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Kabatas S, Civelek E, Savrunlu EC, Karaaslan U, Yıldız Ö, Karaöz E. Advances in the treatment of autism spectrum disorder: Wharton jelly mesenchymal stem cell transplantation. World J Methodol 2025; 15:95857. [DOI: 10.5662/wjm.v15.i1.95857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2024] [Revised: 06/23/2024] [Accepted: 08/02/2024] [Indexed: 09/29/2024] [Imported: 09/29/2024] Open
Abstract
BACKGROUND Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder with multifaceted origins. In recent studies, neuroinflammation and immune dysregulation have come to the forefront in its pathogenesis. There are studies suggesting that stem cell therapy may be effective in the treatment of ASD.
AIM To evolve the landscape of ASD treatment, focusing on the potential benefits and safety of stem cell transplantation.
METHODS A detailed case report is presented, displaying the positive outcomes observed in a child who underwent intrathecal and intravenous Wharton’s jelly-derived mesenchymal stem cells (WJ-MSCs) transplantation combined with neurorehabilitation.
RESULTS The study demonstrates a significant improvement in the child’s functional outcomes (Childhood Autism Rating Scale, Denver 2 Developmental Screening Test), especially in language and gross motor skills. No serious side effects were encountered during the 2-year follow-up.
CONCLUSION The findings support the safety and effectiveness of WJ-MSC transplantation in managing ASD.
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Deniz HA, Polat Balkan E, İncebeyaz B, Kamburoğlu K. Effect of gamification applications on success of dentistry students. World J Methodol 2025; 15:97374. [DOI: 10.5662/wjm.v15.i1.97374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 07/03/2024] [Accepted: 08/05/2024] [Indexed: 09/29/2024] [Imported: 09/29/2024] Open
Abstract
BACKGROUND Gamification, the use of game materials in education, has been used in several scientific fields, and studies have demonstrated its effectiveness in student comprehension.
AIM To evaluate whether the success of 4th- and 5th-grade dentistry students increases when using the gamification applications Kahoot! and Mentimeter.
METHODS An experimental design was used to measure the effect of gamification applications on students who were taught using the traditional method. For this purpose, Mentimeter and Kahoot! applications were used in this experimental study. Three groups of 4th- and 5th-grade students were formed: Mentimeter, Kahoot!, and control groups. The effect of gamification applications on achievement was evaluated by administering a post-test to these groups after the instructional process. One-way analysis of variance and t-tests were used for statistical analyses.
RESULTS A total of 35.5% of the students were in the Mentimeter group, 29.8% in the Kahoot! group, and 34.6% in the control group. Of the total number of students, 54.8% were female and 45.2% were male, while 52.2% were 5th-grade students and 47.8% were 4th-grade students. The overall grade point average was found to be 66.65 (range, 24-100). There was a statistically significant difference in average success scores between students of different groups (P = 0.003 < 0.05) and grades (P = 0.036 < 0.05). The average success score was the highest in the Mentimeter group (71.64) and the lowest in the Kahoot! group (62.15). In the control group, this score was 65.41. The average success score was higher for students in the 5th-grade (68.16) and for female students (68.84).
CONCLUSION Gamification has a great potential in the education of dentomaxillofacial radiology students. Mentimeter outperformed both the Kahoot! and the traditional method in terms of average student success rates.
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Mahatme C, Kaushik M, Saravanan VR, Kumar K, Shah VM. Macular microvascular and structural changes on optical coherence tomography angiography in atypical optic neuritis. World J Methodol 2025; 15:98482. [DOI: 10.5662/wjm.v15.i1.98482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Revised: 08/01/2024] [Accepted: 08/13/2024] [Indexed: 09/29/2024] [Imported: 09/29/2024] Open
Abstract
BACKGROUND Atypical optic neuritis, consisting of neuromyelitis optica spectrum disorders (NMOSD) or myelin oligodendrocyte glycoprotein antibody disease (MOGAD), has a very similar presentation but different prognostic implications and long-term management strategies. Vascular and metabolic factors are being thought to play a role in such autoimmune neuro-inflammatory disorders, apart from the obvious immune mediated damage. With the advent of optical coherence tomography angiography (OCTA), it is easy to pick up on these subclinical macular microvascular and structural changes.
AIM To study the macular microvascular and structural changes on OCTA in atypical optic neuritis.
METHODS This observational cross-sectional study involved 8 NMOSD and 17 MOGAD patients, diagnosed serologically, as well as 10 healthy controls. Macular vascular density (MVD) and ganglion cell + inner plexiform layer thickness (GCIPL) were studied using OCTA.
RESULTS There was a significant reduction in MVD in NMOSD and MOGAD affected as well as unaffected eyes when compared with healthy controls. NMOSD and MOGAD affected eyes had significant GCIPL thinning compared with healthy controls. NMOSD unaffected eyes did not show significant GCIPL thinning compared to healthy controls in contrast to MOGAD unaffected eyes. On comparing NMOSD with MOGAD, there was no significant difference in terms of MVD or GCIPL in the affected or unaffected eyes.
CONCLUSION Although significant microvascular and structural changes are present on OCTA between atypical optic neuritis and normal patients, they could not help in differentiating between NMOSD and MOGAD cases.
