Neuro endocrinology letters最新文献

{"title":"The INS-IGF2 transcript in schizophrenia or related psychosis: tendency towards association between an INS-IGF2 SNP and schizoaffective disorder, and one report of a patient with this SNP and diagnoses of both schizoaffective disorder and polycystic ovary syndrome.","authors":"Kristina Melkersson, Bengt Persson","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objectives: </strong>We found earlier increased antibody reactivity against the insulin receptor-A and insulin-like growth factor 1 receptor and their ligands (insulin and insulin-like growth factor 1) in patients with schizophrenia or related psychosis. Hypothetically, a newly-identified insulin-insulin-like growth factor 2 (INS-IGF2) protein may be a ligand to these receptors too, and recently, significantly higher antibody reactivity was found against a part of this protein in patients with schizophrenia or related psychosis in partial than full symptom remission. The aim of this study was to map the region of the INS-IGF2 transcript that codes this part of the protein in schizophrenia and related psychosis susceptibility.</p><p><strong>Material and methods: </strong>The present INS-IGF2 region was DNA-sequenced by the Sanger method in a study population, consisting of 94 patients with schizophrenia, 11 patients with schizoaffective disorder and 58 controls.</p><p><strong>Results: </strong>Two novel SNPs were identified solely in patients, but not in controls. Tendencies towards overall differences in genotype- and allele frequencies between patients with schizophrenia or schizoaffective disorder and controls were found for SNP no 1 (p = 0.067 and p = 0.067, respectively), with the G/A-genotype and G-allele appearing more frequently in patients with schizoaffective disorder. The patient with SNP no 1 was diagnosed with both schizoaffective disorder and polycystic ovary syndrome, and the patient with SNP no 2 was diagnosed with schizophrenia, paranoid type with affective features.</p><p><strong>Conclusion: </strong>The findings in this exploratory study suggest that SNPs in the INS-IGF2 transcript may be associated with psychosis, specifically with schizoaffective disorder, and warrant replication in larger samples.</p>","PeriodicalId":94154,"journal":{"name":"Neuro endocrinology letters","volume":"47 5","pages":"338-346"},"PeriodicalIF":0.6,"publicationDate":"2026-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148834925","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":"Microbial contamination patterns in dental unit waterlines and evaluation of a centralized automated cleaning and disinfection system .","authors":"Tingting Yin, Miao He, Boyi Ma, Mingmei Zhou, Lumin Luo, Rong Tang, Jingdi Huang, Pingjing Sun, Li Wang, Qiaowen Li","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to quantitatively characterize microbial contamination patterns in dental unit waterlines (DUWLs) and to evaluate a centralized, data-driven cleaning and disinfection system in a university dental hospital.</p><p><strong>Methods: </strong>We conducted a cross-sectional survey combined with longitudinal monitoring of DUWL samples from 56 dental chairs in three clinical departments of a university hospital. One-way analysis of variance, Kruskal-Wallis tests, paired t tests, linear regression, correlation analysis, and multiple linear regression were used to evaluate interdepartmental differences, sampling site-specific contamination risk, temporal trends, and independent predictors. Based on the statistical findings, a centralized cleaning and disinfection system was designed and subsequently validated.</p><p><strong>Results: </strong>A total of 726 water samples were analyzed. Statistically significant differences in microbial colony counts were observed between departments (p < 0.001), with the Optics Valley Teeth Cleaning Center exhibiting the highest contamination levels. Significant differences were also detected among sampling points (p < 0.001), with the handpiece water outlet identified as the highest-risk location. Active dental procedures were associated with a significant increase in microbial colony counts (p < 0.001). Under conventional disinfection, contamination levels increased progressively from April to July (p < 0.01). Significant positive correlations were identified among contamination levels at different sampling points. Multiple linear regression identified month, sampling site, treatment status, and department as independent predictors of microbial contamination. Implementation of the centralized cleaning and disinfection system significantly extended the duration of compliance with established water quality standards from 1.2 ± 0.4 days to 4.1 ± 0.7 days (p < 0.001).