Medical principles and practice : international journal of the Kuwait University, Health Science Centre最新文献

{"title":"Efficacy of Drug Coated Balloon versus Drug Eluting Stent for Patients with De Novo Coronary Artery Disease: A Systematic Review and Meta-Analysis.","authors":"Affan Ul Haq, Amina Suhail, Waseh Ahsan, Hamza Maqbool, Ayesha Nawal, Hamza Hassan, Musa Khan Bungish, Muhammad Ali Shahid, Hakim Ullah Wazir, Humayoun Yousaf, Mohammad Ebad Ur Rehman, Huzaifa Ahmad Cheema, Asma'a Munasar Ali Alsubari, Muhammad Aslam Khan, Bilawal Nadeem, Raheel Ahmed, Adeel Ahmad","doi":"10.1159/000547099","DOIUrl":"https://doi.org/10.1159/000547099","url":null,"abstract":"<p><strong>Objectives: </strong>This meta-analysis compared the efficacy and safety of drug coated balloon (DCB) angioplasty with drug eluting stent (DES) for the treatment of de novo coronary artery disease.</p><p><strong>Methods: </strong>Following PRISMA guidelines, we conducted a systematic search of major databases, including Cochrane, MEDLINE, Embase and clinicaltrials.gov, to identify eligible randomized controlled trials (RCTs) comparing DCB and DES. Mantel-Haenszel model was used for dichotomous outcomes. Risk ratios (RR) with 95% confidence intervals (CI) were calculated using a random-effects model using RevMan software.</p><p><strong>Results: </strong>Thirteen RCTs with a total of 4,686 patients were included. The analysis found no significant differences between DCB and DES for all-cause mortality (RR: 1.11, 95% CI: 0.81-1.53, p = 0.51) or myocardial infarction (RR: 0.80, 95% CI: 0.56-1.15, p = 0.23). Similarly, no significant differences were observed for cardiac death (RR: 1.33, 95% CI: 0.86-2.05, p = 0.19), target lesion revascularization (RR: 1.19, 95% CI: 0.64-2.21, p = 0.59), or target vessel revascularization (RR: 1.34, 95% CI: 0.79-2.28, p = 0.28).</p><p><strong>Conclusion: </strong>This meta-analysis demonstrates comparable efficacy and safety outcomes for DCBs and DES in the treatment of de novo coronary artery disease. While DCBs offer a viable alternative, particularly for high-risk patients or those unsuitable for prolonged dual antiplatelet therapy, further large-scale studies are warranted to strengthen these findings and refine clinical recommendations.</p>","PeriodicalId":520708,"journal":{"name":"Medical principles and practice : international journal of the Kuwait University, Health Science Centre","volume":" ","pages":"1-16"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532843","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":"Red Blood Cells and their Immunoregulatory Role.","authors":"Angela Risso, Guglielmo Antonutto","doi":"10.1159/000547047","DOIUrl":"https://doi.org/10.1159/000547047","url":null,"abstract":"<p><p>The physiological roles played by red blood cells (RBCs), i.e. oxygen transport to all cells and tissues, CO2 delivery to the lungs, control of pH in blood and ions transport into and out of the cell membrane, have been investigated extensively over the past decades. The roles mature and immature RBCs play, while in the blood vessels, when they come in contact with other blood and endothelial cells, are only partially known. Here we will focus on the RBCs ability to modulate innate and adaptive immune responses when they interact with cells or molecules encountered during their flow in the vessels. We will outline the possible clinical impact on treatment of some diseases, such as autoimmune diseases, inflammatory pathologies or tumors, where immunotherapy can be applied.</p>","PeriodicalId":520708,"journal":{"name":"Medical principles and practice : international journal of the Kuwait University, Health Science Centre","volume":" ","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144500298","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":"Comment on \"Surveillance of Corrected QT Interval-Prolonging Medications upon Admission Throughout Hospitalization in a Tertiary Care Geriatric Ward\".","authors":"Mehmet Göl, Yusuf Hosoglu","doi":"10.1159/000547053","DOIUrl":"https://doi.org/10.1159/000547053","url":null,"abstract":"","PeriodicalId":520708,"journal":{"name":"Medical principles and practice : international journal of the Kuwait University, Health Science Centre","volume":" ","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487738","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":"Response to the Letter on \"Surveillance of QTc-Interval Prolonging Medications Upon Admission Throughout Hospitalization in a Tertiary Care Geriatric Ward\".","authors":"Ivana Baralić Knežević, Milena Kovačević, Katarina