Diseases (Basel, Switzerland)最新文献

{"title":"Evaluating Osteotomy Accuracy in Mandibular Reconstruction: A Preliminary Study Using Custom Cutting Guides and Virtual Reality.","authors":"Claudia Borbon, Andrea Novaresio, Oreste Iocca, Francesca Nonis, Sandro Moos, Enrico Vezzetti, Guglielmo Ramieri, Emanuele Zavattero","doi":"10.3390/diseases13030081","DOIUrl":"10.3390/diseases13030081","url":null,"abstract":"<p><strong>Background: </strong>Mandibular reconstruction has evolved significantly since its inception in the early 1900s. Currently, the fibula free flap (FFF) is considered the gold standard for mandibular and maxillary reconstructions, particularly for extensive defects, and the introduction of Extended Reality (XR) and virtual surgical planning (VSP) is revolutionizing maxillofacial surgery.</p><p><strong>Methods: </strong>This study focuses on evaluating the accuracy of using in-house cutting guides for mandibular reconstruction with FFF supported by virtual surgical planning (VSP). Planned and intraoperative osteotomies obtained from postoperative CT scans were compared in 17 patients who met the inclusion criteria. The proposed analysis included measurements of deviation angles, thickness at the centre of gravity, and the maximum thickness of the deviation volume. Additionally, a mandibular resection coding including 12 configurations was defined to classify and analyze the precision of mandibular osteotomies and investigate systematic errors. Preoperative, planned, and postoperative models have been inserted in an interactive VR environment, VieweR, to enhance surgical planning and outcome analysis.</p><p><strong>Results: </strong>The results proved the efficiency of adopting customized cutting guides and highlighted the critical role of advanced technologies such as CAD/CAM and VR in modern maxillofacial surgery. A novel coding system including 12 possible configurations was developed to classify and analyze the precision of mandibular osteotomies. This system considers (1) the position of the cutting blade relative to the cutting plane of the mandibular guide; (2) the position of the intersection axis between the planned and intraoperative osteotomy relative to the mandible; (3) the direction of rotation of the intraoperative osteotomy plane around the intersection axis from the upper view of the model.</p><p><strong>Conclusions: </strong>This study demonstrates the accuracy and reliability of in-house cutting guides for mandibular reconstruction using fibula free flaps (FFF) supported by virtual surgical planning (VSP). The comparison between planned and intraoperative osteotomies confirmed the precision of this approach, with minimal deviations observed. These findings highlight the critical role of CAD/CAM and XR technologies in modern maxillofacial surgery, offering improved surgical precision and optimizing patient outcomes.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"13 3","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712415","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":"Dancing Towards Stability: The Therapeutic Potential of Argentine Tango for Balance and Mobility in Parkinson's Disease.","authors":"Federica Giorgi, Daniela Platano, Lisa Berti, Danilo Donati, Roberto Tedeschi","doi":"10.3390/diseases13030082","DOIUrl":"10.3390/diseases13030082","url":null,"abstract":"<p><p><b>Background:</b> Parkinson's Disease (PD) is a progressive neurodegenerative disorder characterized by motor impairments, including balance deficits, gait disturbances, and postural instability. Given the limitations of pharmacological treatments, alternative rehabilitative strategies such as Argentine Tango (AT) have been explored for their potential benefits in improving mobility and quality of life in individuals with PD. This systematic review evaluates the effectiveness of AT in enhancing balance, gait, and functional mobility in PD patients. <b>Methods:</b> A systematic literature search was conducted across PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, PEDro, and Web of Science. Studies were included if they were randomized controlled trials (RCTs) assessing the impact of AT on motor outcomes in PD. Data extraction and risk of bias assessment were performed independently by two reviewers using the Risk of Bias 2 (RoB 2) tool. <b>Results:</b> Five randomized controlled trials (RCTs) were included, with sample sizes ranging from 10 to 62 participants and intervention durations varying from 10 weeks to 24 months. AT significantly improved balance (Mini-BESTest, BBS, FRT), gait performance (6MWT, TUG), and mobility compared to usual care or conventional exercise. Some studies also reported psychological benefits, including reduced depressive symptoms and increased balance confidence. However, freezing of gait outcomes