Clinica Terapeutica最新文献

{"title":"The Effect of Probiotic Use on Gut Leakage Measured by Zonulin and its Relation to P Cresyl Sulfate and Inflammation in Hemodialysis Patients: A prospective controlled clinical study.","authors":"Mostafa Abdelnasier, H Elshinnawy, Waleed Anwar Abdelmohsen, Diana Daniel, Nayra Mehanna, Nahla Tohami","doi":"10.7417/CT.2026.2022","DOIUrl":"10.7417/CT.2026.2022","url":null,"abstract":"<p><strong>Objective: </strong>In chronic kidney disease, gut dysbiosis increases intestinal permeability, allowing toxins to enter the bloodstream and causing inflammation. This study aimed to assess the impact of probiotic supplementation on serum Zonulin levels, P-cresyl sulfate and highly sensitive C-reactive protein (hs-CRP) in hemodialysis patients.</p><p><strong>Materials and methods: </strong>Forty hemodialysis patients were enrolled and divided into either a probiotic group or a control group (20 patients per group). The probiotic group received supplements for 3 months. Serum Zonulin, hs-CRP and P-cresyl sulfate were measured at baseline and after the 3-month intervention.</p><p><strong>Results: </strong>After 3 months of probiotic administration, the probiotic group showed a statistically significant decrease in serum Zonulin (p < 0.001), P-cresyl sulfate (p < 0.001) and hs-CRP (p = 0.037). Furthermore, a significant difference was observed between the two groups regarding post-intervention levels of Zonulin (p < 0.001), P-cresyl sulfate (p < 0.001), and hs-CRP (p < 0.001).</p><p><strong>Conclusions: </strong>Probiotic administration in hemodialysis patients improved intestinal barrier integrity, reduced gut-derived toxin levels, and lowered systemic inflammation.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"177 3","pages":"405-413"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147788081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plasma Asymmetric Dimethylarginine as a Biomarker of Disease Severity and Therapeutic Response in Neonatal Persistent Pulmonary Hypertension: An Observational Prospective Case-Control Study.","authors":"Rania M Abdou, Maged A El Wakeel, Ghada M El-Kassas, Walaa H Ali, Hend M Ahmed, Mohamed Agha, Mohamed Abdel Atti Abdel Fatah, Ramy Saleh Abdelghany, Kareem Salah Eldin Fekry Madbouly, Haidy Badei Mohamad, Iman Shawky Hassan, Mohamed Abdelsalam Mohamed Ahmed, Heba T Okda, Hatem Attia Mostafa Ismail","doi":"10.7417/CT.2026.2039","DOIUrl":"10.7417/CT.2026.2039","url":null,"abstract":"<p><strong>Background: </strong>Persistent pulmonary hypertension of the newborn (PPHN) is a life-threatening condition characterized by elevated pulmonary vascular resistance and impaired oxygenation. Endothelial dysfunction plays a central role in its pathophysiology. Asymmetric dimethylarginine (ADMA), an endogenous inhibitor of nitric oxide synthase, has been implicated in pulmonary vascular disease; however, its clinical utility as a biomarker of disease severity and therapeutic response in neonatal PPHN remains insufficiently defined.</p><p><strong>Methods: </strong>This prospective observational case-control study included neonates diagnosed with PPHN and age- and sex-matched healthy controls. Plasma ADMA levels were measured using enzyme-linked immunosorbent assay (ELISA). Clinical severity was assessed using oxygenation index (OI) and echocardiographic parameters. Associations between ADMA levels, disease severity, and therapeutic response were analyzed using correlation analysis, multivariable regression models, and receiver operating characteristic (ROC) curve analysis.</p><p><strong>Results: </strong>Neonates with PPHN demonstrated significantly elevated plasma ADMA levels compared with controls (p < 0.001). ADMA levels showed a positive correlation with oxygenation index and echocardiographic markers of pulmonary hypertension severity. Higher baseline ADMA concentrations were independently associated with increased disease severity after adjustment for relevant confounders. ROC curve analysis demonstrated good discriminatory performance of ADMA in identifying severe PPHN. Additionally, declining ADMA levels were associated with clinical improvement following standard therapeutic interventions.</p><p><strong>Conclusion: </strong>Plasma ADMA levels are significantly elevated in neonates with PPHN and correlate with disease severity and therapeutic response. ADMA may serve as a promising biomarker for risk stratification and monitoring in neonatal PPHN. Larger multicenter studies are warranted to validate these findings and explore its prognostic utility.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"177 3","pages":"539-548"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond Glycemia: The Role of Vitamin D and Iron Biomarkers in Diabetes Mellitus.","authors":"Zainab Amjad, Hessa Al Hussaini, Naushad Abid, Lubna Meraj, Eman Elsheikh","doi":"10.7417/CT.2026.2038","DOIUrl":"10.7417/CT.2026.2038","url":null,"abstract":"<p><strong>Background: </strong>Diabetes mellitus is known to be an international health concern with micronutrient deficiencies, especially an imbalance of vitamin D and iron levels, being identified as possible risk factors for increased development of diabetes. This report proposes research that examines correlations between vitamin D, hemoglobin, ferritin, and diabetes for the Saudi Arabian population.