Advances in Clinical and Experimental Medicine最新文献

{"title":"Endocardial lead insulation wear in a scanning and optical microscope.","authors":"Mateusz Ulman, Krzysztof Boczar, Katarzyna Holcman, Magdalena Ziąbka, Maciej Dębski, Jacek Lelakowski, Andrzej Ząbek","doi":"10.17219/acem/186864","DOIUrl":"10.17219/acem/186864","url":null,"abstract":"<p><strong>Background: </strong>The path and interaction of leads within the cardiovascular system are influenced by various factors, including the implantation technique. Furthermore, the multifaceted composition of these leads, often comprising multiple materials, can contribute to their potential degradation and wear over time.</p><p><strong>Objectives: </strong>Our aim was to investigate the wear of lead insulation following the removal of transvenous leads and pinpoint the regions of the lead most vulnerable to damage.</p><p><strong>Material and methods: </strong>We undertook a prospective analysis of patients from a single tertiary center who underwent transvenous lead explantation (TLE) between October 1, 2013, and July 31, 2015. Specifically, our examination focused on endocardial leads removed using simple screw-out and gentle traction techniques. Subsequent lead evaluations were conducted utilizing scanning electron and optical microscopes.</p><p><strong>Results: </strong>Among the 86 patients who underwent the TLE procedure, 26 patients (30%) required the removal of 39 leads through simple traction. Inspection using scanning electron microscopy consistently indicated insulation damage across all leads. A total of 347 damaged sites were identified: 261 without lead unsealing and 86 exhibiting unsealing. Notably, the sections of the leads located within the intra-pocket area demonstrated the highest vulnerability to damage (odds ratio (OR): = 9.112, 95% confidence interval (95% CI): 3.326-24.960), whereas the intravenous regions displayed the lowest susceptibility (OR: 0.323, 95% CI: 0.151-0.694).</p><p><strong>Conclusions: </strong>Our study reveals that all evaluated leads exhibited insulation damage, with the intra-pocket segments manifesting a notably higher prevalence of damage than the intravenous segments.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":"597-604"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141454517","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":"Therapeutic efficiency and safety assessment of intradermal platelet-rich plasma combined with oral tranexamic acid in patients with facial melasma.","authors":"Weeratian Tawanwongsri, Doungkamol Siri-Archawawat, Sasipaka Sindhusen, Chime Eden","doi":"10.17219/acem/187874","DOIUrl":"10.17219/acem/187874","url":null,"abstract":"<p><strong>Background: </strong>Melasma is a chronic, acquired hypermelanosis that primarily affects the face. Platelet-rich plasma (PRP) and tranexamic acid (TXA) are promising treatments for melasma. However, only a few randomized clinical trials have examined the efficacy and safety of combining these therapies for melasma.</p><p><strong>Objectives: </strong>We aimed to compare the efficacy and safety of combining PRP and oral TXA with those of PRP alone in the treatment of facial melasma.</p><p><strong>Material and methods: </strong>A randomized controlled trial was conducted at Walailak University Hospital, Nakhon Si Thammarat, Thailand, between March and September 2023. Participants with mixed-type melasma were randomly allocated in a 1:1 ratio to either group A (PRP injection alone without placebo) or group B (PRP injection with oral TXA). Therapeutic efficacy and safety assessments were performed over a 12-week follow-up period.</p><p><strong>Results: </strong>The study included 26 participants (mean age: 45.9 years, standard deviation (±SD): 5.0) who were predominantly female (84.6%). In group A, the modified Melasma Area and Severity Index (mMASI) scores significantly decreased from a median of 4.30 interquartile range (IQR): 4.10) to 3.60 (IQR: 3.10) between week 0 and week 12, respectively. In group B, the median mMASI decreased from 6.40 (IQR: 7.80) to 3.60 (IQR: 3.70) over the same period. The median change in mMASI scores in group B (2.90, IQR: 2.40) was significantly larger than in group A (0.90, IQR: 0.60) (p < 0.001, U = 160.50). However, there were no significant differences in the physicians' global assessment (PGA), melasma quality of life scale (MelasQoL) or patient satisfaction during follow-up. Four patients (15.4%) experienced transient erythema and swelling. In group B, 1 participant (7.7%) experienced transient mild gastrointestinal discomfort after receiving oral TXA.</p><p><strong>Conclusions: </strong>The combination of intradermal PRP injection and oral TXA is effective for melasma, even in patients with poor prognostic treatment response factors. No serious adverse reactions were observed in either group.