Annals of Medicine and Surgery最新文献

{"title":"Diagnostic role of Ki-67 expression in distinguishing thyroid follicular carcinoma from follicular adenoma: a systematic review and meta-analysis.","authors":"Rayehe Rahimi, Fakhrieh Kalavari, Yalda Ashoorian, Mohammad Amin Ashoobi, Enayatollah Homaie Rad, Saeid Anvari","doi":"10.1097/MS9.0000000000004503","DOIUrl":"10.1097/MS9.0000000000004503","url":null,"abstract":"<p><strong>Background: </strong>Differentiating follicular thyroid carcinoma (FTC) from follicular adenoma (FA) is challenging due to their histological similarities. This systematic review and meta-analysis aimed to assess the difference in Ki-67 expression between FTC and FA to evaluate its diagnostic utility.</p><p><strong>Methods: </strong>We conducted a comprehensive search of PubMed, Embase, Scopus, and Web of Science databases for studies reporting Ki-67 expression in FTC and FA. The quality of the included studies was assessed using the Newcastle-Ottawa Scale. A random-effects model was applied to calculate the pooled mean difference of the Ki-67 index, with heterogeneity assessed by the Cochran <i>Q</i> and <i>I</i>-squared tests. Meta-regression was used to explore sources of heterogeneity, and publication bias was evaluated using Egger's test, Begg's test, and funnel plot.</p><p><strong>Results: </strong>The meta-analysis revealed a pooled mean difference in Ki-67 expression between FTC and FA of 1.13 (0.63-1.63), indicating a significant difference. In addition, the difference in the Ki-67 index between minimally invasive follicular carcinoma and FA was 0.56 (0.12-1.00), which was also statistically significant. The heterogeneity among included studies was due to variations in Ki-67 index calculation methods. The reviewed studies demonstrated low sensitivity but high specificity of Ki-67 for differentiating FTC vs. FA, although diagnostic cut-offs were inconsistent.</p><p><strong>Conclusions: </strong>This study demonstrates a significant difference in Ki-67 expression between FTC and FA, supporting its potential role as a diagnostic marker. Further research is required to establish standardized diagnostic cut-offs and evaluate Ki-67's sensitivity and specificity in clinical practice.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"88 2","pages":"1695-1705"},"PeriodicalIF":1.6,"publicationDate":"2026-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12889238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146163634","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":"Long-term safety and effectiveness of hybrid coronary revascularization compared to conventional revascularization strategies: a systematic review and meta-analysis.","authors":"Singam Shashank, Rashmikaa Netyam, Chiranjeevee R Saravanan, Nikhil D Kolanu, Nanditha Karra, Harshada S Keluskar, Ziad Helaly, Mohammed H Albitar, Abdullah Sharbek, Seba Albitar, Pugazhendi Inban, Mohammed D M Marsool, Omniat A Hussin","doi":"10.1097/MS9.0000000000004561","DOIUrl":"10.1097/MS9.0000000000004561","url":null,"abstract":"<p><strong>Background: </strong>Hybrid coronary revascularization (HCR), a combination of percutaneous coronary intervention and coronary artery bypass grafting (CABG), is an emerging treatment for patients with multivessel coronary artery disease (MVCAD). While traditional CABG is considered the standard, HCR may mitigate issues like saphenous vein graft failure.</p><p><strong>Methods: </strong>We systematically searched PubMed, Scopus, Web of Science, and Embase until September 2024, targeting randomized controlled trials (RCTs) that evaluated HCR against CABG in MVCAD patients. The quality of included studies was assessed using the ROB2 tool, and data were analyzed using RevMan 5.4. Four RCTs (<i>n</i> = 382) involving 382 participants were analyzed using a random-effects model. Risk of bias was assessed using the ROB2 tool.</p><p><strong>Results: </strong>Four RCTs (<i>n</i> = 382) met inclusion criteria. At 30 days, there were no statistically significant differences between HCR and CABG in all-cause death (risk ratios [RR] = 1.35, <i>P</i> = 0.74), stroke (RR = 0.99, <i>P</i> = 0.99), myocardial infarction (RR = 1.17, <i>P</i> = 0.74), or blood transfusion (RR = 0.70, <i>P</i> = 0.14), with zero heterogeneity (<i>I</i> ² = 0%). At 1-year follow-up, pooled analyses showed no significant differences in all-cause death (RR = 1.37, <i>P</i> = 0.62) or myocardial infarction (RR = 1.29, <i>P</i> = 0.56), also with consistent homogeneity (<i>I</i> ² = 0%).