Annals of medicine最新文献

{"title":"Examined lymph node counts affected the staging and survival in cervical cancer: a retrospective study using the SEER and Chinese cohort.","authors":"Tao Guo, Yuxi Zhao, Jia Zeng, Jian Li, Enyu Tang, Lingying Wu","doi":"10.1080/07853890.2025.2459821","DOIUrl":"10.1080/07853890.2025.2459821","url":null,"abstract":"<p><strong>Background: </strong>The impact of examined lymph node (LN) count on survival in cervical cancer remains understudied, with no consensus on the optimal number required.</p><p><strong>Objectives: </strong>We aimed to investigate the role of LN count in postoperative pathological evaluation for cervical cancer patients undergoing surgery.</p><p><strong>Methods: </strong>Data from the US SEER database and a retrospective Chinese cohort were analyzed. Multivariable logistic and Cox regression models assessed LN positivity detection and overall survival (OS), respectively. Smoothing spline curves and Chow tests identified structural change points in hazard ratios and LN-positive ratios.</p><p><strong>Results: </strong>Among 14,133 SEER and 2,811 Chinese cases, higher LN counts correlated with increased detection of positive LNs (OR: 1.040, 95% CI: 1.019-1.062) and improved OS (HR: 0.990, 95% CI: 0.984-0.996). Structural change points occurred at 20 LNs for LN-negative patients and 13 LNs for LN-positive patients (both P < 0.001). An elevated LN-positive ratio (positive/examined LNs) strongly predicted worse OS (HR: 4.208; 95% CI: 1.454-12.181).</p><p><strong>Conclusions: </strong>An increased number of examined LNs significantly contributes to the detection of positive LNs and improved patient survival. For patients with claimed LN-negative and LN-positive disease, a minimum examination of 20 and 13 LNs, respectively, is recommended to ensure adequate LN evaluation. The LN positive ratio is a strong prognostic indicator in patients with LN-positive disease.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2459821"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082554","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":"Utilizing vaginal natural orifice to facilitate bowel manipulation during totally intracorporeal ileal conduit construction: a retrospective cohort study.","authors":"Kaipeng Jia, Shiwang Huang, Zhun Wang, Yuda Lin, Yiduo Bai, Chong Shen, Zhe Zhang, Zhouliang Wu, Yunkai Qie, Hailong Hu","doi":"10.1080/07853890.2025.2453827","DOIUrl":"10.1080/07853890.2025.2453827","url":null,"abstract":"<p><strong>Objective: </strong>To explore the feasibility and efficacy of the modified technique of totally intracorporeal ileal conduit (IC) construction <i>via</i> vaginal approach following robot-assisted radical cystectomy (RARC) in females.</p><p><strong>Methods: </strong>By comparing the perioperative outcomes of the modified technique with extracorporeal urinary diversion (ECUD), 31 females treated for bladder cancer with RARC and IC from May 2020 to December 2023 were retrospectively analyzed and divided into two groups: the ECUD group (10 patients) and the modified intracorporeal urinary diversion (MICUD group) (21 patients). The modified technique involved performing transvaginal natural orifice specimen extraction surgery (TV-NOSES) after RARC; followed by the transvaginal placement of an Endo-GIA stapler to manipulate the bowel for intracorporeal IC construction.</p><p><strong>Results: </strong>Both groups' surgeries were successfully completed by the same surgeon and team. Patients in the MICUD group had shorter total operative time, lower postoperative pain scores, quicker recovery, and shorter hospital stays. The learning curve of the MICUD showed two phases: a learning phase (cases 1-7) and a proficiency phase (cases 8-21). The incidence of postoperative complications between the two groups was similar. The mean follow-up times were 29.3 months (ECUD group) and 22.6 months (MICUD group). In the MICUD group, there was one case of local tumor recurrence, two cases of distant metastasis, including one death from progression; in the ECUD group, one patient had distant metastasis and died from progression.</p><p><strong>Conclusion: </strong>RARC with MICUD represents a safe, feasible and easy-to-learn minimally invasive surgical approach. Patients experience less trauma and faster recoveries.