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":"529-537"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141454518","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":"Resilience of primary healthcare facilities: Experiences from 16 European countries during the COVID-19 pandemic. A mixed-methods study conducted by EURIPA.","authors":"Ferdinando Petrazzuoli, Ozden Gokdemir, Maria Antonopoulou, Beata Blahová, Natasa Mrduljaš-Đujić, Gindrovel G Dumitra, Rosario Falanga, Mercedes Ferreira, Sandra Gintere, Sehnaz Hatipoglu, Jean-Pierre Jacquet, Kateřina Javorská, Ana Kareli, András Mohos, Sody Naimer, Victoria Tkachenko, Angela Tomacinschii, Jane Randall-Smith, Krzysztof Kujawa, Donata Kurpas","doi":"10.17219/acem/194212","DOIUrl":"10.17219/acem/194212","url":null,"abstract":"<p><strong>Background: </strong>The role of primary healthcare (PHC) during a pandemic varies across European countries. The coronavirus disease 2019 (COVID-19) pandemic has altered the working practices of family medicine doctors and impacted the resilience of healthcare systems.</p><p><strong>Objectives: </strong>This study aimed to examine European healthcare system responses to the pandemic, focusing on rural and urban differences.</p><p><strong>Material and methods: </strong>This cross-sectional, mixed-methods study used a semi-structured online questionnaire with 68 questions, including 21 free-text comments. Data were collected from May 2020 to January 2021. Key informants from 16 European Rural and Isolated Practitioners Association (EURIPA) member countries distributed questionnaires to 406 PHC doctors. Data were analyzed using descriptive statistics and nonparametric tests (χ2, Kruskal-Wallis, Mann-Whitney U) with a significance threshold of 0.05.</p><p><strong>Results: </strong>A statistically significant difference was found between rural (36.4%, 55/151), semirural (19.4%, 24/124) and urban populations (29.8%, 39/131) regarding medicine shortages (χ2 = 9.91, degrees of freedom (df) = 4, p = 0.042). The semirural setting showed a statistically significant difference from the other settings (p = 0.004 in post hoc χ2 test). Significant differences were found between countries in resilience features including, effectiveness of triage, adapting to the rapidly changing requirements, government help, existence of a community resilience group, improved interprofessional collaboration, medicine shortage, and general practitioners (GPs) involvement in palliative care.</p><p><strong>Conclusions: </strong>Medicine shortage was more prevalent in rural and urban areas compared to semirural areas. Differences were observed between countries in their responses to the pandemic, particularly in adapting to the rapidly changing requirements, effectiveness of triage, government help, and the existence of a community resilience group. These differences were confirmed with qualitative analysis. The results emphasize the need for tailored approaches considering diverse contexts in shaping effective healthcare system resilience.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":"487-505"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142826729","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":"Correlation analysis of patients with diabetic foot ulcers treated with tibial cortex transverse transport surgery and platelet-to-lymphocyte ratio and monocyte-to-neutrophil ratio.","authors":"Sijie Yang, Kaixiang Pan, Qikai Hua, Hongjie Su, Jun Hou, Kaibing Liu, Jinmin Zhao","doi":"10.17219/acem/187765","DOIUrl":"10.17219/acem/187765","url":null,"abstract":"<p><strong>Background: </strong>Diabetic foot ulcers (DFUs) represent one of the most severe late-stage complications of diabetes. Tibial cortex transverse transport (TTT) surgery stands as the prevailing method for addressing DFUs. This surgical intervention holds the promise of expediting DFU wound healing and diminishing the rate of amputations, with the mitigation of inflammatory responses playing a pivotal role. In this study, we aim to explore the correlation between inflammation and TTT surgery, with the overarching goal of facilitating swift prognostic assessments in clinical practice.</p><p><strong>Objectives: </strong>The correlation between the severity of DFUs and clinical test results remains ambiguous. A clinical prediction model was devised to explore the connection between DFU severity and the efficacy of TTT surgery, utilizing straightforward and efficient clinical indicators.</p><p><strong>Material and methods: </strong>Clinical data and examination results were gathered by tracking hospitalized DFU patients who underwent TTT surgery at the First Affiliated Hospital of Guangxi Medical University (Nanning, China). Indicators associated with DFU severity and wound healing time post-surgery were identified through logistic regression and least absolute shrinkage and selection operator (LASSO) regression analyses. Subsequently, a clinical prediction model was constructed. Finally, the intersection of these 2 sets of indicators revealed factors correlated with wound severity and post-operative healing duration.