Annals of Medicine and Surgery最新文献

{"title":"Effects of music therapy on anxiety among patients undergoing cardiac procedures: a systematic review and meta-analysis.","authors":"Zoaib Habib Tharwani, Prince Kumar, Avinash Kumar, Saad Javaid, Rohet Kumar, Mohsin Ali Shah, Sean Kaisser Shaeen, Fnu Sunita, Naresh Kumar Ladhwani, Abdullah Malikzai","doi":"10.1097/MS9.0000000000003226","DOIUrl":"https://doi.org/10.1097/MS9.0000000000003226","url":null,"abstract":"<p><strong>Objective: </strong>The article aims to assess impact of music therapy on anxiety in patients undergoing cardiac procedures.</p><p><strong>Methods: </strong>MEDLINE, Embase, and Cochrane Central were searched to identify relevant cohorts and randomized controlled trials (RCTs). We evaluated anxiety, heart rate (HR), systolic and diastolic blood pressures (SBP and DBP), respiratory rate, mean arterial pressure (MAP), and mean oxygen saturation (SaO₂) using weighted random-effects models, reporting mean difference (MD) with 95% confidence intervals.</p><p><strong>Results: </strong>In total, 1706 patients from 18 RCTs and one cohort study were analyzed. Music therapy recipients showed significantly lower anxiety measured by the State-Trait Anxiety Inventory (MD: -4.75; <i>P</i> = 0.002). The music therapy group demonstrated improved HR (MD: -4.90, <i>P</i> = 0.02), SBP (MD: -5.14, <i>P</i> = 0.01), and respiratory rate (MD: -1.15, <i>P</i> = 0.01). No significant differences were observed in anxiety measured by the Numerical Anxiety Rating Scale (MD: -1.09, <i>P</i> = 0.14), DBP (MD: -2.61, <i>P</i> = 0.15), MAP (MD: -4.71, <i>P</i> = 0.47), or SaO₂ (MD: 0.93, <i>P</i> = 0.61).</p><p><strong>Conclusion: </strong>Music therapy significantly reduces anxiety and enhances post-procedural HR, SBP, and respiratory rates in cardiac procedure patients.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 5","pages":"2904-2913"},"PeriodicalIF":1.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12055049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958132","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":"Exploring the burden of non-communicable diseases on surgical services in Africa: a comprehensive literature review.","authors":"Poliana Zanotto Manoel, Olivier Uwishema, Agnes Zanotto Manoel, Innocent Chijioke Dike, Nour Yassin, Sarah Mshaymesh","doi":"10.1097/MS9.0000000000003236","DOIUrl":"https://doi.org/10.1097/MS9.0000000000003236","url":null,"abstract":"<p><strong>Introduction: </strong>Non-communicable diseases (NCDs) encompass five major categories: cardiovascular disease, cancer, diabetes mellitus, mental health disorders, and chronic respiratory diseases. The burden of NCDs is rising in Africa, particularly in sub-Saharan Africa, having increased by 67% from 1990 to 2017, which puts additional pressure on healthcare services. Although most treatments for NCDs are non-surgical, surgical intervention plays a crucial role in managing many of these diseases. Unfortunately, barriers to accessing surgical care for NCDs remain in Africa.</p><p><strong>Methods: </strong>A comprehensive literature review was conducted employing the following search databases: AJOL, PubMed/Medline, and Google Scholar. Search strategies that combined terms pertaining to \"non-communicable disease,\" \"surgical care,\" and \"Africa\" were utilized.</p><p><strong>Results: </strong>The main barriers to surgical access in the management of NCDs in Africa include restricted financial resources, a lack of adequate infrastructure, and deficiencies in competent surgical training. Measures to improve surgical intervention associated with NCDs include international collaborations, improved education and training of professionals, and the use of mobile technology tools.</p><p><strong>Discussion: </strong>There is a need to implement strategies that seek to improve access to surgery for the treatment of NCDs on the African continent. Some of these strategies involve multi-professional action alongside the establishment of prevention actions and policies aimed at the management of NCDs. Furthermore, support from the governments of each nation, as well as ongoing research on the subject, also contribute to better development of surgical care for these diseases in the African context.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 5","pages":"2847-2854"},"PeriodicalIF":1.