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Prakash S, Vadodaria V, Chawda N, Shah CS, Prakash A. Restless head syndrome: A retrospective study. World J Methodol 2025; 15:97171. [DOI: 10.5662/wjm.v15.i1.97171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 07/07/2024] [Accepted: 07/15/2024] [Indexed: 09/29/2024] [Imported: 09/29/2024] Open
Abstract
BACKGROUND Restless legs syndrome (RLS) is characterized by an urge to move with an unpleasant sensation in the lower limbs. RLS typically affects the legs. However, it can also affect several other body regions, such as the arms, abdomen, face, neck, head, and genital area. There are only a few reports of the RLS variant affecting the head.
AIM To assess the epidemiological, clinical, and other aspects of the RLS variant affecting the head.
METHODS We conducted a retrospective study of 17 adult patients (> 18 years) who met the RLS criteria and simultaneously experienced RLS-like symptoms in the head.
RESULTS The median age at which symptoms appeared was 41.6 years. Males and females were equally affected (1.1:1). All 17 patients had uncomfortable sensations in the lower legs. Insomnia or disturbed sleep was the most common comorbidity (n = 16, 88.2%). However, headache was the most common presenting or primary symptom (n = 10, 70.5%). Dizziness or an abnormal sensation in the head was the second most common presenting symptom (5 patients, 29.4%). Other presenting features were leg pain, backache, and generalized body pain. All patients responded favorably to dopaminergic medications.
CONCLUSION If RLS-related unpleasant sensations and pain are felt in the head, they may be misinterpreted as headache, dizziness, or psychosomatic symptoms. RLS and headaches in a subset of patients may be two phenotypic manifestations of the same disorder.
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Pitsilos C, Papadopoulos P, Givissis P, Chalidis B. Pulmonary embolism after shoulder surgery: Is it a real threat? World J Methodol 2025; 15:98343. [DOI: 10.5662/wjm.v15.i1.98343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2024] [Revised: 08/22/2024] [Accepted: 08/29/2024] [Indexed: 09/29/2024] [Imported: 09/29/2024] Open
Abstract
Pulmonary embolism (PE) is a rare but devastating complication of shoulder surgery. Apart from increased morbidity and mortality rates, it may significantly impair postoperative recovery and functional outcome. Its frequency accounts for up to 5.7% of all shoulder surgery procedures with a higher occurrence in women and patients older than 70 years. It is most commonly associated with thrombophilia, diabetes mellitus, obesity, smoking, hypertension, and a history of malignancy. PE usually occurs secondary to upper or lower-extremity deep vein thrombosis (DVT). However, in rare cases, the source of the thrombi cannot be determined. Prophylaxis for PE following shoulder surgery remains a topic of debate, and the standard of care does not routinely require prophylactic medication for DVT prophylaxis. Early ambulation and elastic stockings are important preventative measures for DVT of the lower extremity and medical agents such as aspirin, low-molecular-weight heparin, and vitamin K antagonists are indicated for high-risk patients, long-lasting operations, or concomitant severe acute respiratory syndrome coronavirus 2 infection. The most common symptoms of PE include chest pain and shortness of breath, but PE can also be asymptomatic in patients with intrinsic tolerance of hypoxia. Patients with DVT may also present with swelling and pain of the respective extremity. The treatment of PE includes inpatient or outpatient anticoagulant therapy if the patient is hemodynamically unstable or stable, respectively. Hemodynamic instability may require transfer to the intensive care unit, and cardiovascular arrest can be implicated in fatal events. An important issue for patients with PE in the postoperative period after shoulder surgery is residual stiffness due to a delay in rehabilitation and a prolonged hospital stay. Early physiotherapy and range-of-motion exercises do not adversely affect the prognosis of PE and are highly recommended to preserve shoulder mobility and function.
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Chauhan S, Chauhan R, Bhasin P, Sharaf BG. Present status and future directions: Apexification. World J Methodol 2025; 15:96923. [DOI: 10.5662/wjm.v15.i1.96923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2024] [Revised: 08/09/2024] [Accepted: 08/21/2024] [Indexed: 09/29/2024] [Imported: 09/29/2024] Open
Abstract
The success rate of apexification is primarily determined by multiple factors, including the material used, the size of the open apex compared to the length of the root, and the technique used in each case. The main objective of this review was to provide an update on the present management of open apex to identify factors and circumstances that may influence the success of apexification using different materials and techniques. Future research on apexification should focus on how to treat open apices with wide periapical lesions without surgery. Previously, the predictability of these parameters with non-surgical procedures was uncertain, but now, with the use of a dental operating microscope, it has become more predictable. Another reason could be that extra visits are no longer required due to major advances in the armamentarium and materials used for apexification.
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Nashwan AJ. Harnessing artificial intelligence for identifying conflicts of interest in research. World J Methodol 2025; 15:98376. [DOI: 10.5662/wjm.v15.i1.98376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Revised: 08/05/2024] [Accepted: 08/08/2024] [Indexed: 09/29/2024] [Imported: 09/29/2024] Open
Abstract
This editorial explores the transformative potential of artificial intelligence (AI) in identifying conflicts of interest (COIs) within academic and scientific research. By harnessing advanced data analysis, pattern recognition, and natural language processing techniques, AI offers innovative solutions for enhancing transparency and integrity in research. This editorial discusses how AI can automatically detect COIs, integrate data from various sources, and streamline reporting processes, thereby maintaining the credibility of scientific findings.
