Annals of medicinePub Date : 2025-12-01Epub Date: 2025-03-28DOI: 10.1080/07853890.2025.2483383
Laura Pini, Jordan Giordani, Guido Levi, Michele Guerini, Simone Piva, Elena Peli, Manuela Violini, Stefano Piras, Yehia El Masri, Alessandro Pini, Dina Visca, Deodato Assanelli, Maria Lorenza Muiesan, Nicola Latronico, Claudio Tantucci
{"title":"Long-term alveolar-capillary diffusion impairments after severe SARS-CoV-2 pneumonia.","authors":"Laura Pini, Jordan Giordani, Guido Levi, Michele Guerini, Simone Piva, Elena Peli, Manuela Violini, Stefano Piras, Yehia El Masri, Alessandro Pini, Dina Visca, Deodato Assanelli, Maria Lorenza Muiesan, Nicola Latronico, Claudio Tantucci","doi":"10.1080/07853890.2025.2483383","DOIUrl":"10.1080/07853890.2025.2483383","url":null,"abstract":"<p><strong>Background: </strong>Persistent respiratory symptoms and impaired gas exchange are common in patients recovering from COVID-19 pneumonia. The Lung Diffusing Capacity for Carbon Monoxide (DLCO) and Carbon Monoxide Transfer Coefficient (KCO) do not adequately distinguish alveolar membrane dysfunction from vascular abnormalities. This study aimed to characterize persistent diffusion impairment in post-ICU patients with prior SARS-CoV-2 pneumonia and reduced DLCO.</p><p><strong>Methods: </strong>After hospital discharge, patients underwent spirometry, DLCO measurement, and a 6-minute walking test every six months. If DLCO remained impaired at 18-24 months, a combined Lung Diffusing Capacity for Nitric Oxide (DLNO) and DLCO assessment was performed to differentiate alveolar-capillary membrane (DmCO) and pulmonary capillary blood volume (Vc) alterations.</p><p><strong>Results: </strong>Among 20 patients with persistent DLCO reduction, 3 had an obstructive ventilatory pattern, 6 had restriction, and 12 had low KCO. In restrictive cases, KCO was reduced but remained within normal limits without compensation. The DLNO/DLCO ratio exceeded 113.5% predicted in all patients. DmCO was impaired in 7 patients, while Vc was reduced in 16.</p><p><strong>Conclusion: </strong>Both DLCO determinants were affected, with vascular impairment predominating. Vc reduction was present in most patients, with mean values below the lower limit of normality, whereas DmCO was less affected and often normal. The elevated DLNO/DLCO ratio suggests that persistent DLCO reduction is primarily driven by prolonged pulmonary capillary circulation dysfunction rather than alveolar membrane alterations, highlighting the vascular component as the primary site of long-term impairment.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2483383"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733563","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}
Annals of medicinePub Date : 2025-12-01Epub Date: 2025-04-02DOI: 10.1080/07853890.2025.2485399
Kai Shi, Shouzhen Chen, Xueli Wang, Wenfu Wang, Yaofeng Zhu, Bo Han, Yong Wang, Benkang Shi
{"title":"Prognostic value of pathological sensitivity for high-risk, localized prostate cancer receiving neoadjuvant hormonal therapy combined with radical prostatectomy.","authors":"Kai Shi, Shouzhen Chen, Xueli Wang, Wenfu Wang, Yaofeng Zhu, Bo Han, Yong Wang, Benkang Shi","doi":"10.1080/07853890.2025.2485399","DOIUrl":"10.1080/07853890.2025.2485399","url":null,"abstract":"<p><strong>Objective: </strong>The exact factors influencing the prognosis of patients with prostate cancer (PCa) receiving neoadjuvant hormonal therapy (NHT) remain obscure. In our previous study, we proposed a new pathological response grading system for PCa using NHT. The aim of this study was to explore the potential prognostic value of this new system in high-risk and locally advanced PCa patients receiving NHT.</p><p><strong>Methods: </strong>We retrospectively analyzed 84 patients with high-risk locally advanced PCa. All patients received at least 3 months of NHT before radical prostatectomy (RP). The new pathological response system, the Qilu NHT pathological score (QNPS), has been described in our previous study. According to the QNPS, 84 patients were divided into two groups. 62 patients with good pathological reactions were grouped into the drug-sensitive (DS) group and 22 patients with poor pathological reactions were grouped into the drug-resistant (DR) group. Surgical outcomes and prognostic data were also analyzed.