Advances in Clinical and Experimental Medicine最新文献

{"title":"A meta-analysis examining the impact of the continuous intervention for intraoperative pressure wound ulcers associated problems in women with breast cancer.","authors":"Xiaoxia Zhang, Ruoling Mo, Yue Liu, Xiuying Guo","doi":"10.17219/acem/197323","DOIUrl":"https://doi.org/10.17219/acem/197323","url":null,"abstract":"<p><strong>Background: </strong>Even though ongoing intervention is essential, several uncertainties remain about the management of intraoperative pressure wound ulcers in breast cancer patients.</p><p><strong>Objectives: </strong>To evaluate the impact of the ongoing intervention for intraoperative pressure wound ulcer problems related with female breast cancer patients, a meta-analysis study was conducted.</p><p><strong>Material and methods: </strong>Up until June 2024, comprehensive literature study was completed and 2,720 related studies were found. At the beginning point, 9 studies that were chosen included 1,467 women with breast cancer. Using dichotomous or continuous techniques and a random model, the odds ratio (OR) and mean difference (MD) and 95% confidence intervals (95% CIs) were used to evaluate the impact of continuous intervention for intraoperative pressure wound ulcers-associated difficulties in women with breast cancer.</p><p><strong>Results: </strong>In comparison to the control group of female breast cancer patients, continuous intervention resulted in significantly better quality of life (QoL) (MD = 8.07; 95% CI: 4.84-11.29, p < 0.001), fewer intraoperative pressure wound ulcers (OR = 0.18; 95% CI: 0.13-0.24, p < 0.001) and higher Braden risk score (OR = 2.11; 95% CI: 1.91-2.31, p < 0.001).</p><p><strong>Conclusion: </strong>In comparison to the control group, women with breast cancer undergoing continuous intervention experienced a significantly better QoL fewer intraoperative pressure wound ulcers, and had a higher Braden risk score. However, because there were not many studies chosen for comparison in the meta-analysis, reader's discretion is advised regarding its results.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of propofol and midazolam with the 30-day mortality in patients with sepsis-associated encephalopathy: A study of the MIMIC database.","authors":"Lanfen Zhan, Xinyao Xiang, Yu Zhang, Lingmin Zhou","doi":"10.17219/acem/196102","DOIUrl":"https://doi.org/10.17219/acem/196102","url":null,"abstract":"<p><strong>Background: </strong>Propofol and midazolam have been widely used in patients with sepsis. However, the effectiveness of these drugs in reducing the duration of mechanical ventilation and the risk of mortality remains controversial.</p><p><strong>Objectives: </strong>To investigate and compare effects of propofol and midazolam on 30-day mortality in patients with sepsis-associated encephalopathy (SAE).</p><p><strong>Material and methods: </strong>A retrospective cohort study was conducted on data from 952 adult patients with SAE extracted from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. Univariable and multivariable Cox proportional hazard models were utilized to investigate the associations of propofol and midazolam with 30-day mortality; and univariable and multivariable logistic regression analyses were used to explore the relationships of propofol and midazolam with ventilation duration. The outcome measures were hazard ratios (HRs), odds ratios (ORs), and 95% confidence intervals (95% CIs). In addition, subgroup analyses of age, simplified acute physiological score (SAPS)-II, Charlson Comorbidity Index (CCI), and ventilation duration were also performed to further assess the associations of propofol and midazolam with 30-day mortality.</p><p><strong>Results: </strong>Among eligible patients, 265 (27.84%) died within 30 days. After adjusting for covariates, treatment with propofol was associated with both lower risk of 30-day mortality (HR = 0.67, 95% CI: 0.51-0.88) and lower odds of prolonged ventilation duration (OR = 0.71, 95% CI: 0.53-0.96) compared to treatment with midazolam. Moreover, the negative association between treatment with propofol and 30-day mortality was also significant in subgroups of age ≥65 years, SAPS-II score ≥47, CCI score ≥3, and ventilation duration ≥5 days (all p < 0.05).</p><p><strong>Conclusions: </strong>Among patients with SAE, treatment with propofol was relatively more effective than treatment with midazolam in reducing the risk of 30-day mortality and the duration of mechanical ventilation. However, the causal relationships of propofol and midazolam with prognosis in patients with SAE need further clarification.