</p><p><strong>Results: </strong>Our study was comprised of 202 patients who were categorized into 2 groups based on Wagner's grading classifications. Utilizing Student's t-tests, LASSO regression and logistic regression analyses, we identified 3 factors indicative of DFU severity: platelet-to-lymphocyte ratio (PLR), mixed lymphocyte reaction (MLR) and hemoglobin (HGB). Univariate COX regression analysis revealed 12 factors such as: white blood cells (WBC), neutrophils (NEUT), monocytes (MO), PLR, MLR, neutrophil-to-lymphocyte ratio (NLR), erythrocyte sedimentation rate (ESR), age, lymphocytes (LY), monocyte-to-neutrophil ratio (MNR), uric acid (UA), and albumin (ALB) associated with the postoperative healing duration. Ultimately, we identified 2 factors, PLR and MNR, at the intersection of these 2 datasets.</p><p><strong>Conclusions: </strong>Platelet-to-lymphocyte ratio and MNR were identified as factors associated with both the severity of DFUs and the prognosis following TTT surgery.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":"549-559"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141454516","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 equity-based financial framework for a sustainable healthcare system in Arab countries.","authors":"Wadi B Alonazi, Sahar Alkhawtani","doi":"10.17219/acem/195571","DOIUrl":"https://doi.org/10.17219/acem/195571","url":null,"abstract":"<p><strong>Background: </strong>Disparities persist in access, quality and outcomes across different socioeconomic strata. Addressing these disparities requires a comprehensive understanding of the underlying factors contributing to healthcare inequities. Even though healthcare equity has been discussed in the literature, no comprehensive frameworks have been developed considering the given country's distinctive demographic cultural and socioeconomic variables.</p><p><strong>Objectives: </strong>This study proposed an equity-based financial framework to enhance the sustainability of the healthcare system in Saudi Arabia, the United Arab Emirates (UAE) and Qatar. Moreover, this research aimed to examine the key factors influencing equitable access to healthcare services.</p><p><strong>Material and methods: </strong>A cross-sectional study design was employed, utilizing national health accounts, demographic surveys and health outcomes data from 3 Arab countries: Saudi Arabia, UAE and Qatar. The study included participants from 15 medical organizations, 500 policymakers and 10,000 patients. A stratified random sampling technique was employed to ensure a diverse and representative sample. The economic equity measurements included the principal component analysis (PCA) and Theil index. Financial sustainability was evaluated using techniques such as the cost-effectiveness analysis (CEA) and systems dynamics modeling techniques.</p><p><strong>Results: </strong>This study identified a positive convergence in healthcare systems among Qatar, Saudi Arabia and the UAE. The Theil index value of 0.35 suggested a balanced distribution of healthcare resources across the 3 countries. Policy A had an incremental cost-effectiveness ratio (ICER) of $15,000 per quality-adjusted life year (QALY), making it more cost-effective compared to Policy B with an ICER of $20,000 per QALY and Policy C with an ICER of $25,000 per QALY. The Delphi technique achieved a consensus level of 90%, while Policy C emerged as the most preferred option in the multi-criteria decision analysis (MCDA), scoring a total of 85 points. Moreover, the PCA accounted for 60% of the variations related to healthcare equity in the specified countries.</p><p><strong>Conclusions: </strong>The findings of this study provide valuable insights for policymakers, offering a new roadmap for economic evaluation studies aimed at enhancing healthcare equity and sustainability in Arab countries.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":"34 4","pages":"507-527"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143956908","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":"Association between preoperative advanced lung cancer inflammation index and recurrence of hepatocellular carcinoma after curative resection.","authors":"Weidong Yuan, Hewei Zhao, Shaochuang Wang","doi":"10.17219/acem/188424","DOIUrl":"10.17219/acem/188424","url":null,"abstract":"<p><strong>Background: </strong>The association between the advanced lung cancer inflammation index (ALI) and the recurrence of hepatocellular carcinoma (HCC) in patients treated with curative resection and its predictive value remains unclear.</p><p><strong>Objectives: </strong>To assess the association between preoperative ALI and the recurrence of HCC in patients treated with surgical resection.</p><p><strong>Material and methods: </strong>This retrospective study analyzed patients with HCC treated with surgical resection at The Affiliated Huai'an No. 1 People's Hospital of Nanjing Medical University (Huai'an, China) from 2019 to 2021. The advanced lung cancer inflammation index was calculated as (BMI × ALB/NLR), where BMI = body mass index, ALB = serum albumin and NLR = neutrophil-lymphocyte ratio. Univariate and multivariable Cox proportional risk models were performed to evaluate the association between the ALI and recurrence of HCC patients treated with surgical resection. Subgroup analyses were conducted based on age, sex, performance status (PS), cirrhosis, pathological staging, tumor grading, tumor size, and number of tumors.