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12055136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143952709","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":"Knowledge comparison amongst telehealth service utilized and never-utilized adults in Bangladesh: a cross-sectional study.","authors":"Masuda Akter, Shimpi Akter, Md Ikbal Hossain, Nahida Akter, Sopon Akter, Anar Koly, Sohel Mahmud, Humayun Kabir, Md Kamrul Hasan","doi":"10.1097/MS9.0000000000003201","DOIUrl":"https://doi.org/10.1097/MS9.0000000000003201","url":null,"abstract":"<p><strong>Background: </strong>Telehealth service is an approach to health care delivery that uses various telecommunication technologies, where the knowledge of the patient plays an important role in its acceptance, preference, and utilization. This study compared telehealth service knowledge among adults who utilized and never-utilized telehealth services and explored factors associated with telehealth knowledge.</p><p><strong>Methods: </strong>This comparative cross-sectional study recruited 1252 adults from Bangladesh. The outcome variable of the study was the knowledge of telehealth services. We used convenience sampling approaches to recruit participants. The online questionnaire was distributed via Google Forms through Facebook, Messenger, and WhatsApp. The independent variables of the study were sociodemographic factors and the perceived health status of the participants. The bivariate logistic regression model was used to investigate the association between study variables and the level of knowledge among those who utilized and never-utilized the telehealth service. The data analysis was done using STATA version 16.</p><p><strong>Results: </strong>In the never-utilized group, 54.41% of participants were male, with an average age of 28.89 years. In the utilized group, 55.77% of the participants were male, with an average age of 30 years. Age, marital status, educational level, student status, and perceived health status were significantly associated with good telehealth knowledge among those who never-utilized the telehealth service. Among the utilized groups, we found that age, marital status, and perceived health status were significantly associated with good knowledge of telehealth services.</p><p><strong>Conclusions: </strong>This study emphasizes the importance of addressing the associated factors to improve telehealth knowledge, considering existing variations among adults who utilized and who never-utilize telehealth services.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 5","pages":"2638-2644"},"PeriodicalIF":1.7,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12055196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967341","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":"Duvyzat (givinostat): a new hope for Duchenne muscular dystrophy patients.","authors":"Nabiha Syed, Zaib Un Nisa Mughal, Abdul Haseeb, Gaffar Alemam Manhal, Abdullatif Yasir Eissa, Khabab Abbasher Hussien Mohamed Ahmed","doi":"10.1097/MS9.0000000000003196","DOIUrl":"https://doi.org/10.1097/MS9.0000000000003196","url":null,"abstract":"<p><p>The approval of Duvyzat (givinostat) by the Food and Drug Administration (FDA) marks a significant milestone in the treatment of Duchenne muscular dystrophy (DMD), offering renewed hope for patients and their families. DMD is a rare genetic disorder characterized by progressive muscle degeneration and weakness, often leading to loss of mobility and life-threatening complications. Currently, there is no cure for DMD, and available treatments focus on managing symptoms and slowing disease progression. Duvyzat belongs to a class of drugs known as histone deacetylase inhibitors, which have shown promise in preclinical studies for their ability to modulate gene expression and potentially improve muscle function in DMD. Clinical trials evaluating the safety and efficacy of Duvyzat in DMD patients have demonstrated encouraging results, prompting the FDA's approval. The approval of Duvyzat represents a significant advancement in the field of DMD therapeutics, providing patients with a much-needed treatment option that targets the underlying mechanisms of the disease. By inhibiting histone deacetylases, Duvyzat has the potential to restore dystrophin expression, reduce inflammation, and preserve muscle integrity, ultimately improving the quality of life for individuals with DMD. However, it is essential to recognize that while Duvyzat represents a step forward, it is not a cure for DMD. Continued research and development efforts are needed to further refine treatment approaches and address the complex challenges associated with this devastating disorder. Nonetheless, the approval of Duvyzat offers hope and optimism for the DMD community, signaling progress toward more effective therapies and improved outcomes for patients.