</p><p><strong>Conclusion: </strong>We observed significant interdepartmental variation, site-specific contamination risk profiles, and clear temporal patterns in DUWL microbial contamination. The centralized cleaning and disinfection system, developed based on these statistical findings, significantly improved microbial control and prolonged compliance with water quality standards.</p>","PeriodicalId":94154,"journal":{"name":"Neuro endocrinology letters","volume":"47 5","pages":"326-332"},"PeriodicalIF":0.6,"publicationDate":"2026-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148834920","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":"Mediating Role of Coping Strategies Between Self-Perceived Burden and Disability Acceptance in Parkinson's Disease .","authors":"Qin Si, Huawei Huang","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>This study examined the associations among self-perceived burden (SPB), medical coping strategies, and acceptance of disability (AOD) and evaluated whether avoidance coping mediated the relationship between SPB and AOD in patients with Parkinson's disease (PD).</p><p><strong>Methods: </strong>A cross-sectional survey of 180 patients with PD admitted to the Department of Neurology, Lishui Hospital of Traditional Chinese Medicine between September 2024 and July 2025 was conducted to collect data on SPB, coping strategies, and AOD using validated questionnaires. Data were collected using a general information questionnaire, the SPB scale, the Medical Coping Modes Questionnaire, and the Acceptance of Disability Scale‑Revised.</p><p><strong>Results: </strong>Correlation analysis demonstrated significant associations between SPB, coping strategies, and AOD (all p < 0.01). Mediation analysis indicated that avoidance coping partially mediated the relationship between SPB and AOD, accounting for 33.84% of the total effect of SPB on AOD in the structural equation model.</p><p><strong>Conclusion: </strong>SPB and avoidance coping demonstrated predictive value for AOD in patients with PD-related disability, and avoidance coping partially mediated the association between SPB and AOD. These findings suggest that psychosocial and rehabilitation interventions should aim to reduce reliance on avoidance coping and strengthen active coping to improve disability acceptance.</p>","PeriodicalId":94154,"journal":{"name":"Neuro endocrinology letters","volume":"47 5","pages":"298-303"},"PeriodicalIF":0.6,"publicationDate":"2026-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148835879","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":"Randomized Trial of KANO Model-Based Structured Nursing to Prevent Perioperative Hypothermia in MyoSure Hysteroscopy .","authors":"Zheng Meng, Li Kang, Qiu-Ju Yan","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate, in a randomized controlled trial, the effects of KANO model-based structured nursing versus conventional care on perioperative hypothermia, comfort, and early postoperative recovery in patients undergoing MyoSure hysteroscopy.</p><p><strong>Methods: </strong>A total of 134 patients undergoing MyoSure hysteroscopy between March 2022 and March 2023 were randomly assigned (1:1) to a control group (conventional nursing, n = 67) or a study group (KANO model-based structured nursing, n = 67).</p><p><strong>Results: </strong>No significant difference was observed in operation duration (p > 0.05). The study group had a shorter time to ambulation (mean difference 2.8 hours, 95% CI 1.7 - 3.9, p < 0.001) and a lower incidence of hypothermia‑related reactions (5.97% vs 17.91%; relative risk 0.33, 95% CI 0.13 - 0.86; number needed to treat 9, 95% CI 5 - 25). In exploratory logistic regression, neither intervention method nor body temperature at surgery completion was independently associated with hypothermia‑related reactions (p > 0.05).</p><p><strong>Conclusion: </strong>In this single‑center randomized trial, KANO model‑based structured nursing was associated with better perioperative thermoregulation, higher comfort scores, higher nursing satisfaction, and shorter time to ambulation in patients undergoing MyoSure hysteroscopy.</p>","PeriodicalId":94154,"journal":{"name":"Neuro endocrinology letters","volume":"47 5","pages":"287-297"},"PeriodicalIF":0.6,"publicationDate":"2026-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148834939","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":"Integrating somatic processes into schema therapy: A theoretical and clinical framework.","authors":"Jan Prasko, Marie Ociskova, Ijisesan Perryova Racheal Temitope, Ilona Krone, Jakub Vanek, Roman Liska, Julius Burkauskas, Ieva Bite, Julija Gecaite-Stonciene, Marta Popelkova, Erika Jurisova","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>In recent decades, psychotherapy has shown increasing interest in the embodied aspects of psychological experience. This \"body turn\" reflects increasing recognition of the need to better understand individuals with complex trauma, dissociation, and personality disorders, for whom purely verbal approaches are often insufficient. Schema therapy, as an integrative model, offers a suitable framework for incorporating a somatic perspective.