Annals of Medicine and Surgery最新文献

{"title":"The vitamin C paradigm: new frontiers in blood transfusion.","authors":"Emmanuel Ifeanyi Obeagu","doi":"10.1097/MS9.0000000000003018","DOIUrl":"10.1097/MS9.0000000000003018","url":null,"abstract":"<p><p>Vitamin C, a potent antioxidant, is gaining attention in the field of transfusion medicine for its potential to enhance blood transfusion practices. Recent studies suggest that vitamin C can significantly improve erythrocyte preservation by mitigating oxidative damage during storage, thereby maintaining cell membrane integrity and functionality. This preservation is crucial for ensuring the efficacy and safety of transfused blood, ultimately leading to better patient outcomes. In addition to its role in erythrocyte preservation, vitamin C has been shown to modulate immune responses, which can be particularly beneficial in reducing the risks associated with transfusion-related immunomodulation (TRIM). By influencing both innate and adaptive immunity, vitamin C can help mitigate adverse immune reactions and improve the overall clinical outcomes for transfusion recipients. These immune-modulating properties underscore the potential of vitamin C to address some of the critical challenges in transfusion medicine. Furthermore, clinical trials have demonstrated that the incorporation of vitamin C in transfusion protocols can lead to enhanced recovery rates and reduced incidence of transfusion-related complications. The multifaceted benefits of vitamin C, including its antioxidant defense, immune support, and metabolic regulation, highlight its promise as a transformative agent in blood transfusion practices. As research continues to uncover the optimal use of vitamin C in this context, it is poised to become a pivotal element in improving transfusion efficacy and patient care.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 6","pages":"3310-3326"},"PeriodicalIF":1.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246068","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":"Evaluating the influence of vitamin K supplementation on bone markers in hemodialysis patients.","authors":"Mousa Ghelichi-Ghojogh, Sedighe Maghsoudloo, Leila Moftakhar, Sahar Delavari, Maryam Kabootari, Sima Sedighi, Saeid Amirkhanlou","doi":"10.1097/MS9.0000000000003283","DOIUrl":"10.1097/MS9.0000000000003283","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the impact of vitamin K supplementation on bone factors in hemodialysis patients.</p><p><strong>Methods: </strong>In this randomized clinical trial, 80 patients with end-stage renal disease undergoing hemodialysis, aged over 18 years, and who had been on chronic dialysis for at least 1 month without taking warfarin, underwent blood tests for bone factors. Subsequently, patients were randomly assigned to either the treatment or control group using block randomization. The effects of vitamin K on bone activity markers were evaluated in both groups. Data collected were analyzed using SPSS-24 after encoding and entry.</p><p><strong>Results: </strong>The study comprised 41 patients in the treatment group and 39 in the control group. The average age was 53.17 ± 9.88 years in the treatment group and 54.61 ± 10.71 years in the control group. There was a significant difference in the mean albumin levels post-supplementation between the treatment (4.62 ± 0.47) and control groups (4.78 ± 0.51) (<i>P</i> = 0.024). Additionally, significant differences were noted in the serum levels of all bone markers (albumin, calcium, phosphorus, alkaline phosphatase, and vitamin D) before and after treatment across different age groups under 40, 40-60 years, and over 60 years (<i>P</i> = 0.001).</p><p><strong>Conclusions: </strong>The findings of this study indicate that supplementation with vitamin K, along with vitamin D and calcium, could lead to the fortification of bone tissue and mineralization, subsequently reducing the occurrence of fractures in dialysis patients.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 6","pages":"3229-3235"},"PeriodicalIF":1.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246023","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":"Comparison of TAVR with SAVR on clinical outcomes in patients with aortic stenosis: a systematic review and meta-analysis.","authors":"Kiyan Ghani Khan, Israel Garcia, Ambar Rodriguez, Whitney Wright, Habiba Shahid, Abdulrahaman Alrashed, Angsupat Pornchai, Mathew P Manoj, Oluwaseun Fagbamila, Maneeth Mylavarapu","doi":"10.1097/MS9.0000000000003275","DOIUrl":"10.1097/MS9.0000000000003275","url":null,"abstract":"<p><strong>Introduction: </strong>The advances and studies carried out in the area have shown that patients with aortic stenosis (AS) undergoing surgical valve replacement (SAVR) did not have encouraging outcomes. This study aims to compare the different risk factors in patients with AS undergoing transcatheter aortic valve replacement (TAVR) vs. SAVR, respectively, to offer options and more favorable results based on the results obtained in patients with these conditions.