</p><p><strong>Objective: </strong>The aim is to evaluate the association between serum vitamin D, ferritin, and hemoglobin levels and glycemic status, as measured by fasting blood glucose (FBS) and glycated hemoglobin (HbA1c), among adult patients attending a tertiary care hospital in Al-Ahsa, Saudi Arabia.</p><p><strong>Methods: </strong>This Cross-sectional study was carried out in King Faisal Polyclinics in Al-Ahsa, Kingdom of Saudi Arabia between Aug 2024 and Jan 2025 on 249 participants (proportional sampling for both genders). The variables were measured for Fasting Blood Sugar (FBS) levels, HbA1c%, Hemoglobin (Hb), Ferritin level, and Vitamin D level. All analyses were done in SPSS software version 26. Correlation analysis between variables were done by using One-Way ANOVA and Pearson's Chi-Square Tests. Significance level was kept at p<0.05.</p><p><strong>Results: </strong>The mean age (in years) was 47.4 ± 13.8 years. For HbA1c, the value was 18.9% for diabetics, 21.3% for pre-diabetics, and 40.6% for non-diabetics. Vitamin D deficiency (<20 ng/mL) was observed in 11.2% of the subjects. Ferritin had a significant association with HbA1c and FBS (p <0.05). For females, hemoglobin approached significance in the context of FBS. Vitamin D.</p><p><strong>Conclusion: </strong>The results indicate the importance of ferritin and hemoglobin levels for glucose regulation as well as the uncertain and potentially insignificant role of the level of vitamin D. Larger follow-up studies will have the potential to clarify the importance of micronutrients for the prevalence of diabetes.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"177 3","pages":"532-538"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147788075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of the quality of life of patients with haemorrhoids.","authors":"Beimbet Baimanov, Maksut Kulzhanov, Auyeskhan Dzhumabekov, Asel Baimanova, Maira Sarsenbaeva","doi":"10.7417/CT.2026.2030","DOIUrl":"10.7417/CT.2026.2030","url":null,"abstract":"<p><strong>Abstract: </strong>Haemorrhoids are a chronic disease of the anorectal area characterised by pain, bleeding and discomfort, which significantly reduce the quality of life of patients, limiting their physical activity, emotional state and social interactions, especially in cases requiring surgery. Despite significant progress in surgical treatment methods, the impact of these methods on the quality of life of patients remains insufficiently studied. The study aimed to determine the impact of haemorrhoids and their surgical treatment on the quality of life of patients. The study involved 634 patients, most of whom were women (76.5%). Participants were divided by age group, professional activity and place of residence. A modified sociological questionnaire was used to assess the physical, emotional and social aspects of respondents' lives. The results of the study demonstrated that, in most cases, the quality of life of patients improved significantly after surgery: most respondents reported no significant limitations in physical activity, and it did not cause significant discomfort in 88% of cases, although moderate or mild pain persisted in 46% of patients. The findings demonstrate that timely surgical treatment of haemorrhoids has a positive impact on the quality of life of patients, reducing pain symptoms and improving their general condition. The practical significance of the study is determined by the possibility of using its results to improve approaches to the treatment and rehabilitation of patients with haemorrhoids, as well as to introduce standards for assessing the quality of life of patients with haemorrhoids to optimise therapy.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"177 3","pages":"466-474"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147788120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Promoting self-awareness among health professional.","authors":"Anastasia Lavigna, Giuseppe La Torre","doi":"10.7417/CT.2026.2024","DOIUrl":"10.7417/CT.2026.2024","url":null,"abstract":"<p><strong>Introduction: </strong>Self-awareness is a crucial aspect of personality development and a key concept in psychology. It refers to the ability to understand oneself, including one's thoughts, feelings and behavior at a given time. Being self-aware means being able to recognize and understand one's own needs, desires, limits and values, as well as reflecting on how we relate to others and the world around us.</p><p><strong>Study design: </strong>This research project presents a randomized controlled trial to evaluate the impact of a self-coaching method on self-awareness. The main objective is to test whether this approach can increase participants' self-awareness.