Cureus最新文献

{"title":"Morphology of the First Tarsometatarsal Joint and the Incidence of Arthritis and Post-operative Complications.","authors":"Rohid Zamani, Aman Akhtar, Ibrahim I Haq, Alesha Gibbs, Umar N Said","doi":"10.7759/cureus.72605","DOIUrl":"https://doi.org/10.7759/cureus.72605","url":null,"abstract":"<p><p>Introduction The first tarsometatarsal joint (TMTJ) is often overlooked regarding foot pathology or a secondary measure in most studies, despite its heavy involvement in surgical procedures and foot stability. The primary aim of this study is to assess the effect of the first TMTJ morphology on the incidence of arthritis and post-operative complications following a Lapidus procedure. Materials and methods A total of 39 feet/subjects (19 left and 20 right) were assessed by two independent reviewers. The first TMTJ angle and articulating surface shape were measured, and relevant descriptive data was compiled. Statistical analysis was used to analyse variable outcomes via a logistical regression model and inter-rater reliability tests to determine the validity of the methods used.  Results A statistically significant relationship between first TMTJ angle and incidence of arthritis was revealed but not with articulating surface shape, or between either measure of first​​​​​​​ TMTJ morphology and post-operative complications. Inter-rater reliability tests showed a very strong correlation between inter-rater measurements.  Discussion The smaller the angle of the first​​​​​​​ TMTJ, the increased incidence of arthritis; therefore, it may be an early sign for clinicians to look for and implement prophylactic interventions sooner. Furthermore, it also signifies that conducting corrective surgeries at this joint will likely have a positive effect on decreasing arthritis pathology. The strong inter-rater reliability findings offer validity to the methods used in this study however can be improved using expert radiographers and AI software.  Conclusion The first​​​​​​​ TMTJ angle and shape of the articulating surface are both valuable predictors of the incidence of arthritis; however, this study cannot claim that they are good predictors for post-surgical complications. Further research is needed to address the limitations found in this study however it is a valuable initial step in identifying foot pathology early and initiating early management.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11519830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Managing Perforated Diverticulitis: An Overview of Treatment Trends and Clinical Outcomes at a Single Centre in the United Kingdom.","authors":"Kush Patel, Ahmad Shehadeh, Kyrllos Farag, Vladimir Nichita, Ahmed Esawi, Rishi Sen, Elisabeth Drye, Sanad Isswiasi","doi":"10.7759/cureus.72591","DOIUrl":"https://doi.org/10.7759/cureus.72591","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Introduction Perforation represents the most critical manifestation of complicated diverticulitis. In 2008, it was estimated that about 2,000 cases of perforated diverticulitis (PD) were diagnosed in the United Kingdom (UK). Management of PD is evolving with considerable variation in approaches between hospitals and countries with an increased trend towards a conservative approach. Objective Our aim is to provide a comprehensive overview of the management strategies and treatment outcomes for PD, with a particular focus on the influence of abscess size and the presence of distant air (DA) on the success of conservative management. Methods Data from 112 patients admitted with PD to a single district hospital in the UK between 2013 and 2018 were retrospectively analysed. CT scan reports and images were examined to assess the size and number of abscesses, as well as the presence of DA. Failed initial management was defined as the need for an alternative therapeutic option after 48 hours during the index admission or readmission within 12 weeks. Follow-up data were also reviewed to evaluate the need for elective resection and stoma reversal. Result In this cohort of 112 patients with PD, a variety of treatment strategies were employed. Antibiotic therapy alone was successful in 46 patients (41%). Radiological management was successful in only six patients (5%). Surgical washout was required in 12 cases (11%), while resection was performed in 40 cases (36%). Best supportive care was provided to eight patients (7%) who were considered unfit for invasive interventions. The success rate was higher in cases with smaller abscesses and no DA (p &lt;0.05). Specifically, 30 out of 45 patients (66.6%) with abscesses less than 4 cm and no DA were managed successfully with conservative treatment, whereas the success rate dropped to 14 out of 30 patients (47%) when DA was present (p&lt;0.05). For abscesses larger than 4 cm, the success rate was seven out of 20 patients (35%) without DA and significantly lower at two out of 20 patients (10%) with DA (p=0.01). The data also show a shift towards increased conservative management over the six-year period, with a steady reduction in the number of surgical interventions. However, 12 patients (19%) were readmitted with complicated diverticulitis after the initial non-resectional management. Conclusion We observed a shift towards more conservative, non-operative management of acute complicated diverticulitis with perforation over the six-year period, likely influenced by advancements in diagnostic and interventional radiology, antibiotic therapy, and minimally invasive techniques. Our data also stress that cases of PD with distant