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 5","pages":"2529-2531"},"PeriodicalIF":1.7,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12055071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957700","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":"Efficacy and safety of low-dose naltrexone (LDN) in fibromyalgia: a systematic review and meta-analysis.","authors":"Muhammad Hashir Nazir, Uswa Mehboob, Muhammad Farhan, Tirath Patel, Muhammad Ahmad, Saleha Nazir, Tooba Ahmed Durrani, Mustafa Khafaja, Abdulaziz Sobhi, Mariyam Kuznetsova, Muhammad Ahmed, Ayoola Awosika","doi":"10.1097/MS9.0000000000003203","DOIUrl":"https://doi.org/10.1097/MS9.0000000000003203","url":null,"abstract":"<p><strong>Background: </strong>Fibromyalgia is a chronic disorder characterized by pain and psychological symptoms in adults. Several randomized controlled trials (RCTs) have shown the effectiveness and safety of low-dose naltrexone (LDN) in the treatment of fibromyalgia in variable small settings. Hence the need to conducted a meta-analysis to evaluate the overall effect and the strength of evidence.</p><p><strong>Methodology: </strong>PUBMED, CENTRAL, and ClinicalTrials.gov were searched to retrieve RCTs comparing naltrexone with placebo in fibromyalgia patients for systematic review and meta-analysis. We conducted pairwise meta-analyses using DerSimonian and Laird random-effects model via RevMan 5.4. We reported dichotomous outcomes as relative risk (RR) and continuous outcomes as standardized mean difference (SMD) with 95% confidence intervals (CIs). Quality of included RCTs was assessed using revised Cochrane Risk of Bias Tool for RCTs (RoB 2.0). Heterogeneity was detected by Chi² and <i>I</i> ² values for each meta-analysis and if significant, sensitivity analysis was performed.</p><p><strong>Results: </strong>We included five RCTs in meta-analysis. Our results estimated that LDN is superior to placebo in alleviating pain both in primary (SMD -0.61; 95% CI -1.14, -0.08) and sensitivity analysis (SMD -0.87; 95% CI -1.28, -0.46) but not in raising mechanical pain threshold (SMD 0.24; 95% CI -0.09, 0.56) in fibromyalgia patients. Neither the primary (RR 1.68; 95% CI 0.84, 3.36) nor sensitivity analysis (RR 0.98; 95% CI 0.72, 1.34) could associate LDN use with the incidence of headache. The incidence of vivid dreams (RR 2.41; 95% CI 1.77, 3.28) was significantly higher in treatment group as compared to placebo.</p><p><strong>Conclusion: </strong>LDN is considered to be effective in the treatment of fibromyalgia. No serious adverse effects were reported in treatment group. There is need for more RCTs to support the evidence.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 5","pages":"2928-2935"},"PeriodicalIF":1.7,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12055162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143952476","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":"Short-term functional and oncological outcomes of intralesional curettage supplemented by bone cementation for chondroblastoma : a cross-sectional study.","authors":"Hassan Mohammed Hassan Elbahri, Hozifa Mohammed Ali AbdElmaged, Musa Yassin Mohamed Awad, Yousif Omer Elgaili Yousif, Sara Gamareldein A Khalafalla","doi":"10.1097/MS9.0000000000003191","DOIUrl":"https://doi.org/10.1097/MS9.0000000000003191","url":null,"abstract":"<p><strong>Background: </strong>Chondroblastoma is a rare, benign neoplasm accounting for less than 1% of all primary bone tumors. It is treated with complete surgical curettage with or without chemical or physical adjuvants. The present study aims to assess the functional and oncological outcomes of patients with chondroblastoma treated with intralesional curettage supplemented by bone cementation of the resulting bone defect.