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Jamal A, Singh S, Qureshi F. Synthetic data as an investigative tool in hypertension and renal diseases research. World J Methodol 2025; 15:98626. [DOI: 10.5662/wjm.v15.i1.98626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2024] [Revised: 08/15/2024] [Accepted: 08/29/2024] [Indexed: 09/29/2024] [Imported: 09/29/2024] Open
Abstract
There is a growing body of clinical research on the utility of synthetic data derivatives, an emerging research tool in medicine. In nephrology, clinicians can use machine learning and artificial intelligence as powerful aids in their clinical decision-making while also preserving patient privacy. This is especially important given the epidemiology of chronic kidney disease, renal oncology, and hypertension worldwide. However, there remains a need to create a framework for guidance regarding how to better utilize synthetic data as a practical application in this research.
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Stifter S, McCaffrey J, Nichols T, Ozcan Edeer A, Ward J. Effect of external and internal cues on core muscle activation during the Sahrmann five-level core stability test. World J Methodol 2025; 15:92943. [DOI: 10.5662/wjm.v15.i1.92943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 08/16/2024] [Accepted: 08/26/2024] [Indexed: 09/29/2024] [Imported: 09/29/2024] Open
Abstract
BACKGROUND Pain in the back or pelvis or fear of back pain may affect the timing or co-contraction of the core muscles. In both static and dynamic movements, the Sahrmann core stability test provides an assessment of core muscle activation and a person's ability to stabilize the lumbopelvic complex. Preparatory cues and images can be used to increase the activation of these muscles. To attain optimal movement patterns, it will be necessary to determine what cueing will give the most effective results for core stability.
AIM To investigate the effects of external and internal cues on core muscle activation during the Sahrmann five-level core stability test.
METHODS Total 68 participants (21.83 ± 3.47 years) were randomly allocated to an external (n = 35) or internal cue group (n = 33). Participants performed the Sahrmann five-level core stability test without a cue as baseline and the five-level stability exercises with an internal or external cue. External cue group received a pressure biofeedback unit (PBU), and the internal cue group received an audio cue. A Delsys TrignoTM surface electromyography unit was used for muscle activation from the rectus abdominis, external oblique, and transverse abdominis/internal oblique muscles.
RESULTS Linear mixed effects model analysis showed that cueing had a significant effect on core muscle activation (P = 0.001); however, there was no significant difference between cue types (internal or external) (P = 0.130).
CONCLUSION Both external and internal cueing have significant effects on core muscle activation during the Sahrmann five-level core stability test and the PBU does not create higher muscle activation than internal cueing.
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Fatakhova K, Inayat F, Ali H, Patel P, Rehman AU, Afzal A, Sarfraz M, Sarfraz S, Nawaz G, Chaudhry A, Dhillon R, Dilibe A, Glazebnik B, Jones L, Glazer E. Gender disparities and woman-specific trends in Barrett’s esophagus in the United States: An 11-year nationwide population-based study. World J Methodol 2025; 15:97512. [DOI: 10.5662/wjm.v15.i1.97512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Revised: 07/25/2024] [Accepted: 07/29/2024] [Indexed: 09/29/2024] [Imported: 09/29/2024] Open
Abstract
BACKGROUND Barrett's esophagus (BE) is a known premalignant precursor to esophageal adenocarcinoma (EAC). The prevalence rates continue to rise in the United States, but many patients who are at risk of EAC are not screened. Current practice guidelines include male gender as a predisposing factor for BE and EAC. The population-based clinical evidence regarding female gender remains limited.
AIM To study comparative trends of gender disparities in patients with BE in the United States.
METHODS A nationwide retrospective study was conducted using the 2009-2019 National Inpatient Sample (NIS) database. Patients with a primary or secondary diagnosis code of BE were identified. The major outcome of interest was determining the gender disparities in patients with BE. Trend analysis for respective outcomes for females was also reported to ascertain any time-based shifts.
RESULTS We identified 1204190 patients with BE for the study period. Among the included patients, 717439 (59.6%) were men and 486751 (40.4%) were women. The mean age was higher in women than in men (67.1 ± 0.4 vs 66.6 ± 0.3 years, P < 0.001). The rate of BE per 100000 total NIS hospitalizations for males increased from 144.6 in 2009 to 213.4 in 2019 (P < 0.001). The rate for females increased from 96.8 in 2009 to 148.7 in 2019 (P < 0.001). There was a higher frequency of obesity among women compared to men (17.4% vs 12.6%, P < 0.001). Obesity prevalence among females increased from 12.3% in 2009 to 21.9% in 2019 (P < 0.001). A lower prevalence of smoking was noted in women than in men (20.8% vs 35.7%, P < 0.001). However, trend analysis showed an increasing prevalence of smoking among women, from 12.9% in 2009 to 30.7% in 2019 (P < 0.001). Additionally, there was a lower prevalence of alcohol abuse, Helicobacter pylori (H. pylori), and diabetes mellitus among females than males (P < 0.001). Trend analysis showed an increasing prevalence of alcohol use disorder and a decreasing prevalence of H. pylori and diabetes mellitus among women (P < 0.001).