Stefanović, Predrag Erceg, Gordana Mihajlović, Jovana Aćimović, Katarina M Vučićević","doi":"10.1159/000547054","DOIUrl":"https://doi.org/10.1159/000547054","url":null,"abstract":"","PeriodicalId":520708,"journal":{"name":"Medical principles and practice : international journal of the Kuwait University, Health Science Centre","volume":" ","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487739","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":"Vedolizumab: Beyond Inflammatory Bowel Disease.","authors":"Yafang Li, Minli Hu, Yuan Chen, Xiao-Yun Yang, Qunying Wang, Jin Ding, Yibing Hu","doi":"10.1159/000547015","DOIUrl":"10.1159/000547015","url":null,"abstract":"<p><p>Vedolizumab (VDZ) is a key therapeutic option for inflammatory bowel disease (IBD) patients, not responding to conventional treatments. An α4β7 integrin antagonist, VDZ primarily prevents T cell migration to the gut by inhibiting the binding of integrins to mucosal vascular address in cellular adhesion molecule. Its gut-selective mechanism of action and safety profile makes it a valuable intervention for treating non-IBD-related diseases, which are difficult to treat and lack standardized guidelines. There is plenty of evidence to suggest that vedolizumab has therapeutic potential beyond its primary indication in IBD, with clinical applications now extending to immune checkpoint inhibitor-associated colitis, chronic pouchitis, gastrointestinal graft-versus-host disease, and acquired immunodeficiency syndrome. This review aimed to analyze the therapeutic value of VDZ for non-IBD-related diseases and provide a reference for treating these patients. It has been observed that long-term follow-up data are lacking, and additional well-designed large-scale studies are still needed to further validate the efficacy and safety of VDZ.</p>","PeriodicalId":520708,"journal":{"name":"Medical principles and practice : international journal of the Kuwait University, Health Science Centre","volume":" ","pages":"1-23"},"PeriodicalIF":0.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144370069","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":"The Dual Impact of Obesity and Diabetes on Heart Failure Readmissions: Results from the CHF Registry at Harlem Hospital Center.","authors":"Mariel Magdits, Asmaa AlShammari, Rosemarie Majdalani, Sriraman Devarajan, Farbod Raiszadeh","doi":"10.1159/000546681","DOIUrl":"https://doi.org/10.1159/000546681","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate the obesity paradox in patients with congestive heart failure (CHF) at Harlem Hospital Center (HHC), examine the role of diabetes in CHF readmissions, and explore the combined impact of obesity and diabetes on readmission rates.</p><p><strong>Methods: </strong>A retrospective chart review was conducted on 390 patients from HHC's CHF registry (January 2019-December 2021). CHF admissions and 30-day readmissions were analyzed, focusing on obesity, diabetes, and their interplay.</p><p><strong>Results: </strong>Preliminary analyses revealed a correlation between obesity and reduced 30-day readmission rates. Diabetes alone did not significantly influence readmissions; however, patients with both obesity and diabetes had higher readmission rates than those with obesity alone. However, after adjusting for confounders, none of the observed associations remained statistically significant, highlighting the complexity of interpreting the obesity paradox in this population.</p><p><strong>Conclusions: </strong>These findings suggest that the obesity paradox may exist but is attenuated by the presence of diabetes. Further research is needed to elucidate these relationships and their implications for managing CHF in obese diabetic patients.</p>","PeriodicalId":520708,"journal":{"name":"Medical principles and practice : international journal of the Kuwait University, Health Science Centre","volume":" ","pages":"1-15"},"PeriodicalIF":0.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144201335","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":"Post-Operative Pain and Its Relationship with Patient-Related Factors after Vital Pulpotomy in Teeth with Symptomatic Pulpitis: A Prospective Clinical Study.","authors":"Berk Çelikkol, Hasibe Elif Kuru","doi":"10.1159/000546582","DOIUrl":"10.1159/000546582","url":null,"abstract":"<p><strong>Objective: </strong>Postoperative pain during endodontic treatment can impair patient comfort and complicate clinical management, particularly in symptomatic irreversible pulpitis. Vital pulpotomy treatment (VPT) is less invasive than total pulpectomy for symptomatic irreversible pulpitis.