Postgraduate medicine最新文献

{"title":"Development of respiratory allergic diseases according to cow's milk protein allergy mechanisms.","authors":"Büşra Demirci, Özge Yılmaz Topal, İrem Turgay Yağmur, Emine Dibek Mısırlıoğlu","doi":"10.1080/00325481.2025.2502312","DOIUrl":"10.1080/00325481.2025.2502312","url":null,"abstract":"<p><strong>Background: </strong>Cow's milk protein allergy (CMPA) is early life's most common food allergy. There is limited data on the development of respiratory allergies in childhood for infants with CMPA.</p><p><strong>Objective: </strong>This study aimed to evaluate the development of respiratory allergic diseases in childhood according to the mechanism of CMPA in patients with CMPA in the first two years of life.</p><p><strong>Methods: </strong>Patients who were diagnosed with CMPA in the first two years of life and were over five years old during the study period were included in the study. The sociodemographic, clinical, and laboratory data of patients were recorded, and the status of respiratory allergic disease development in patients was assessed using the ISAAC questionnaire.</p><p><strong>Results: </strong>A total of 301 patients were included in the study; 182 (60.5%) were male. Most of the patients had mixed-type (87;28.9%) and had non-IgE-mediated (n:87;28.9%) CMPA. Of CMPA cases, 27.9% developed doctor-diagnosed asthma and 31.2% developed doctor-diagnosed allergic rhinitis. Doctor-diagnosed asthma was observed mostly with IgE-mediated CMPA (n:30;37%), and doctor-diagnosed allergic rhinitis was observed mostly with non-IgE-mediated CMPA (n:32;36.8%), and these differences were not statistically significant (<i>p</i> = 0.094, <i>p</i> = 0.385). Also, maternal asthma increased the risk of doctor-diagnosed asthma, while parental consanguinity, allergic rhinitis in mother/sibling, and paternal eczema were risk factors for doctor-diagnosed allergic rhinitis.</p><p><strong>Conclusion: </strong>In this study, 27.9% of patients with CMPA in the first two years of life developed doctor-diagnosed asthma, and 31.2% developed allergic rhinitis. There was no difference in the frequency of occurrence based on the mechanism of CMPA development.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"416-422"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059629","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 effect of intrapartum care model given in line with World Health Organization (WHO) recommendations on labor pain, fear of labor, comfort of labor, duration of labor, administration of oxytocin and perception of midwifery care: a randomized controlled study.","authors":"Kübra Mangır Meler, Seyhan Çankaya","doi":"10.1080/00325481.2025.2501943","DOIUrl":"10.1080/00325481.2025.2501943","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to assess the impact of a WHO-aligned intrapartum care model on labor aspects, including pain, fear, comfort, labor duration, oxytocin use, and perceptions of supportive care.</p><p><strong>Methods: </strong>This is a randomized controlled study. The study was conducted with 124 primiparous pregnant women (intervention group <i>n</i> = 62, control group <i>n</i> = 62) who were admitted to the maternity unit of a hospital in Central Anatolia, Türkiye. The intervention group was subjected to the intrapartum care model, once cervical dilatation reached 5 cm. The control group received only standard intrapartum care in the hospital.</p><p><strong>Results: </strong>The Visual Analog Scale (VAS) scores for the pregnant women in the intervention group who received intrapartum care in accordance with WHO recommendations were significantly lower than those for the control group (<i>p</i> < 0.001). The pregnant women in the intervention group exhibited lower fear of labor scores and higher comfort of labor scores during the active phase than those in the control group (<i>p</i> < 0.001). Furthermore, the duration of the first, second, and third stages of labor was observed to be significantly shorter in the intervention group compared to the control group (<i>p</i> < 0.001). Additionally, the use of oxytocin was found to be less prevalent in the intervention group compared to the control group (<i>p</i> < 0.001). Furthermore, the mean scores of the scale measuring women's perception of supportive care during labor were found to be significantly higher in the intervention group compared to the control group (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>In alignment with these findings, it is recommended that midwives and obstetricians implement the intrapartum care model in accordance with the World Health Organization's (WHO) recommendations. The implementation of this model aims to reduce labor pain, fear, and oxytocin use, enhance women's perception of birth comfort and care, and transform the birth experience into a more positive one.