</p><p><strong>Objective: </strong>The aim of this paper is to provide a systematic conceptualisation of the somatic perspective in schema therapy, situate it within a broader theoretical context, and illustrate its clinical applications.</p><p><strong>Methods: </strong>This article is a narrative review integrating clinical experience, with an emphasis on conceptual synthesis rather than systematic evidence evaluation. Literature was searched in PubMed, PsycINFO, Scopus, and Web of Science, supplemented by key monographs and training materials. Clinical vignettes are included to illustrate practical applications.</p><p><strong>Results: </strong>The somatic perspective conceptualizes schemas and modes as complex patterns involving cognitive, emotional, relational, and bodily processes. The body may serve both as an early indicator of schema activation and as an entry point for therapeutic change. Within the conceptual and clinical literature reviewed here, integrating somatic interventions is proposed to enhance assessment, affect regulation, and experiential transformation, particularly in individuals with complex trauma and personality disorders.</p><p><strong>Conclusion: </strong>The somatic perspective may represent a theoretically and clinically relevant extension of schema therapy, contributing to deeper experiential integration and improved therapeutic effectiveness. Future research should focus on mechanisms of change and specific clinical indications of somatic interventions.</p>","PeriodicalId":94154,"journal":{"name":"Neuro endocrinology letters","volume":"47 5","pages":"357-377"},"PeriodicalIF":0.6,"publicationDate":"2026-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148835754","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":"Construction and Preliminary Evaluation of a Precise Perioperative Glycemic Management Model for Kidney Transplant Recipients Using Healthcare Failure Mode and Effect Analysis (HFMEA) Combined with Continuous Glucose Monitoring (CGM) and Artificial Intelligence: A Retrospective Cohort Study. .","authors":"Xiangyu Zhang, Deru Zhang, Lina Guo, Mengmeng Wang, Zheyu Wei, Jiaojiao Zhang, Haitao Zhu, Qingqing Shi","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objectives: </strong>Post-transplantation diabetes mellitus (PTDM) is a common complication after kidney transplantation and contributes to graft dysfunction and adverse cardiovascular outcomes. We conducted a preliminary evaluation of an integrated perioperative glycemic management model combining Healthcare Failure Mode and Effect Analysis (HFMEA), continuous glucose monitoring (CGM), and artificial intelligence (AI)-driven prediction in routine clinical practice.</p><p><strong>Design: </strong>Single-center retrospective cohort study with historical controls.</p><p><strong>Methods: </strong>We included 120 adult kidney transplant recipients from 2021-2024 and divided them into a historical control group (n = 60, conventional intermittent capillary glucose monitoring) and an intervention group (n = 60, HFMEA-CGM-AI integrated management). Primary outcomes were perioperative CGM-derived glycemic metrics over 14 days (time in range TIR, coefficient of variation CV, time below range TBR, mean amplitude of glycemic excursions MAGE) and 3-month PTDM incidence. Secondary outcomes included hospital length of stay and postoperative complications; patient satisfaction was assessed descriptively in the intervention group.</p><p><strong>Results: </strong>The intervention group was associated with substantially tighter perioperative glycemic control, with higher TIR (80.0 ± 9.0% vs 63.8 ± 11.6%) and lower CV, TBR, and MAGE (all p < 0.001). TIR in the intervention group exceeded recommended CGM targets (>70%). Three-month PTDM incidence was numerically lower (10.0% vs 20.0%; p = 0.201; 18 events), consistent with limited power for this endpoint and an exploratory role of PTDM in this study. Hospital stay was shorter with the integrated model (12.4 ± 2.2 vs 14.2 ± 3.3 days, p < 0.001), and postoperative complications were numerically reduced but non-significant. Patient satisfaction in the intervention group was high (mean 8.4 ± 1.1 on a 10-point scale).</p><p><strong>Conclusion: </strong>In this retrospective historical cohort, the HFMEA-CGM-AI model was feasibly implemented and was associated with improved perioperative CGM metrics and shorter hospital stay. PTDM and complication outcomes remained exploratory due to limited power and the non-randomized design. Prospective, adequately powered randomized trials are required to determine the causal impact and cost-effectiveness of this integrated HFMEA-CGM-AI management approach.