</p><p><strong>Results: </strong>Survival analysis of two groups showed that the overall survival (OS) and progression-free survival (PFS) of the DS group were both significantly longer than those of the DR group (<i>p</i> < 0.05). We further explored the prognostic values of preoperative clinical and pathological characteristics on the postoperative OS and PFS. Preoperative PSA level (<24.50 or >24.50, HR = 98.36, 95% CI 1.376-7030.033, <i>p</i> = 0.035), Gleason score (≤7 or ≥8, HR = 10.44, 95% CI 1.371-79.425, <i>p</i> = 0.024) and cribriform growth pattern were found to be associated with PFS but not OS in univariable analysis. In addition, surgical margins and ductal adenocarcinoma differentiation showed a statistically significant correlation with OS in both univariable analysis and multivariable analyses.</p><p><strong>Conclusions: </strong>The difference in pathological response of PCa patients to neoadjuvant hormonal therapy has an important influence on patient survival, and can be used as an indicator to evaluate the prognosis of PCa.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2485399"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143766039","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}
Annals of medicinePub Date : 2025-12-01Epub Date: 2025-04-23DOI: 10.1080/07853890.2025.2491659
Ming Li, Lujing Xiang, Yan Li
{"title":"Efficacy and safety of compound glycyrrhizin in patients with alopecia areata: a systematic review and meta-analysis.","authors":"Ming Li, Lujing Xiang, Yan Li","doi":"10.1080/07853890.2025.2491659","DOIUrl":"10.1080/07853890.2025.2491659","url":null,"abstract":"<p><strong>Background: </strong>Although compound glycyrrhizin (CG) has been widely used to alopecia areata (AA) in China, its efficacy and safety remain unclear. This systematic review and meta-analysis aimed to evaluate the efficacy and safety of CG for AA.</p><p><strong>Materials and methods: </strong>Eight literature databases were retrieved from their inceptions to 29 February 2024 to identify the eligible randomized controlled trials comparing CG plus conventional treatments with conventional treatments alone for the treatment of AA. Risk ratio (RR), mean difference and 95% confidence interval (CI) were used to estimate the pooled results. RevMan 5.4 (Cochrane Collaboration, Copenhagen, Denmark) and Stata 12.0 software (StataCorp., College Station, TX) were used for statistical analysis.</p><p><strong>Results: </strong>A total of 23 eligible studies with 2219 patients were included. The pooled results revealed that CG plus conventional treatments was superior to conventional treatments alone in cure rate (RR = 1.60, 95%CI [1.47, 1.74], <i>p</i> < .001), total efficacy rate (RR = 1.37, 95%CI [1.29, 1.45], <i>p</i> < .001) and the Severity of Alopecia Tool (SALT) score, regardless of different conventional treatments, treatment courses and doses of CG. In terms of safety, a few patients suffered from adverse events (AEs), including oedema, elevated blood pressure and gastrointestinal tract discomfort, and the incidence of oedema was higher in the patients receiving CG (RR = 2.53, 95%CI [1.04, 6.19], <i>p</i> = .04).</p><p><strong>Conclusions: </strong>The combination of CG and conventional treatments was effective and safe for patients with AA, and CG could promote hair regrowth with mild AEs.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2491659"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033776","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}
Annals of medicinePub Date : 2025-12-01Epub Date: 2025-01-20DOI: 10.1080/07853890.2025.2453634
Mariam S Carson, Alein Y Haro-Ramos, Naomi López-Solano, Carla Fernandez, Marcus Cummins, Alicia Fernandez, Triveni DeFries, Marlene Martin
{"title":"Facilitators and barriers of alcohol goals for Latinx men hospitalized with alcohol use disorder seen by an Addiction Consult Team.","authors":"Mariam S Carson, Alein Y Haro-Ramos, Naomi López-Solano, Carla Fernandez, Marcus Cummins, Alicia Fernandez, Triveni DeFries, Marlene Martin","doi":"10.1080/07853890.2025.2453634","DOIUrl":"10.1080/07853890.2025.2453634","url":null,"abstract":"<p><strong>Introduction: </strong>Latinx individuals are disproportionately affected by alcohol use disorder (AUD). Understanding Latinx individuals' barriers and facilitators to reach AUD-related goals can help implement culturally and linguistically concordant interventions to improve alcohol-related outcomes.