Medical sciences (Basel, Switzerland)最新文献

{"title":"Novel Therapeutic Approach for Obesity: Seaweeds as an Alternative Medicine with the Latest Conventional Therapy.","authors":"Rajesh Yadav, Ankita Nigam, Richa Mishra, Saurabh Gupta, Anis Ahmad Chaudhary, Salah-Ud-Din Khan, Eman Abdullah Almuqri, Zakir Hassain Ahmed, Sarvesh Rustagi, Deependra Pratap Singh, Sanjay Kumar","doi":"10.3390/medsci12040055","DOIUrl":"https://doi.org/10.3390/medsci12040055","url":null,"abstract":"<p><p>The prevalence of overweight and obesity is increasing worldwide. Common comorbidities related to obesity, significantly polygenic disorders, cardiovascular disease, and heart conditions affect social and monetary systems. Over the past decade, research in drug discovery and development has opened new paths for alternative and conventional medicine. With a deeper comprehension of its underlying mechanisms, obesity is now recognized more as a chronic condition rather than merely a result of lifestyle choices. Nonetheless, addressing it solely through lifestyle changes is challenging due to the intricate nature of energy regulation dysfunction. The Federal Drug Administration (FDA) has approved six medications for the management of overweight and obesity. Seaweed are plants and algae that grow in oceans, rivers, and lakes. Studies have shown that seaweed has therapeutic potential in the management of body weight and obesity. Seaweed compounds such as carotenoids, xanthophyll, astaxanthin, fucoidans, and fucoxanthin have been demonstrated as potential bioactive components in the treatment of obesity. The abundance of natural seaweed bioactive compounds has been explored for their therapeutic potential for treating obesity worldwide. Keeping this view, this review covered the latest developments in the discovery of varied anti-obese seaweed and its bioactive components for the management of obesity.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"12 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11503287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514263","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":"One-Step Cannulation and Distance Measurement during Aortic Branched Endograft Repair: The Neuron Catheter Trick.","authors":"Gioele Simonte, Gianluigi Fino, Gianbattista Parlani, Rachele Simonte, Giacomo Isernia","doi":"10.3390/medsci12040054","DOIUrl":"https://doi.org/10.3390/medsci12040054","url":null,"abstract":"<p><strong>Purpose: </strong>This paper aims to describe a straightforward, efficient, and reliable technique to simplify cannulation maneuvers during aortic branched endograft repair.</p><p><strong>Technique: </strong>The suggested approach utilizes the Penumbra Neuron Select catheter, which combines diagnostic, sizing, and support capabilities in one. This has the potential to reduce procedural time and minimize the need for serial catheter and guidewire exchanges.</p><p><strong>Conclusions: </strong>The proposed technique offers a simple yet effective tool to mitigate the risk of vessel loss and injury, and to streamline complex aortic repair procedures.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"12 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11503350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514264","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 Increasing Problem of Resistant Hypertension: We'll Manage till Help Comes!","authors":"Francesco Natale, Rosa Franzese, Ettore Luisi, Noemi Mollo, Luigi Marotta, Achille Solimene, Saverio D'Elia, Paolo Golino, Giovanni Cimmino","doi":"10.3390/medsci12040053","DOIUrl":"https://doi.org/10.3390/medsci12040053","url":null,"abstract":"<p><p>Arterial hypertension remains the major cardiovascular risk worldwide. It is estimated that under 50 years of age one in every three adults is hypertensive while beyond the age of 50 the prevalence is almost 50% globally. The latest World Health Organization (WHO) Global Report on Hypertension indicated that the global number of hypertensive patients almost doubled in the last three decades, with related increasing deaths, disability, and costs annually. Because of this global increase, early diagnosis and timely treatment is of great importance. However, based on the WHO Global Report, it is estimated that up to 46% of individuals were never diagnosed. Of those diagnosed, less than 50% were on treatment, with nearly half among these at target according to the current guidelines. It is also important to note that an increasing number of hypertensive patients, despite the use of three or more drugs, still do not achieve a blood pressure normalization, thus defining the clinical scenario of resistant hypertension (RH). This condition is associated to a higher risk of hypertension-mediated organ damage and hospitalization due to acute cardiovascular events. Current guidelines recommend a triple combination therapy (renin angiotensin system blocking agent + a thiazide or thiazide-like diuretic + a dihydropyridinic calcium-channel blocker) to all patients with RH. Beta-blockers and mineralocorticoid receptor antagonists, alone or in combination, should be also considered based on concomitant conditions and potential contraindications. Finally, the renal denervation is also proposed in patients with preserved kidney function that remain hypertensive despite the use of maximum tolerated medical treatment. However, the failure of this procedure in the long term and the contraindication in patients with kidney failure is a strong call for a new therapeutic approach. In the present review, we will discuss the pharmacological novelties to come for the management of hypertension and RH in the next future.