</p>","PeriodicalId":94154,"journal":{"name":"Neuro endocrinology letters","volume":"47 5","pages":"347-356"},"PeriodicalIF":0.6,"publicationDate":"2026-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148835795","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":"Functional Levels of Children with Cerebral Palsy and Their Association with Family Impact and Maternal Health .","authors":"Arzu Dinc Yavas, Sumeyye Akcay, Hatice Gamze Poyrazoglu, Bahar Coruh","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objectives: </strong>To examine the relationships between gross motor function, manual ability, and functional independence in children with cerebral palsy (CP), and their associations with maternal health-related quality of life and family impact.</p><p><strong>Design: </strong>Retrospective cross-sectional chart review with blinded assessment of routinely collected outcome measures.</p><p><strong>Materials and methods: </strong>Records of 45 children with CP were screened; 23 children aged 4-13 years who met predefined eligibility criteria and their primary caregiver mothers were included in the final analysis. Children's gross motor function, manual ability, and functional independence were assessed using the Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), and Pediatric Functional Independence Measure (WeeFIM). Maternal health-related quality of life and family impact were evaluated using the Nottingham Health Profile (NHP) and Impact on Family Scale (IOFS). Associations were analysed using Spearman correlation and multiple linear regression.</p><p><strong>Results: </strong>WeeFIM showed a strong positive correlation with IOFS, whereas GMFCS showed a strong negative correlation with IOFS. NHP was negatively correlated with child age and WeeFIM. In multivariable analysis, WeeFIM was the only independent factor associated with IOFS. The correlations of IOFS with child age, maternal age, MACS, and NHP did not reach statistical significance. NHP scores were negatively correlated with child age (ρ = -0.458, p = 0.028) and WeeFIM scores (ρ = -0.535, p = 0.009). In multiple linear regression, WeeFIM remained the only significant independent factor associated with IOFS, explaining 68.6% of the variance in family impact (R² = 0.686, adjusted R² = 0.672).</p><p><strong>Conclusion: </strong>Greater functional independence in children with CP was associated with more favorable family impact and better maternal health-related quality of life. These findings support family-centred rehabilitation approaches that prioritize daily living skills and systematically address caregiver needs.</p>","PeriodicalId":94154,"journal":{"name":"Neuro endocrinology letters","volume":"47 5","pages":"317-325"},"PeriodicalIF":0.6,"publicationDate":"2026-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148835802","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":"Identification of Key Regulatory Genes Involved in Pyroptosis in Osteoarthritis Through Integrated Single-Cell Transcriptomic and Machine Learning Analysis.","authors":"Jun-Lin Chen, Yan-Hui Suo, Rui-Hai Yan","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to identify pyroptosis related genes (pyroptosis RGs) in osteoarthritis (OA) and to evaluate their potential as candidate biomarkers by integrating bulk transcriptomic analysis, machine learning, and single cell RNA sequencing.</p><p><strong>Methods: </strong>Bulk RNA sequencing datasets (GSE55235 and GSE55457) and a single cell RNA sequencing dataset (GSE216651) related to OA were obtained from the Gene Expression Omnibus database, and gene sets associated with OA and pyroptosis were retrieved from GeneCards. Differential expression analysis and weighted gene co expression network analysis (WGCNA) of GSE55235 were used to derive differentially expressed pyroptosis related genes (DEPRGs). Candidate hub genes were screened by intersecting rankings from five cytoHubba algorithms with three supervised machine learning models (least absolute shrinkage and selection operator, support vector machine-recursive feature elimination, and random forest), and their diagnostic performance was evaluated using receiver operating characteristic curve analysis in the training and validation cohorts. The potential biological roles of the identified hub genes were further examined through functional enrichment analysis, immune cell infiltration assessment, and single-cell transcriptomic profiling.