CONCLUSION The prevalence of BE among women has steadily increased from 2009 to 2019. The existing knowledge concerning BE development has historically focused on men, but our findings show that the risk in women is not insignificant.
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Samarasinghe NR, Nagpal TS, Barbeau ML, Martin CM. Getting physical with medical education: Exercise based virtual anatomy review classes for medical students. World J Methodol 2025; 15:95985. [DOI: 10.5662/wjm.v15.i1.95985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 08/07/2024] [Accepted: 08/13/2024] [Indexed: 09/29/2024] [Imported: 09/29/2024] Open
Abstract
The benefits of regular physical activity are well known. Yet, few studies have examined the effectiveness of integrating physical activity (PA) into curricula within a post-secondary setting. To investigate the incorporation of PA into medical curriculum, we developed a series of optional exercise-based review sessions designed to reinforce musculoskeletal (MSK) anatomy course material. These synchronous sessions were co-taught by a group fitness instructor and an anatomy instructor. The fitness instructor would lead students through both strength and yoga style exercises, while the anatomy instructor asked questions about relevant anatomical structures related to course material previously covered. After the sessions, participants were asked to evaluate the classes on their self-reported exam preparedness in improving MSK anatomy knowledge, PA levels, and mental wellbeing. Thirty participants completed surveys; a majority agreed that the classes increased understanding of MSK concepts (90.0%) and activity levels (97.7%). Many (70.0%) felt that the classes helped reduce stress. The majority of respondents (90.0%) agreed that the classes contributed to increased feelings of social connectedness. Overall, medical students saw benefit in PA based interventions to supplement MSK course concepts. Along with increasing activity levels and promoting health behaviours, integrating PA into medical curriculum may improve comprehension of learning material, alleviate stress and foster social connectivity among medical students.
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Jeyaraman N, Jeyaraman M, Ramasubramanian S, Balaji S, Muthu S. Beyond statistical significance: Embracing minimal clinically important difference for better patient care. World J Methodol 2025; 15:97814. [DOI: 10.5662/wjm.v15.i1.97814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2024] [Revised: 09/09/2024] [Accepted: 09/13/2024] [Indexed: 09/29/2024] [Imported: 09/29/2024] Open
Abstract
The minimal clinically important difference (MCID) represents a pivotal metric in bridging the gap between statistical significance and clinical relevance, addressing the direct impact of medical interventions from the patient's perspective. This comprehensive review analyzes the evolution, applications, and challenges of MCID across medical specialties, emphasizing its necessity in ensuring that clinical outcomes not only demonstrate statistical significance but also offer genuine clinical utility that aligns with patient expectations and needs. We discuss the evolution of MCID since its inception in the 1980s, its current applications across various medical specialties, and the methodologies used in its calculation, highlighting both anchor-based and distribution-based approaches. Furthermore, the paper delves into the challenges associated with the application of MCID, such as methodological variability and the interpretation difficulties that arise in clinical settings. Recommendations for the future include standardizing MCID calculation methods, enhancing patient involvement in setting MCID thresholds, and extending research to incorporate diverse global perspectives. These steps are critical to refining the role of MCID in patient-centered healthcare, addressing existing gaps in methodology and interpretation, and ensuring that medical interventions lead to significant, patient-perceived improvements.
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Jeyaraman M, Jeyaraman N, Ramasubramanian S, Balaji S. Navigating the ethical terrain: Off-label and experimental treatments in medical case reports. World J Methodol 2025; 15:94833. [DOI: 10.5662/wjm.v15.i1.94833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 07/15/2024] [Accepted: 07/18/2024] [Indexed: 09/29/2024] [Imported: 09/29/2024] Open
Abstract
This article explores the ethical considerations surrounding the reporting of off-label and experimental treatments in medical case reports, with a focus on fields such as oncology, psychiatry, and pediatrics. It emphasizes the balance between innovation and evidence-based medicine, highlighting the critical role of case reports in disseminating clinical experiences and advancing medical knowledge. The discussion delves into the ethical framework guiding case reporting, including principles of patient autonomy, informed consent, non-maleficence, beneficence, justice, and transparency. Challenges such as negative outcome reporting, commercial interests, and the balance between innovation and caution are examined. Recommendations for ethical vigilance, the development of comprehensive guidelines, and the role of regulatory bodies are proposed to ensure patient safety and uphold scientific integrity. The article concludes by underscoring the importance of a collaborative effort among clinicians, researchers, ethicists, and regulatory bodies to foster the responsible advancement of medical science while adhering to the highest ethical standards.