extraluminal air or larger abscesses are less suited to conservative treatment, often necessitating traditional surgical interventions. Long-term follow-up showed a moderate rate of readmissions after non-resectional management, and while stoma reversal was successful in a proportion of patient","PeriodicalId":93960,"journal":{"name":"Cureus","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11519386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549731","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":"Induced Native Phage Cocktails for Multi-microbial Activation Syndrome in Treatment-Resistant Illnesses.","authors":"David A Jernigan","doi":"10.7759/cureus.72587","DOIUrl":"https://doi.org/10.7759/cureus.72587","url":null,"abstract":"<p><p>The global population is plagued by chronic illnesses of many types due to, in part, the activation of virulence of many latent microbes leading to chronic multi-system illness, stimulating the new term, multi-microbial activation syndrome (MMAS). Treatment-resistant infections across the entire microbial spectrum are now largely untreatable using the previously successful pharmaceutical and natural medicine options. The heavy-handed methods of long-term chemotherapeutic antibiotics, antifungals, and antiviral drugs, whose adverse effects could be worse than the original illness, are presently essentially useless in the long run, as microbes have developed rapid adaptive mutations, becoming drug-resistant. The introduction of induced native phage therapy opened a completely new treatment category that has the potential to complement or replace aggressive drug therapies of many classes. Since its introduction, many advancements have been made to the technology. The most recent development in this new treatment genre is the ability to formulate induced native phage cocktails that use a wide spectrum of induction signatures within the formulation to stimulate various types of beneficial phages already living within the phageome of the body, to target a wide range of pathogenic microbes and associated advantageous physiological targets. The ability to address the MMAS commonly seen in various chronic illnesses simultaneously within the same formulation enables greater clinical outcomes without harm to the microbiome or to the tissues and systems of the body.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11518919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142550102","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":"Anesthetic Implications of Factor XI Deficiency: A Clinical Case Study and Review of Literature.","authors":"Pedro-Rafael Martinez-Lopez, Alejandro Barroso-Gonzalez","doi":"10.7759/cureus.72594","DOIUrl":"10.7759/cureus.72594","url":null,"abstract":"<p><p>Factor XI deficiency, a rare but significant coagulopathy, poses unique challenges in perioperative management, particularly in obstetric settings. This review provides an in-depth exploration of the pathophysiology, diagnosis, and anesthetic implications of factor XI deficiency, thereby emphasizing the useful role of anesthesiologists. The variable bleeding phenotype of the disorder necessitates a nuanced understanding and tailored management strategies to mitigate severe perioperative bleeding risks. Conventional coagulation tests, while useful, often fall short in predicting bleeding risks, underscoring the importance of advanced diagnostic tools, such as viscoelastic testing. Viscoelastic testing provides real-time data on clot stability, which allows for immediate intervention and more targeted therapeutic strategies compared to standard coagulation tests. A clinical case of a 25-year-old patient with factor XI deficiency undergoing emergency surgery for an ectopic pregnancy illustrates the application of viscoelastic testing in managing acute bleeding and optimizing patient outcomes and advocates for the development of standardized protocols, continuous monitoring techniques, and enhanced training programs to improve the perioperative care of patients with factor XI deficiency, providing anesthesiologists with the tools necessary to navigate the complexities of factor XI deficiency in the perioperative environment. Integrating these advanced diagnostic and therapeutic approaches could significantly improve patient safety and surgical outcomes in patients with complex coagulopathy.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549723","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":"Parathyroid Carcinoma Complicated by Parathyromatosis and Refractory Hypercalcemia.","authors":"Yug Garg, Madhumati S Vaishnav, Nidhi Garg, Kavitha Muniraj, Sathyanarayana Srikanta","doi":"10.7759/cureus.72584","DOIUrl":"10.7759/cureus.72584","url":null,"abstract":"<p><p>Parathyroid carcinoma (PC) is a rare malignancy. In January 2022, a 41-year-old woman presented with weight loss, proximal muscle weakness, and bone pain. She was diagnosed with severe hypercalcemia with serum calcium of 15.5 mg/dL (8.8-10.6 mg/dL). A biopsy of cervical lymphadenopathy revealed non-caseating granulomatous lymphadenitis. Primary hyperparathyroidism was subsequently confirmed with parathormone (PTH) exceeding 2,500 pg/mL (12-88 pg/mL), leading to left-superior parathyroidectomy and hemithyroidectomy. Histopathology suggested PC versus adenoma, with oxyphilic cells. Postoperatively, she manifested severe hypocalcemia and vitamin D deficiency alongside elevated PTH levels. In January 2023, she experienced a hypercalcemic crisis and developed a new right-sided neck mass. Wide excision revealed PC with parathyromatosis. By September 2023, another hypercalcemic crisis and new left cervical nodules necessitated further surgery, confirming PC deposits in the neck, though without lymph node metastases. Despite treatment with cinacalcet and zoledronic acid, her hypercalcemia persisted until denosumab produced a dramatic response (serum calcium dropping from 16.7 to 7.9 mg/dL; PTH 1,168 pg/mL). However, she remains at risk for progressive local disease and potential distant metastases.