</p><p><strong>Methods: </strong>We conducted semi-structured qualitative interviews with Latinx, Spanish-speaking men with AUD within 20 weeks of hospital discharge who were seen by an addiction consult team during hospitalization in an urban, safety-net hospital in San Francisco. Interviews focused on the facilitators and barriers to participants' AUD-related goals pre-, during, and post-hospitalization. We recorded and transcribed interviews and used a mixed deductive and inductive analytic approach until we reached thematic saturation (<i>n</i> = 10).</p><p><strong>Results: </strong>We identified three major themes: 1. Hospitalization was an actionable moment for change; 2. Social factors were closely intertwined with AUD goals; and 3. Accessible addiction, physical health, and mental health services can help achieve AUD goals.</p><p><strong>Conclusions: </strong>Hospitalization may serve as a facilitator for Latinx individuals with AUD to achieve AUD goals. Addressing social determinants of health including housing, immigration status, and social support networks before, during, and after hospitalization, may help facilitate AUD goals. Providing language-concordant and accessible services may decrease barriers to achieving AUD goals.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2453634"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018276","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":"Workload-capacity imbalances and their impact on self-management complexity in patients with multimorbidity: a multicenter cross-sectional study.","authors":"Binyu Zhao, Yujia Fu, Jingjie Wu, Erxu Xue, Chuyang Lai, Dandan Chen, Qiwei Wu, Jianing Yu, Qiaoyu Wu, Zhihong Ye, Jing Shao","doi":"10.1080/07853890.2025.2451195","DOIUrl":"10.1080/07853890.2025.2451195","url":null,"abstract":"<p><strong>Introduction: </strong>Multimorbidity is increasing globally, emphasizing the need for effective self-management strategies. The Cumulative Complexity Model (CuCoM) offers a unique perspective on understanding self-management based on workload and capacity. This study aims to validate the CuCoM in multimorbid patients and identify tailored predictors of self-management.</p><p><strong>Methods: </strong>This multicenter cross-sectional survey recruited 1920 multimorbid patients in five primary health centres and four hospitals in China. The questionnaire assessed workload (drug intake, doctor visits and follow-up, disruption in life, and health problems), capacity (social, environmental, financial, physical, and psychological), and self-management. Data were analyzed using latent profile analysis, chi-square, multivariate linear regression, and network analysis.</p><p><strong>Results: </strong>d Patients were classified into four profiles: low workload-low capacity (10.2%), high workload-low capacity (7.5%), low workload-high capacity (64.6%), and high workload-high capacity (17.7%). Patients with low workload and high capacity exhibited better self-management (β = 0.271, <i>p</i> < 0.001), while those with high workload and low capacity exhibited poorer self-management (β=-0.187, <i>p</i> < 0.001). Social capacity was the strongest predictor for all profiles. Environmental capacity ranked second for 'high workload-high capacity' (R² = 3.26) and 'low workload-low capacity' (R² = 5.32) profiles. Financial capacity followed for the 'low workload-high capacity' profile (R² = 5.40), while psychological capacity was key in the 'high workload-low capacity' profile (R² = 6.40). In the network analysis, socioeconomic factors exhibited the central nodes (<i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>Personalized interventions designed to increase capacity and reduce workload are essential for improving self-management in multimorbid patients. Upstream policies promoting health equity are also crucial for better self-management outcomes.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2451195"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018085","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}
Annals of medicinePub Date : 2025-12-01Epub Date: 2025-01-24DOI: 10.1080/07853890.2024.2428431
Jung Hee Kim, Sung-Eun Kim, Do Seon Song, Hee Yeon Kim, Eileen L Yoon, Ji Won Park, Tae Hyung Kim, Young-Kul Jung, Ki Tae Suk, Hyung Joon Yim, Jung Hyun Kwon, Sung Won Lee, Seong Hee Kang, Moon Young Kim, Soung Won Jeong, Jae-Young Jang, Jeong Ju Yoo, Sang Gyune Kim, Young-Joo Jin, Gab Jin Cheon, Byung Seok Kim, Yeon Seok Seo, Hyoungsu Kim, Dong Hyun Sinn, Woo Jin Chung, Hwi Young Kim, Han Ah Lee, Seung Woo Nam, In Hee Kim, Ji Hoon Kim, Hee Bok Chae, Joo Hyun Sohn, Ju Yeon Cho, Yoon Jun Kim, Jin Mo Yang, Jung Gil Park, Won Kim, Hyun Chin Cho, Dong Joon Kim