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Beresniak A, Bremond-Gignac D, Dupont D, Duru G. Reevaluating health metrics: Unraveling the limitations of disability-adjusted life years as an indicator in disease burden assessment. World J Methodol 2025; 15:95796. [DOI: 10.5662/wjm.v15.i1.95796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 09/12/2024] [Accepted: 09/23/2024] [Indexed: 09/29/2024] [Imported: 09/29/2024] Open
Abstract
In 1993, the World Bank released a global report on the efficacy of health promotion, introducing the disability-adjusted life years (DALY) as a novel indicator. The DALY, a composite metric incorporating temporal and qualitative data, is grounded in preferences regarding disability status. This review delineates the algorithm used to calculate the value of the proposed DALY synthetic indicator and elucidates key methodological challenges associated with its application. In contrast to the quality-adjusted life years approach, derived from multi-attribute utility theory, the DALY stands as an independent synthetic indicator that adopts the assumptions of the Time Trade Off utility technique to define Disability Weights. Claiming to rely on no mathematical or economic theory, DALY users appear to have exempted themselves from verifying whether this indicator meets the classical properties required of all indicators, notably content validity, reliability, specificity, and sensitivity. The DALY concept emerged primarily to facilitate comparisons of the health impacts of various diseases globally within the framework of the Global Burden of Disease initiative, leading to numerous publications in international literature. Despite widespread adoption, the DALY synthetic indicator has prompted significant methodological concerns since its inception, manifesting in inconsistent and non-reproducible results. Given the substantial diffusion of the DALY indicator and its critical role in health impact assessments, a reassessment is warranted. This reconsideration is imperative for enhancing the robustness and reliability of public health decision-making processes.
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Yang J, Peng H, Tu SK, Li M, Song K. Extramedullary plasmacytoma with the uvula as first affected site: A case report. World J Clin Oncol 2025; 16:96131. [DOI: 10.5306/wjco.v16.i1.96131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2024] [Revised: 09/03/2024] [Accepted: 09/23/2024] [Indexed: 10/30/2024] [Imported: 10/30/2024] Open
Abstract
BACKGROUND Extramedullary plasmacytoma (EMP) represents one of the rarer forms of plasma cell malignancies, capable of impacting a variety of tissues and organs throughout the body. The majority of EMP cases are predominantly found in the head and neck region, especially within the laryngopharynx, as well as in the gastrointestinal tract. While there have been documented instances of oropharyngeal involvement in EMP cases in the academic literature, it is important to note that EMP specifically affecting the uvula is exceedingly uncommon. Furthermore, it is noteworthy that over 60% of epithelial carcinomas in the upper respiratory tract and oropharynx tend to metastasize to the cervical lymph nodes, indicating a propensity for regional spread in these types of cancers. In this context, we present a rare case of extramedullary plasmacytoma where the uvula served as the initially affected site. This case emphasizes the need for heightened awareness among clinicians regarding such unusual comorbidities, as early recognition and diagnosis can significantly influence patient management and treatment outcomes. In addition, a review of the relevant literature is included to further educate and inform healthcare professionals about this rare presentation, ultimately aiming to enhance clinical understanding and improve patient care in similar situations.
CASE SUMMARY A 51-year-old man was admitted to our hospital because of a slowly enlarging neck mass. A physical examination revealed a palpable left lymph node, and magnetic resonance imaging (MRI) of the oropharynx and the neck showed a soft tissue mass in the oropharynx and enlargement of multiple lymph nodes in the neck. The soft tissue mass was diagnosed as plasmacytoma by immunohistochemical analysis. Monoclonal immunoglobulins and bone marrow biopsy showed normal results. Therefore, we diagnosed that as EMP of the uvula. After four cycles of adjuvant chemotherapy dominated by bortezomib, MRI reexamination showed a significant reduction of the mass in the oropharynx and the cervical lymph nodes. Afterwards, the λ light chain returned to normal levels. There was no evidence of evolution to multiple myeloma.
CONCLUSION We have reported a rare case of extramedullary plasmacytoma with the uvula as the first affected site and the relevant literature is reviewed to improve clinicians' awareness of such rare comorbidities.
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Qayed E. Optimizing care for gastric cancer with overt bleeding: Is systemic therapy a valid option? World J Clin Oncol 2025; 16:100943. [DOI: 10.5306/wjco.v16.i1.100943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2024] [Revised: 09/26/2024] [Accepted: 10/22/2024] [Indexed: 10/30/2024] [Imported: 10/30/2024] Open
Abstract
Gastric cancer (GC) and gastroesophageal junction cancer (GEJC) represent a significant burden globally, with complications such as overt bleeding (OB) further exacerbating patient outcomes. A recent study by Yao et al evaluated the effectiveness and safety of systematic treatment in GC/GEJC patients presenting with OB. Using propensity score matching, the study balanced the comparison groups to investigate overall survival and treatment-related adverse events. The study's findings emphasize that systematic therapy can be safe and effective and contribute to the ongoing debate about the management of advanced GC/GEJC with OB, highlighting the complexities of treatment decisions in these high-risk patients.
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Cheng CH, Hao WR, Cheng TH. Improving postoperative outcomes in patients with pancreatic cancer: Inflammatory and nutritional biomarkers. World J Clin Oncol 2025; 16:99651. [DOI: 10.5306/wjco.v16.i1.99651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2024] [Revised: 10/02/2024] [Accepted: 10/20/2024] [Indexed: 10/30/2024] [Imported: 10/30/2024] Open
Abstract
This editorial assesses the prognostic value of preoperative inflammatory and nutritional biomarkers in patients undergoing surgical resection for pancreatic cancer. Lu et al evaluated the ability of seven biomarkers to predict postoperative recovery and long-term outcomes. These biomarkers were albumin-to-globulin ratio, prognostic nutritional index (PNI), systemic immune-inflammation index, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, nutritional risk index, and geriatric nutritional risk index. The PNI was found to be a strong predictor of both overall and recurrence-free survival, underscoring its clinical relevance in managing patients with pancreatic cancer.