</p><p><strong>Materials and methods: </strong>This study is an observational, descriptive, prospective hospital-based study conducted from April 2022 to August 2022 at the Ibrahim Malik Teaching Hospital and Future Hospital in Khartoum State, Sudan. It included patients with chondroblastoma who were treated with intralesional curettage and subsequent filling of the remaining bone cavity with bone cement. The researchers collected data from the patients' hospital records, as well as with the aid of the Musculoskeletal Tumor Society Scoring System, and analyzed them using SPSS V 28.</p><p><strong>Results: </strong>The study population comprised 32 patients with a mean age of 20 ± 6 years; the majority were males, 62.5% (<i>n</i> = 20), and students by occupation, 66% (<i>n</i> = 21). The proximal tibia was the most commonly involved site, corresponding to 59% of the cases (<i>n</i> = 19). Functional evaluation using the Musculoskeletal Tumor Society Scoring System revealed a statistically significant improvement from a preoperative score of 62 ± 10 to a postoperative score of 91 ± 3 (<i>P</i> value = 0.001). No recurrence or need for amputation was reported. Almost half of the study participants, 47% (<i>n</i> = 15) experienced moderate to severe pain. Postoperatively, 97% (<i>n</i> = 31) were satisfied with pain relief, and all patients were satisfied with the procedure. Functional outcomes improve with time after surgery.</p><p><strong>Conclusion: </strong>The study showed a favorable outcome regarding pain relief and functional restoration in patients with chondroblastoma. The oncological results were also satisfactory; no recurrence, or need for amputation was recorded.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 5","pages":"2626-2632"},"PeriodicalIF":1.7,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12055065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954340","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":"A narrative review on cutaneous manifestations in polycystic ovary syndrome: pathophysiology, diagnosis, management, and psychosocial impact.","authors":"Muhammad Farhan, Ariana Seyfi, Afra Alnuaimi, Maya Alamour, Sarah Alwarafi, Haya Elastal, Muhammad Hashir Nazir, Balakrishnan Kamaraj, Hrithik Dakssesh Putta Nagarajan, Deborah Delianne, Shyamala Ganesan, Tirath Patel","doi":"10.1097/MS9.0000000000003217","DOIUrl":"https://doi.org/10.1097/MS9.0000000000003217","url":null,"abstract":"<p><strong>Background: </strong>Polycystic ovary syndrome (PCOS) is a complex endocrine disorder affecting 5%-10% of reproductive-aged women. Its diverse clinical spectrum includes reproductive, metabolic, and dermatological abnormalities, with cutaneous manifestations often serving as visible indicators of underlying hormonal and metabolic imbalances.</p><p><strong>Objective: </strong>This review explores the pathophysiology, diagnosis, management, and psychosocial impact of the cutaneous manifestations of PCOS, providing an integrated understanding of their clinical significance.</p><p><strong>Methods: </strong>A comprehensive analysis was conducted based on existing literature to elucidate the underlying mechanisms, diagnostic approaches, and treatment options for dermatological features associated with PCOS, including acne, hirsutism, acanthosis nigricans, seborrheic dermatitis, and androgenic alopecia.</p><p><strong>Results: </strong>The pathophysiology of cutaneous manifestations in PCOS is driven by hyperandrogenism, insulin resistance, and local androgenic effects on the pilosebaceous unit. Acne and hirsutism are among the most common skin findings, followed by androgenic alopecia and acanthosis nigricans. Diagnostic strategies combine clinical evaluation with hormonal assays and imaging. Management requires a multidisciplinary approach encompassing hormonal therapies, lifestyle modifications, and targeted dermatological treatments. Additionally, these manifestations significantly impair psychosocial well-being, necessitating holistic care.</p><p><strong>Conclusion: </strong>Cutaneous manifestations are a cosmetic concern and an essential diagnostic and therapeutic focus in PCOS. Addressing these features can enhance patient outcomes by mitigating physical symptoms and improving quality of life. Future research should emphasize personalized treatments and the psychosocial aspects of care to provide comprehensive management for women with PCOS.