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"12 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11503307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514266","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":"Fractional Exhaled Nitric Oxide (FeNO) in Biomass Smoke-Associated Chronic Obstructive Pulmonary Disease.","authors":"Juan Silva-Gallardo, Raúl H Sansores, Alejandra Ramírez-Venegas, Robinson E Robles Hernández, Gustavo I Centeno-Saenz, Rafael J Hernández-Zenteno","doi":"10.3390/medsci12040052","DOIUrl":"10.3390/medsci12040052","url":null,"abstract":"<p><p>Chronic Obstructive Pulmonary Disease (COPD) is a disease characterized by local and systemic inflammation independently of the risk factor; during the exacerbations, such inflammation is accentuated and amplified. A practical inflammatory marker and one with an applicable predictive value in the follow-up has been sought. FeNO has shown an excellent performance in that respect within the context of asthma and has also been studied in tobacco-smoke COPD (COPD-TS). In Biomass-smoke COPD (COPD-BS), this, to our knowledge, has not been evaluated.</p><p><strong>Objective: </strong>To measure FeNO levels in patients with COPD-BS and to compare these with those of patients with stable COPD-TS and in healthy controls.</p><p><strong>Methods: </strong>Transversal, observational, descriptive, comparative, and analytical study. A total of 57 patients, including 23 with COPD-BS, 17 with COPD-TS, and 17 healthy control subjects. The measurement of FeNO was carried out on all of these by means of the on-line chemiluminescence technique; the values were expressed in parts per billion (ppb) for their analysis.</p><p><strong>Results: </strong>It was observed that the FeNO values were similar between COPD-BS and COPD-TS and were significantly different between the healthy and stable COPD (both groups). No correlation was found between pulmonary function and symptoms with FeNO in any of the groups.</p><p><strong>Conclusions: </strong>The level of FeNO in stable COPD is found to be increased in a similar manner in COPD-BS and COPD-TS, with a significant difference on comparing it with that of the healthy subjects.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"12 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11503285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514261","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":"Combined Effects of Environmental Metals and Physiological Stress on Lipid Dysregulation.","authors":"Emmanuel Obeng-Gyasi, Yvonne R Ford","doi":"10.3390/medsci12040051","DOIUrl":"https://doi.org/10.3390/medsci12040051","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular diseases (CVD) are a leading cause of mortality worldwide, influenced by genetic, environmental, and behavioral factors. This study examines the relationship between heavy metal exposure, chronic physiological stress (allostatic load), and lipid profiles, which are markers of CVD risk, using data from the National Health and Nutrition Examination Survey (NHANES) 2017-2018.</p><p><strong>Methods: </strong>We utilized structural equation modeling (SEM) to explore the associations between blood levels of lead, cadmium, allostatic load (AL), and lipid measures (low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides). The AL index was derived from cardiovascular, inflammatory, and metabolic biomarkers and categorized into quartiles to identify high-risk individuals, with an index out of 10 subsequently developed.</p><p><strong>Results: </strong>The SEM analysis revealed that both heavy metal exposure and allostatic load are significantly associated with lipid profiles. Higher levels of lead and cadmium were associated with increased LDL and triglycerides, while higher AL scores were linked to increased LDL and triglycerides and decreased HDL levels. Age was also a significant factor, showing positive correlations with LDL and triglycerides, and a negative correlation with HDL.</p><p><strong>Conclusions: </strong>This study underscores the multifactorial nature of CVD, highlighting the combined impact of environmental pollutants and physiological stress on lipid dysregulation. These findings suggest the need for integrated public health strategies that address both environmental exposures and chronic stress to mitigate cardiovascular risk. Further research is warranted to explore the underlying mechanisms and develop targeted interventions.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"12 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11503437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514259","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":"Changes in Central Sensitivity to Thyroid Hormones vs. Urine Iodine during Pregnancy.","authors":"Ioannis Ilias, Charalampos Milionis, Maria Alexiou, Ekaterini Michou, Chrysi Karavasili, Evangelia Venaki, Kostas Markou, Irini Mamali, Eftychia Koukkou","doi":"10.3390/medsci12040050","DOIUrl":"https://doi.org/10.3390/medsci12040050","url":null,"abstract":"<p><strong>Introduction/aim: </strong>Central sensitivity to thyroid hormones refers to the responsiveness of the hypothalamic-pituitary-thyroid (HPT) axis to changes in circulating free thyroxine (fT4). Although dose-response relationships between thyroid hormones per se and urinary iodine (UI) levels have been observed, central sensitivity to thyroid hormones in relation to UI remains unexplored. The aim of the present study was to evaluate central sensitivity to thyroid hormones (by means of the Thyroid Feedback Quantile-based Index [TFQI], which is a calculated measure, based on TSH and fT4, that estimates central sensitivity to thyroid hormones) in pregnancy and to assess whether it differs according to gestational age and/or iodine intake.