</p><p><strong>Methods: </strong>The study was in accordance with the PRISMA guidelines. Studies comparing outcomes of surgical and transaortic catheter valve replacements in adults were included. Descriptive statistics, binary random effects, and continuous random effects were used. <i>I</i> ² statistics were used to assess for heterogeneity. A <i>P</i>-value ≤0.05 was considered statistically significant.</p><p><strong>Results: </strong>In total, eight studies with 18 671 patients were included in our study. All-cause mortality (2.48% vs. 3.03%), major bleeding (11.25% vs. 31.05%), and atrial fibrillation (2.39% vs. 50.42%) were lower in TAVR compared to SAVR. Furthermore, odds of all-cause mortality (odds ratio [OR]: 0.79; 95% CI: 0.63-1.00; <i>P</i> = 0.05), stroke (OR: 0.71; 95% CI: 0.58-0.87; <i>P</i> = 0.0008), and acute kidney injury (AKI) (OR: 0.38; 95% CI: 0.29-0.49; <i>P</i> < 0.00001) were lower in the TAVR group compared to the SAVR group.</p><p><strong>Conclusion: </strong>TAVR is superior to SAVR and significantly reduces the risks associated with all-cause mortality, stroke, AKI, and other clinical outcomes. Furthermore, additional research is regarding the long-term effects of transcatheter aortic valve replacement.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 6","pages":"3768-3776"},"PeriodicalIF":1.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246008","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":"Stress-induced hemostasis: mechanisms and implications for health.","authors":"Emmanuel Ifeanyi Obeagu","doi":"10.1097/MS9.0000000000003012","DOIUrl":"10.1097/MS9.0000000000003012","url":null,"abstract":"<p><p>Stress, encompassing both psychological and physical dimensions, profoundly affects the hemostatic system, which is responsible for maintaining the delicate balance between blood fluidity and clot formation. The interplay between stress and hemostasis involves intricate mechanisms where stress hormones like cortisol, adrenaline, and noradrenaline interact with coagulation factors and platelets, promoting a hypercoagulable state. This review delves into the various pathways through which stress influences hemostasis, highlighting the critical roles of the sympathetic nervous system, the hypothalamic-pituitary-adrenal axis, and inflammatory mediators. Psychological stress, arising from anxiety, depression, and acute mental stress, has been shown to elevate levels of coagulation factors such as fibrinogen and D-dimer, increasing the risk of thrombotic events. Similarly, physical stress from intense exercise or trauma enhances platelet reactivity and the expression of procoagulant factors. The body's response to severe physical stress, such as trauma or burns, can overwhelm the hemostatic system, leading to conditions like disseminated intravascular coagulation, characterized by widespread clotting and subsequent bleeding. The health implications of stress-induced hemostatic changes are significant, particularly concerning cardiovascular diseases. Chronic stress contributes to persistent hypercoagulability, elevating the risk of myocardial infarction and stroke. Acute stress episodes can precipitate acute coronary syndromes, especially in individuals with preexisting conditions like hypertension or diabetes.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 6","pages":"3300-3309"},"PeriodicalIF":1.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144245994","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":"Managing obstetric and gynecologic complications in obese women: Evidence-Based Strategies for Optimizing Outcomes and Reducing Risks.","authors":"Chunawala Prachi Jatin, Chunawala Purvi Jatin, Shreya Singh Beniwal, Likhitha Bhavani Pithalla, Ayush Dwivedi, Vaishnavi Rajesh Shetty, Arusha Desai","doi":"10.1097/MS9.0000000000003300","DOIUrl":"10.1097/MS9.0000000000003300","url":null,"abstract":"<p><strong>Introduction: </strong>Obesity among reproductive-aged women increases the risk of gestational diabetes, preeclampsia, menstrual disorders, infertility, and delivery complications. Despite rising global obesity rates, clinical guidelines often lack comprehensive management strategies. This review examines evidence-based approaches to optimize maternal and gynecologic outcomes through multidisciplinary care.