</p><p><strong>Subject: </strong>This study aimed to evaluate postoperative pain in patients after VPT of permanent molars with symptomatic pulpitis and explore the relationship between postoperative pain and patient-related factors.</p><p><strong>Methods: </strong>A total of 114 patients, aged 7-39, were included. Permanent molars (n = 114) with symptomatic irreversible pulpitis (periapical index ≤2) were selected. Preoperative pain levels, analgesic intake, and demographic data were recorded. All participants underwent a standardized pulpotomy procedure. Hemostasis was achieved within 5 min using a saline-embedded cotton pellet. A mineral trioxide aggregate was used as a pulpotomy agent, and the teeth were restored using a base of resin-modified glass ionomer, followed by composite restoration. Using a 4-point pain scale, the patients recorded their pain preoperatively before the administration of local anesthesia and postoperatively at 24 h, 72 h, and 1 week. Fisher's exact test was used to assess the relationships between categorical variables. Statistical significance was set at p < 0.05.</p><p><strong>Results: </strong>Among the 114 patients, 110 (96.49%) had complete relief from preoperative pain after treatment, and no postoperative pain was recorded at 1 week, irrespective of patient-related factors, such as age, sex, and painkiller intake (95% CI: 0.529-0.554).</p><p><strong>Conclusions: </strong>Vital pulpotomy is an effective treatment for relieving preoperative pain and preventing postoperative pain in teeth with symptomatic irreversible pulpitis independent of patient-related factors.</p>","PeriodicalId":520708,"journal":{"name":"Medical principles and practice : international journal of the Kuwait University, Health Science Centre","volume":" ","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12215438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144153292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Machine Learning Prediction of Magnetic Resonance Imaging Prostate Imaging Reporting and Data System Correlate with Target Prostate Biopsy Results?","authors":"Mostafa A Arafa, Karim H Farhat, Nesma Lotfy, Farrukh K Khan, Alaa Mokhtar, Abdulaziz M Althunayan, Waleed Al-Taweel, Sultan S Al-Khateeb, Sami Azhari, Danny M Rabah","doi":"10.1159/000546509","DOIUrl":"10.1159/000546509","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to predict and classify magnetic resonance imaging (MRI) Prostate Imaging Reporting and Data System (PI-RADS) scores using different machine learning algorithms and to detect the concordance of PI-RADS scoring with the outcome target of prostate biopsy.</p><p><strong>Methods: </strong>Machine learning (ML) algorithms were used to develop best-fitting models for the prediction and classification of MRI PI-RAD. The Random Forest and Extra Trees models achieved the best performance compared to the other methods.</p><p><strong>Results: </strong>The accuracy of both models was 91.95%. The AUC was 0.9329 for the Random Forest model and 0.9404 for the Extra Trees model. PSA level, PSA density, and diameter of the largest lesion were the most important features for the importance of outcome classification. ML prediction enhanced the PI-RAD classification, where clinically significant prostate cancer (csPCa) cases increased from 0% to 1.9% in the low-risk PI-RAD class, this showed that the model identified some previously missed cases.</p><p><strong>Conclusions: </strong>Predictive machine learning models showed an excellent ability to predict MRI Pi-RAD scores and discriminate between low- and high-risk scores. However, caution should be exercised, as a high percentage of negative biopsy cases were assigned Pi-RAD 4 and Pi-RAD 5 scores. ML integration may enhance PI-RAD's utility by reducing unnecessary biopsies in low-risk patients (via better csPCa detection) and refining the high-risk categorization. Combining such PI-RAD scores with significant parameters, such as PSA density, lesion diameter, number of lesions, and age, in decision curve analysis and utility paradigms would assist physicians' clinical decisions.