Annals of medicine最新文献

{"title":"Effect of curcumin on methotrexate-induced ovarian damage and follicle reserve in rats: the role of PARP-1 and P53.","authors":"Mete Keçeci, Nesibe Karaoluk","doi":"10.1080/07853890.2024.2446688","DOIUrl":"https://doi.org/10.1080/07853890.2024.2446688","url":null,"abstract":"<p><strong>Background: </strong>Methotrexate (MTX) is an agent used in the treatment of many neoplastic and non-neoplastic diseases and is known to cause oxidative damage in normal tissues. Curcumin (Cur) is a natural polyphenol compound with powerful antioxidant and antiapoptotic effects. In this study we investigate the effects of Cur on MTX-induced ovarian damage.</p><p><strong>Materials and methods: </strong>Thirty-two young adult female Wistar albino rats were divided into four groups: (1) Control (<i>n</i> = 8): only vehicle group, (2) Cur (<i>n</i> = 8): Cur-only group (200 mg/kg/day), (3) MTX (<i>n</i> = 8): MTX-only group (0.35 mg/kg/day), (4) MTX+Cur (<i>n</i> = 8): The group was given MTX (0.35 mg/kg/day) and Cur (200 mg/kg/day) for 28 days. Then, SOD, CAT, MDA, AMH levels were measured using ELISA kits. Follicle count was performed on H&E stained slides. In addition, the expressions of P53 and PARP-1 were analysed by immunohistochemistry.</p><p><strong>Results: </strong>MDA levels were seen to be higher in the MTX group than in the MTX+Cur group (<i>p</i> < 0.05). Cur treatment lowered MDA levels and increased SOD and CAT levels (<i>p</i> < 0.05 for all). In the MTX+Cur group, atretic follicle count decreased (<i>p</i> < 0,05), however, primordial follicle count increased (<i>p</i> < 0,01). Secondary follicle count and AMH levels were higher in MTX-treated groups (<i>p</i> < 0,05 and <i>p</i> < 0,01, respectively). Expressions of p53 and Poly [ADP-ribose] polymerase 1 (PARP-1) increased significantly in the MTX group compared to the other groups (<i>p</i> < 0,05).</p><p><strong>Conclusion: </strong>Cur pretreatment prior to MTX administration may be an effective option in preserving the ovarian follicle pool by regulating P53 and PARP-1 expressions with its antioxidant effect.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2446688"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of contrast-enhanced ultrasound liver imaging reporting and data system for differentiation of patients at risk of hepatocellular carcinoma and liver metastasis.","authors":"Weiqin Huang, Ruoxuan Lin, Zhongshi Du, Zhougui Wu, Xiaohui Ke, Lina Tang","doi":"10.1080/07853890.2024.2442072","DOIUrl":"10.1080/07853890.2024.2442072","url":null,"abstract":"<p><strong>Background: </strong>Hepatocellular carcinoma (HCC) and metastatic liver tumors (MLT) are the most common malignant liver lesions, each requiring distinct therapeutic approaches. Accurate differentiation between these malignancies is critical for appropriate treatment planning and prognostication. However, there is limited data on the performance of contrast-enhanced ultrasound liver imaging reporting and data system (CEUS-LI-RADS) in this differentiation.</p><p><strong>Objective: </strong>To evaluate the diagnostic efficacy of the CEUS-LI-RADS in distinguishing between HCC and MLT in an expanded population at risk for both tumors.</p><p><strong>Methods: </strong>Between June 2017 and January 2022, 108 patients with HCC and 138 patients with MLT who were pathologically diagnosed, where included in this retrospective study. Two radiologists independently reviewed the CEUS features and liver imaging reporting and data system (LI-RADS) categories of the lesions, and based on their consensus, we calculated the diagnostic performance, including the area under the receiver operating characteristic curve, sensitivity, specificity, and accuracy of the CEUS-LI-RADS criteria.</p><p><strong>Results: </strong>The sensitivity, specificity, and accuracy of CEUS LI-RADS category 5 (CEUS-LR-5) for predicting HCC were 49.1% [95% confidence interval (CI)) 39.3-58.9], 97.1% (95% CI 92.7-99.2), and 76%, respectively, whereas the corresponding values for LI-RADS category M (LR-M) for diagnosing MLT were 89.1% (95%CI 82.7-93.8), 72.2% (95%CI 62.8-80.4), and 81.7%, respectively. Based on current LR-M criteria, a small proportion of HCCs were classified as LR-M due to the presence of early cessation (45-60s). In the analysis of the MLT subgroup, we found that the tumor size affects the distribution of LI-RADS (LR) classification in the subgroup (<i>p</i> = 0.037), and LI-RADS category 3 (LR-3) classification was observed more frequently in tumors of small size (≤3cm) than those of larger size. In addition, LR-3 metastases were more frequently characterized by hypovascular supply.</p><p><strong>Conclusions: </strong>CEUS-LI-RADS demonstrates high specificity in distinguishing HCC from MLT, providing a reliable noninvasive diagnostic tool that can enhance clinical decision-making. These findings are clinically significant as they can improve patient management and treatment outcomes, and they underscore the need for future research to refine and expand the use of CEUS-LI-RADS in diverse clinical settings.