were inconclusive, and methodological limitations, such as small sample sizes and inconsistent intervention durations, were noted. Outcomes for freezing of gait (FoG) remained inconclusive due to the variability in assessment methods and inconsistent reporting across studies. <b>Conclusions:</b> AT appears to be an effective rehabilitation strategy for improving balance, gait, and functional mobility in PD. While preliminary evidence suggests additional psychological benefits, larger, high-quality trials are needed to confirm its long-term efficacy and establish standardized intervention protocols. AT may be integrated into multimodal rehabilitation programs to enhance motor and psychosocial outcomes in PD management. However, the small sample sizes of included studies and the heterogeneity in intervention durations limit the generalizability of findings. AT may serve as a structured rehabilitative approach for improving mobility and psychosocial outcomes in PD and could be integrated into community-based or clinical rehabilitation programs.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"13 3","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712411","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":"Non-Pharmacological Interventions for Managing the Symptoms of Depression in Women with Breast Cancer: A Literature Review of Clinical Trials.","authors":"Mayra Alejandra Mafla-España, Omar Cauli","doi":"10.3390/diseases13030080","DOIUrl":"10.3390/diseases13030080","url":null,"abstract":"<p><p>Symptoms of depression represent a significant burden to patients with breast cancer, not only because of the psychological stress associated with their diagnosis, but also because of the adverse effects of its treatment. We reviewed the clinical trials examining the management of the symptoms of depression in breast cancer patients through different non-pharmacological interventions in different databases (PubMed, Embase, Scopus, and the American Psychological Association). Cognitive behavioural therapy, interpersonal psychotherapy or psychodynamic psychotherapy, as well as acceptance and commitment therapy have been effective in improving symptoms of depression in cancer patients with moderate to severe symptoms. Physical exercise, yoga, mindfulness, and support groups have been shown to benefit patients with mild depressive symptoms. These interventions not only showed positive results in interventions in women with breast cancer in terms of the symptoms of depression, but also highlighted their benefits for comorbid anxiety, stress, and poor sleep quality; moreover, it is suggested that these interventions should be leveraged to manage mental health issues in breast cancer patients. The molecular effects of these interventions, such as the reduction in inflammatory cytokines and cortisol levels, have seldom been reported and need further studies.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"13 3","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712425","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":"Gemcitabine Plus Docetaxel, Dacarbazine, Doxorubicin Combinations, or Doxorubicin Alone as First-Line Treatment for Advanced/Metastatic Leiomyosarcoma: A Retrospective Analysis at a Sarcoma Center.","authors":"Ted Kim, Clara Hao, Minggui Pan, Kristen N Ganjoo, Nam Q Bui","doi":"10.3390/diseases13030079","DOIUrl":"10.3390/diseases13030079","url":null,"abstract":"<p><strong>Background/objectives: </strong>Locally advanced and metastatic leiomyosarcoma (LMS) is an aggressive cancer with limited treatment options. This single-institution, retrospective study evaluated the efficacy of first-line chemotherapy regimens in patients with advanced or metastatic LMS treated at Stanford Medical Center.</p><p><strong>Methods: </strong>Seventy-four patients with unresectable or metastatic LMS were deemed eligible and treated with first-line chemotherapy regimens, including gemcitabine plus docetaxel, dacarbazine, doxorubicin combinations (with evofosfamide or ifosfamide), and doxorubicin monotherapy. Progression-free survival (PFS), overall survival (OS), and disease control rate (DCR) were assessed using RECIST v1.1, with survival analyses performed using Kaplan-Meier and Cox proportional hazards methods.</p><p><strong>Results: </strong>The cohort consisted of 56 females (75.7%) and 18 males (24.3%), with a median age of 55.5 years. The majority (93.2%) had metastatic disease. The median PFS for the entire cohort was 4.9 months (range: 0.6-28.1 mo), and the median OS was 27.3 months (range: 1.9-140.2 mo). The doxorubicin combination (DC) group had the highest median PFS of 7.9 months (range: 0.6-15.8 mo). Doxorubicin alone had the highest median OS of 33.8 months (4.2-100.2 mo). Doxorubicin combinations demonstrated superior PFS in both uterine and non-uterine LMS subgroups.