</p><p><strong>Methods: </strong>The self-coaching method will be implemented by means of a structured diary that aims to guide participants to achieve a greater understanding of themselves and their abilities. Participants in the study were randomly assigned to two groups: an experimental group to which the self-coaching method was delivered and a control group to which links to four self-awareness videos via the YouTube platform were sent.</p><p><strong>Results: </strong>The results suggest that the use of self-coaching methods can help to reduce stress and improve certain areas of psychological well-being and self-awareness. In particular, a significant decrease was noted in the experimental group in emotional cost, i.e. the negative impact in terms of emotions that a self-awareness course can cause.</p><p><strong>Discussion: </strong>The pilot study explored the short-term effects of self-coaching on healthcare professionals. Results showed improvements in personal growth and self-acceptance, but limited impact on stress and overall well-being. Both diary writing and videos supported self-reflection, with no major differences between them. However, self-coaching alone appears less effective without guidance, suggesting the need for longer duration and professional support.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"177 3","pages":"424-431"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147788139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation Between Chemerin Levels and Diagnosis of Diabetic Nephropathy: A Case-Control Study.","authors":"Fatma M Attia Elsayed, Sara Mohamed Salem, Maha M Attia Elbadry, Abdulmabod Omar, Mohammad Abd Elhameed Alwaseef, Elham Shabaan Mohamed, Mariam Sameh Boshra, Hatem Attia Mostafa Ismail, Mohamed Husseini Saeid Zidan, Osama Safwat Hamed Ali, Omaima Ahmed Elsayed Hamed, Mai Youssef Abd El Fattah, Dina Fathy Rashad, Rasha Muhammad Ibrahim Rashed, Ayman Abdelmonem Ahmed Kayed, Lamiaa Hosney Azel, Rasha Hassan Abd Asalam Saleh, Ahmed Hesham Moneer, Hany Kamal Ahmed Mahrose, Abdelhady DA","doi":"10.7417/CT.2026.2041","DOIUrl":"10.7417/CT.2026.2041","url":null,"abstract":"<p><strong>Background: </strong>Diabetic nephropathy (DN) and diabetic retinopathy (DR) are major microvascular complications of type 2 diabetes mellitus (T2DM), sharing common inflammatory and metabolic pathways. Chemerin, an adipokine involved in inflammation and endothelial dysfunction, may serve as an early biomarker for DN.</p><p><strong>Objective: </strong>To evaluate serum Chemerin levels in type 2 diabetic patients across different stages of albuminuria and to explore its correlation with anthropometric indices and inflammatory markers.</p><p><strong>Methods: </strong>This case-control study included patients with T2DM categorized according to urinary albumin excretion into normoalbuminuria, microalbuminuria, and macroalbuminuria groups. Serum Chemerin levels were measured using ELISA. All participants underwent comprehensive fundus examination after pupillary dilation, and diabetic retinopathy was graded according to standard clinical criteria. Clinical, biochemical, and metabolic parameters were recorded and correlated with albuminuria stages and retinal findings.</p><p><strong>Results: </strong>Serum Chemerin levels were significantly elevated in diabetic patients with micro- and macro-albuminuria compared with normo-albuminuric patients and healthy controls. Median Chemerin levels increased progressively from 721 ng/mL in the normo-albuminuric group to 1367 ng/mL in the micro-albuminuria group and 2793 ng/mL in the macro-albuminuria group (p < 0.001). Similarly, inflammatory markers demonstrated a stepwise increase with worsening albuminuria; median IL-6 levels rose from 6.34 pg/mL in normo-albuminuric patients to 7.34 pg/mL and 9.6 pg/mL in the micro- and macro-albuminuria groups, respectively, while TNF-α increased from 94 pg/mL to 124 pg/mL and 296 pg/mL across the same groups (p < 0.001). Insulin resistance indices also increased significantly, with median HOMA-IR values rising from 2.45 in normo-albuminuric patients to 3.29 and 4.68 in the micro- and macro-albuminuria groups (p < 0.001). Serum Chemerin showed strong positive correlations with albuminuria (r = 0.85), HOMA-IR (r = 0.85), IL-6 (r = 0.873), and TNF-α (r = 0.813), while demonstrating negative correlations with eGFR and serum albumin. Additionally, the prevalence of diabetic retinopathy increased significantly across albuminuria stages, reaching 82.6% in the macro-albuminuria group (p = 0.001).</p><p><strong>Conclusion: </strong>Serum Chemerin is significantly elevated in T2DM patients with albuminuria and correlates with both inflammatory markers and retinal microvascular changes, suggesting its potential utility as an adjunct biomarker for diabetic nephropathy and systemic microvascular complications. Fundus examination findings reinforce the parallel progression of diabetic nephropathy and retinopathy, highlighting shared pathogenic mechanisms.