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143956860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing Castor stent graft placement: A novel approach using direction-turnover and unwrapping techniques.","authors":"Weikai Dong, Lijuan Yang, Wei Li","doi":"10.17219/acem/197313","DOIUrl":"https://doi.org/10.17219/acem/197313","url":null,"abstract":"<p><strong>Background: </strong>Patients with aortic arch lesions involving the left subclavian artery (LSA) usually require endovascular surgery. The Castor single-branch stent graft provides a targeted solution for such cases, with potential benefits enhanced by the direction-turnover and unwrapping techniques.</p><p><strong>Objectives: </strong>To evaluate the safety, efficacy and short-term outcomes of the direction-turnover joint unwrapping techniques combined with a Castor single-branch stent graft in treating aortic arch lesions involving the LSA.</p><p><strong>Material and methods: </strong>From January 2022 to June 2023, 18 patients with aortic arch and LSA lesions underwent Castor stent graft placement at Binzhou Medical University Hospital (Shangdong, China). Preoperative and postoperative imaging with computed tomography angiography (CTA) was used to assess stent placement and efficacy at 1, 3, 6, and 12 months post-surgery.</p><p><strong>Results: </strong>All 18 patients successfully received the stent graft without intraoperative complications, stent migration or residual shunting. Postoperative imaging confirmed accurate stent placement with no evidence of thrombosis or endoleaks.</p><p><strong>Conclusions: </strong>The direction-turnover and unwrapping techniques improve the accuracy and safety of Castor stent graft placement, effectively reducing guidewire entanglement and enhancing procedural success. These techniques show promise for broader application in complex aortic arch interventions.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143956586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IGF2BP2-mediated m6A modifies SLC7A11 to regulate proliferation and ferroptosis in non-small cell lung cancer cells.","authors":"Bo Li, Si-Ying Li, Yi-Chao Yan","doi":"10.17219/acem/200588","DOIUrl":"https://doi.org/10.17219/acem/200588","url":null,"abstract":"<p><strong>Background: </strong>Insulin-like growth factor 2 mRNA-binding protein 2 (IGF2BP2) is implicated in various cancers, but its role in modulating ferroptosis and tumor cell behavior in non-small cell lung cancer (NSCLC) remains unclear.</p><p><strong>Objectives: </strong>This study aimed to investigate how IGF2BP2-mediated N6-methyladenosine (m6A) modification of solute carrier family 7 member 11 (SLC7A11) affects ferroptosis and NSCLC cell viability.</p><p><strong>Material and methods: </strong>NSCLC H1299 cells were transfected with either IGF2BP2 or SLC7A11 plasmids and corresponding siRNAs. Expression levels of IGF2BP2, SLC7A11 and ferroptosis markers were analyzed using reverse transcription real-time quantitative polymerase chain reaction (RT-qPCR) and western blot. Cell viability was assessed using the Cell Counting Kit-8 (CCK-8) assay. Reactive oxygen species (ROS) and lipid peroxidation levels were measured with flow cytometry and biochemical kits. The RNA immunoprecipitation (RIP) and mRNA stability assays were utilized to explore the interaction between IGF2BP2 and SLC7A11.</p><p><strong>Results: </strong>IGF2BP2 expression was significantly upregulated in H1299 cells. Overexpression of IGF2BP2 enhanced cell viability and decreased ferroptosis, whereas its knockdown resulted in reduced cell viability and increased ferroptotic activity. IGF2BP2 enhanced SLC7A11 mRNA stability through m6A modification, and SLC7A11 overexpression reversed the effects of IGF2BP2 knockdown. This interaction increased cell viability and reduced ROS and lipid peroxidation.</p><p><strong>Conclusions: </strong>IGF2BP2 plays a critical role in NSCLC by stabilizing SLC7A11 mRNA via m6A modification, promoting cell proliferation and suppressing ferroptosis. Targeting the IGF2BP2-SLC7A11 axis may offer a promising therapeutic strategy for NSCLC.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preliminary exploration of the potential role of salvianolic acid F in regulating ovarian cancer cell proliferation, migration, invasion, and apoptosis and its association with the EP300/PI3K/AKT pathway.","authors":"Chunxia Ding, Xiaoying Xu, Lingyun Wei, Yixiao Wang","doi":"10.17219/acem/195334","DOIUrl":"https://doi.org/10.17219/acem/195334","url":null,"abstract":"<p><strong>Background: </strong>Salvianolic acid F (SAF), an important water-soluble monomeric component, is derived from the herbal medicine Salvia miltiorrhiza (SM) Bunge. Although SAF has been suggested to suppress various cancers, its role in ovarian cancer (OC) and the underlying mechanisms remain largely unclear.