</p><p><strong>Clinical trial registration: </strong>www.clinicaltrials.gov identifier NCT06681675.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"379-395"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061313","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":"Impact of methotrexate monotherapy in patients with idiopathic granulomatous mastitis.","authors":"Mehmet Nur Kaya, Emre Tekgöz, Seda Çolak, Özlem Kılıç, Muhammet Çınar, Sedat Yılmaz","doi":"10.1080/00325481.2025.2502322","DOIUrl":"10.1080/00325481.2025.2502322","url":null,"abstract":"<p><strong>Objectives: </strong>Idiopathic granulomatous mastitis (IGM) is a rare benign inflammatory disease of the breast. It is characterized by chronic inflammation and granuloma formation. We designed this study to assess the compliance and remission status of patients with IGM on methotrexate treatment.</p><p><strong>Methods: </strong>The study included 114 patients who were treated with methotrexate for at least 1 year after a biopsy-proven diagnosis of IGM at a tertiary rheumatology center between January 2017 and February 2024. Demographic characteristics, clinical findings, laboratory parameters, treatment options and patient compliance with treatment were obtained from patient files.</p><p><strong>Results: </strong>The mean age of patients diagnosed with IGM was 32.3 ± 6.3 years. Patients were treated with a combination of methotrexate, and complete remission was achieved in 97 patients (85.1%) after an average of one year. When Kaplan-Meier analysis was performed for the average annual methotrexate use, the average duration of drug use in patients with IGM was found to be 11.24 (10.88-11.49) months.</p><p><strong>Conclusion: </strong>The use of methotrexate treatment in IGM patients has been shown to be both successful and well tolerated when evaluated according to the duration of drug administration.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"404-407"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039318","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":"Impact of surgical intervention on obstructive sleep apnea (OSA) and body-mass index: a scoping review.","authors":"Liang Chye Goh, Ein Wan Chin, Benjamin Kye Jyn Tan, Esther Yanxin Gao, Sheron Sir Loon Goh, Ranita Hisham Shunmugam, Jeyanthi Kulasegarah, Mohd Zulkiflee Abu Bakar, Song Tar Toh","doi":"10.1080/00325481.2025.2506981","DOIUrl":"10.1080/00325481.2025.2506981","url":null,"abstract":"<p><strong>Background: </strong>Upper airway surgery for obstructive sleep apnea (OSA) offers an alternative to CPAP, but its impact on weight changes is poorly studied.</p><p><strong>Purpose: </strong>To systematically review published literature on the relationship between surgical intervention for OSA and changes in body mass index (BMI).</p><p><strong>Methods: </strong>A literature search was conducted from 2013-2024 in five databases. Full-text English articles which examined BMI changes in adults with OSA pre- and post-surgery were included. The quality of each study was assessed independently by two researchers using the Newcastle-Ottawa Scale. This study was reported according to the PRISMA-ScR.</p><p><strong>Results: </strong>Eleven studies, involving 406 patients from six countries were included. Most patients were males (88.4%) with a mean age of 40 years old. The pre-operative BMI were higher [27.8 kg/m² (SD = 2.6)] compared to a BMI of 27.7 kg/m² (SD = 1.3) at 21.0 months post-operation. The pre-operative Epworth Sleepiness Score was 13.28 (SD = 6.36), while the apnea-hypopnea index was 41.2 (SD = 16.88), indicating that most patients were diagnosed with severe OSA. The average oxygen desaturation index was 35.63 (SD = 11.17). The meta-analysis showed no significant BMI changes after surgery (mean difference:-0.29; 95% CI:-0.80 to 0.21; I² = 30%). Findings were consistent with no publication bias found.</p><p><strong>Conclusions: </strong>Upper airway surgery for OSA does not significantly affect BMI. The authors propose closer monitoring of weight changes following upper airway surgery, as weight fluctuations can impact the outcomes of surgery. Unchanged weight post-surgery may be attributed to suboptimal OSA treatment.