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"177 3","pages":"554-562"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147788079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Atherogenic Index of Plasma and No-Reflow After Primary PCI in STEMI.","authors":"Mohamed Khaled, Mohamed Khedrawy, Mostafa Elsayed Abd El Ghany, Mahmoud M Ibrahim, Khaled Mohamed Khalifa Mahmoud, Ashraf Mohamed Alkabeer, Hany Gamal Abozaid, Ahmed M Mostafa, Ahmed A Elhagary, Wael Shaibat Alhamd Mohamed","doi":"10.7417/CT.2026.2046","DOIUrl":"10.7417/CT.2026.2046","url":null,"abstract":"<p><strong>Background: </strong>The no-reflow phenomenon is a serious complication following primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI). It is associated with poor myocardial perfusion, increased infarct size, and worse clinical outcomes. Recently, the atherogenic index of plasma (AIP) - calculated from triglyceride and HDL-cholesterol levels - has emerged as a potential marker of atherogenic dyslipidemia and cardiovascular risk. However, the relationship between AIP and the occurrence of no-reflow after PCI remains insufficiently explored. Consequently, this study was conducted to investigate the impact of the atherogenic index of plasma (AIP) on the occurrence of the no-reflow phenomenon in patients presenting with STEMI who underwent primary PCI.</p><p><strong>Methods: </strong>A prospective cohort study was conducted including 300 patients with STEMI admitted within 24 hours of symptom onset and treated with primary PCI. Patients managed conservatively or with thrombolytic therapy were excluded. Clinical characteristics, laboratory parameters, angiographic findings, and echocardiographic data were collected and analyzed. Patients were divided into two groups according to the occurrence of the no-reflow phenomenon. Logistic regression analysis was performed to identify independent predictors of no-reflow, and receiver operating characteristic (ROC) curve analysis was used to assess the predictive value of AIP and other biomarkers.</p><p><strong>Results: </strong>Patients with no-reflow had significantly higher levels of triglycerides, LDL cholesterol, inflammatory markers, and AIP, along with lower HDL levels. Multivariate logistic regression identified AIP as an independent predictor of no-reflow (OR≈1.44, p<0.001). ROC curve analysis showed that AIP demonstrated the highest predictive value among lipid parameters, with an AUC of 0.721 and an optimal cutoff value of ≥0.55, yielding high sensitivity (87.1%) for predicting no-reflow. Other independent predictors included hypertension, family history of coronary artery disease, baseline TIMI flow <3, higher CK-MB levels, triglycerides, LDL cholesterol, reduced eGFR, and longer stent length.</p><p><strong>Conclusions: </strong>The atherogenic index of plasma is a significant and independent predictor of the no-reflow phenomenon in STEMI patients undergoing primary PCI. AIP may serve as a simple and accessible biomarker for early risk stratification and may help guide preventive strategies to improve clinical outcomes.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"177 3","pages":"597-605"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147788093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of the Oakland Score for Safe Discharge in Asian Patients After Acute Presentation With Lower GI Bleeding.","authors":"Prasad Mothayapan, Chin Wee Ang","doi":"10.7417/CT.2026.2026","DOIUrl":"10.7417/CT.2026.2026","url":null,"abstract":"<p><strong>Objectives: </strong>The Oakland score, originally developed and validated in the Western population, aims to identify patients with lower gastrointestinal bleeding (LGIB) who are suitable for safe discharge. We aimed to validate the Oakland score in predicting safe discharge in our Asian cohort.</p><p><strong>Materials and methods: </strong>A retrospective study was conducted on patients presenting with LGIB who underwent emergency colonoscopies at University Malaya Medical Centre, from January 2018 to December 2018. Demographics, clinical, laboratory parameters, and the Oakland score were evaluated to predict safe discharge, which was defined as the absence of blood transfusion, rebleeding, hemostatic intervention, readmission, and death. The performance of the Oakland score was assessed using the area under the ROC curve.</p><p><strong>Results: </strong>Of 133 patients, 33.8% fulfilled the criteria for safe discharge. Mean age was 66.6 years, predominantly males (64.7%) and from Chinese ethnicity (56.4%). For safe discharge, an Oakland score of ≤ 8 and ≤ 10 had a sensitivity of 97.7% and 95.5%, respectively. The specificities for both thresholds were low (4.4% and 24.4%, respectively). Packed cell transfusion showed a strong association with 'not safe for discharge' status (p < 0.001). Oakland score demonstrated good prediction for safe discharge with an AU-ROC of 0.82 (95% CI, 0.76-0.89).</p><p><strong>Conclusion: </strong>Consistent with previous studies, the Oakland score has shown good performance in this Asian-based population. However, the proportion of patients identified as safe for discharge in our study appears significantly lower compared to other studies. Further large-scale prospective validation studies are warranted before the application of this scoring system in our practice.