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2453827"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018033","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":"Clinical and epidemiological characteristics of respiratory syncytial virus, SARS-CoV-2 and influenza paediatric viral respiratory infections in southwest Saudi Arabia.","authors":"Ali Alsuheel Asseri, Saleh M Al-Qahtani, Ibrahim A Alzaydani, Ahmed Al-Jarie, Noha Saad Alyazidi, Ali A Alrmelawi, Alya Musfer Alqahtani, Rahaf S Alsulayyim, Ameerah K Alzailaie, Dhay M Abdullah, Abdelwahid S Ali","doi":"10.1080/07853890.2024.2445791","DOIUrl":"https://doi.org/10.1080/07853890.2024.2445791","url":null,"abstract":"<p><strong>Background: </strong>There is a global consensus that respiratory tract infections are the major causes of morbidity and mortality among children. In this study, we aimed to compare the clinical and epidemiological characteristics of respiratory syncytial virus (RSV), influenza and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections among children admitted to hospital with acute respiratory infections. We also opted to identify the predictors of paediatric intensive care unit (PICU) admission.</p><p><strong>Methods: </strong>In this study, a retrospective investigation and analysis of 423 children who were admitted to Abha Maternity and Children Hospital, in the southern region of Saudi Arabia, between January and December 2022 were conducted.</p><p><strong>Results: </strong>The median age of these children was 16.5 months (Q1-Q3: 6-46.3). It was observed that the infectivity levels of RSV, SARS-CoV-2, influenza A and influenza B infections peaked in early to mid-September, mid-July, May and June, and October, respectively. There was a statistically significant difference in the total WBC counts between RSV and influenza B (<i>p</i> = 0.035) and SARS-CoV-2 and influenza B (<i>p</i> = 0.013). Moreover, there was a statistically significant difference in the absolute lymphocyte count between influenza A and RSV (<i>p</i> = 0.002). The median number of days in hospital was 6 days (Q1-Q3: 4-10). Patients with RSV infection required a significantly longer hospital stay, with a median of 8 days (Q1-Q3: 4-10). The factors associated with the likelihood of PICU admission for all study participants were congenital heart disease (odds ratio (OR) = 2.9, 95% confidence intervals (CI) [1.4-6.1]), RSV (OR = 2.3, 95% CI [1.3-4.1]) and age <6 months (OR = 2.0, 95% CI [1.2-3.4]).</p><p><strong>Conclusions: </strong>RSV was identified as the most common pathogen causing acute lower respiratory infections among the studied patients. One of the more significant findings to emerge from this study is the seasonal changes in RSV and influenza infections, which mandates further research.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2445791"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883837","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":"The impact of uric acid on acute coronary syndrome prognosis in elderly patients.","authors":"Yifan Li, Tiantian Sang, Naqiang Lv, Jinxing Liu, Yingzhen Gu, Xiaorong Han, Wei Zhang, Aimin Dang","doi":"10.1080/07853890.2024.2445200","DOIUrl":"https://doi.org/10.1080/07853890.2024.2445200","url":null,"abstract":"<p><strong>Background: </strong>Uric acid (UA) plays an important role in cardiovascular diseases, yet its implications in elderly patients remains incompletely understood. This study aimed to explore the impact of UA on the prognosis in advanced-age patients with acute coronary syndrome (ACS).</p><p><strong>Methods: </strong>We included 526 patients aged 80 and older who were diagnosed with ACS. The UA levels were measured at admission, and patients were divided into four groups based on quartiles of UA levels. Major adverse cardiovascular events (MACE) during follow-up were recorded.</p><p><strong>Results: </strong>The median UA level was 344.09 μmol/L, while the median follow-up duration was 64 months. Kaplan-Meier curves demonstrated a higher cumulative incidence of MACE during long-term follow-up in the Q4 group (Log-rank <i>p</i> < 0.05). Cox regression analysis revealed an independent correlation between UA levels and an increased risk of MACE (HR 1.002, 95%CI 1.000-1.003, <i>p</i> = 0.021). The ROC curve indicated that the optimal UA value for predicting MACE was 324.25 μmol/L. After matching through PSM, the MACE-free survival rate was lower in both hyperuricemia group (UA> 420.00 μmol/L) and high UA group (324.25 μmol/L < UA≤ 420.00 μmol/L) compared to the control group. Both hyperuricemia and high UA levels were independent risk factors for long-term MACE in advanced-age ACS patients, with HR values of 1.546 (1.049-2.280, <i>p</i> = 0.028) and 1.491 (1.011-2.198, <i>p</i> = 0.044), respectively.