</p><p><strong>Conclusion: </strong>HCR demonstrates comparable safety and effectiveness to CABG for MVCAD, with similar rates of key outcomes at both 30 days and 1 year. Further research with larger samples and longer follow-up is recommended to confirm these findings.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"88 2","pages":"1779-1788"},"PeriodicalIF":1.6,"publicationDate":"2026-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12889239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146163672","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":"Vykat XR (diazoxide choline-extended release): a new FDA-approved treatment for hyperphagia in Prader-Willi syndrome.","authors":"Prakriti Pokhrel, Hidhaya S Noorul, Laraib Fatima, Aakash Kumar, Amrah Abdul Samad, Gerardo F Ferrer","doi":"10.1097/MS9.0000000000004938","DOIUrl":"https://doi.org/10.1097/MS9.0000000000004938","url":null,"abstract":"<p><p>On March 27, 2025, the U.S. Food and Drug Administration (FDA) approved Vykat XR (diazoxide choline-extended release tablets) for the treatment of hyperphagia in individuals aged 4 years and older with Prader-Willi Syndrome (PWS). This marks the first FDA-approved pharmacologic therapy targeting hyperphagia in this population, addressing a long-standing unmet need and offering new hope for patients, caregivers, and clinicians.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"88 5","pages":"2728-2730"},"PeriodicalIF":1.6,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147809873","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":"Malignant pleural mesothelioma in a young adult without asbestos exposure: a case report highlighting diagnostic pitfalls and literature review.","authors":"Rohan Chauhan, Kashish Fnu, Bhavna Sahil, Arshnoor Kaur Chug, Mirza Mohammad Ali Baig, Muhammad Umar, Iman Osman Abufatima","doi":"10.1097/MS9.0000000000005011","DOIUrl":"https://doi.org/10.1097/MS9.0000000000005011","url":null,"abstract":"<p><strong>Background: </strong>Malignant pleural mesothelioma (MPM) is a rare and aggressive malignancy typically associated with asbestos exposure in older adults. Its occurrence in young individuals without asbestos exposure poses significant diagnostic challenges, particularly in tuberculosis-endemic regions.</p><p><strong>Case presentation: </strong>We report the case of a 23-year-old man with no history of asbestos exposure who presented with progressive pleuritic chest pain, dyspnea, fever, and weight loss. Initial evaluation suggested tuberculous pleuritis, and empirical therapy was initiated. Imaging revealed diffuse nodular pleural thickening with loculated effusion. Ultrasound-guided pleural biopsy demonstrated epithelioid MPM, confirmed by immunohistochemical positivity for calretinin and WT-1 with TTF-1 negativity. Despite supportive care, the patient experienced rapid clinical deterioration and died within 1 week of histopathological confirmation. Genetic testing for BAP1 mutation was recommended but could not be performed due to rapid disease progression.</p><p><strong>Conclusion: </strong>This case underscores the importance of considering MPM in the differential diagnosis of pleural effusion in young adults, even in the absence of asbestos exposure. Early pleural biopsy and immunohistochemical evaluation are essential to avoid diagnostic delay, particularly in tuberculosis-endemic settings.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"88 5","pages":"2960-2964"},"PeriodicalIF":1.6,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147810190","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":"Analyzing the effects of anemia on the outcomes of mechanical thrombectomy in ischemic stroke patients: a systematic review and meta-analysis.","authors":"Mostafa Hossam El Din Moawad, Ibrahim Serag, Ibraheem M Alkhawaldeh, Ahmed F Gadelmawla, Mohammed Khaled Mohammed, Mohamed Samir A Zaki, Hamza A Abdul-Hafez, Mohamed Abouzid","doi":"10.1097/MS9.0000000000004872","DOIUrl":"https://doi.org/10.1097/MS9.0000000000004872","url":null,"abstract":"<p><strong>Background: </strong>Anemia is a common yet often overlooked condition in patients with acute ischemic stroke (AIS) undergoing mechanical thrombectomy. Hemoglobin levels play a crucial role in oxygen transport, and their depletion may exacerbate ischemic injury and worsen functional outcomes. This meta-analysis aimed to evaluate the effect of anemia on the functional and survival outcomes of patients with AIS treated with mechanical thrombectomy.