</p><p><strong>Conclusions: </strong>These findings reaffirm the efficacy of doxorubicin-based combination regimens as a first-line treatment for locally advanced and metastatic LMS, particularly in non-uterine LMS.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"13 3","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712228","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":"Lifestyle and Biochemical Parameters That May Hamper Immune Responses in Pediatric Patients After Immunization with the BNT162b2 mRNA COVID-19 Vaccine.","authors":"Anthie Damianaki, Antonios Marmarinos, Margaritis Avgeris, Dimitrios Gourgiotis, Elpis-Athina Vlachopapadopoulou, Marietta Charakida, Maria Tsolia, Lydia Kossiva","doi":"10.3390/diseases13030078","DOIUrl":"10.3390/diseases13030078","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to evaluate whether increased body mass index (BMI) and biochemical and lifestyle parameters linked to obesity and smoke exposure disrupt immune responses of children and adolescents following vaccination with the mRNA BNT162b2 vaccine.</p><p><strong>Methods: </strong>A prospective, single-center, cohort study was conducted. Participants were assigned to receive two doses of the mRNA vaccine. Anti-SARS-CoV-2 IgG and neutralizing antibodies (AB) were measured before vaccination (T0) and 14 days after the second dose (T1). BMI and biochemical parameters were evaluated at T0. A questionnaire on lifestyle characteristics was filled in.</p><p><strong>Results: </strong>IgG optical density (OD) ratio at T1 was lower in the overweight-obese group regardless of COVID-19 disease positive history [<i>p</i> = 0.028 for the seronegative group, <i>p</i> = 0.032 for the seropositive group]. Neutralizing AB were lower in overweight-obese participants in the seronegative group at T1 [<i>p</i> = 0.008]. HDL, fasting glucose/insulin ratio (FGIR), C-reactive protein (CRP), HBA1c, uric acid, and smoke exposure were significantly correlated with BMI [<i>p</i> = 0.006, <i>p</i> < 0.001, <i>p</i> < 0.001, <i>p</i> = 0.006, <i>p</i> = 0.009, <i>p</i> < 0.001, respectively]. The main biochemical parameters that were inversely correlated with IgG and neutralizing AB titers at T1 were uric acid [<i>p</i> = 0.018, <i>p</i> = 0.002], FGIR [<i>p</i> = 0.001, <i>p</i> = 0.008] and HBA1C [<i>p</i> = 0.027, <i>p</i> = 0.038], while smoke exposure negatively affected the humoral immune responses at T0 in the convalescent group [<i>p</i> = 0.004, <i>p</i> = 0.005].</p><p><strong>Conclusions: </strong>Current data suggests that uric acid, insulin resistance (IR), and smoke exposure could adversely affect the immune responses in overweight-obese vaccinated children, highlighting the need for actions to enhance the protection of this particular subgroup.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"13 3","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11940919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712424","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":"The Influence of Occupational Factors on Contact Dermatitis in Symptomatic Healthcare Workers: A Patch Test Study.","authors":"Cristiana Ferrari, Giuseppina Somma, Viola Giovinazzo, Margherita Iarossi, Michele Treglia, Margherita Pallocci, Luca Di Giampaolo, Andrea Magrini, Luca Coppeta","doi":"10.3390/diseases13030077","DOIUrl":"10.3390/diseases13030077","url":null,"abstract":"<p><p>Healthcare workers (HCWs) are frequently exposed to a variety of chemical agents, which can result in the development of allergic or irritant contact dermatitis. The present study aimed to assess the prevalence of skin sensitization among HCWs who presented with symptoms of contact dermatitis, considering both occupational and non-occupational risk factors. The study population comprised 127 HCWs who attended routine occupational health surveillance at the Tor Vergata Teaching Hospital in Rome between November 2023 and May 2024. A structured dermatitis questionnaire and patch testing were administered to the participants. Demographic and lifestyle data, including information on occupation, night shift work, smoking habits, and body mass index (BMI), were collected. Patch test positivity was observed in 31.5% of participants, with the most common clinical presentation being erythematous-desquamative allergic contact dermatitis. A significantly higher likelihood of patch test positivity was observed among nurses (57.1%), particularly for nickel sensitization, compared to other occupational groups. A trend towards an association between night shift work and skin sensitization was observed, although this did not reach statistical significance. No significant associations were found for ages over 35 years, sex, or BMI. These findings highlight the elevated risk of contact sensitization among nurses, emphasizing the need for targeted interventions, including exposure reduction strategies and protective measures, to mitigate occupational skin hazards in healthcare settings.