</p><p><strong>Conclusion: </strong>Elevated UA levels were identified as independent risk factors for MACE in elderly patients with ACS. The optimal predictive value of UA for poor cardiovascular prognosis was significantly lower than the traditional definition of hyperuricemia.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2445200"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883841","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":"Demographic and clinical features of rosacea in North Jordan: a 10-year university hospital retrospective study.","authors":"Diala Alshiyab, Saleh A Ba-Shammakh, Alaa Bani Bakr, Mohammad Abu-Hussein, Abdulqudos Al-Fakih, Sarah Alawneh, Leen Alhuneafat, Leen Heis, Firas Al-Qarqaz","doi":"10.1080/07853890.2024.2445775","DOIUrl":"https://doi.org/10.1080/07853890.2024.2445775","url":null,"abstract":"<p><strong>Background/objectives: </strong>This study aims to investigate the demographic and clinical characteristics of rosacea within the North Jordan population, focusing on Fitzpatrick skin types III and IV. The intent is to address gaps in dermatological research concerning ethnic and racial variations in rosacea's presentation and impact.</p><p><strong>Methods: </strong>We conducted a retrospective cohort analysis at the dermatology department of King Abdullah University Hospital, North Jordan, reviewing medical records of patients diagnosed with rosacea from January 2013 to December 2023. Data collection focused on demographics, rosacea subtypes and environmental factors exacerbating the condition. Statistical analysis utilized Jamovi and GraphPad Prism software.</p><p><strong>Results: </strong>The study included 610 patients, revealing a rosacea prevalence of 1.5% within the hospital's catchment area. Most patients were female (84.4%), with a median age of 44. The majority had Fitzpatrick skin types III and IV. The erythematotelangiectatic subtype was most common (73.6%), followed by papulopustular (23.4%) and phymatous (3%). Environmental triggers like sun exposure and temperature changes were nearly universally reported as exacerbating factors.</p><p><strong>Conclusions: </strong>Rosacea shows significant gender disparities and is influenced by environmental factors. The study underscores the need for targeted research and treatment strategies that consider ethnic and racial variations, along with gender-specific presentations of the disease.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2445775"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901056","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":"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":"Solid and cystic intrapancreatic accessory spleen: report of 10 cases in a single institution.","authors":"Jianjie Sheng, Yifei Yang, Yudong Qiu, Chenglin Lu, Xu Fu","doi":"10.1080/07853890.2025.2463564","DOIUrl":"10.1080/07853890.2025.2463564","url":null,"abstract":"<p><strong>Background: </strong>Precise diagnosis of intrapancreatic accessory spleen (IPAS) remains challenging due to its rarity and diverse presentations. Despite comprehensive examinations, including radiography and other diagnostic methods, the potential for malignancy cannot be excluded, often leading to unnecessary pancreatic surgeries. We review our institutional experience to provide insights for accurately distinguishing IPAS.</p><p><strong>Methods: </strong>We retrospectively reviewed 10 patients who underwent distal pancreatectomy for the lesion in the pancreas tail which was determined to be IPAS on final pathology at our institution between January 2020 and April 2024. The presenting symptoms, medical history, preoperative imaging, operative therapy, final pathology and postoperative course were evaluated.