</p><p><strong>Methods: </strong>Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched electronic databases (PubMed, Scopus, and Web of Science) to identify eligible studies reported up to January 2025. Using Review Manager software, we reported outcomes as odds ratios (ORs) or mean difference and confidence intervals (CIs). A <i>P</i>-value ≤ 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Nine retrospective cohort studies comprising 2189 patients were included. Anemia was significantly associated with lower odds of achieving good functional outcomes (OR = 0.30, 95% CI: 0.13-0.68, <i>P</i> = 0.004) and a higher risk of mortality (OR = 1.76, 95% CI: 1.19-2.60, <i>P</i> = 0.005). No significant association was found between anemia and symptomatic intracerebral hemorrhage risk (OR = 0.95, 95% CI: 0.34-2.27, <i>P</i> = 0.91). Younger age, lower baseline NIH Stroke Scale, and higher hemoglobin levels were significant predictors of good prognosis.</p><p><strong>Conclusion: </strong>Anemia negatively impacted functional recovery and survival in patients with AIS undergoing mechanical thrombectomy. Given these findings, optimizing hemoglobin levels may be a potential strategy to improve patient outcomes. Further prospective studies are needed to explore the benefits of anemia correction strategies in stroke management.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"88 5","pages":"2888-2896"},"PeriodicalIF":1.6,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147810009","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":"Effect of preoperative fasting on acute postoperative pain following cesarean section: a retrospective cohort study.","authors":"Huiyan Xu, Yanshuang Wang, Dongge Niu, MingJun Xu, Lan Yao","doi":"10.1097/MS9.0000000000004865","DOIUrl":"https://doi.org/10.1097/MS9.0000000000004865","url":null,"abstract":"<p><strong>Background: </strong>Preoperative fasting is a cornerstone of Enhanced Recovery After Surgery (ERAS) protocols in cesarean delivery, primarily aimed at reducing aspiration risk. However, its impact on acute postoperative pain remains unclear. This study addresses a critical evidence gap regarding whether adherence to ERAS-compliant fasting guidelines influences post-cesarean pain intensity.</p><p><strong>Methods: </strong>Data from 329 women who underwent cesarean sections at the hospital between March and December 2024 were retrospectively reviewed. Women were categorized based on adherence to ERAS fasting guidelines (≤8 h solids, ≤2 h clear fluids). The primary outcome was the 24-h postoperative Visual Analogue Scale (VAS) pain score. Univariate and multivariable linear regression models were used to assess the association between fasting compliance and VAS scores, adjusting for key covariates including age, body mass index, comorbidities, anesthesia type, surgical duration, and intraoperative morphine use.</p><p><strong>Results: </strong>Women adhering to ERAS fasting protocols had significantly lower mean 24-h VAS scores compared to non-adherent women (β = -0.6; 95% confidence interval: -1.2, -0.1; <i>P</i> = 0.029). This association remained significant after minor (β = -0.6; <i>P</i> = 0.046) and partial adjustment (β = -0.6; <i>P</i> = 0.038), though it attenuated to non-significance after full adjustment including epidural morphine (β = -0.5; <i>P</i> = 0.137). Subgroup analyses suggested consistent directional effects, but detailed subgroup results are reported in the main text.</p><p><strong>Conclusions: </strong>Adherence to ERAS fasting guidelines is associated with a modest but statistically significant reduction in acute postoperative pain after cesarean section. While the clinical relevance of a 0.6-point VAS difference may be limited, these findings support integrating standardized preoperative fasting into obstetric ERAS pathways as a safe, low-cost component of multimodal pain management and enhanced recovery.