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"344-351"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082548","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":"Clinical features and management strategies of acute soluble barium poisoning: a review of case reports.","authors":"Jiacheng Wu, Zhenning Liu","doi":"10.1080/00325481.2025.2511340","DOIUrl":"10.1080/00325481.2025.2511340","url":null,"abstract":"<p><p>Soluble barium salts including barium carbonate, nitrate, acetate, and chloride are commonly used in the manufacture of ceramics, insecticides, and rodenticides. Soluble barium salts are highly toxic to humans if ingested. Acute soluble barium poisoning is an uncommon but life-threatening problem. The fatal dose of barium chloride for man has been reported to be only 0.8 to 0.9 gram. Currently, there have been no systematic studies on acute soluble barium poisoning. Based on the retrospective analysis of 55 global cases, toxicological characteristics, clinical features and management of acute soluble barium poisoning were summarized. Barium is a competitive blocker of potassium inward rectifier channels to inhibit K⁺ efflux, resulting in profound hypokalemia. Acute soluble barium poisoning can result in gastrointestinal effects including vomiting and diarrhea, followed by hemodynamic disturbances, cardiac arrhythmias, muscle weakness, and cardiac arrest. Respiratory failure induced by muscle paralysis is the major cause of death. Management strategies mainly include prevention of barium absorption, administration of soluble sulfates, potassium supplementation, antiarrhythmic medications, hemodialysis/CVVHDF, and cardiorespiratory support. Timely administration of decontamination and correction of hypokalemia are the two important points. This narrative review will offer crucial information for treating patients with acute soluble barium poisoning.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"338-343"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144133355","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":"Newborn screening programs promote vaccine acceptance among parents in Turkey: a cross-sectional study.","authors":"İzzet Erdal, Ayça Burcu Kahraman, Yılmaz Yıldız, Siddika Songül Yalçın","doi":"10.1080/00325481.2025.2504866","DOIUrl":"10.1080/00325481.2025.2504866","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;Newborn screening and childhood immunization are among the most successful public health initiatives. Turkey has a high vaccination coverage (95-99%), but a recent decline is concerning. Vaccine hesitancy (VH) is a growing global issue, identified by the WHO as a major public health threat. Given that VH may correlate with attitudes toward other health practices, we explored whether early engagement with the health system via newborn screening influences childhood vaccine acceptance. Although these programs are implemented separately but concurrently as part of the national healthcare system in Turkey, integrating newborn screening and immunization initiatives may increase vaccine uptake through early engagement and trust building. This study aims to evaluate the relationship between newborn screening and parental vaccine hesitancy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This study was conducted at a tertiary care center in Turkey from July 2023 to April 2024. Parental VH was assessed using the PACV scale, along with questions on demographics and parental vaccination status. Participants with PACV score ≥ 50 were classified as VH+, others as VH-. Groups were compared using t-tests, Mann - Whitney U, chi-squared, or Fisher's exact tests. Multiple logistic regression was used to analyze related factors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;This analytic descriptive study included 481 parents (125 with children diagnosed with biotinidase deficiency or PKU via newborn screening, and 356 with healthy children aged 2-6). The mean age of respondents was 35 years, and the majority were mothers with a college education. The main sources of vaccine information were health professionals, followed by social media and family. Overall, 19.8% of parents were vaccine-hesitant, with a lower rate in the patient group (12% vs. 22.5%). VH was higher in fathers with chronic diseases (35.1% vs 18.1%, &lt;i&gt;p&lt;/i&gt; = .012) and was lower in mothers received tetanus vaccine during pregnancy (16.1% vs. 30.6%, &lt;i&gt;p&lt;/i&gt; = .001) or parents who received COVID-19 vaccine (mothers: 13.9% vs. 50.6%, fathers: 14.8% vs. 49.2%, both &lt;i&gt;p&lt;/i&gt; &lt; .001). VH was lower in those consulting healthcare professionals and higher in those relying on social media or non-medical sources. Diagnosis and treatment through newborn screening had an effect of 0.47 odds on VH in the overall group (95% CI = 0.24-0.92, &lt;i&gt;p&lt;/i&gt; = .028).