</p><p><strong>Methods: </strong>A comprehensive literature review was conducted on obesity-related obstetric and gynecologic complications, including national and international guidelines, clinical trials, and observational studies. Key management strategies such as preconception care, lifestyle interventions, pharmacologic therapies, surgical treatments, and digital health solutions were analyzed.</p><p><strong>Results: </strong>Obesity is linked to multiple adverse maternal outcomes, including increased rates of gestational diabetes, preeclampsia, prolonged labor, postpartum hemorrhage, and fetal complications. Gynecologic conditions such as polycystic ovary syndrome, endometrial hyperplasia, and infertility are also exacerbated by obesity-related metabolic changes. Effective management strategies involve a combination of preconception weight loss interventions, structured gestational monitoring, pharmacologic treatments, and surgical approaches like bariatric surgery for high-risk cases. Telehealth interventions and digital health solutions provide an opportunity to bridge the gap in healthcare access, particularly in rural areas. However, challenges remain due to provider bias, adherence issues, and evolving clinical guidelines.</p><p><strong>Conclusions: </strong>Integrating medical, surgical, and digital health strategies is essential for improving outcomes in obese women. Expanding telehealth, enhancing provider training, and developing culturally tailored interventions will promote equitable healthcare. Future research should focus on region-specific solutions to optimize maternal and fetal health.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 6","pages":"3586-3595"},"PeriodicalIF":1.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246052","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":"Congenital deafness: from screening to management.","authors":"Saad Bouchlarhem, Sbai Achraf, Benfadil Drissia, Eabdenbitsen Adil, Lachkar Azeddine, El Ayoubi El Idrissi Fahd","doi":"10.1097/MS9.0000000000002637","DOIUrl":"10.1097/MS9.0000000000002637","url":null,"abstract":"<p><p>Congenital deafness represents a major global health challenge, impacting both communication skills and social integration. The results of epidemiological observations show variable prevalence rates, influenced by genetic and environmental factors. The pathophysiological processes involve abnormalities of the auditory system resulting from genetic mutations, prenatal infections, and exposure to ototoxic substances. Diagnostic approaches are multidisciplinary, combining audiological, genetic, and imaging assessments. Management options include the use of hearing aids, cochlear implants, therapies, and educational assistance, with a strong focus on the importance of early intervention. The implementation of universal newborn hearing screening programs plays a crucial role in early detection, although there are disparities. Future research efforts should focus on understanding genetic and environmental contributions, as well as developing innovative screening and intervention strategies. Collaboration between healthcare professionals, researchers, policymakers, and educators is essential to ensure equal and adequate care and support for people with congenital deafness. This comprehensive review synthesizes the current state of the art on congenital deafness, covering topics such as epidemiology, pathophysiology, etiology, diagnostic methods, management strategies, screening procedures, and future directions.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 6","pages":"3236-3243"},"PeriodicalIF":1.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246010","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":"Public-private partnerships in tackling sickle cell disease in Uganda: a narrative review.","authors":"Emmanuel Ifeanyi Obeagu","doi":"10.1097/MS9.0000000000003082","DOIUrl":"10.1097/MS9.0000000000003082","url":null,"abstract":"<p><p>Sickle cell disease (SCD) remains a critical public health challenge in Uganda, where the prevalence is among the highest globally, and particularly affecting children. The management of SCD is complicated by limited healthcare infrastructure, a shortage of trained healthcare professionals, and widespread stigmatization. Public-private partnerships (PPPs) have emerged as a strategic solution to these challenges, leveraging the strengths of both the public and private sectors to improve access to care, enhance patient outcomes, and raise public awareness. This narrative review examines the role of PPPs in tackling SCD in Uganda, focusing on key areas such as health infrastructure development, capacity building for healthcare workers, and access to essential medications and treatments. The review highlights successful models of PPPs that have facilitated the establishment of specialized sickle cell clinics, the implementation of cost-effective screening programs, and community engagement initiatives aimed at reducing stigma and promoting early diagnosis. These partnerships have significantly contributed to improving the quality of care for individuals with SCD, particularly in high-prevalence regions.