</p>","PeriodicalId":520708,"journal":{"name":"Medical principles and practice : international journal of the Kuwait University, Health Science Centre","volume":" ","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12201951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144153303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sustained Expression of Plasminogen Activator Inhibitor-1 in Patients Recovered from COVID-19 Disease.","authors":"Otto Mayer, Simona Bílková, Tereza Nezbedová, Petra Karnosová, Jindra Windrichová, Jana Hirmerová, Petr Pazdiora, Jan Filipovský","doi":"10.1159/000546399","DOIUrl":"10.1159/000546399","url":null,"abstract":"<p><strong>Objectives: </strong>The overexpression of plasminogen activator inhibitor-1 (PAI-1) was frequently observed during coronavirus disease 2019 (COVID-19), and it was found to be closely associated with disease severity. We have analyzed the PAI-1 status in fully recovered post-COVID patients.</p><p><strong>Subjects and methods: </strong>In a case-control and cross-sectional study, we compared 377 patients, 30-210 days after PCR-verified COVID-19 and 884 COVID-naive controls.</p><p><strong>Results: </strong>Post-COVID patients (\"cases\") showed significantly higher plasma PAI-1 concentrations than COVID-naive controls. This difference remained significant even after complex adjustment by multiple regression. On the other hand, since the strongest covariate of increased PAI-1 was antihypertensive treatment, the difference between cases and controls in those who were on antihypertensives completely disappeared. In the subgroup of post-COVID patients only, we also found that highly symptomatic patients or those who required hospitalization in the acute phase showed significantly higher PAI-1 than patients with only mild symptoms of the disease. Similarly, the presence of β mutation increased the relative risk (≈11 times) of high post-COVID concentrations of PAI-1. Similarly, the presence of β mutation increased the relative risk (≈11 times) of high post-COVID concentrations of PAI-1.</p><p><strong>Conclusions: </strong>Increased values of PAI-1 can persist for several months after complete recovery from COVID-19 (namely, by β variant of the virus), and their expression also corresponded to clinical course of the disease.</p>","PeriodicalId":520708,"journal":{"name":"Medical principles and practice : international journal of the Kuwait University, Health Science Centre","volume":" ","pages":"1-12"},"PeriodicalIF":0.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12215436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Evaluation of Clinical Efficacy of Leukocyte-Rich Platelet-Rich Fibrin with Advanced Platelet-Rich Fibrin in Management of Gingival Recession Defects: A Randomized Controlled Trial.","authors":"Anupama Tadepalli,&nbsp;Swapna Chekurthi,&nbsp;Swarupa Kavassery Balasubramanian,&nbsp;Harinath Parthasarathy,&nbsp;Deepa Ponnaiyan","doi":"10.1159/000525560","DOIUrl":"https://doi.org/10.1159/000525560","url":null,"abstract":"<p><strong>Background: </strong>The aim of this research was to determine and compare the clinical efficacy of leukocyte platelet-rich fibrin (L-PRF) and advanced platelet-rich fibrin (A-PRF) in combination with coronally advanced flap (CAF) in the treatment of gingival recession defects.</p><p><strong>Methods: </strong>Systemically healthy subjects presenting with 30 Miller's class I or II gingival recession defects in maxillary anteriors and premolars, were treated with either CAF + L-PRF or CAF + A-PRF. Clinical parameters such as recession height (RH), width, probing pocket depth, clinical attachment level (CAL), keratinized tissue height (KTH), and width of attached gingiva (WAG) were measured at baseline, 3, and 6 months. Gingival biotype was evaluated at baseline and 6 months post-surgery. Mean root coverage percentage (MRC%) was evaluated at 3 and 6 months.</p><p><strong>Results: </strong>Statistically significant reduction in mean RH was observed from baseline (2.53 ± 0.74 mm, 2.63 ± 0.82 mm) to 6 months (0.87 ± 0.83 mm, 0.53 ± 0.91 mm) in CAF + L-PRF and CAF + A-PRF groups, respectively. The MRC% achieved at 6 months was 67.20 ± 32.81 in the CAF + L-PRF group and 81.66 ± 28.21 in the CAF + A-PRF group. Statistically significant gain in CAL, WAG, and KTH was observed in both therapeutic groups (p < 0.05). Intergroup analysis revealed no statistically significant differences among study parameters between groups at any time point (p > 0.05).</p><p><strong>Conclusion: </strong>Based on the findings of this study, both L-PRF and A-PRF may be suggested as viable treatment options for the management of gingival recession in maxilla.</p>","PeriodicalId":520708,"journal":{"name":"Medical principles and practice : international journal of the Kuwait University, Health Science Centre","volume":" ","pages":"376-383"},"PeriodicalIF":3.2,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6b/35/mpp-0031-0376.PMC9485915.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40150904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}