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549733","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 Risk Factors for Post-operative Complications in Laparoscopic Common Bile Duct Exploration: A Literature Review.","authors":"Mina Manasseh, Islam Mt Elsamalouty, Cho Nu San, Marcos Kostalas","doi":"10.7759/cureus.72570","DOIUrl":"https://doi.org/10.7759/cureus.72570","url":null,"abstract":"<p><p>Gallstone-related diseases, particularly common bile duct (CBD) stones, pose a significant global health challenge. The emergence of laparoscopic common bile duct exploration (LCBDE) has transformed the management of these conditions by offering a less invasive alternative to traditional open surgery. This literature review aims to analyze published literature to identify and understand the risk factors associated with LCBDE. The study aims to offer valuable insights that could potentially enhance patient care and outcomes in managing CBD stones. A comprehensive search of English-language studies from the past 20 years was conducted using PubMed, focusing on peer-reviewed primary research, systematic reviews, and meta-analyses. From 830 initial articles, 25 were selected based on relevance and availability. The review identified several key risk factors influencing LCBDE outcomes, including patient-related factors such as advanced age, high comorbidity scores, narrow bile ducts, and complex stones, which increase the likelihood of complications. Surgeon experience also plays a crucial role, with lower complication rates observed among surgeons who have performed at least 70 LCBDE procedures over a 10-year period. Additionally, procedure-related factors such as the transcystic (TC) approach, primary suture (PS) closure, and intraoperative imaging were found to reduce complication rates. LCBDE remains a promising approach for managing bile duct stones, particularly when patient, surgeon, and procedural factors are optimized.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11519757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549730","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":"Scalp Metastasis From Renal Cell Carcinoma: A Rare Case With Rapid Progression.","authors":"Mohammed S Alzahrani, Abdulsamad O Alharbi, Abdulaziz Alghamdi, Abdulrahman Mojallid, Mohamed Alghamdi, Abdullrahman Alayyad, Awnallah Alotaibi, Abdulrhman A Alamri, Rehab Fadag, Mohamed Sheta, Abdulrahman S Khalil, Ibrahem F Alassiri, Abdulghani Khogeer, Adel Elatreisy","doi":"10.7759/cureus.72546","DOIUrl":"10.7759/cureus.72546","url":null,"abstract":"<p><p>Renal cell carcinoma (RCC) is a common renal malignancy that frequently metastasizes, though cutaneous metastasis, particularly to the scalp, is rare and generally indicates a poor prognosis. We report a case of scalp metastasis from RCC in a 69-year-old man who presented with unexplained weight loss and painless hematuria. Imaging revealed a 12-cm renal mass with adrenal, pulmonary, and scalp metastases. The patient's condition rapidly deteriorated, and he died one month after the presentation. Hematogenous spread through Batson's plexus might be the primary mechanism of RCC dissemination to the scalp. While targeted therapies have improved the management of metastatic RCC, the prognosis for patients with skin metastases remains poor.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11514952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523906","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":"Brachial Plexus Injury Following Fracture-Dislocation of the Proximal Humerus: A Case Report.","authors":"Samuel J Smith, Andy Webb","doi":"10.7759/cureus.72593","DOIUrl":"10.7759/cureus.72593","url":null,"abstract":"<p><p>Fracture-dislocations of the proximal humerus with brachial plexus injury are exceedingly rare, and although infrequently encountered, it is important to recognize this complication due to its potentially devastating impact. We present the case of a 75-year-old female who sustained the described injury following a fall onto their left arm, demonstrating combined sensory and motor deficits in the radial, median, and ulnar distribution of the left forearm and hand shortly afterward. Immediate management involved closed reduction under anesthesia, resulting in the improvement of neurological symptoms. For definitive management, surgical fixation of the fracture-dislocation is normally recommended in cases with an associated brachial plexus injury. However, due to a range of personal factors, the patient decided against this. Physiotherapy plays an important role in the management of these injuries, aiding mobility and recovery, with another key part of the follow-up being electrodiagnostic studies. These allow the physician to assess the extent of injury, monitor recovery for prognostication, and aid decisions regarding further surgical management. The importance of these studies is highlighted by the finding of severe brachial plexus injury, despite minimal pathological changes on MRI. Rare but significant, it is important to maintain a high index of suspicion for these injuries and consider underlying risk factors, with prompt surgical input required to optimize outcomes. Alongside surgical management, a considered approach must be taken by the anesthetic team, as regional anesthesia can confound post-procedure neurological assessment.