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2442072"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856989","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":"Risk factors for severe postpartum hemorrhage in placenta accreta spectrum patients undergoing prophylactic resuscitative endovascular balloon occlusion of the aorta during cesarean delivery.","authors":"Xiafei Wu, Jie He, Yuxiang Bai, Yanqiong Gan, Hongbing Xu, Hongbo Qi, Xinyang Yu","doi":"10.1080/07853890.2024.2442065","DOIUrl":"10.1080/07853890.2024.2442065","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to investigate the risk factors for severe postpartum hemorrhage (SPPH) in patients with placenta accreta spectrum (PAS) undergoing cesarean delivery, despite the prophylactic use of resuscitative endovascular balloon occlusion of the aorta (REBOA).</p><p><strong>Materials and methods: </strong>We conducted a retrospective case-control study on PAS patients who underwent cesarean delivery with prophylactic REBOA at the First Affiliated Hospital of Chongqing Medical University from January 2017 to December 2021. Prophylactic REBOA placement was determined by a prenatal ultrasound scoring system. Patients were divided into those who experienced SPPH (case group) and those who did not (control group), with SPPH defined by one or a combination of the following criteria: intraoperative blood loss ≥1500 mL, transfusion of ≥4 units of packed red blood cells, intraoperative hysterectomy, or sequential uterine artery embolization. Propensity score matching (PSM) was employed to minimize biases, and multivariate logistic regression was used to calculate adjusted odds ratios (aOR) for risk factors.</p><p><strong>Results: </strong>Of the 424 enrolled patients, 102 experienced SPPH (case group), while 322 did not (control group). After PSM, the case group comprised 79 patients, and the control group included 130. After adjusting for confounders, patients with placenta increta (aOR 3, 95% CI 1.49-6.03, <i>p</i> = 0.002), percreta (aOR 21.77, 95% CI 6.57-72.09, <i>p</i> < 0.001), lower hemoglobin levels (aOR 0.98, 95% CI 0.95-1, <i>p</i> = 0.050), and higher D-dimer levels (aOR 1.36, 95% CI 1.12-1.65, <i>p</i> = 0.002) had an elevated risk of SPPH. Threshold effect analysis indicated no significant nonlinear relationship between hemoglobin, D-dimer, and outcomes.</p><p><strong>Conclusions: </strong>PAS patients, particularly those with placenta increta and percreta, lower hemoglobin levels, and elevated D-dimer levels, are at an increased risk of SPPH during cesarean delivery, even with REBOA intervention.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2442065"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857004","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 cisplatin in modulating the tumor immune microenvironment and its combination therapy strategies: a new approach to enhance anti-tumor efficacy.","authors":"Guandu Li, Xiangyu Che, Shijin Wang, Dequan Liu, Deqian Xie, Bowen Jiang, Zunwen Zheng, Xu Zheng, Guangzhen Wu","doi":"10.1080/07853890.2024.2447403","DOIUrl":"10.1080/07853890.2024.2447403","url":null,"abstract":"<p><p>Cisplatin is a platinum-based drug that is frequently used to treat multiple tumors. The anti-tumor effect of cisplatin is closely related to the tumor immune microenvironment (TIME), which includes several immune cell types, such as the tumor-associated macrophages (TAMs), cytotoxic T-lymphocytes (CTLs), dendritic cells (DCs), myeloid-derived suppressor cells (MDSCs), regulatory T cells (Tregs), and natural killer (NK) cells. The interaction between these immune cells can promote tumor survival and chemoresistance, and decrease the efficacy of cisplatin monotherapy. Therefore, various combination treatment strategies have been devised to enhance patient responsiveness to cisplatin therapy. Cisplatin can augment anti-tumor immune responses in combination with immune checkpoint blockers (such as PD-1/PD-L1 or CTLA4 inhibitors), lipid metabolism disruptors (like FASN inhibitors and SCD inhibitors) and nanoparticles (NPs), resulting in better outcomes. Exploring the interaction between cisplatin and the TIME will help identify potential therapeutic targets for improving the treatment outcomes in cancer patients.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2447403"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142934011","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":"Endovascular therapy versus best medical care for acute ischemic stroke with distal medium vessel occlusion: a systematic review and meta-analysis.","authors":"Ziyue Wang, Jiacheng Li, Qianqian Kong, Hao Yan, Yi Zhang, Xirui Zhou, Zhiyuan Yu, Hao Huang, Xiang Luo","doi":"10.1080/07853890.2024.2447407","DOIUrl":"10.1080/07853890.2024.2447407","url":null,"abstract":"<p><strong>Background: </strong>With the refinement of catheter technology, distal medium vessel occlusions (DMVOs) are now viewed as amenable to endovascular treatment (EVT) but its efficacy and safety remains unclear in AIS patients with DMVO.