, cuneus, and inferior temporal, was different between the patient and healthy groups. Based on connectivity analysis of pair regions, 36 of the 136 correlations in the cluster were significantly different between the two groups. The middle temporal gyrus had more communication than the other regions. The largest difference between groups was - 0.112, which corresponding to the right middle temporal and right thalamus regions.</p><p><strong>Conclusion: </strong>The findings of this study revealed functional relationship alterations in patients with autism compared to healthy individuals, indicating the disease's effects on the brain connectivity network.</p>","PeriodicalId":50062,"journal":{"name":"Journal of Research in Medical Sciences","volume":"29 ","pages":"2"},"PeriodicalIF":1.6,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10956556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140208153","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 validity and reliability of the Persian version of the Athlete Sleep Screening Questionnaire.","authors":"Mohammad Mandegar Najafabadi, Hooman Angoorani, Jonathan Charest, Charles H Samuels, Kiana Bagherzadeh, Ahmad Nazari, Ali Mazaherinezhad","doi":"10.4103/jrms.jrms_246_23","DOIUrl":"10.4103/jrms.jrms_246_23","url":null,"abstract":"<p><strong>Background: </strong>Sleep as a biological phenomenon is effective in the performance and recovery of athletes. Questionnaires can be used as a cost-effective initial assessment tool for sleep. The Athlete Sleep Screening Questionnaire (ASSQ) demonstrated a clinically valid instrument for screening relevant sleep issues in athletic populations. Due to the lack of validated tools for adequate screening for sleep difficulties in the Iranian athlete population, the present study was conducted to evaluate the validity and reliability of the Persian version of the ASSQ.</p><p><strong>Materials and methods: </strong>The translation process was performed using instructions by Beaton <i>et al</i>. Content validity was assessed by a panel of experts. Exploratory and confirmatory factor analysis was performed for two 5-item sleep difficulty scores (SDS) and a 4-item chronotype score. Internal consistency based on Cronbach's alpha and McDonald's omega and stability reliability were used to evaluate reliability.</p><p><strong>Results: </strong>The ASSQ achieved conceptual and semantic equivalence with the original scale. The item-level content validity index (I-CVI) of each item ranged from 0.87 to 1, and the averaging scale-level CVI/average was 0.95. In factor analysis, one factor for SDS and one factor for chronotype score were identified and confirmed. The internal consistency of the SDS scale (α =0.77, Ω =0.83) and chronotype (α =0.74, Ω =0.77) was acceptable. Stability reliability was confirmed for SDS scale (intra-class correlation [ICC] =0.87) and for chronotype (ICC = 0.83).</p><p><strong>Conclusion: </strong>Persian ASSQ has acceptable psychometric measurement properties as a screening tool to assess sleep in Iranian athletes.</p>","PeriodicalId":50062,"journal":{"name":"Journal of Research in Medical Sciences","volume":"29 ","pages":"1"},"PeriodicalIF":1.6,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10956700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140208156","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 frequency of NRAS mutation in stool samples of Iranian colorectal cancers compared to Finnish patients.","authors":"Farideh Saberi, Omar Youssef, Arto Kokkola, Mahsa Khodadoostan, Pauli Puolakkainen, Rasoul Salehi, Sakari Knuutila","doi":"10.4103/jrms.jrms_208_23","DOIUrl":"10.4103/jrms.jrms_208_23","url":null,"abstract":"<p><strong>Background: </strong>Stools from colorectal cancer patients are noninvasive samples that could be used to compare the frequency of hotspot mutations between two different ethnic cohorts.</p><p><strong>Materials and methods: </strong>We collected stool samples from the Iranian cohort (52 patients and 49 controls) and the Finnish cohort (40 patients and 14 controls). Following stool DNA extraction, we used the AmpliSeq Colon and Lung Cancer panel to prepare DNA libraries before sequencing.</p><p><strong>Results: </strong>The Iranian cohort exhibited 35 hotspot mutations in the <i>BRAF</i>, <i>ERBB4</i>, <i>FBXW7</i>, <i>FGFR1</i>, <i>FGFR3</i>, <i>KRAS</i>, <i>MAP2K</i>, <i>MET</i>, <i>NRAS</i>, <i>PIK3C</i>, <i>SMAD4</i>, and <i>TP53</i> genes. In the Finnish cohort, 13 hotspot mutations were found in the <i>AKT1</i>, <i>APC</i>, <i>KIT</i>, <i>KRAS</i>, <i>SMO</i>, <i>STK11</i>, and <i>TP53</i> genes. Mutations in <i>NRAS</i> and <i>FGFR3</i> were observed only in the Iranian cohort, while <i>APC</i> mutations were exclusive for the Finnish cohort.</p><p><strong>Conclusion: </strong>Genes involved in MAPK and PI3K-MAPK pathways showed a higher frequency of mutations in Iranian patients which may have therapeutic implications.</p>","PeriodicalId":50062,"journal":{"name":"Journal of Research in Medical Sciences","volume":"29 ","pages":"4"},"PeriodicalIF":1.6,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10956560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140208155","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":"Does metabolic syndrome increase contrast-induced nephropathy in patients with normal renal function?","authors":"Hasan Shemirani, Ali Hosseini","doi":"10.4103/jrms.jrms_136_21","DOIUrl":"10.4103/jrms.jrms_136_21","url":null,"abstract":"<p><strong>Background: </strong>Contrast-induced nephropathy (CIN) is associated with increased mortality and morbidity in patients undergoing coronary angiography (CAG) and percutaneous coronary intervention. This study aimed to compare the incidence of CIN in two groups of patients with and without metabolic syndrome (Mets) with baseline normal renal function.