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Tang ZJ, Pan YM, Li W, Ma RQ, Wang JL. Unlocking the future: Mitochondrial genes and neural networks in predicting ovarian cancer prognosis and immunotherapy response. World J Clin Oncol 2025; 16:94813. [DOI: 10.5306/wjco.v16.i1.94813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 05/17/2024] [Accepted: 06/05/2024] [Indexed: 10/30/2024] [Imported: 10/30/2024] Open
Abstract
BACKGROUND Mitochondrial genes are involved in tumor metabolism in ovarian cancer (OC) and affect immune cell infiltration and treatment responses.
AIM To predict prognosis and immunotherapy response in patients diagnosed with OC using mitochondrial genes and neural networks.
METHODS Prognosis, immunotherapy efficacy, and next-generation sequencing data of patients with OC were downloaded from The Cancer Genome Atlas and Gene Expression Omnibus. Mitochondrial genes were sourced from the MitoCarta3.0 database. The discovery cohort for model construction was created from 70% of the patients, whereas the remaining 30% constituted the validation cohort. Using the expression of mitochondrial genes as the predictor variable and based on neural network algorithm, the overall survival time and immunotherapy efficacy (complete or partial response) of patients were predicted.
RESULTS In total, 375 patients with OC were included to construct the prognostic model, and 26 patients were included to construct the immune efficacy model. The average area under the receiver operating characteristic curve of the prognostic model was 0.7268 [95% confidence interval (CI): 0.7258-0.7278] in the discovery cohort and 0.6475 (95%CI: 0.6466-0.6484) in the validation cohort. The average area under the receiver operating characteristic curve of the immunotherapy efficacy model was 0.9444 (95%CI: 0.8333-1.0000) in the discovery cohort and 0.9167 (95%CI: 0.6667-1.0000) in the validation cohort.
CONCLUSION The application of mitochondrial genes and neural networks has the potential to predict prognosis and immunotherapy response in patients with OC, providing valuable insights into personalized treatment strategies.
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Krishnan A, Schneider CV, Walsh D. Proton pump inhibitors and all-cause mortality risk among cancer patients. World J Clin Oncol 2025; 16:99240. [DOI: 10.5306/wjco.v16.i1.99240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2024] [Revised: 09/09/2024] [Accepted: 10/11/2024] [Indexed: 10/30/2024] [Imported: 10/30/2024] Open
Abstract
BACKGROUND Proton pump inhibitors (PPIs) are widely used, including among cancer patients, to manage gastroesophageal reflux and other gastric acid-related disorders. Recent evidence suggests associations between long-term PPI use and higher risks for various adverse health outcomes, including greater mortality.
AIM To investigate the association between PPI use and all-cause mortality among cancer patients by a comprehensive analysis after adjustment for various confounders and a robust methodological approach to minimize bias.
METHODS This retrospective cohort study used data from the TriNetX research network, with electronic health records from multiple healthcare organizations. The study employed a new-user, active comparator design, which compared newly treated PPI users with non-users and newly treated histamine2 receptor antagonists (H2RA) users among adult cancer patients. Newly prescribed PPIs (esomeprazole, lansoprazole, omeprazole, pantoprazole, or rabeprazole) users were compared to non-users or newly prescribed H2RAs (cimetidine, famotidine, nizatidine, or ranitidine) users. The primary outcome was all-cause mortality. Each patient in the main group was matched to a patient in the control group using 1:1 propensity score matching to reduce confounding effects. Multivariable Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence interval (CI).
RESULTS During the follow-up period (median 5.4 ± 1.8 years for PPI users and 6.5 ± 1.0 years for non-users), PPI users demonstrated a higher all-cause mortality rate than non-users after 1 year, 2 years, and at the end of follow up (HRs: 2.34-2.72). Compared with H2RA users, PPI users demonstrated a higher rate of all-cause mortality HR: 1.51 (95%CI: 1.41-1.69). Similar results were observed across sensitivity analyses by excluding deaths from the first 9 months and 1-year post-exposure, confirming the robustness of these findings. In a sensitivity analysis, we analyzed all-cause mortality outcomes between former PPI users and individuals who have never used PPIs, providing insights into the long-term effects of past PPI use. In addition, at 1-year follow-up, the analysis revealed a significant difference in mortality rates between former PPI users and non-users (HR: 1.84; 95%CI: 1.82-1.96).
CONCLUSION PPI use among cancer patients was associated with a higher risk of all-cause mortality compared to non-users or H2RA users. These findings emphasize the need for cautious use of PPIs in cancer patients and suggest that alternative treatments should be considered when clinically feasible. However, further studies are needed to corroborate our findings, given the significant adverse outcomes in cancer patients.