</p><p><strong>Results: </strong>Patient ages ranged from 30 to 72 (median 55.5), including six women and four men. Most patients were asymptomatic. One patient had the medical history of splenectomy. Lesions ranged from 1.4 to 7.3 cm (mean 2.9 cm). All lesions were located in the pancreatic tail. On radiologic evaluation, these lesions had both solid and cystic presentations. The most common operative approach was laparoscopic distal pancreatectomy and splenectomy. Four patients were diagnosed with epidermoid cysts arising in intrapancreatic accessory spleen (ECIPAS) on final pathologic evaluation.</p><p><strong>Conclusions: </strong>IPAS are predominantly benign lesions which have solid and cystic presentations commonly mistaken for pancreatic neoplasms. Combining CT, MRI, EUS-FNA and nuclear medicine may enhance IPAS detection, though no definitive diagnostic method exists. Increased awareness of IPAS in the differential diagnosis of pancreatic tail tumors, coupled with advancements in imaging techniques could improve diagnostic accuracy and exclude malignancy, preventing unnecessary surgeries.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2463564"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11812107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384211","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 reliability and validity of the Swedish translation of the Vertigo Symptom Scale - short form in a cohort with acute vestibular syndrome.","authors":"Solmaz Surano, Erik Faergemann, Gabriel Granåsen, Jonatan Salzer","doi":"10.1080/07853890.2025.2457517","DOIUrl":"10.1080/07853890.2025.2457517","url":null,"abstract":"<p><strong>Background: </strong>The Vertigo Symptom Scale - short form (VSS-SF) is commonly used to measure dizziness and vertigo over the past month. This study aimed to (1) adapt the VSS-SF for the Swedish population and assess its psychometric properties, and (2) develop a modified version for measuring symptoms in the acute phase of acute vestibular syndrome (AVS).</p><p><strong>Methods: </strong>The VSS-SF was translated into Swedish and adapted cross-culturally. Its psychometric properties were evaluated in 86 AVS patients, both in the acute stage (1-7 days from symptom onset) with a modified acute version, and after six weeks of vestibular rehabilitation using the standard VSS-SF. Factor structure, convergent and discriminant validity, and internal consistency were analyzed. Test-retest reliability was assessed at six weeks. Participants were also evaluated with the Dizziness Handicap Inventory (DHI) and balance tests. Controls included 54 healthy participants.</p><p><strong>Results: </strong>Exploratory factor analysis revealed a two-factor structure for both versions, corresponding to vertigo-balance (VSS-V) and autonomic-anxiety (VSS-A) subscales. Both versions demonstrated strong factor structures with adequate loadings. Internal consistency was high for the standard version (Cronbach's alpha 0.76 to 0.87) and for the total and VSS-V subscale of the acute version (0.82 and 0.85, respectively), but poor for the acute VSS-A subscale (0.50). Convergent validity was supported by Spearman's rank correlations. The discriminative ability was excellent for the acute VSS-SF and VSS-V (AUC 0.98 and 0.99), and acceptable for VSS-A (AUC 0.77). After six weeks, discriminative ability decreased but remained above 0.5. Test-retest reliability at six weeks was excellent for all scales (ICC 0.94, 0.93, and 0.93 for VSS-SF, VSS-V, and VSS-A).</p><p><strong>Conclusions: </strong>The VSS-SF was successfully adapted for the Swedish population, including an acute version for early dizziness assessment. Both versions confirmed a robust two-factor structure, with the acute version showing excellent early discriminative ability, particularly for the vertigo-balance dimension. However, the autonomic-anxiety subscale showed weaker psychometric properties, suggesting limited suitability for AVS patients. The adapted scales show promise for clinical use in diagnosing and evaluating dizziness and vertigo in the Swedish population.</p><p><strong>Trial registration: </strong>Clinicaltrials.gov Identifier NCT05056324, September 24, 2021. https://clinicaltrials.gov/ct2/show/NCT05056324.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2457517"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11812103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384281","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}