{"title":"Aetiology of chronic liver disease is a valuable factor for stratifying adverse outcomes of acute decompensation: prospective observational study.","authors":"Jung Hee Kim, Sung-Eun Kim, Do Seon Song, Hee Yeon Kim, Eileen L Yoon, Ji Won Park, Tae Hyung Kim, Young-Kul Jung, Ki Tae Suk, Hyung Joon Yim, Jung Hyun Kwon, Sung Won Lee, Seong Hee Kang, Moon Young Kim, Soung Won Jeong, Jae-Young Jang, Jeong Ju Yoo, Sang Gyune Kim, Young-Joo Jin, Gab Jin Cheon, Byung Seok Kim, Yeon Seok Seo, Hyoungsu Kim, Dong Hyun Sinn, Woo Jin Chung, Hwi Young Kim, Han Ah Lee, Seung Woo Nam, In Hee Kim, Ji Hoon Kim, Hee Bok Chae, Joo Hyun Sohn, Ju Yeon Cho, Yoon Jun Kim, Jin Mo Yang, Jung Gil Park, Won Kim, Hyun Chin Cho, Dong Joon Kim","doi":"10.1080/07853890.2024.2428431","DOIUrl":"10.1080/07853890.2024.2428431","url":null,"abstract":"<p><strong>Background/aims: </strong>Acute decompensation (AD) is defined as the development of complications related to portal hypertension and liver dysfunction that affect the progression of chronic liver disease (CLD) or liver cirrhosis (LC). Variations exist in patient demographics and prognostic outcomes of AD based on the aetiology of CLD, encompassing LC. However, limited research has been conducted to analyse these discrepancies across aetiologies.</p><p><strong>Methods: </strong>The prospective Korean Acute-on-Chronic Liver Failure (KACLiF) cohort consisted of 1,501 patients who were hospitalized with AD of CLD from July 2015 to August 2018. In this study, we assess the clinical attributes and prognostic implications of AD with CLD/LC stratified by the aetiology.</p><p><strong>Results: </strong>Among 1,501 patients, the mean age was 54.7 years old and 1,118 patients (74.5%) were men. The common events of AD were GI bleeding (35.3%) and jaundice (35.0%). There was a median follow-up of 8.0 months (1.0-16.0 months). The most common aetiology of CLD was alcohol (<i>n</i> = 1021), followed by viral hepatitis (<i>n</i> = 206), viral hepatitis with alcohol-related (<i>n</i> = 129), cryptogenic (<i>n</i> = 108) and autoimmune (<i>n</i> = 37). Viral hepatitis with alcohol-related CLD showed a poor liver function profile and a high frequency of acute-on-chronic liver failure (ACLF) [22.1% vs. 19.6% (alcohol CLD), 8.1% (viral CLD), 5.6% (autoimmune related CLD and 16.0% (cryptogenic CLD)] with worse adverse outcomes (mortality or liver transplantation) than other aetiologies. The difference in aetiology was a significant factor for 28-day adverse outcomes in multivariate analysis even in a high MELD score (≥15), which indicated poor baseline liver function and prognosis (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>The aetiology of CLD constitutes a pivotal determinant influencing both short- and long-term adverse outcomes of AD in CLD, even among individuals presenting with elevated MELD scores. Notably, patients afflicted with viral hepatitis should exercise caution even in the consumption of modest quantities of alcohol that induced the exacerbations in the adverse outcomes associated with AD.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2428431"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11770857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043909","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":"Cardiovascular safety of Janus kinase inhibitors in inflammatory bowel disease: a systematic review and network meta-analysis.","authors":"Huibin Yang, Ting An, Yuxuan Zhao, Xiaojing Shi, Bangmao Wang, Qingyu Zhang","doi":"10.1080/07853890.2025.2455536","DOIUrl":"10.1080/07853890.2025.2455536","url":null,"abstract":"<p><strong>Background and objective: </strong>Janus kinase (JAK) inhibitors (JAKinibs) are effective for inflammatory bowel disease (IBD), but their cardiovascular safety is inconclusive. We aim to assess the cardiovascular risks associated with JAKinibs in IBD patients.</p><p><strong>Patients and methods: </strong>Systematic searches of seven databases and ClinicalTrials.gov from inception to February 2024 were conducted. Outcomes included major adverse cardiovascular events (MACE), venous thromboembolism events (VTE) and cardiovascular events (CVE), which were separately evaluated based on whether or not the dose was considered. P-score was applied to rank interventions.