</p><p><strong>Results: </strong>Among the 295 HCC patients treated with surgical resection, 180 patients (61.02%) had recurrences, with the mean follow-up being 462 (187, 730) days. Patients with higher ALI scores were significantly less likely to have a recurrence of HCC after surgical resection (hazard ratio (HR): 0.59, 95% confidence interval (95% CI): 0.42-0.83, p = 0.003). Based on subgroup analyses, HCC patients undergoing surgical resection with higher ALI scores were associated with recurrence in those ≥60 years of age, with tumors ≥5 cm, and in patients with single tumors and ≥2 tumors.</p><p><strong>Conclusions: </strong>This study confirms the association between ALI and the reduced risk of recurrence in HCC patients treated with surgical resection.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":"573-583"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455708","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":"LncRNA LINC00969 modified by METTL3 attenuates papillary thyroid cancer progression in an m6A-dependent manner.","authors":"Chaogang Huang, Ziqi Duan, Baojie Chen, Hailiang Xia, Guangxin Wang","doi":"10.17219/acem/188367","DOIUrl":"10.17219/acem/188367","url":null,"abstract":"<p><strong>Background: </strong>The long non-coding RNA (lncRNA) LINC00969 is involved in human disease progression, and n6-methyladenosine (m6A) modification of lncRNAs in cancer has been proven to be a key regulatory mechanism. However, our understanding of its effects and mechanisms of action in papillary thyroid carcinoma (PTC) remains limited.</p><p><strong>Objectives: </strong>This study aimed to elucidate the role of methyltransferase-like 3 (METTL3)-induced m6A modification of LINC00969 in PTC tumorigenesis.</p><p><strong>Material and methods: </strong>Quantitative reverse transcription polymerase chain reaction (qRT-PCR) was performed to analyze LINC00969 and METTL3 mRNA levels in PTC. The regulation of LINC00969 by METTL3 was confirmed using cell function experiments, molecular biology assays and bioinformatics analysis. LINC00969 stabilization analysis was performed to verify the regulatory roles of METTL3 and LINC00969.</p><p><strong>Results: </strong>LINC00969 expression was downregulated in PTC tissues. Increased LINC00969 expression inhibited the invasion, growth and migration of PTC cells. METTL3 downregulation in PTC mediated the m6A modification of LINC00969, increasing its stability. Furthermore, METTL3 levels were downregulated in PTC, and its silencing partially reversed the inhibitory effect of LINC00969 overexpression on PTC cell malignancy.</p><p><strong>Conclusions: </strong>LINC00969 overexpression inhibits PTC cell malignancy via METTL3-mediated m6A modification. These findings suggest that METTL3-m6A-LINC00969 is a promising therapeutic target for PTC.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":"623-632"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141970353","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":"Clearing the path: Hypertonic saline's impact on intracranial pressure in traumatic brain injury. A systematic review and meta-analysis.","authors":"Xiaoping Ren, Shuyan Liu, Ju Gao, Rupshikha Choudhury, Sanjay Rastogi","doi":"10.17219/acem/197437","DOIUrl":"https://doi.org/10.17219/acem/197437","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the effectiveness of HTS in lowering elevated ICP in TBI patients with TBI.</p><p><strong>Material and methods: </strong>A systematic search was conducted using 4 electronic databases (PubMed, Embase, Scopus, and Cochrane Library) to select relevant articles published in peer-reviewed journals. The risk ratio (RR) and mean difference (MD) were calculated, along with their 95% confidence intervals (95% CIs). Heterogeneity was assessed using Cochrane Q, I2 statistics and p-value. RevMan 5.4 was used.</p><p><strong>Results: </strong>The current meta-analysis included 965 TBI patients from 15 randomized controlled trials (RCTs). We found that HTS was significantly more effective than other ICP-lowering agents with RR of 0.74 (95% CI: 0.58-0.94) for reduction of elevated ICP; RR = 0.57 (95% CI: 0.40-0.81) for all-cause mortality; RR = 0.68 (95% CI: 0.49-0.95) for rate of adverse hypernatremia; RR = 0.73 (95% CI: 0.60-0.88) for substantial change in the Glasgow Outcome Scale (GOS) score and shorter period of hospital stay with MD of -1.26 (95% CI: -2.30 to -0.21).</p><p><strong>Conclusion: </strong>We found that HTS is considerably effective in reducing elevated ICP with improvement in long-term neurological functions, all-cause mortality, rate of hypernatremia, and length of hospital stay in TBI patients.