</p><p><strong>Materials and methods: </strong>One thousand, one hundred and two blood and urine samples were collected from pregnant women (with a mean age ± SD of 30.4 ± 4.6 years) during singleton pregnancies; women with known/diagnosed thyroid disease were excluded. Specifically, TSH and fT4, anti-thyroid peroxidase antibodies and UI were measured in each trimester and at two months postpartum, while the TFQI was calculated for all the study samples. After the elimination of outliers, statistical analysis was conducted with analysis of variance (ANOVA) for the variables versus time period, while Pearson's correlation was used to assess the TFQI versus UI.</p><p><strong>Results: </strong>The mean TFQI index ranged from -0.060 (second trimester) to -0.053 (two months postpartum), while the corresponding UI was 137 and 165 μg/L, respectively. The TFQI-UI correlation was marginally negative (Pearson r: -0.323, <i>p</i>: 0.04) and significantly positive (r: +0.368, <i>p</i>: 0.050) for UI values over 250 μg/L, in the first and the second trimesters of pregnancy, respectively.</p><p><strong>Discussion: </strong>The TFQI is a new index reflecting central sensitivity to thyroid hormones. A lower TFQI indicates higher sensitivity to thyroid hormones. In our sample, the TFQI was mainly positively related to iodine intake in the second trimester of pregnancy (following the critical period of organogenesis). Thus, the observed changes in the TFQI may reflect the different ways of the central action of thyroid hormones, according to the phase of pregnancy. These results have the potential to enhance our comprehension of the changes in the HPT axis' function via variations in central sensitivity to thyroid hormones and its interplay with nutritional iodine status during pregnancy.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"12 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11503427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514258","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":"Enhanced Osteoporosis Detection Using Artificial Intelligence: A Deep Learning Approach to Panoramic Radiographs with an Emphasis on the Mental Foramen.","authors":"Robert Gaudin, Wolfram Otto, Iman Ghanad, Stephan Kewenig, Carsten Rendenbach, Vasilios Alevizakos, Pascal Grün, Florian Kofler, Max Heiland, Constantin von See","doi":"10.3390/medsci12030049","DOIUrl":"10.3390/medsci12030049","url":null,"abstract":"<p><p>Osteoporosis, a skeletal disorder, is expected to affect 60% of women aged over 50 years. Dual-energy X-ray absorptiometry (DXA) scans, the current gold standard, are typically used post-fracture, highlighting the need for early detection tools. Panoramic radiographs (PRs), common in annual dental evaluations, have been explored for osteoporosis detection using deep learning, but methodological flaws have cast doubt on otherwise optimistic results. This study aims to develop a robust artificial intelligence (AI) application for accurate osteoporosis identification in PRs, contributing to early and reliable diagnostics. A total of 250 PRs from three groups (A: osteoporosis group, B: non-osteoporosis group matching A in age and gender, C: non-osteoporosis group differing from A in age and gender) were cropped to the mental foramen region. A pretrained convolutional neural network (CNN) classifier was used for training, testing, and validation with a random split of the dataset into subsets (A vs. B, A vs. C). Detection accuracy and area under the curve (AUC) were calculated. The method achieved an F1 score of 0.74 and an AUC of 0.8401 (A vs. B). For young patients (A vs. C), it performed with 98% accuracy and an AUC of 0.9812. This study presents a proof-of-concept algorithm, demonstrating the potential of deep learning to identify osteoporosis in dental radiographs. It also highlights the importance of methodological rigor, as not all optimistic results are credible.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"12 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11417815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302763","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":"Sunitinib in Patients with Metastatic Renal Cell Carcinoma with Favorable Risk: Be Aware of PD-L1 Expression.","authors":"Ilya Tsimafeyeu","doi":"10.3390/medsci12030048","DOIUrl":"10.3390/medsci12030048","url":null,"abstract":"<p><p>The treatment landscape for metastatic renal cell carcinoma (RCC) has advanced significantly with first-line immunotargeted therapy combinations. However, no statistically significant differences were observed in the cohort of patients with favorable risk and some oncologists continue to use sunitinib in these patients. PD-L1 expression has emerged as a negative prognostic factor in RCC, particularly in sunitinib-treated patients, where higher PD-L1 levels are linked to worse outcomes. This article discusses the potential risks associated with the use of sunitinib in PD-L1-positive patients.