</p><p><strong>Objectives: </strong>This study aimed to investigate the effects of SAF on OC cell growth, invasion, migration, and apoptosis, as well as to elucidate the underlying mechanisms, including those involving the EP300/PI3K/AKT signaling pathway.</p><p><strong>Material and methods: </strong>In vitro cell culture experiments were conducted to assess the effects of SAF on the proliferation, migration, invasion, and apoptosis of OVCAR-3 (Ovarian Cancer Cell Line 3) and SK-OV-3 (Sloan-Kettering Ovarian Cancer 3) cells. Network pharmacology was further employed to explore SAF's impact on OC and to elucidate the potential underlying mechanisms. The EP300-mediated PI3K/AKT signaling pathway was selected for validation to confirm SAF's effects on inducing apoptosis and inhibiting cell proliferation in these OC cell lines.</p><p><strong>Results: </strong>Salvianolic acid F suppressed the growth, invasion and migration of SK-OV-3 and OVCAR-3 cells, and induced apoptosis. A network pharmacology analysis of SAF's effects on OC identified core targets, TP53, EP300, STAT3, MMP9, NFKB1, HIF1A, and PTGS2, through protein-protein interaction (PPI) network analysis using the STRING database. Salvianolic acid F inhibited EP300 expression in SK-OV-3 cells, reduced the p-PI3K/PI3K ratio, and increased both the Bax/Bcl-2 ratio and the cleaved caspase-3/caspase-3 ratio in OVCAR-3 and SK-OV-3 cells. However, the addition of A485, an EP300 inhibitor, did not further enhance the effects of SAF.</p><p><strong>Conclusions: </strong>Salvianolic acid F inhibited OC cell growth, migration and invasion while promoting apoptosis. The EP300/PI3K/AKT pathway is a key mechanism through which SAF regulates OC progression. Additionally, SAF may represent a promising candidate drug for treating OC.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiological characteristics of thyroid cancer worldwide and construction of a machine learning diagnostic model.","authors":"Yanqiong Liu, Lian Li, Shasha Wang, Shuangyan Zhou, Jianhui Zou","doi":"10.17219/acem/199327","DOIUrl":"https://doi.org/10.17219/acem/199327","url":null,"abstract":"<p><strong>Background: </strong>Age and gender have been identified as significant factors contributing to the global rise in thyroid cancer (TC), with this disease predominantly affecting women. It is crucial to thoroughly investigate the trends of the disease over time to better understand its progression and potential risk factors.</p><p><strong>Objectives: </strong>This study analyzed the global incidence of TC using data from the Global Burden of Disease (GBD) database from 1990 to 2021. Additionally, we aimed to develop a high-performance diagnostic model using machine-learning algorithms and to explore the tumor microenvironment through single-cell sequencing.</p><p><strong>Material and methods: </strong>To analyze trends in incidence, age-period cohort models were applied, with a particular focus on birth cohort and period effects. Machine learning algorithms, including least absolute shrinkage and selection operator (LASSO) and Ridge regression, were used for gene feature selection. Subsequently, cross-validation was conducted to validate the diagnostic model. For deeper insights, single-cell RNA sequencing was conducted to analyze myeloid cell subpopulations within the tumor microenvironment.</p><p><strong>Results: </strong>Age and period effects emerged as the primary drivers in our analysis of TC trends, particularly among women. Machine learning models, specifically LASSO and Ridge regression, demonstrated high predictive accuracy in diagnosing the disease. Additionally, single-cell RNA sequencing unveiled crucial interactions between myeloid cells and the tumor microenvironment.</p><p><strong>Conclusions: </strong>This study provides a comprehensive analysis of TC trends and introduces a machine-learning-based diagnostic tool. Additionally, single-cell RNA sequencing offers novel insights into the tumor microenvironment, which may help shape future treatment strategies for TC.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An experimental rat model of non-alcoholic fatty liver disease: Ameliorative effect of green coffee and prediction of disease activity.","authors":"Gülşah Mete, Gökçen Gökçe, Sevim Aydın, Hasan Serdar Öztürk","doi":"10.17219/acem/195189","DOIUrl":"https://doi.org/10.17219/acem/195189","url":null,"abstract":"<p><strong>Background: </strong>Non-alcoholic fatty liver disease (NAFLD) is currently a public health problem that affects many people worldwide. New-generation dietary agents can contribute to disease control. Also, prediction of liver disease activity with serum markers is an important factor to reduce the need for liver biopsies.