</p><p><strong>Methods: </strong>We conducted a systematic search of PubMed, Embase databases and Cochrane Library up to December 2023 using keywords to identify studies comparing EVT versus BMT in AIS with DMVOs. The assessed clinical outcomes were excellent functional outcome, good functional outcome, 90-day mortality, symptomatic intracranial hemorrhage (sICH), and early neurological improvement (ENI) after treatment.</p><p><strong>Results: </strong>Overall, 31 studies were included. There were no significant differences in excellent functional outcome (OR: 1.21, 95% CI: 0.99-1.47), good functional outcome (OR: 1.03, 95% CI: 0.82-1.30) and 90-day mortality (OR: 1.17, 95% CI: 0.84-1.62). Additionally, EVT led to higher sICH (OR: 1.64, 95% CI: 1.09-2.47) and better ENI (OR: 1.50, 95% CI: 1.02-2.19) compared to BMT. In individuals with M2 occlusion receiving EVT showed better excellent functional outcomes (OR: 1.48, 95% CI: 1.07-2.03). Those patients with PCA occlusion showed no significant difference in functional outcomes. In individuals with ACA occlusion, EVT resulted in reduced functional independence (OR: 0.55, 95% CI: 0.31-0.98). For NIHSS < 6, BMT achieved better functional independence compared to EVT (OR: 0.71, 95% CI: 0.51-0.98) and EVT showed higher sICH (OR: 3.44, 95% CI: 1.42-8.31).</p><p><strong>Conclusion: </strong>For patients with AIS and DMVO occlusion, EVT fails to improve functional prognosis while increasing sICH incidence. More randomized controlled trials are needed in the future to confirm these results.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2447407"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142924074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic ability for common skin diseases among general practitioners working in community health service centers in Shanghai, China: a cross-sectional study.","authors":"Lei Zhang, Guanghui Wang, Haiying Chen, Xiaoqing Gu, Minjie Jia, Ying Yu, Xiaoxiao Cao, Ruiping Wang","doi":"10.1080/07853890.2024.2442066","DOIUrl":"10.1080/07853890.2024.2442066","url":null,"abstract":"<p><strong>Objective: </strong>Primary care general practitioners (GPs) play a crucial role in common skin diseases (CSDs) diagnosis and treatment for community residents. This study investigates their clinical diagnostic ability for CSDs and influencing factors among GPs in Shanghai.</p><p><strong>Methods: </strong>In 2023, we recruited 5745 GPs in Shanghai, and online survey was conducted among 5745 GPs with written informed consents. Images of ten CSDs was used to evaluate the diagnostic ability among GPs, logistic regression (LR) analysis was applied to explore influencing factors in GPs with a good skin diseases diagnostic ability.</p><p><strong>Results: </strong>The 5745 GPs included 1740 male (30.3%), the age ranged from 25 to 60 years with an average of age of 40.8 years. The total score for GSDs diagnostic ability ranged from 2 to 10, with a median of 7.5. In this study, GPs who have achieved ≥ 9 scores were identified as GPs with good diagnostic ability, with a prevalence of 26.7%. LR analysis indicated that GPs with 11 to 15 and over 15 years of work experience had a higher prevalence of good diagnostic ability compared with those with <5 years, the OR was 1.23 (95% CI: 1.02-1.48) and 1.25 (95% CI: 1.05-1.49) respectively. GPs with advanced studies [OR = 1.61, 95% CI:1.33-1.95] and work experience [OR = 1.39, 95% CI:1.20-1.61] in dermatology had a higher prevalence of good diagnostic ability.</p><p><strong>Conclusion: </strong>The diagnostic ability for CSDs was good among GPs in Shanghai. GPs with more years of work, advanced studies and work experience in dermatology have better diagnostic abilities CSDs.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2442066"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11654032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840534","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 expression and clinical significance of serum exosomal-long non-coding RNA DLEU1 in patients with cervical cancer.","authors":"Yu Chen, Facai Cui, Xiaoyu Wu, Weifeng Zhao, Qingxin Xia","doi":"10.1080/07853890.2024.2442537","DOIUrl":"10.1080/07853890.2024.2442537","url":null,"abstract":"<p><strong>Background: </strong>Accumulating evidence has demonstrated that the long non-coding RNA (lncRNA) lymphocytic leukaemia deletion gene 1 (DLEU1) is abnormally overexpressed in many cancer types, including cervical cancer (CC). However, the potential clinical significance of DLEU1 in serum exosomes of patients with CC remains unclear.