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690849","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":"Assessment of the physical fitness status of patients with hematological malignancies qualified for hematopoietic stem cell transplantation.","authors":"Michał Chmielewski, Agnieszka Szeremet, Paula Jabłonowska-Babij, Maciej Majcherek, Anna Czyż, Natalia Bursiewicz, Tomasz Wróbel, Iwona Malicka","doi":"10.17219/acem/193825","DOIUrl":"https://doi.org/10.17219/acem/193825","url":null,"abstract":"<p><strong>Background: </strong>Hematopoietic stem cell transplantation (HSCT) is a procedure commonly used in the treatment of various hematological disorders with the aim of curing the patient or prolonging life. The vast majority of patients must have antineoplastic therapy before HSCT, which can result in weight loss, sarcopenia or cachexia. Additionally, there is a high risk of malnutrition and physical deterioration during HSCT. By assessing physical fitness prior to HSCT, a physical therapist can individualize an exercise program, which in turn may speed up recovery after HSCT.</p><p><strong>Objectives: </strong>The aim of the study was to assess the physical fitness of patients with hematological malignancies qualified for HSCT as an indication for prehabilitation.</p><p><strong>Material and methods: </strong>The study included 65 patients with hematological malignancies who were qualified for HSCT between September 1, 2022, and September 1, 2023. The reference group consisted of 219 healthy adults. The clinical study protocol involved participants performing 3 tests: the 6-minute walk test (6MWT), the timed-up and go test (TUG) and the 30-second chair-stand test (30CST).</p><p><strong>Results: </strong>Patients with hematological malignancies were characterized by significantly lower endurance capacity (median (Me) = 420.50 (IQR 110.25) vs Me = 580.00 (IQR 133.00); p < 0.001) and significantly lower body strength (Me = 11.00 (IQR 6.00) vs Me = 15.00 (IQR 5.00); p < 0.001). There was also a statistically significant difference in the diagnosis and in the number of lines of systemic therapy. Additionally, a statistically significant difference was observed between the outcomes of the physical fitness level, particularly for TUG and 30CST, and the time from diagnosis to transplantation.</p><p><strong>Conclusions: </strong>The presented results suggest a negative consequence of hematological disease and its treatment on the functional status of patients qualified for HSCT and indicate the need for individualized rehabilitation management depending on the type of diagnosis, the number of lines of systemic therapy, and the time between diagnosis and transplantation.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646695","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":"Comorbidity-related risk factors for acute respiratory distress syndrome in sepsis patients: A systematic review and meta-analysis.","authors":"Xin Lin, Yang Liu, Li Kong, Tejin Ba, Bagenna Bao, Shuanglin Zhang, Weihong Liu","doi":"10.17219/acem/191594","DOIUrl":"https://doi.org/10.17219/acem/191594","url":null,"abstract":"<p><strong>Background: </strong>Acute respiratory distress syndrome (ARDS) presents a significant challenge in the management of sepsis, with various comorbidities potentially influencing its development. Understanding the impact of these comorbidities is crucial for improving patient outcomes.</p><p><strong>Objectives: </strong>This meta-analysis was conducted to investigate the relationship between various comorbidities and the development of ARDS in patients with sepsis, with the aim of improving understanding and management of this condition.</p><p><strong>Material and methods: </strong>The study included adult sepsis patients from 8 studies, totaling 16,964 participants. Risk of bias was assessed using the Newcastle-Ottawa scale (NOS), and the data analysis was performed and reported as pooled odds ratios (ORs) computed using a random-effects model. Heterogeneity and publication bias were assessed using the I2 statistic and Doi plots with the Luis Furuya-Kanamori (LFK) index, respectively.</p><p><strong>Results: </strong>Chronic obstructive pulmonary disease was significantly associated with an increased risk of ARDS (OR: 1.43, 95% confidence interval (95% CI): 1.02-2.01). Other comorbidities showed no significant associations: diabetes mellitus (DM) (OR: 0.88, 95% CI: 0.69-1.11), hypertension (HTN) (OR: 0.86, 95% CI: 0.56 to 1.34), coronary artery disease (CAD) (OR: 0.95, 95% CI: 0.86-1.06), congestive heart failure (CHF) (OR: 1.08, 95% CI: 0.61 to 1.90), chronic kidney disease (CKD) (OR: 0.89, 95% CI: 0.65-1.22), chronic liver disease (CLD) (OR: 1.13, 95% CI: 0.61-2.09), and cancer (OR: 0.90, 95% CI: 0.59-1.35). Additional analyses indicated moderate-to-high heterogeneity and some evidence of publication bias.</p><p><strong>Conclusion: </strong>Chronic obstructive pulmonary disease is a notable risk factor for ARDS in sepsis patients, suggesting the need for enhanced surveillance and management in this group. Further research is necessary to understand the mechanisms and explore other potential ARDS risk factors in sepsis.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603364","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}