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"177 3","pages":"439-445"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147788005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Study between Conventional Laparoscopic Nissen Fundoplication and Modified Nissen Fundoplication: A Prospective Randomized Controlled Trial.","authors":"Khaled Mohamed Albeialy, Mohamed Mahfouz Mohamed, Mohamed Ibrahim Hassan, Mohamed Ezzat Elserafy, Moustafa Mahmoud Emad","doi":"10.7417/CT.2026.2025","DOIUrl":"10.7417/CT.2026.2025","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic Nissen Fundoplication (NF) remains the gold standard anti-reflux procedure due to its well-established long-term efficacy and safety. However, the modified Nissen fundoplication (MNF) which incorporates additional sutures to fixate the esophagus to the right and left crus aims to enhance hiatal stabilization and potentially reduce GERD symptom recurrence.</p><p><strong>Aim: </strong>This study aims to compare between conventional Laparoscopic Nissen Fundoplicalion and Modified Nissen Fundoplication regarding post-operative complications specially \"Dysphagia, recurrence of GERD symptoms\".</p><p><strong>Patients and methods: </strong>This study is a prospective randomized controlled trial. The study took place at Ain Shams University Hospitals. The study was conducted from January 2023 to January 2025, including one year for patient recruitment and one year for follow-up.</p><p><strong>Results: </strong>This study compared NF and MNF in terms of postoperative complications, revealing a statistically significant difference in the incidence of postoperative hiccups and left shoulder pain. While some prior studies found no significant differences between the two techniques, our results suggest that MNF can be performed safely by experienced surgeons without increased morbidity or complication rates.</p><p><strong>Conclusion: </strong>The current study was constrained by its limited sample size and follow-up duration, which may affect the generalizability of findings. To further validate these results, future research should involve larger cohorts and extended follow-up periods to assess long-term recurrence rates and complications. Such data will help determine whether MNF offers superior outcomes over conventional NF, guiding clinical decision-making for optimal surgical management of GERD.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"177 3","pages":"432-438"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147788077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Failure to achieve LDL-C and HS-CRP targets in post-acute myocardial infarction patients: prevalence and predictors.","authors":"Thai Hao Phan, Minh Quang Phan","doi":"10.7417/CT.2026.2028","DOIUrl":"10.7417/CT.2026.2028","url":null,"abstract":"<p><strong>Background: </strong>Residual cardiovascular risk after acute myocardial infarction (AMI) is driven not only by dyslipidemia but also by systemic inflammation. High-sensitivity C-reactive protein (hs-CRP) and low-density lipoprotein cholesterol (LDL-C) represent two independent and complementary biomarkers of risk. Achieving dual therapeutic targets for both markers has been shown to improve outcomes, yet data in Southeast Asian populations remain scarce.</p><p><strong>Objectives: </strong>This study investigated the prevalence and predictors of failure to achieve hs-CRP and LDL-C targets in post-AMI patients in Vietnam.</p><p><strong>Methods: </strong>A descriptive cross-sectional study was conducted on 93 patients with prior AMI at Tam Duc Heart Hospital between September 2024 and June 2025. Demographic, clinical, and laboratory parameters were collected. hs-CRP and LDL-C levels were measured, and target achievement rates were assessed. Logistic regression analyses were performed to identify independent predictors.</p><p><strong>Results: </strong>Among 93 patients (mean age 66.1 ± 10.1 years, 76.3% male), 24.7% had hs-CRP ≥ 2 mg/L and 43.0% failed to achieve LDL-C < 70 mg/dL. Overall, 51.6% of patients failed to reach at least one target, with 16.1% failing both. Chronic kidney disease, sacubitril/valsartan use, and LDL-C ≥ 70 mg/dL were associated with failure to achieve hs-CRP targets. Diabetes mellitus and elevated hs-CRP were associated with LDL-C non-attainment. Use of ACEI/ARB therapy was identified as a protective factor against dual target failure.</p><p><strong>Conclusions: </strong>A substantial proportion of Vietnamese post-AMI patients fail to achieve dual hs-CRP and LDL-C targets, with diabetes and chronic kidney disease contributing to residual risk. These findings underscore the need for intensified secondary prevention strategies addressing both lipid and inflammatory pathways.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"177 3","pages":"452-459"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}