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 5","pages":"2804-2811"},"PeriodicalIF":1.7,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12055046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965242","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":"Nesidioblastosis post-bariatric surgery in an adult patient: a case report and review of literature.","authors":"Hamza A Abdul-Hafez, Karam Rabi, Asmaa Sarama, Layan Melhem, Waddah Abed, Mohammed Maree","doi":"10.1097/MS9.0000000000003198","DOIUrl":"https://doi.org/10.1097/MS9.0000000000003198","url":null,"abstract":"<p><strong>Introduction and importance: </strong>Adult-onset nesidioblastosis is an exceedingly rare yet significant cause of persistent hyperinsulinemic hypoglycemia. This condition is often associated to bariatric surgeries such as Roux-en-Y gastric bypass and sleeve gastrectomy. Characterized by abnormal β-cell hyperplasia and hypertrophy, its diagnosis presents a unique challenge due to overlapping features with insulinomas and post-bariatric hypoglycemia syndrome (PBHS).</p><p><strong>Case presentation: </strong>We report a 55-year-old woman with a history of gastric sleeve and Roux-en-Y gastric bypass surgeries who presented with a 1.5-year history of recurrent hypoglycemic episodes. Her symptoms, including blurred vision, tremors, and altered consciousness, persisted despite medical therapy with octreotide, acarbose, and nifedipine. Extensive imaging, including magnetic resonance imaging and endoscopic ultrasound, ruled out insulinomas, raising suspicion of non-insulinoma pancreatogenous hypoglycemia syndrome. The patient underwent laparoscopic subtotal distal pancreatectomy with spleen preservation. Histopathological examination confirmed nesidioblastosis, revealing irregular islet distribution and β-cell hypertrophy. Post-surgery, the patient achieved normoglycemia without recurrence of hypoglycemic episodes during follow-up.</p><p><strong>Discussion: </strong>This case highlights the complexity of diagnosing nesidioblastosis in adults, especially following bariatric surgeries. Nesidioblastosis involves β-cell hyperplasia and hypertrophy driven by hormonal factors like GLP-1, whereas PBHS results from altered incretin patterns causing excessive insulin release. Advanced imaging and multidisciplinary collaboration are important for accurate diagnosis. Surgical management remains a cornerstone for refractory cases, as demonstrated in this patient's remarkable recovery.</p><p><strong>Conclusion: </strong>Nesidioblastosis is a rare condition but should be considered in the differential diagnosis of post-bariatric surgery hypoglycemia. This case highlights the importance of distinguishing nesidioblastosis from PBHS to ensure appropriate and effective management strategies.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 5","pages":"3006-3011"},"PeriodicalIF":1.7,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12055073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961295","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":"A cross-sectional, retrospective study analyzing the impact of COVID-19 on surgical mortality in Johannesburg, South Africa.","authors":"Sean Engelhardt, Ciara Morley, Janus Van Rooyen, Fredalet Thiart, Katlego Masemola, Muhammad Boda, Thifhelimbilu Luvhengo","doi":"10.1097/MS9.0000000000003197","DOIUrl":"https://doi.org/10.1097/MS9.0000000000003197","url":null,"abstract":"<p><strong>Background: </strong>Various comorbidities are known to exacerbate the risk of surgical mortality with COVID-19 infection. The effect of HIV infection on surgical mortality in the context of COVID-19 has also not been investigated. The aim of our study was to investigate the influence of HIV status on mortality in surgical patients admitted during the COVID-19 pandemic in Johannesburg, South Africa.</p><p><strong>Material and methods: </strong>We reviewed records of patients who were admitted and underwent surgery during the COVID-19 pandemic and died. Data regarding perioperative COVID-19 infection, risk factors, comorbidities, mortality preventability, and contributing factors were extracted. Logistic regression was used to analyze comorbidities associated with COVID-19 infection among surgical mortalities.