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"13 3","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712442","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":"Setting the Stage for Branched-Chain Amino Acids Use in Neurological Pathologies: Does a Single Oral Dose Provide Hours of Elevated Systemic Levels?","authors":"Ezek Mathew, Nathan Jones, McKinley Dews, Dominique Neal, Anders Cohen","doi":"10.3390/diseases13030076","DOIUrl":"10.3390/diseases13030076","url":null,"abstract":"<p><strong>Background: </strong>Recent studies have demonstrated that branched-chain amino acids are neuroprotective and neurorestorative. Branched-chain amino acid supplements are now being recommended to be taken before contact sports to reduce concussions. While peaks and troughs in branched-chain amino acids have previously been reported in hospital settings, the metabolism of a single recommended dose of over-the-counter branched-chain amino acids has yet to be elucidated.</p><p><strong>Methods: </strong>We analyzed a patented branched-chain amino acid product to assess its metabolism in 10 healthy adults.</p><p><strong>Results: </strong>Over the defined time points, measured levels of branched-chain amino acids remained significantly elevated when compared to the physiological baseline. The elevations in measured plasma levels indicate that a single oral dose is a viable intake option for increasing levels of branched-chain amino acids.</p><p><strong>Conclusions: </strong>This information can be leveraged to better plan branched-chain amino acid-based treatment doses in order to treat pathologies such as brain injury.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"13 3","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712429","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":"The Genetic and Biological Basis of Pseudoarthrosis in Fractures: Current Understanding and Future Directions.","authors":"Amalia Kotsifaki, Georgia Kalouda, Sousanna Maroulaki, Athanasios Foukas, Athanasios Armakolas","doi":"10.3390/diseases13030075","DOIUrl":"10.3390/diseases13030075","url":null,"abstract":"<p><p>Pseudoarthrosis-the failure of normal fracture healing-remains a significant orthopedic challenge affecting approximately 10-15% of long bone fractures, and is associated with significant pain, prolonged disability, and repeated surgical interventions. Despite extensive research into the pathophysiological mechanisms of bone healing, diagnostic approaches remain reliant on clinical findings and radiographic evaluations, with little innovation in tools to predict or diagnose non-union. The present review evaluates the current understanding of the genetic and biological basis of pseudoarthrosis and highlights future research directions. Recent studies have highlighted the potential of specific molecules and genetic markers to serve as predictors of unsuccessful fracture healing. Alterations in mesenchymal stromal cell (MSC) function, including diminished osteogenic potential and increased cellular senescence, are central to pseudoarthrosis pathogenesis. Molecular analyses reveal suppressed bone morphogenetic protein (BMP) signaling and elevated levels of its inhibitors, such as Noggin and Gremlin, which impair bone regeneration. Genetic studies have uncovered polymorphisms in BMP, matrix metalloproteinase (MMP), and Wnt signaling pathways, suggesting a genetic predisposition to non-union. Additionally, the biological differences between atrophic and hypertrophic pseudoarthrosis, including variations in vascularity and inflammatory responses, emphasize the need for targeted approaches to management. Emerging biomarkers, such as circulating microRNAs (miRNAs), cytokine profiles, blood-derived MSCs, and other markers (B7-1 and PlGF-1), have the potential to contribute to early detection of at-risk patients and personalized therapeutic approaches. Advancing our understanding of the genetic and biological underpinnings of pseudoarthrosis is essential for the development of innovative diagnostic tools and therapeutic strategies.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"13 3","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712439","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":"In and Outpatients Bacteria Antibiotic Resistances in Positive Urine Cultures from a Tertiary Care Hospital in the Western Part of Romania-A Cross-Sectional Study.","authors":"Nicu Olariu, Monica Licker, Lazar Chisavu, Flavia Chisavu, Adalbert Schiller, Luciana Marc, Oana Albai, Andrei Paunescu, Vlad Tucicovschi, Adelina Mihaescu, Adrian Apostol","doi":"10.3390/diseases13030074","DOIUrl":"10.3390/diseases13030074","url":null,"abstract":"<p><strong>Background/objectives: </strong>Urinary tract infections (UTI) represent a global problem with implications for mortality and morbidity. Published data present different bacterial incidences and different antibiotic resistance. The objective of our study is to evaluate the bacteria distribution in positive urine cultures in a mixed adult population and evaluate the differences in antibiotic resistance in in- and outpatients.