</p><p><strong>Materials and methods: </strong>In this case - control study, 260 patient candidates for CAG, 130 patients with Mets and 130 patients without Mets participated, and their serum creatinine (Cr) level before and the 48 and 72 h after the angiography was measured. The incidence of CIN was compared in two groups. Two-way analysis of variance with repeated measures and univariate and multivariate logistic regression models.</p><p><strong>Results: </strong>The results showed a higher chance of being Mets with raising in triglyceride (adjusted odds ratio = 1.05, 95% confidence interval = (1.03-1.06), <i>P</i> < 0.001), Fasting blood glucose (1.010 [1.001-1.019], <i>P</i> = 0.025), and diastolic blood pressure (1.07 [1.07-1.20], <i>P</i> < 0.001), but declining in high-density lipoprotein-cholesterol (HDL-C) (0.91 [0.85-0.98], <i>P</i> = 0.008). Furthermore, blood urea nitrogen (BUN) and Cr level was raised in 48 and 72 h after contrast injection in both groups (All <i>P</i> < 0.001). Furthermore, in 48 h (3.11 [1.12-9.93], <i>P</i> = 0.016) and 72 h (2.82 [1.07-8.28], <i>P</i> = 0.021) after injection, a total of 25 patients had an increased Cr level and a significant difference between Mets and without Mets groups. The developing Mets had a significant association with the increased risk of AKI, which increased the chance of developing nephropathy (7.14 [2.27-22.5], <i>P</i> = 0.001).</p><p><strong>Conclusion: </strong>Mets, together with other risk factors, increased the overall risk of CIN development. Therefore, the incidence of CIN in patients Mets is significantly higher than that of patients without Mets, indicating a more important CIN risk factor.</p>","PeriodicalId":50062,"journal":{"name":"Journal of Research in Medical Sciences","volume":"29 ","pages":"5"},"PeriodicalIF":1.6,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10956558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140208096","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":"Erratum: Metformin: Current knowledge.","authors":"","doi":"10.4103/JRMS.JRMS_62_24","DOIUrl":"10.4103/JRMS.JRMS_62_24","url":null,"abstract":"<p><p>[This corrects the article on p. 658 in vol. 19, PMID: 25364368.].</p>","PeriodicalId":50062,"journal":{"name":"Journal of Research in Medical Sciences","volume":"29 ","pages":"6"},"PeriodicalIF":1.6,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10956562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140208149","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":"Avascular necrosis predictive factors after closed reduction in patients with developmental dysplasia of the hip.","authors":"Sara Kheiri, Mohammad Ali Tahririan, Soheil Shahnaser, Mohammadreza Piri Ardakani","doi":"10.4103/jrms.jrms_288_23","DOIUrl":"10.4103/jrms.jrms_288_23","url":null,"abstract":"<p><strong>Background: </strong>Developmental dysplasia of the hip (DDH) is a common pediatric orthopedic condition. Closed reduction (CR) is the conservative treatment approach with high success rates for DDH. However, avascular necrosis (AVN) is a severe potential complication after this procedure. This study retrospectively assessed the potential risk factors for AVN occurrence after CR and Spica cast immobilization.</p><p><strong>Materials and methods: </strong>In a retrospective observational study, 71 patients (89 hips) with DDH aged 6-24 months old undergoing CR were enrolled. All patients were followed up for 3 years, and their demographic data, initial Tönnis grade, pre-reduction procedures, abduction angle in the Spica cast, and the AVN presence (based on Bucholz and Ogden classification [3^rd-4^th class]) were documented.</p><p><strong>Results: </strong>Of 71 patients (89 hips) with a mean age of 12.5 ± 3.9 months, 13 patients (18 hips) developed AVN. The mean age of patients in the AVN and non-AVN groups was 14.3 ± 4.9 and 12.2 ± 3 months (<i>P</i> = 0.07); also, the mean abduction angle in patients with and without AVN was 51.86 ± 3.66 and 58.46 ± 3.91 (<i>P</i> < 0.001) in univariate analysis. The distribution of initial Tönnis grade, and previous conservative procedures, adductor tenotomies during the CR were comparable between the two groups (<i>P</i> > 0.05). We found age 12 months and 54° in abduction angle as the best cutoff values for differentiating AVN patients from non-AVN and the risk of experiencing AVN for patients older than 12 months was odds ratio (OR) =4.22 (<i>P</i> = 0.06) and patients with abduction angle greater than 54 was OR = 34.88 (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>In this study, older age at the time of intervention and larger abduction angle in the hip Spica cast were two predictors of experiencing AVN in DDH patients after undergoing CR treatment approach. Performing CR at a younger age and keeping the abduction angle lower than 54° in the hip Spica cast could help to have the best possible prognosis.</p><p><strong>Level of evidence: </strong>IV, retrospective, observational, cross-sectional study.</p>","PeriodicalId":50062,"journal":{"name":"Journal of Research in Medical Sciences","volume":"28 ","pages":"81"},"PeriodicalIF":1.5,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10826850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139643252","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}