</p><p><strong>Results: </strong>A total of 26 trials involving 10,537 IBD patients were included, and results showed no significantly increased risk of MACE, VTE and CVE was associated with JAKinibs. However, when the dose was considered, Tofacitinib 5 mg BID (versus placebo) showed a trend towards an increased risk of MACE [odds ratio (OR)=1.05, 95% confidence interval (CI): 0.23-4.82], as well as Upadacitinib 30 mg QD (versus placebo) showed a trend towards increased risks of VTE (OR=1.36, 95% CI: 0.23-8.03) and CVE (OR=1.08, 95% CI: 0.24-4.85), and ranked higher than placebo for the risk of VTE [P-score=0.766 (versus 0.722)]. Notably, Deucravacitinib ranked lowest for all cardiovascular risks, and significantly decreased the risks of VTE (OR=0.03, 95% CI: 0.00-0.87) and CVE (OR=0.03, 95% CI: 0.00-0.87) compared with placebo.</p><p><strong>Conclusions: </strong>Although a trend of increased cardiovascular risks was found considering dose, no significantly increased cardiovascular risk was associated with JAKinibs in IBD patients, and Deucravacitinib significantly decreased the risks of VTE and CVE.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2455536"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11755742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061744","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}
Annals of medicinePub Date : 2025-12-01Epub Date: 2025-05-31DOI: 10.1080/07853890.2025.2499022
Elise Baron, Amy Pratt, Betsy Donahoe-Fillmore
{"title":"Integrating augmented reality technology into physical therapy in the school setting: a feasibility study.","authors":"Elise Baron, Amy Pratt, Betsy Donahoe-Fillmore","doi":"10.1080/07853890.2025.2499022","DOIUrl":"10.1080/07853890.2025.2499022","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the feasibility of using an immersive augmented-reality technology (AT) in conjunction with physical therapy (PT) for in-school therapy, while determining whether this technology would be as engaging and motivating as standard PT.</p><p><strong>Methods: </strong>Participants included Fifteen students (6-8 y/o) receiving once-weekly PT. The therapist was instructed to engage students in AT and standard PT for one academic year, alternating sessions. Before each session, students were informed of therapy modality and rated their excitement using a Smiley Face Likert scale with associated text. To assess feasibility, the number and order of each session type, as well as student refusal rate, were investigated. To assess engagement, the therapist recorded time-on-task and number of times redirection was needed. Feasibility was reported as descriptive statistics, and Wilcoxon signed-rank tests were used to compare average scores on excitement and engagement between AT and standard PT.</p><p><strong>Results: </strong>60% of students (9/15) reaching the intended goal of 50% of therapy sessions as AT, as well as 60% (9/15) of students 'roughly alternating' (no more than three same session types in a row) their sessions throughout the duration of the study. The student refusal rate of AT was 0%. When using AT, students were 23% (<i>p</i>= <.0001) more excited, 4.4% (<i>p</i>=.004) more on task and needed 61% (<i>p</i>= <.0001) less refocusing compared to standard PT.</p><p><strong>Conclusion: </strong>Integrating AT alongside standard PT proved to be moderately feasible in a school setting. Additionally, students demonstrated increased excitement, increased time on tasks and decreased refocusing during a session using AT. A flexible-use approach will make AT a motivating addition to school-based therapy.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2499022"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210463","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":"Erector spinae plane block spread patterns and its analgesic effects after computed tomography-guided hepatic tumour ablation: a randomized double-blind trial.","authors":"Wei-Han Chou, Wen-Yun Niu, Po-Chin Liang, Shih-Han Lin, Jen-Ting Yang, Chih-Peng Lin, Ming-Shiang Wu, Chun-Yu Wu","doi":"10.1080/07853890.2025.2480255","DOIUrl":"10.1080/07853890.2025.2480255","url":null,"abstract":"<p><strong>Introduction: </strong>Spread patterns of the erector spinae plane block (ESPB) in a larger cohort of living subjects remain inadequately understood. This study investigated the spread of local anaesthetics or saline with contrast in patients undergoing computed tomography-guided radiofrequency ablation of hepatic tumours.