</p><p><strong>Methods: </strong>The expression of serum exosomal DLEU1 was detected by quantitative real-time polymerase chain reaction (qRT-PCR). A receiver operating characteristic (ROC) curve was plotted to evaluate the clinical diagnostic efficacy of DLEU1. The Kaplan-Meier survival curve and Cox proportional hazards model were used to assess the effect of DLEU1 on postoperative recurrence, metastasis and prognosis among patients with CC.</p><p><strong>Results: </strong>Our research showed that DLEU1 expression in the serum exosomes of patients with CC was significantly upregulated compared to that in patients with cervical intraepithelial neoplasia (CIN) and healthy controls (HCs) (both <i>p</i> < .001). DLEU1 relative expression was significantly correlated with tumour size, cervical invasion depth, pathological grade, International Federation of Gynecology and Obstetrics (FIGO) stage and lymph node metastasis among patients with CC (<i>p</i> < .01 all). The combined detection of DLEU1, carbohydrate antigen 125 (CA-125) and squamous cell carcinoma (SCC) exhibited significantly higher diagnostic efficiency (<i>p</i> < .01). Furthermore, the overall survival (OS) and disease-free survival (DFS) of CC patients in the high DLEU1 expression group were markedly lower than those in the low DLEU1 expression group (both <i>p</i> < .01). Cox univariate and multivariate regression analyses indicated that DLEU1 was an independent risk factor for postoperative recurrence and metastasis in CC patients.</p><p><strong>Conclusions: </strong>Our findings suggest that serum exosome DLEU1 has certain clinical value for diagnosing, monitoring recurrence and metastasis, and evaluating CC prognosis.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2442537"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11654034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840540","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":"Response to letter regarding 'demographic and clinical Features of rosacea in North Jordan: a 10-year University Hospital Retrospective study'.","authors":"Diala Alshiyab, Saleh A Ba-Shammakh","doi":"10.1080/07853890.2025.2482861","DOIUrl":"10.1080/07853890.2025.2482861","url":null,"abstract":"","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2482861"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11926892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665680","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":"Regarding 'long-term cognitive and autonomic effects of COVID-19 in young adults: a cross-sectional study at 28 months'.","authors":"Lien-Chung Wei, Chun-Hung Lee","doi":"10.1080/07853890.2025.2464940","DOIUrl":"10.1080/07853890.2025.2464940","url":null,"abstract":"","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2464940"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517647","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":"Underdosing and response to pharmacotherapy in patients with status epilepticus: a retrospective study from Saudi Arabia.","authors":"Sultan M Alghadeer, Aseel Alsuwayegh, Hessa AlMuqati, Maha A Alammari, Omar A Almohammed","doi":"10.1080/07853890.2025.2496797","DOIUrl":"https://doi.org/10.1080/07853890.2025.2496797","url":null,"abstract":"<p><strong>Background: </strong>Despite the essential of understanding patterns of status epilepticus (SE) and investigating appropriate therapy for these patients, such data are limited in the Saudi population.</p><p><strong>Methods: </strong>A retrospective study including adult patients who were admitted to emergency departments (EDs) in two hospitals due to SE was conducted between May 2015 and July 2021. We aimed to describe the characteristics for patients who were admitted to ED with SE, describe the pattern of pharmacotherapy used in these patients, assess patients' response to these pharmacotherapy agents in different stages and investigate reasons for treatment failure.</p><p><strong>Results: </strong>A total of 420 SE episodes that received at least one dose of benzodiazepines (BDZs) or anti-seizure medications (ASMs) in ED were included. The mean age for them was 38.7 ±19.1 years and 89.0% had a history of epilepsy . BDZs or ASMs were used on first trial in 60.0% and 40.0% of episodes; and 20.6% and 84.5% (<i>p</i> < 0.0001) of these cases responded, respectively. The overall response to BDZs in all trials was 24.8% while it was 79.1% for the ASMs. The issue of under-dosing was more prevalent in BDZs' compared to ASMs trials (63.4% vs. 19.6%) and was significantly associated with lack of response to therapy (86.6% vs. 0.0%; <i>p</i> < 0.0001).</p><p><strong>Conclusions: </strong>There is an immanent need for educational, drug regulation awareness programs, and protocols enforcement policies that aims to optimize patient care by improving physicians' adherence to clinical guidelines' recommendations to improve the status of managing patients with SE in Saudi Arabia.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2496797"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12051597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051942","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}