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11526838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559778","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":"Outcomes of Intramedullary Nailing Versus Plate Fixation in the Management of Humeral Shaft Fractures: A Systematic Review and Meta-Analysis.","authors":"Adeel Nadeem, Hannah Abbasi","doi":"10.7759/cureus.72473","DOIUrl":"10.7759/cureus.72473","url":null,"abstract":"<p><p>This systematic review and meta-analysis aimed to compare the outcomes of intramedullary nailing (IMN) and open reduction with internal fixation (ORIF) in treating traumatic humeral shaft fractures in adults (18 years and above). A comprehensive literature search was conducted in databases including PubMed, Google Scholar, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL). The primary outcome was time to union, while secondary outcomes included non-union rates, incidences of iatrogenic radial nerve palsy, surgical site infections, and intra-operative comminution. Twenty-six studies, encompassing 1,674 patients (867 IMN, 807 ORIF), were included. IMN demonstrated a shorter time to union compared to ORIF (mean difference -1.06 (95% CI, -1.88 to -0.23)), with significant statistical heterogeneity (I² = 70%), and a mean difference of -2.14 (95% CI, -3.16 to -1.12) in the randomized controlled trial (RCT) subgroup analysis, which had no significant statistical heterogeneity. Both techniques had comparable non-union rates (risk ratio 0.34 (95% CI, 0.94 to 1.93)). IMN was associated with lower incidences of iatrogenic radial nerve palsy (risk ratio 0.48 (95% CI, 0.27 to 0.87)) and surgical site infections (risk ratio 0.44 (95% CI, 0.25 to 0.76)), but had a higher risk of intra-operative comminution (risk ratio 3.04 (95% CI, 1.24 to 7.44)). The studies exhibited significant heterogeneity and varying outcome measures, highlighting the need for cautious interpretation. IMN offers rapid fracture stabilization and minimal additional physiological insult, while ORIF remains preferable for achieving precise anatomical reduction. These findings highlight the importance of considering patient-specific factors and surgical expertise in selecting the appropriate fixation technique.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11514719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523904","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 of Epoetin Alfa in Managing Symptomatic Anaemia in Low-Risk Myelodysplastic Syndromes: A Retrospective Analysis.","authors":"Mohamed Aboulela, Angela Collins","doi":"10.7759/cureus.72460","DOIUrl":"10.7759/cureus.72460","url":null,"abstract":"<p><p>Background Myelodysplastic syndromes (MDS) are clonal myeloid disorders characterised by ineffective haematopoiesis, leading to anaemia that often requires dependence on red blood cell (RBC) transfusions. Epoetin alfa (Eprex®) is now a mainstay in the management of symptomatic anaemia in low-risk MDS patients, reducing transfusion dependence and improving the quality of life in this patient group. Objective This retrospective study aimed to assess the efficacy of epoetin alfa in treating symptomatic anaemia in low-risk MDS patients, focusing on transfusion independence and its relationship with baseline erythropoietin (EPO) levels and haemoglobin (Hb) response. Methods Data from 56 patients with low-risk MDS treated with epoetin alfa at Norfolk and Norwich University Hospital, Norwich, United Kingdom, between 2018 and 2023 were retrospectively analysed. Baseline EPO levels, transfusion history, Hb response, and the duration of transfusion independence were assessed. Statistical analyses were performed to evaluate the correlation between baseline characteristics and treatment outcomes. Results Among the patients, 98.2% had baseline EPO levels below the 500 IU/L threshold, with a median EPO level of 74.3 IU/L. Following an eight-week trial of 30,000 units of epoetin-alfa, 41.1% of patients showed improved Hb levels, 41.1% maintained stable Hb levels, and 17.9% experienced a decline. A significant correlation was found between lower baseline EPO levels (<250 IU/L) and a positive treatment response (p = 0.0065). Additionally, patients who required fewer transfusions before treatment had longer durations of transfusion independence (correlation coefficient = -0.40, p = 0.015). Dose escalation to 60,000 units provided a benefit to 53.3% of patients with initially stable Hb levels. The average duration of transfusion independence was 8.1 months, and patients with improved Hb levels had the longest periods of transfusion independence (p = 0.005). Conclusion Epoetin alfa is an effective therapy for managing symptomatic anaemia in low-risk MDS patients. This study highlights its efficacy and provides valuable predictive information, particularly showing that patients with lower baseline EPO levels are more likely to respond to treatment. While prior transfusion dependence did not significantly predict response to therapy in this cohort, it was associated with the duration of transfusion independence.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11512730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515073","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}