</p><p><strong>Patients and methods: </strong>Thirty patients participated in a double-blinded randomized controlled trial, 14 April 2021 and 18 January 2023. These patients were randomized into two groups: the ESPB group, which received local anaesthetic with contrast, and the sham group, which received saline with contrast. The spread of the drug was assessed regarding vertebral levels and its correlation with the patient characteristics. Pain intensity and morphine consumption were also evaluated.</p><p><strong>Results: </strong>The ESPB consistently spread cranio-caudally to the dorsal erector spinae muscle in all patients, with a median (IQR) spread of 9 (8-11) vertebral levels, and to the intercostal space with a median (IQR) spread of 4 (3-6) vertebral levels. Paravertebral spread occurred in 90% of patients (27 out of 30) with a median (IQR) spread of 3 (2-5) vertebral levels, while epidural spread was observed in 36.7% of patients (11 out of 30) with a median (IQR) spread of 0 (0-2) vertebral levels. Cranio-caudal spread negatively correlated with back muscle thickness (<i>r</i>= -0.4; <i>p</i> = 0.035), and females exhibited significantly more intercostal spread levels than males (5.8 ± 1.0 vs. 4.3 ± 1.6 levels in females and males, respectively; <i>p</i> = 0.021). However, no significant difference was found in pain intensity and morphine consumption between the two study groups.</p><p><strong>Conclusion: </strong>This study provides insights into the drug spread patterns of ESPB in living subjects. However, a unilateral ESPB did not yield sufficient analgesic effects for radiofrequency ablation of hepatic tumours.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2480255"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659843","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}
Annals of medicinePub Date : 2025-12-01Epub Date: 2025-05-24DOI: 10.1080/07853890.2025.2506481
Andriany Qanitha, Abdul Hakim Alkatiri, Nurul Qalby, Gita Vita Soraya, Muhammad Azka Alatsari, Nabilah Puteri Larassaphira, Rif'at Hanifah, Peter Kabo, Muzakkir Amir
{"title":"Determinants of stroke following percutaneous coronary intervention in patients with acute coronary syndrome: a systematic review and meta-analysis.","authors":"Andriany Qanitha, Abdul Hakim Alkatiri, Nurul Qalby, Gita Vita Soraya, Muhammad Azka Alatsari, Nabilah Puteri Larassaphira, Rif'at Hanifah, Peter Kabo, Muzakkir Amir","doi":"10.1080/07853890.2025.2506481","DOIUrl":"10.1080/07853890.2025.2506481","url":null,"abstract":"<p><strong>Background: </strong>Despite advances in the field, no systematic review has thoroughly documented the occurrence of stroke following Percutaneous Coronary Intervention (PCI) in patients with Acute Coronary Syndrome (ACS). This study aimed to investigate the factors contributing to stroke occurrence post-PCI in ACS patients.</p><p><strong>Methods: </strong>A systematic search of PubMed and EMBASE identified 2,369 articles. After full-text screening, 109 articles were included in the systematic review, with 55 articles selected for meta-analysis.</p><p><strong>Results: </strong>Data from 18,466,823 patients across 109 studies were analyzed. Among these, 202,999 patients (1.1%) experienced post-PCI stroke. The participants' ages ranged from 49.0 to 87.6 years (mean 64.3 ± 6.2 years). The incidence of early post-PCI stroke within 30 days was 1.1%, while the incidence of stroke occurring >30 days post-PCI was 1.8%, predominantly ischemic strokes. Predictors of stroke following PCI in ACS patients included traditional risk factors (i.e. female sex, older age, diabetes mellitus, hypertension, prior stroke or transient ischemic attack); comorbidities (i.e. chronic kidney disease, atrial fibrillation, anemia, high bleeding risk); and procedural factors (i.e. thrombus aspiration and Clopidogrel use).</p><p><strong>Conclusions: </strong>This study highlights the relatively low prevalence of stroke following PCI, estimated at approximately 1% of the studied population. These findings emphasize the critical need for continued vigilance in identifying and managing risk factors associated with post-PCI stroke in ACS patients. Future research should prioritize refining risk prediction models, developing innovative preventive strategies, and optimizing post-PCI care pathways to effectively reduce the incidence of stroke in this population.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2506481"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136429","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}