</p><p><strong>Results: </strong>Twenty-one DEPRGs were identified. Among these, interleukin 8 (CXCL8) and NF kappa B inhibitor alpha (NFKBIA) emerged as central hub genes with consistent diagnostic performance across cohorts. Functional enrichment analyses indicated that these genes are primarily implicated in inflammatory signaling and immune regulation pathways, including responses to tumor necrosis factor and lipopolysaccharide, chemokine and cytokine activity, and Toll like receptor, TNF, and IL 17 signaling. Single-cell transcriptomic analysis demonstrated predominant expression of CXCL8 and NFKBIA in synovial macrophages. In these cells, expression of both genes was positively correlated with pyroptosis scores, and macrophages displayed the highest pyroptosis activity among the analyzed synovial cell populations in OA.</p><p><strong>Conclusion: </strong>CXCL8 and NFKBIA were identified as synovium associated pyroptosis related genes in OA with promising diagnostic performance in public datasets. These in silico findings refine current understanding of OA related inflammatory pathways and generate hypotheses for future mechanistic and experimental studies.</p>","PeriodicalId":94154,"journal":{"name":"Neuro endocrinology letters","volume":"47 5","pages":"304-316"},"PeriodicalIF":0.6,"publicationDate":"2026-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148835774","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":"A Rare Presentation of X-Linked Primary Ciliary Dyskinesia Due to Xq22.3 Deletion .","authors":"Li Yan, Yan Su, He Li","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Primary ciliary dyskinesia (PCD) is a rare genetic disorder caused by mutations affecting the structure or function of motile cilia, with more than 50 causative genes identified to date. PCD is predominantly inherited in an autosomal recessive manner; however, X-linked recessive inheritance is exceptionally rare.</p><p><strong>Case presentation: </strong>We report a male pediatric patient with recurrent pulmonary infections, chronic sinusitis, and situs inversus. Genetic analysis identified an approximately 720.3 kb hemizygous deletion in the Xq22.3 region, consistent with a rare X-linked recessive form of PCD.</p><p><strong>Conclusion: </strong>This case highlights the importance of genetic testing for identifying rare PCD variants, facilitating early diagnosis and informing clinical management to improve long‑term outcomes.</p>","PeriodicalId":94154,"journal":{"name":"Neuro endocrinology letters","volume":"47 5","pages":"333-337"},"PeriodicalIF":0.6,"publicationDate":"2026-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148835730","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":"Ventriculoperitoneal Shunt Infection in Severely Disabled Adults: Association of a Modified Tracheostomy Focused Surgical Protocol with Reduced Infection Rates.","authors":"Jian-Jun Wang, Yu Wang, Wei Sun, Shuang Chen, Jian-Yun Zhou","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Ventriculoperitoneal shunt (VPS) infection is a serious complication following shunt placement for hydrocephalus, particularly in patients with severe neurological impairment who require prolonged rehabilitation and invasive supportive devices such as tracheostomy and nasogastric feeding.</p><p><strong>Objective: </strong>This study aimed to determine the incidence of VPS infection in a severely disabled adult hydrocephalus cohort and to evaluate the association between a modified surgical technique and VPS infection, alongside other potential risk factors. The findings were intended to guide the refinement and ongoing optimization of our department's standardized surgical protocols to further reduce infection risk.</p><p><strong>Methods: </strong>We conducted a single centre retrospective before-after cohort study of 284 adults undergoing first time VPS between 2022 and 2024, comparing patients treated with the conventional technique (n = 168) and those treated after implementation of a modified, tracheostomy focused surgical protocol (n = 116). All patients were followed for 12 months, and predefined clinical, laboratory, and procedural variables were extracted from medical records.</p><p><strong>Results: </strong>A total of 284 patients with hydrocephalus who were followed up for at least one year were included in the study. VPS infection occurred in 35 of 284 patients (12.3%), with 29 of 35 infections (82.8%) arising within 3 weeks of surgery. Infection rates were 17.9% (30/168) in the conventional group and 4.3% (5/116) in the modified protocol group (absolute risk reduction 13.6%), corresponding to approximately one infection prevented for every 7-8 patients treated with the modified technique (χ² = 11.654, p < 0.001). No other predefined patient related or shunt related factors showed a significant association with infection.</p>","PeriodicalId":94154,"journal":{"name":"Neuro endocrinology letters","volume":"47 4","pages":"195-203"},"PeriodicalIF":0.6,"publicationDate":"2026-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148474989","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}