</p><p><strong>Objectives: </strong>The aim of this study was to compare the effects of 20 mg/kg green coffee bean extract (GCBE, standardized to 10 mg/kg chlorogenic acid), 10 mg/kg chlorogenic acid (CA) and 50 mg/kg CA on NAFLD activity score (NAS). We also aimed to create a NAS prediction model as an alternative to liver biopsies.</p><p><strong>Material and methods: </strong>Male Wistar rats were fed either a high-fat high-cholesterol (HFHC) diet (NAFLD groups, n = 32) or a normal diet (control groups, n = 24). Green coffee bean extract (20 mg/kg) and CA (10 mg/kg and 50 mg/kg) were given by daily oral gavage. At the end of the study, blood samples and liver tissues were collected. Biochemical parameters, glyoxalase 1 (GLO1) and oxidative stress parameters were analyzed. An experienced histopathologist graded NAS.</p><p><strong>Results: </strong>Green coffee bean extract and 50 mg/kg CA significantly reduced NAS (p < 0.01 and p < 0.001, respectively). HFHC-diet induced NAFLD was associated with higher serum GLO1 levels (p < 0.001). Serum malondialdehyde (MDA) levels were positively correlated with NAS while GLO1 was negatively correlated with NAS (p < 0.001, r = 0.698; p < 0.05, r = -0.367, respectively). Serum MDA and triglyceride were found to be statistically significant in predicting NAS (p < 0.001).</p><p><strong>Conclusions: </strong>Our study suggests that GCBE and CA can both ameliorate the development of NAFLD. Also, low-dose GCBE and high-dose CA showed similar hepatoprotective effects. Increased GLO1 in NAFLD may be a defense mechanism which is enhanced by GCBE and CA. Moreover, serum MDA and triglyceride levels are promising in NAS prediction.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143952665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychometric properties and cultural adaptation of the Spanish version of the Lesbian, Gay, Bisexual, and Transgender Development of Clinical Skills Scale (LGBT-DOCSS-ES).","authors":"Piotr Karniej, Raúl Juárez-Vela, Anthony Dissen, Antonio Martinez-Sabater, Pablo Del Pozo-Herce, Vicente Gea-Caballero, Emmanuel Echániz-Serrano, Elena Chover-Sierra, Ruben Perez-Elvira, Michał Czapla","doi":"10.17219/acem/203430","DOIUrl":"https://doi.org/10.17219/acem/203430","url":null,"abstract":"<p><strong>Background: </strong>Healthcare systems can present unique challenges for individuals in the lesbian, gay, bisexual, and transgender (LGBT) community, often making it difficult for them to access suitable and respectful care.</p><p><strong>Objectives: </strong>The aim of this study was to perform a transcultural adaptations and to evaluate psychometric properties of the Spanish version of the Lesbian, Gay, Bisexual, and Transgender Development of Clinical Skills Scale (LGBT-DOCSS-ES). This adaptation is intended for application within Spanish-speaking healthcare settings.</p><p><strong>Material and methods: </strong>The LGBT-DOCSS was translated and adapted from the original English version into Spanish using a standardized process, including forward translation, back-translation, and expert panel review. Psychometric properties were tested on a sample of 270 participants from Spain. Internal consistency was evaluated using confirmatory factor analysis (CFA), Cronbach's alpha, the discriminative power index, and McDonald's omega (ω).</p><p><strong>Results: </strong>The study included 270 participants, with 58.9% being female and 38.9% male. Of the respondents, 52.2% identified as heterosexual, 32.6% as homosexual and 13% as bisexual. The internal consistency of the Spanish version and its domains was good with an overall Cronbach's alpha of 0.746. The alpha ranges for each subscale domains were between 0.769 and 0.822. The McDonald's ω coefficient was 0.808.</p><p><strong>Conclusions: </strong>The Spanish version of the LGBT-DOCSS-ES has good properties of factorial validity. This tool is a valuable resource for assessing cultural competence and clinical skills among healthcare providers in Spanish-speaking settings.