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This study found lower vaccine hesitancy among participants in newborn screening programs and those whose parents received adult vaccinations, potentially due to increased contact with health professionals and greater health-seeking behavior. The influence of social media on vaccine hesitancy, evident in the general population, was not observed among cases, suggesting that systematic follow-up may buffer against external risk factors. Studies with matched cohorts, real-time data collection, and anonymous surveys are needed","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"423-438"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046808","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":"Treatment burden and its impact on residual cardiovascular risk in community-dwelling older adults with cardiometabolic multimorbidity: an exploratory cross-sectional study.","authors":"Yang Gao, Yang Li, Ying Zhang, Hua Jiang","doi":"10.1080/00325481.2025.2510894","DOIUrl":"10.1080/00325481.2025.2510894","url":null,"abstract":"<p><strong>Background and aims: </strong>Cardiometabolic multimorbidity (CMM), defined as ≥ 2 coexisting cardiometabol ic diseases, contributes significantly to global disease burden in older adults. Treatment burden and inflammation-related residual cardiovascular risk in this population remain poorly characterized. This study aimed to quantify treatment burden in community-dwelling older adults with CMM and explore its association with inflammatory indicators.</p><p><strong>Methods: </strong>A random sample of 170 CMM patients (age ≥60 years) from a Shanghai community completed questionnaires, such as the Treatment Burden Questionnaire (TBQ), and underwent laboratory tests. The participants were stratified according to their treatment burden and then compared in terms of demographics, lifestyle, number of cardiometabolic diseases, medication usage, and cardiometabolic and inflammatory indicators (monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR), and systemic immune-inflammation index (SII)). Linear regression models and restricted cubic splines were employed to examine the associations of treatment burden with inflammatory indicators.</p><p><strong>Results: </strong>Among participants, 37.65% (64/170) reported high treatment burden (TBQ >59). The high TBQ group exhibited poorer medication adherence (39.06% vs. 24.53%) and higher inflammatory indicators (MLR: 0.24 vs. 0.19; NLR: 1.86 vs. 1.43; SII: 352.55 vs. 276.26). No significant differences were observed in cardiometabolic indicators (except for creatinine) or medication counts. Each 10-point TBQ increase was associated with higher MLR (β = 0.01), NLR (β = 0.11), and SII (β = 18.76) in adjusted models. Non-linear associations were observed between TBQ and NLR/SII.</p><p><strong>Conclusion: </strong>Over one-third of elderly CMM patients experience high treatment burden linked to inflammation-driven residual cardiovascular risk. Early treatment burden assessment and anti-inflammatory strategies may improve their prognosis in primary care.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"396-403"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129873","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":"Significance of relative fat mass to estimate prevalent prehypertension and hypertension in the general population.","authors":"Shan Li, Zhi Du, Heng Chen, Liding Zhao, Pei Zhou, Xuan Zhang, Safraz Anwar, Jialan Lv, Zhicheng Pan, Xiaogang Guo","doi":"10.1080/00325481.2025.2502317","DOIUrl":"10.1080/00325481.2025.2502317","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the relationship between relative fat mass (RFM) with prehypertension and hypertension in general population.</p><p><strong>Methods: </strong>This investigation was a cross-sectional study that recruited 4,885 community-dwelling residents from Zhejiang Province in September 2023 to November 2023. The logistic regression and penalized spline method were applicated to determine the correlation between RFM with prehypertension and hypertension. The interaction effects and subgroups analyses were further conducted to estimate the stability of the aforesaid findings. Besides, the category-free analysis was performed to demonstrate whether the addition of the RFM levels to the traditional model could improve the risk classification of prehypertension and hypertension.</p><p><strong>Results: </strong>The prevalence of prehypertension and hypertension were, respectively, 64.8%. Multivariable logistic regression indicated that the risk of prehypertension (hazard ratio, 1.99; 95% confidence interval, 1.63-2.44) and hypertension (3.41; 2.81-4.14), respectively, increased by 99% and 241% per standard deviation increase in RFM after adjusting for established risk factors. Taking the participants in the lowest RFM quartile as the reference, and those with the highest quartile had a significantly increased risk of prehypertension (5.26; 3.03-9.12) and hypertension (20.42; 11.84-35.22). The restricted cubic splines demonstrated aforesaid associations were linear, and interaction and subgroup analysis observed the stability of these findings. The category-free analysis suggested that the addition of RFM to the traditional model eventuated an improvement in predictive ability of prehypertension and hypertension.</p><p><strong>Conclusions: </strong>Our results corroborated the positive association between RFM with prehypertension and hypertension. Clinically, the calculation of RFM should be emphasized in the risk assessment of hypertension and prehypertension.