</p><p><strong>Results: </strong>A total of 404 records of mortalities were found and 25% (82/404) tested positive for COVID-19. 40% Of the mortalities were either potentially preventable or preventable. Comorbidities in patients who were COVID-19-positive surgical mortalities compared to their negative counterparts included smoking in 35% versus 4%, chronic obstructive pulmonary disease (COPD) in 20% versus 3%, and diabetes mellitus in 23% versus 13%, respectively. The odds of being COVID-19 positive in surgical mortalities with hypertension, smoking, and COPD were 1.96 times [OR = 1.96, 95% CI (1.06, 3.59)], 7.78 times [OR = 7.78, 95% CI (3.45, 18.35)], and 3.09 times [OR = 3.09, 95% CI (1.08, 8.95)], respectively. 55% of COVID-19-positive patients who died were HIV positive compared to 31% among the COVID-19-negative group. 26% of HIV-positive patients were on anti-retroviral treatment (ART). 22% of HIV-/COVID-19-coinfected surgical mortalities were not on antiretroviral treatment compared to 9% in the HIV-positive and COVID-19-negative groups. The odds of COVID-19 infection in surgical mortalities who were HIV positive and not on ART was 3.10 [95% CI (1.55, 6.11)].</p><p><strong>Conclusion: </strong>The rate of COVID-19 infection was higher in HIV-positive patients who died, especially if they were not on ART. Smoking, COPD, and hypertension imparted the largest risk on COVID-19 infection in cases of surgical mortality. These comorbidities likely superimpose the pathological effects of COVID-19 infection, worsening surgical prognosis.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 5","pages":"2645-2652"},"PeriodicalIF":1.7,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12055160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969533","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":"Transcaval access for transcatheter aortic valve replacement: a systematic review and meta-analysis.","authors":"Zina Otmani, Ahmad Alzawahreh, Abdelaziz A Awad, Basma Badrawy Khalefa, Hazem Ayman Elsayed, Omar Hany Mohamed Amin, Mohamed Abouzid, Amjad Almansi, Ayman K Awad","doi":"10.1097/MS9.0000000000003193","DOIUrl":"https://doi.org/10.1097/MS9.0000000000003193","url":null,"abstract":"<p><strong>Background: </strong>Transfemoral access is considered the standard route for transcatheter aortic valve replacement (TAVR). However, in some cases, this access route is contraindicated. Alternative access routes, such as transaxillary, are emerging as first-line approaches to address these limitations, while the transcaval approach remains uncertain. Our Meta-analysis aims to evaluate the safety of the transcaval approach compared to other access routes for TAVR.</p><p><strong>Methods: </strong>We searched five databases, PubMed, SCOPUS, Web of Science, Cochrane Library, and Embase, from inception until April 2024 for any study that reports transcaval access alone or compares it to any alternative access in TAVR patients. We used Risk ratio (RR) for dichotomous outcomes and Mean Difference (MD) for continuous outcomes with a 95% confidence interval.</p><p><strong>Results: </strong>Eleven studies with 1003 patients were included, transcaval showed non-statistically significant difference over alternatives in terms of intra-hospital, 30 days, and long-term all-cause mortality with a RR of 0.08 (95% CI -0.83 to 0.99, <i>P</i> = 0.86), 0.11 (95% CI -0.48 to 0.7, <i>P</i> = 0.71), and 1.08 (95% CI -0.50 to 2.66, <i>P</i> = 0.18), respectively. Furthermore, in our single-arm analysis, transcaval access has a low pooled 30-day all-cause mortality rate of 7% (95% CI 5-10) and long-term mortality of 21% (95% CI 2-77). The mean difference in length of stay in the hospital after the operation was 4.88 (95% CI 4.45-5.31), and the major bleeding rate was 14% (95% CI 8-23).</p><p><strong>Conclusion: </strong>Transcaval access for TAVR is a safe and feasible method that can be considered a new alternative when trans-femoral access is contraindicated.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 5","pages":"2914-2927"},"PeriodicalIF":1.7,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12055168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954777","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}