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 6","pages":"3339-3355"},"PeriodicalIF":1.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246036","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":"Paris 2024 Olympics and Paralympics: assessing risks of novel COVID-19 variants, dengue, and other infectious diseases.","authors":"Ranjan K Mohapatra, Snehasish Mishra, Venkataramana Kandi, Muhammed Shabil, Nitin Kumar Bansal, Sanjit Sah, Rudra Narayan Sahoo, Francesco Branda, Lawrence Sena Tuglo","doi":"10.1097/MS9.0000000000002750","DOIUrl":"10.1097/MS9.0000000000002750","url":null,"abstract":"","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 6","pages":"3053-3056"},"PeriodicalIF":1.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144245986","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 role of cytokines in pediatric hematologic malignancies: mechanisms of tumor progression and therapeutic implications - a narrative review.","authors":"Emmanuel Ifeanyi Obeagu","doi":"10.1097/MS9.0000000000003295","DOIUrl":"10.1097/MS9.0000000000003295","url":null,"abstract":"<p><p>Cytokines play a pivotal role in the progression and pathogenesis of pediatric hematologic malignancies, such as leukemia and lymphoma, by orchestrating the tumor microenvironment (TME). These soluble signaling molecules regulate key processes, including immune modulation, tumor cell proliferation, angiogenesis, and resistance to therapy. Elevated levels of pro-inflammatory cytokines such as interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) promote survival pathways, chemoresistance, and immune evasion, while anti-inflammatory cytokines like IL-10 further suppress effective anti-tumor immunity. Targeting cytokine signaling pathways has emerged as a promising therapeutic strategy. Advances in monoclonal antibody therapies, signal transduction inhibitors, and cytokine-neutralizing agents aim to disrupt the pro-tumorigenic effects of cytokines within the TME. Additionally, integrating cytokine modulation with immune checkpoint inhibitors and adoptive cell therapy enhances anti-tumor immune responses. These approaches are complemented by novel therapeutics designed to mitigate resistance to conventional treatments, such as chemotherapies, which are often driven by persistent cytokine-mediated signaling.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 6","pages":"3551-3555"},"PeriodicalIF":1.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246067","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":"Quality of life and oncologic safety of axillary reverse mapping in patients with breast cancer: a systematic review and meta-analysis.","authors":"Yu-Chen Fan, Lin Li, Xiang-Chao Meng","doi":"10.1097/MS9.0000000000002915","DOIUrl":"10.1097/MS9.0000000000002915","url":null,"abstract":"<p><strong>Background: </strong>The axillary reverse mapping (ARM) technique has recently been developed to prevent lymphedema by preserving upper extremity lymphatic drainage. In this article, we evaluated the quality of life and oncologic outcomes of ARM used in patients with breast cancer.</p><p><strong>Methods: </strong>PubMed, Embase, and other databases were searched for relevant articles published between 2013 and 2022. Randomized clinical trials were identified and included in the meta-analysis. The evaluated endpoints included lymphedema, the number of retrieved lymph nodes (LNs), the number of patients with positive LNs, and shoulder restriction. A meta-analysis was performed using RevMan 5.3 software. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to analyze dichotomous data.</p><p><strong>Results: </strong>Seven studies involving 1,820 patients were included for the meta-analysis, which revealed that ARM was associated with a reduced incidence of lymphedema (OR, 0.30; 95% CI, 0.16-0.58; <i>P</i> = 0.0003). There were no significant differences in the number of retrieved LNs, the number of patients with positive LNs, and shoulder restriction between the two groups.</p><p><strong>Conclusion: </strong>The ARM procedure achieved comparable success with a better quality of life and acceptable safe oncologic outcomes for patients with breast cancer. Future multicenter randomized controlled trials are needed to further evaluate the efficacy and safety of ARM.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 6","pages":"3707-3714"},"PeriodicalIF":1.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246038","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}