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"408-415"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047636","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":"All-cause mortality among primary care patients with type 2 diabetes: a prospective cohort study.","authors":"David Martín-Enguix, Juan Carlos Aguirre Rodríguez, Abraham Hidalgo Rodríguez, María Sánchez Cambronero, María Nieves Generoso Torres, María Guisasola Cárdenas, Alicia González Bravo, Carl J Lavie, Francisco J Amaro-Gahete","doi":"10.1080/00325481.2025.2510709","DOIUrl":"10.1080/00325481.2025.2510709","url":null,"abstract":"<p><strong>Objectives: </strong>This research aimed to investigate the factors contributing to mortality in patients with type 2 diabetes (T2D) to identify the primary determinants that exacerbate mortality risks in this population.</p><p><strong>Methods: </strong>In this cohort study, 297 T2D patients from an urban Spanish population were monitored over 49 months to assess survival. The study collected sociodemographic and clinical data, including cardiovascular risk factors and initial treatments, to examine their impact on patient survival.</p><p><strong>Results: </strong>Of the initial 291 T2D patients, 60.1% were over 65y, with a male majority (53.3%) and average T2D duration of 8.8 years. In the 4-year follow-up, 15.4% of the patients died, predominantly due to cardiovascular disease (33.3%) and cancer (31.1%). In multivariate analysis, age (Hazard Ratio [HR] 1.169, <i>p</i> = 0.002) and body mass index (BMI; HR 0.807, <i>p</i> = 0.039) were identified as potential modulators of such relationships.</p><p><strong>Conclusion: </strong>The present study reveals that cardiovascular disease, closely followed by cancer, are the leading causes of mortality in a Spanish T2D patients' cohort over a 4-year follow-up. In addition to age - which, as expected, was clearly associated with higher mortality - BMI was inversely associated with mortality, supporting the existence of an obesity paradox in T2D.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"359-367"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129871","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":"Unlocking the diagnostic potential of parathormone washout: a path to accurate parathyroid tumor localization.","authors":"Ekin Yiğit Köroğlu, Berna Evranos Öğmen, Belma Tural Balsak, Mustafa Ömer Yazicioğlu, Cevdet Aydin, Oya Topaloğlu, Reyhan Ersoy, Bekir Çakir","doi":"10.1080/00325481.2025.2506983","DOIUrl":"10.1080/00325481.2025.2506983","url":null,"abstract":"<p><strong>Objective: </strong>Accurate tumor localization is necessary for the application of minimally invasive surgery, which is preferred in the treatment of primary hyperparathyroidism. Parathormone-washout (PTH-WO) is parathyroid fine-needle aspiration followed by PTH measurement in the needle washout fluid. This study aimed to determine appropriate cutoff values for the PTH-WO method.</p><p><strong>Methods: </strong>A total of 402 PTH-WO assays from 339 patients were included in the study. The diagnostic accuracy of the test was assessed by accepting as a positive result a PTH-WO result higher than the serum PTH level [PTH-WO/serum PTH(PTH ratio)>1]. In addition, a cutoff value for the test was established by evaluating the PTH washout results obtained in comparison with postoperative histopathology. Undiluted test results were not included to obtain a clear numerical value in this evaluation. The results of parathyroid scintigraphy and fine needle aspiration biopsy (FNAB) were compared with postoperative histopathology.</p><p><strong>Results: </strong>While 309 (76.86%) of the PTH-WO procedures were considered positive, 93 (23.13%) were considered negative if the PTH ratio was > 1. When these results were compared with the postoperative histopathology, the test's sensitivity was 92.51%, and the specificity was 100.00%. In the analysis of the remaining 292 PTH-WO samples after excluding the undiluted ones, the sensitivity and specificity of the method were 92.3% and 94.1%, respectively, with a PTH ratio > 0.99. With a cutoff value of 99.5 ng/l for PTH-WO value, 93.1% sensitivity and 94.3% specificity were obtained. The sensitivities of parathyroid scintigraphy and FNAB were 53.4% and 15.3%, respectively.</p><p><strong>Conclusions: </strong>The PTH-WO method is safe and cheap, with high sensitivity and specificity in localizing parathyroid tumor. In cases where radiological methods cannot achieve localization with specified cutoff values, it has high diagnostic accuracy.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"439-446"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082846","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}