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Teja M, Garrido MI, Ocanto A, Couñago F. Prognostic impact of inflammatory and nutritional biomarkers in pancreatic cancer. World J Clin Oncol 2025; 16:101191. [DOI: 10.5306/wjco.v16.i1.101191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2024] [Revised: 09/28/2024] [Accepted: 10/10/2024] [Indexed: 10/30/2024] [Imported: 10/30/2024] Open
Abstract
Pancreatic cancer is usually associated with a poor prognosis. Surgery is the main curative treatment but pancreatic operations are aggressive and new tools that help clinicians to predict surgical and prognostic outcomes are necessary. Lu et al recently published a retrospective, single centre cohort study evaluating the impact of seven nutritional and inflammatory markers in pancreatic cancer surgical patients: The albumin-to-globulin ratio, prognostic nutritional index (PNI), systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), nutritional risk index, and the geriatric nutritional risk index. A significant correlation was found between the PNI, SII, NLR, and PLR and a hospital discharge of less than 15 days. In a univariable analysis, PNI, SII, NLR and PLR were significantly related to recurrence-free survival and, in a multivariable analysis PNI was associated with overall survival. Various meta-analyses corroborate the results in terms of prognosis but individual studies are discordant on their usefulness. Besides, the cut-off values for these markers vary significantly between studies and there are no clinical trials comparing them to identify the most relevant ones. These are limitations when implementing nutritional and inflammatory biomarkers into clinical practice and further studies are needed in order to answer these questions.
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Lan YZ, Wu Z, Chen WJ, Yu XN, Wu HT, Liu J. Sine oculis homeobox homolog family function in gastrointestinal cancer: Progression and comprehensive analysis. World J Clin Oncol 2025; 16:97163. [DOI: 10.5306/wjco.v16.i1.97163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2024] [Revised: 09/20/2024] [Accepted: 10/20/2024] [Indexed: 10/30/2024] [Imported: 10/30/2024] Open
Abstract
The sine oculis homeobox homolog (SIX) family, a group of transcription factors characterized by a conserved DNA-binding homology domain, plays a critical role in orchestrating embryonic development and organogenesis across various organisms, including humans. Comprising six distinct members, from SIX1 to SIX6, each member contributes uniquely to the development and differentiation of diverse tissues and organs, underscoring the versatility of the SIX family. Dysregulation or mutations in SIX genes have been implicated in a spectrum of developmental disorders, as well as in tumor initiation and progression, highlighting their pivotal role in maintaining normal developmental trajectories and cellular functions. Efforts to target the transcriptional complex of the SIX gene family have emerged as a promising strategy to inhibit tumor development. While the development of inhibitors targeting this gene family is still in its early stages, the significant potential of such interventions holds promise for future therapeutic advances. Therefore, this review aimed to comprehensively explore the advancements in understanding the SIX family within gastrointestinal cancers, focusing on its critical role in normal organ development and its implications in gastrointestinal cancers, including gastric, pancreatic, colorectal cancer, and hepatocellular carcinomas. In conclusion, this review deepened the understanding of the functional roles of the SIX family and explored the potential of utilizing this gene family for the diagnosis, prognosis, and treatment of gastrointestinal cancers.
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Bian JY, Feng YF, He WT, Zhang T. Cohort study on the treatment of BRAF V600E mutant metastatic colorectal cancer with integrated Chinese and western medicine. World J Clin Oncol 2025; 16:93670. [DOI: 10.5306/wjco.v16.i1.93670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 09/04/2024] [Accepted: 10/11/2024] [Indexed: 10/30/2024] [Imported: 10/30/2024] Open
Abstract
BACKGROUND Patients with BRAF V600E mutant metastatic colorectal cancer (mCRC) have a low incidence rate, poor biological activity, suboptimal response to conventional treatments, and a poor prognosis. In the previous cohort study on mCRC conducted by our team, it was observed that integrated Chinese and Western medicine treatment could significantly prolong the overall survival (OS) of patients with colorectal cancer. Therefore, we further explored the survival benefits in the population with BRAF V600E mutant mCRC.
AIM To evaluate the efficacy of integrated Chinese and Western medicine in the treatment of BRAF V600E mutant metastatic colorectal cancer.
METHODS A cohort study was conducted on patients with BRAF V600E mutant metastatic colorectal cancer admitted to Xiyuan Hospital of China Academy of Chinese Medical Sciences and Traditional Chinese Medicine Hospital of Xinjiang Uygur Autonomous Region from January 2016 to December 2022. The patients were divided into two cohorts.
RESULTS A total of 34 cases were included, with 23 in Chinese-Western medicine cohort (cohort A) and 11 in Western medicine cohort (cohort B). The median overall survival was 19.9 months in cohort A and 14.2 months in cohort B, with a statistically significant difference (P = 0.038, hazard ratio = 0.46). The 1-3-year survival rates were 95.65% (22/23), 39.13% (9/23), and 26.09% (6/23) in cohort A, and 63.64% (7/11), 18.18% (2/11), and 9.09% (1/11) in cohort B, respectively. Subgroup analysis showed statistically significant differences in median OS between the two cohorts in the right colon, liver metastasis, chemotherapy, and first-line treatment subgroups (P < 0.05).
CONCLUSION Integrated Chinese and Western medicine can prolong the survival and reduce the risk of death in patients with BRAF V600E mutant metastatic colorectal cancer, with more pronounced benefits observed in patients with right colon involvement, liver metastasis, combined chemotherapy, and first-line treatment.