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping the evolution of mitochondrial dynamics research: A bibliometric analysis of global trends and collaborations.","authors":"Fugang Huang, Ke Sun, Zexuan Wu, Guanqun Xie, Jie Bao, Yongsheng Fan","doi":"10.17219/acem/196720","DOIUrl":"https://doi.org/10.17219/acem/196720","url":null,"abstract":"<p><strong>Background: </strong>Mitochondrial dynamics is an important field in cell biology, encompassing mitochondrial fission and fusion. The balance between fission and fusion is responsible for the stability of the mitochondrial network and can be a regulator of mitochondrial function. Recent studies have emphasized that an imbalance in mitochondrial dynamics is the root cause of dysfunction and is involved in various stages, such as oxidative stress, inflammation and apoptosis. Reversing this imbalance can effectively alleviate disease conditions. Although the importance of mitochondrial dynamics has been widely recognized, there is still a lack of literature on the qualitative and quantitative description and analysis of advances in this field.</p><p><strong>Objectives: </strong>This study is a bibliometric analysis of research trends, collaboration networks and thematic evolution in mitochondrial dynamics from 2000 to 2023.</p><p><strong>Material and methods: </strong>Using the Web of Science Core Collection (WoSCC) database, we performed a bibliometric review, applying VOSviewer and CiteSpace to visualize and analyze publications, citations, collaborations, and key word trends.</p><p><strong>Results: </strong>We analyzed 332 publications, identifying China and the USA as leaders in research output and international collaborations. Significant contributions were made by institutions like Chiang Mai University and the California Institute of Technology (Caltech), with major research shifts from basic mitochondrial functions to roles in diseases like Alzheimer's and cardiovascular disease.</p><p><strong>Conclusion: </strong>Mitochondrial dynamics research has expanded, with increasing attention to its role in disease mechanisms. Future research should further explore these connections, potentially leading to innovative treatments.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of changes in mental health, cognitive function and self-care behaviors in patients with heart failure: A prospective cohort study.","authors":"Maria Jędrzejczyk, Christopher S Lee, Ercole Vellone, Anna Gozdzik, Remigiusz Szczepanowski, Michał Czapla, Izabella Uchmanowicz","doi":"10.17219/acem/202773","DOIUrl":"https://doi.org/10.17219/acem/202773","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF) is a chronic condition affecting tens of millions of people worldwide. Despite advances in treatment, its impact on mental health, cognitive function and self-care behaviors remains underexplored, particularly across ejection fraction phenotypes, underscoring the need for comprehensive investigations into these interconnected domains.</p><p><strong>Objectives: </strong>This prospective cohort study investigated changes in affective symptoms, cognitive functioning and self-care behaviors in patients with HF stratified with ejection fraction (EF) phenotypes over 6 months.</p><p><strong>Material and methods: </strong>The study included 162 patients aged over 60 years with a diagnosis of HF. Participants were examined at enrollment and after 6 months. The Mini-Mental State Examination (MMSE), the Hospital Anxiety and Depression Scale (HADS) and Patient Health Questionnaire-9 (PHQ-9) and the European Heart Failure Self-care Behaviour Scale (EHFScB-9) were used to assess cognitive function, affective symptoms and self-care behaviors.</p><p><strong>Results: </strong>Cognitive impairment indicated with the MMSE was less severe in patients with mildly-reduced HF (HFmrEF) compared to preserved EF (HFpEF) (MMSE median scores: 28 [interquartile range (IQR): 27-29] vs 27 [IQR: 25-28]; p = 0.008). The HADS showed that severity of depression worsened over 6 months, particularly in the HFpEF group (median scores increased from 1 [IQR: 0-4] to 3 [IQR: 0-6]; p = 0.006). Self-care ability declined in all groups as indicated in the increased EHFSc-9 (poorer self-care) median scores, which changed from 28 [IQR: 21-33] at baseline to 29 [IQR: 23-34] at 6 months (p = 0.035). Additionally, NT-proBNP parameters were higher in the HFrEF group (3437.7 pg/mL [IQR: 1336.33-6226.43) compared to both HFmrEF and HFpEF (2171.2 pg/mL [IQR: 806.65-4033.15] and 977.1 pg/mL [IQR: 576.9-3708.95, respectively, p = 0.001).</p><p><strong>Conclusions: </strong>Patients with HF showed significant cognitive decline, increased depressive symptoms and reduced self-care over 6 months, with HFpEF patients exhibiting the most pronounced impairments. Differences in outcomes across HF phenotypes highlight the need for tailored diagnostic and therapeutic strategies to address cognitive and emotional challenges in this population.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}