</p><p><strong>Methods: </strong>We analyzed 1186 positive urine cultures in 2021 from the Emergency County Hospital \"Pius Brinzeu\" from Timisoara, Romania. We evaluated the bacteria distribution and antibiotic resistance stratified by in and outpatients from a mixed adult population.</p><p><strong>Results: </strong>The median age was 67, with 65.7% females and 28.5% were outpatients. In inpatients, the most commonly identified bacteria was <i>E. coli</i>, followed by <i>Enterococcus</i> spp., and <i>Klebsiella</i> spp., while in outpatients, <i>E. coli</i>, <i>Enterococcus</i> spp., and <i>Klebsiella</i> spp. were the leading ones. Overall, <i>E. coli</i> presented the highest resistance rate to ampicillin, <i>Enterococcus</i> spp. to ciprofloxacin, <i>Klebsiella</i> spp. to cephalosporins, and <i>Proteus</i> spp. to trimethoprim/sulfamethoxazole. Inpatients presented higher resistance rates for <i>E. coli</i> to ceftazidime, cefuroxime, gentamycin, ciprofloxacin, and trimethoprim/sulfamethoxazole, <i>Klebsiella</i> spp. to most cephalosporin, gentamycin and levofloxacin, <i>Proteus</i> spp. to gentamycin and <i>Enterococcus</i> spp. to gentamycin and quinolones when compared to outpatients. The highest incidence of extensively drug-resistant (XDR) bacteria was among <i>Acinetobacter baumanii</i>, followed by <i>Pseudomonas</i> spp., and <i>Serratia</i> spp.</p><p><strong>Conclusions: </strong>susceptibility. Bacteria identified in inpatients' positive urine cultures present higher resistance rates to several antibiotics. Our study could be a foundation for a local or even national guideline for the antibiotic treatment of urinary tract infections.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"13 3","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712394","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":"Optimal Timing of Colostomy Reversal Following Hartmann's Procedure: A Retrospective Analysis of Postoperative Outcomes.","authors":"Constantin Popazu, Dragoș Voicu, Dorel Firescu, Ionica Grigore, Alexandra Toma, Răzvan Petru Derihaci","doi":"10.3390/diseases13030072","DOIUrl":"10.3390/diseases13030072","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Hartmann's procedure is commonly employed to manage complications of acute sigmoid diverticulitis, such as perforation or abscess formation. However, determining the optimal timing for colostomy reversal remains a topic of debate. This study aims to evaluate the effect of early versus delayed colostomy reversal on postoperative outcomes, focusing on complications, hospital stay duration, and readmission rates. <b>Methods</b>: A retrospective cohort study was conducted on 148 patients who underwent Hartmann's procedure for acute sigmoid diverticulitis at a single tertiary care center between 2014 and 2023. Participants were grouped based on the timing of colostomy reversal: early (45-120 days), intermediate (121-180 days), and late (>180 days). Data on complications, hospital stay length, and readmissions were analyzed. <b>Results</b>: Early reversal was associated with fewer postoperative complications, shorter hospital stays, and reduced readmissions compared to delayed reversal. The late reversal group had higher rates of complications, longer hospital stays, and a higher need for reintervention. Advanced age and comorbidities, such as cardiovascular disease and diabetes, were significant predictors of poor outcomes, contributing to delayed reversal. Logistic regression analysis indicated that late reversal was independently associated with higher complication rates. <b>Conclusions</b>: Early colostomy reversal within 45-120 days following Hartmann's procedure is associated with improved postoperative outcomes, including fewer complications and a shorter hospital stay. The timing of colostomy reversal should be individualized based on patient health status, with early reversal preferred for those without significant comorbidities. Further prospective research is needed to confirm these findings and refine guidelines for optimal reversal timing.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"13 3","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11940837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712426","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}