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"88 5","pages":"2743-2750"},"PeriodicalIF":1.6,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147809908","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":"Yuvezzi™ (carbachol and brimonidine tartrate) dual-agent eyedrops: a new option for presbyopia.","authors":"Muhammad Ali Abid, Muhammad Hafi Abid, Muhammad Daniyal Afzal","doi":"10.1097/MS9.0000000000004984","DOIUrl":"https://doi.org/10.1097/MS9.0000000000004984","url":null,"abstract":"<p><p>Presbyopia is a progressive, irreversible age-related decline in ocular accommodation caused by reduced lens elasticity, resulting in impaired near vision and a significant impact on daily activities and quality of life. Globally, presbyopia affects approximately 1.8 billion individuals, with projections rising to 2.1 billion by 2030. Current management options include spectacles, contact lenses, pharmacologic agents such as pilocarpine, and surgical interventions; however, each approach carries limitations related to convenience, adaptability, or visual compromise. Yuvezzi™ (carbachol 2.75% and brimonidine tartrate 0.1%) is a recently U.S. Food and Drug Administration (FDA)-approved dual-agent ophthalmic solution designed to improve near vision through pharmacologically induced miosis. Carbachol, a parasympathomimetic agent, stimulates muscarinic receptors to produce sustained pupillary constriction, while brimonidine, an α2-adrenergic agonist, inhibits iris dilator activity and prolongs the miotic effect, enhancing tolerability. Its approval was based on two Phase 3 randomized controlled trials, BRIO-I and BRIO-II, which demonstrated significant improvement in binocular uncorrected near visual acuity without compromising distance vision. Common adverse effects included ocular discomfort, irritation, visual disturbances, and headache. Yuvezzi™ offers a noninvasive, reversible alternative for presbyopia management; however, long-term safety and sustained efficacy require further evaluation.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"88 5","pages":"3020-3021"},"PeriodicalIF":1.6,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147809884","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":"Beyond MRI surveillance in radiologically isolated syndrome: the emerging role of VR/AR neurotechnology for subclinical progression.","authors":"Aneeq Mahmood Khan, Liaqat Kareem, Mahnoor Fatima","doi":"10.1097/MS9.0000000000004888","DOIUrl":"https://doi.org/10.1097/MS9.0000000000004888","url":null,"abstract":"","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"88 5","pages":"2994-2995"},"PeriodicalIF":1.6,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147810032","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":"From asymmetry to algorithm: AI-driven innovations in hemifacial microsomia reconstruction.","authors":"Hamna Hassan Siddiqui, Syeda Aliza Aamir, Muhammad Talha, Mahnoor Fatima, Ubaid Ur Rehman","doi":"10.1097/MS9.0000000000004907","DOIUrl":"https://doi.org/10.1097/MS9.0000000000004907","url":null,"abstract":"","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"88 5","pages":"3004-3005"},"PeriodicalIF":1.6,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147809947","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":"Copper-histidine therapy: a targeted metabolic intervention for Menkes disease.","authors":"Ailiya Batool, Huzaifa Mahmood, Anmol Awan, Muhammad Zaid Saeed, Afnan Ahmad Qureshi, Muhammad Adnan Qamar","doi":"10.1097/MS9.0000000000004868","DOIUrl":"https://doi.org/10.1097/MS9.0000000000004868","url":null,"abstract":"<p><p>Menkes disease (MD) is a rare, X-linked recessive disorder of copper metabolism, characterized by progressive neurodegeneration, connective tissue abnormalities, and the distinctive phenotype of pili torti. The disease is caused by pathogenic variants in the ATP7A gene, which encodes a copper-transporting P-type ATPase essential for cellular copper efflux and delivery of copper to secreted cuproenzymes. Severe forms of MD typically present in early infancy and are associated with rapid neurological decline and death within the first 3 years of life. Currently, therapeutic options are limited, and outcomes are highly dependent on the timing of intervention. Copper-histidine represents a biologically rational intervention designed to bypass defective intestinal copper transport and restore systemic copper availability. Experimental and clinical observations suggest that early administration may partially correct copper deficiency, improve biochemical parameters, and, in selected cases, alter neurological outcomes and survival. This letter summarizes the pathophysiological basis of MD, the rationale for copper-histidine therapy, and the existing evidence supporting its potential role as a disease-modifying intervention when initiated early in life.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"88 5","pages":"2990-2991"},"PeriodicalIF":1.6,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147810016","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}