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Alshahrani AF, Ashfaq F, Alsayegh AA, Bajahzer M, Khan MI, Beg MMA. MiRNA-200a and miRNA-200b expression, and vitamin-D level: Prognostic significance in obese non-diabetic and obese type 2 diabetes mellitus individuals. World J Clin Cases 2024; 12:6916-6925. [DOI: 10.12998/wjcc.v12.i36.6916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Revised: 09/18/2024] [Accepted: 10/09/2024] [Indexed: 10/31/2024] [Imported: 10/31/2024] Open
Abstract
BACKGROUND Obesity and type 2 diabetes mellitus (T2DM) are frequent co-occurring disorders that affect regular metabolic functions. Obesity has also been linked to an increased risk of developing diabetes. Obesity and diabetes are on the rise, increasing healthcare costs and raising mortality rates. Research has revealed that the expression profile of microRNAs (miRNAs) changes as diabetes progresses. Furthermore, vitamin D may have an anti-obesity effect and inverse association with body weight and body mass index (BMI). Low vitamin D levels do not solely cause obesity, which could be a factor in the etiology of T2DM.
AIM To evaluate miRNA-200a and miRNA-200b expression, and vitamin-D levels in obese and obese T2DM individuals.
METHODS This study included 210 participants, of which, 82 were obese (BMI > 30 kg/m2) without T2DM, 28 were obese with T2DM, and 100 were healthy controls. BMI was evaluated and both fasting and postprandial blood glucose were used to confirm T2DM. Exosomal miRNA-200a and miRNA-200b expression were analyzed using real-time PCR using Taqman probes, and vitamin-D levels were evaluated using an electrochemiluminescence-based immunoassay technique. All data analyses were performed using SPSS 20.0 and GraphPad Prism 5 software.
RESULTS Overall, a 2.20- and 4.40-fold increase in miRNA-200a and miRNA-200b expression was observed among participants compared to healthy controls. MiRNA-200a and miRNA-200b expression among obese participants increased 2.40-fold and 3.93-fold, respectively, while in obese T2DM participants these values were 2.67-fold, and 5.78-fold, respectively, and these differences were found to be statistically significant (P = 0.02) (P < 0.0001). Obese participants showed a vitamin D level of 34.27 ng/mL, while in obese-T2DM participants vitamin D level was 22.21 ng/mL (P < 0.0001). Vitamin D was negatively correlated with miRNA-200a (r = -0.22, P = 0.01) and miRNA-200b (r = -0.19, P = 0.04). MiRNA-200a sensitivity was 75%, and specificity was 57%, with a cutoff value of 2.07-fold. MiRNA-200b sensitivity was 75%, and specificity was 71% with a cutoff value of 4.12-fold, suggesting that miRNA-200a and miRNA-200b with an increased expression of 2.07- and 4.12-fold could be predictive indicators for the risk of diabetes in obese participants.
CONCLUSION MiRNA-200a and miRNA-200b were higher in diabetic obese participants vs non-diabetic obese participants, and insufficient vitamin D levels in obese T2DM participants may be involved in poor clinical outcome.
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Ferrere M, Garcia-Mansilla I, de Gainza A. Navigating postoperative complications: Uveitis-glaucoma-hyphema syndrome after Ahmed glaucoma valve implantation. World J Clin Cases 2024; 12:6944-6946. [DOI: 10.12998/wjcc.v12.i36.6944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2024] [Revised: 09/26/2024] [Accepted: 10/15/2024] [Indexed: 10/31/2024] [Imported: 10/31/2024] Open
Abstract
Altwijri and Alsirhy reported a case of uveitis-glaucoma-hyphema syndrome after an Ahmed glaucoma valve implantation surgery in an advanced primary open-angle glaucoma patient, being the first ever recorded of its kind. The author describes the position of the tube as the origin of the anterior chamber inflammation and hyphema, which resolved shortly after shortening and relocating it. This publication emphasizes the importance of precise implant positioning and close-up patient follow-up after glaucoma filtration surgery as an important standard for healthcare providers.
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Liu DH, Dong XM, Long WJ. Advancing cardiovascular outcomes with dapagliflozin and sacubitril in post-acute myocardial infarction heart failure and type 2 diabetes mellitus. World J Clin Cases 2024; 12:6935-6938. [DOI: 10.12998/wjcc.v12.i36.6935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2024] [Revised: 09/18/2024] [Accepted: 10/22/2024] [Indexed: 10/31/2024] [Imported: 10/31/2024] Open
Abstract
Coronary heart disease and type 2 diabetes mellitus (T2DM) often co-occur, presenting substantial health risks, particularly following acute myocardial infarction (AMI). While percutaneous coronary intervention (PCI) is a prevalent treatment, complications such as microvascular dysfunction may lead to heart failure, necessitating additional therapies. This editorial examines the emerging roles of sacubitril/valsartan and sodium-glucose co-transporter 2 inhibitors in managing post-PCI. Recent research investigates the combined effects of dapagliflozin and telmisartan on myocardial microperfusion in post-AMI heart failure patients with T2DM. The findings suggest that this combination enhances myocardial microcirculation, improves cardiac function, and achieves better glycemic control, with a reduced incidence of major adverse cardiovascular events. Despite ongoing challenges, the integration of dapagliflozin and sacubitril/valsartan represents a significant advancement in post-AMI care. Further investigation in larger cohorts and more diverse patient populations is required to confirm its long-term clinical outcomes.
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