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"12 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11417775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302766","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":"Survival Analysis, Clinical Characteristics, and Predictors of Cerebral Metastases in Patients with Colorectal Cancer.","authors":"Antoine Jeri-Yabar, Liliana Vittini-Hernandez, Jerry K Benites-Meza, Sebastian Prado-Nuñez","doi":"10.3390/medsci12030047","DOIUrl":"10.3390/medsci12030047","url":null,"abstract":"<p><strong>Introduction: </strong>Colorectal cancer (CRC) is the third most common cancer globally and a leading cause of cancer-related deaths. While liver metastasis is common, brain metastasis (BM) is rare, occurring in 0.1% to 14% of cases. Risk factors for BM include lung metastasis at diagnosis, rectal cancer, and mutations in RAS and KRAS genes. Due to its rarity, guidelines for BM screening and treatment are limited. The aim of this study is to identify the clinical characteristics and predictors of BM at the time of the initial diagnosis of CRC.</p><p><strong>Methods: </strong>We evaluated patients ≥18 years old with metastatic colorectal cancer and brain metastases at diagnosis from the SEER database (2010-2021). A retrospective cohort study was conducted to analyze overall survival and predictive factors for brain metastasis, utilizing multivariate logistic regression, Kaplan-Meier survival analysis, and the Cox proportional hazards models, with <i>p</i>-values < 0.05 considered significant.</p><p><strong>Results: </strong>Out of 24,703 patients with metastatic colorectal cancer (mCRC), 228 (0.92%) had brain metastasis (BM) at diagnosis. BM was more prevalent in average-onset mCRC (≥50 years) compared to early-onset (<50 years) (1% vs. 0.55%, <i>p</i> = 0.004). Certain factors, such as older age and adenocarcinoma subtype, were associated with BM. Additionally, Asians/Pacific-Islanders (HR 1.83 CI: 1.01-3-33, <i>p</i> = 0.045) and American Indians/Alaska Natives (HR 4.79 CI 1.15-19.97, <i>p</i> = 0.032) had higher mortality rates, while surgical treatment and chemotherapy were linked to decreased mortality. Patients with BM had significantly worse overall survival (6 months vs. 21 months, <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>BM in mCRC is uncommon, but it is associated with significantly worse outcomes, including markedly reduced overall survival. Our study highlights several critical factors associated with the presence of BM, such as older age and specific racial/ethnic groups, which may inform risk stratification and early-detection strategies. Our findings emphasize the need for heightened awareness and screening for BM in high-risk mCRC patients, as well as the inclusion of these patients in clinical trials to explore tailored therapeutic approaches aimed at improving survival and quality of life.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"12 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11417931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302767","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":"Perioperative and Long-Term Outcomes of Acute Stanford Type A Aortic Dissection Repair in Octogenarians.","authors":"Hannah Masraf, Manoraj Navaratnarajah, Laura Viola, Davorin Sef, Pietro G Malvindi, Szabolcs Miskolczi, Theodore Velissaris, Suvitesh Luthra","doi":"10.3390/medsci12030045","DOIUrl":"10.3390/medsci12030045","url":null,"abstract":"<p><strong>Background: </strong>The aims of this study were to assess the perioperative morbidity, mortality and long-term survival of octogenarians undergoing acute type A aortic dissection repair (ATAAD), and to compare open and closed distal anastomosis techniques.</p><p><strong>Methods: </strong>This was a single-centre retrospective study (2007-2021). Open versus closed distal anastomosis were compared. Uni- and multivariable logistic regression analyses were performed to identify independent predictors of in-hospital mortality. Kaplan-Meier and Cox proportional hazards methods were used to compare long-term survival.</p><p><strong>Results: </strong>Fifty octogenarian patients were included (median age-82 years; closed distal-22; open distal-28). Median cardiopulmonary bypass time was 187 min (open distal vs. closed distal group; 219 min vs. 115.5 min, <i>p</i> < 0.01, respectively). Median cross-clamp time was 93 min (IQR; 76-130 min). Median circulatory arrest time was 26 min (IQR; 20-39 min) in the open-distal group. In-hospital mortality was 18% (open distal; 14.2% vs. closed distal; 22.7%, <i>p</i> = 0.44). Stroke was 26% (open distal; 28.6% vs. closed distal; 22.7%, <i>p</i> = 0.64). Median survival was 7.2 years (IQR; 4.5-11.6 years). Survival was comparable between open and closed distal groups (median 10.6 vs. 7.2 years, <i>p</i> = 0.35, respectively). Critical preoperative status (HR; 3.2, <i>p</i> = 0.03) and composite endpoint (renal replacement therapy, new neurological event, length of stay > 30 days or return to theatre; HR; 4.1, <i>p</i> = 0.02) predicted adverse survival. Open distal anastomosis did no impact survival.</p><p><strong>Conclusions: </strong>ATAAD repair in selected octogenarians has acceptable short- and long-term survival. There is no significant difference between open versus closed distal anastomosis strategies.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"12 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11417756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302765","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}