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Ogura T, Uba Y, Kanadani T, Bessho K, Nishikawa H. Stent-in-stent deployment for malignant hilar obstruction using multi-hole stent can prevent tumor ingrowth during 6-month cholangioscopic follow-up. Endoscopy 2025; 57:E99-E100. [PMID: 39909411 DOI: 10.1055/a-2518-5430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2025]
Affiliation(s)
- Takeshi Ogura
- Endoscopy Center, Osaka Medical and Pharmaceutical University Hospital, Takatsuki, Japan
- 2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Yuki Uba
- 2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Takafumi Kanadani
- 2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Kimi Bessho
- 2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Hiroki Nishikawa
- 2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
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Sun Z, Chen Y, Su Q. Prenatal ultrasound for the diagnosis of the cerebellar abnormalities: a meta-analysis. J Matern Fetal Neonatal Med 2025; 38:2453997. [PMID: 39864828 DOI: 10.1080/14767058.2025.2453997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2024] [Revised: 01/02/2025] [Accepted: 01/09/2025] [Indexed: 01/28/2025]
Abstract
OBJECTIVE Fetal cerebellar abnormalities are associated with neurodevelopmental disorders and structural brain malformations. Accurate and early diagnosis is crucial for prenatal counseling and planning postnatal interventions. While prenatal ultrasound is a key tool for detecting fetal brain abnormalities, variations in diagnostic accuracy across studies necessitate a systematic evaluation of its effectiveness in diagnosing cerebellar abnormalities. METHODS A comprehensive literature search was conducted across major databases to identify relevant studies on prenatal ultrasound for diagnosing cerebellar anomalies. Inclusion criteria included studies with clear diagnostic outcomes, diverse patient populations, and standardized ultrasound protocols. Meta-analytic techniques were employed to assess overall diagnostic accuracy, sensitivity, specificity, and heterogeneity using Meta Disk. The quality of the included studies was evaluated using the QUADAS-2 tool. RESULTS The meta-analysis included fifteen studies involving 1,902 fetuses with suspected cerebellar abnormalities. The pooled sensitivity and specificity of prenatal ultrasound were 0.83 (95% CI: 0.80-0.86) and 0.97 (95% CI: 0.96-0.98), respectively. The positive likelihood ratio was 7.96 (95% CI: 3.23-19.64), the negative likelihood ratio was 0.18 (95% CI: 0.09-0.36), and the odds ratio was 46.76 (95% CI: 14.06-155.53). The combined area under the curve (AUC) reached 0.93, indicating robust diagnostic performance. Heterogeneity was observed, influenced by factors such as gestational age at screening, operator expertise, and ultrasound equipment quality. CONCLUSIONS Prenatal ultrasound is a reliable tool for detecting cerebellar abnormalities with high sensitivity and specificity. However, variability in diagnostic performance suggests the need for standardized protocols and advanced imaging techniques to enhance accuracy. Future research should focus on integrating multiple imaging modalities to optimize prenatal screening outcomes.
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Affiliation(s)
- Zhen Sun
- Department of Clinical Medicine, Quanzhou Medical College, Quanzhou, China
| | - Yanqiu Chen
- Department of Ultrasound, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Qichen Su
- Department of Ultrasound, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
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Huang FJ, Fang YY, Wen JY, Li JJ, Lin Q, Su QY, Chen YY, Wang L, Zeng JJ, Chi BT, He RQ, Qin DY, Yang LH, Chen G. From PD-1/PD-L1 to tertiary lymphoid structures: Paving the way for precision immunotherapy in cholangiocarcinoma treatment. Hum Vaccin Immunother 2025; 21:2444697. [PMID: 39757910 DOI: 10.1080/21645515.2024.2444697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2024] [Revised: 12/07/2024] [Accepted: 12/16/2024] [Indexed: 01/07/2025] Open
Abstract
Cholangiocarcinoma (CCA) is a highly malignant hepatobiliary tumor characterized by limited treatment options and poor prognosis. The recent rise of immunotherapy has significantly influenced research in this field. This study presents a bibliometric analysis of 416 articles retrieved from the WOSCC, Wan fang Data, CNKI and VIP databases, spanning contributions from 32 countries, 589 institutions and 3,200 authors. The analysis identified "PD-L1," "PD-1" and "pembrolizumab" as central research foci, while "immune checkpoint inhibitors," "tumor immune microenvironment," "tertiary lymphoid structures" and "durvalumab" emerged as key areas of interest. These findings emphasize the pivotal role of immunotherapy in improving survival outcomes for CCA, and they highlight the significance of tertiary lymphoid structures within the tumor microenvironment as a promising target for future research. This study offers a strategic overview of the evolving landscape of CCA immunotherapy, providing valuable insights to guide future scientific endeavors in this domain.
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Affiliation(s)
- Fang-Ju Huang
- Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Ye-Ying Fang
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Jia-Ying Wen
- Department of Radiotherapy, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Jian-Jun Li
- Department of General Surgery, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Qian Lin
- Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Qin-Yan Su
- Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Yi-Yang Chen
- Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Lei Wang
- Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Jian-Jia Zeng
- Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Bang-Teng Chi
- Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Rong-Quan He
- Department of Medical Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Di-Yuan Qin
- Department of Computer Science and Technology, School of Computer and Electronic Information, Guangxi University, Nanning, Guangxi Zhuang Autonomous Region, People's Republic of China
| | - Li-Hua Yang
- Department of Medical Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Gang Chen
- Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
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Han X, Zhang B. Comparison of the value of transvaginal ultrasonography and MRI in the diagnosis of cesarean scar pregnancy: a meta-analysis. J Matern Fetal Neonatal Med 2025; 38:2445661. [PMID: 39762030 DOI: 10.1080/14767058.2024.2445661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 12/13/2024] [Accepted: 12/16/2024] [Indexed: 01/11/2025]
Abstract
OBJECTIVE To compare the diagnostic value of transvaginal ultrasound (TVS) and magnetic resonance imaging (MRI) in cesarean scar pregnancy (CSP) by a method of meta-analysis. METHODS Studies on TVS and MRI for CSP were collected from PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang data, and Chinese Scientific Journal Database (VIP database) until April 1, 2024. Stata 15.0 software was used for data analysis. Mann-Whitney U-test was applied to compare the diagnostic efficiency of the TVS and MRI groups. RESULTS Nine articles with 713 subjects were involved in this review. The pooled sensitivity (0.96, 95%CI: 0.94-0.97), specificity (0.90, 95%CI: 0.84-0.94), and DOR (197.28, 95%CI: 99.71-390.31) in the MRI group were higher than those (Sensitivity = 0.83, 95%CI: 0.77-0.87; Specificity= 0.74, 95%CI: 0.63-0.83; DOR = 13.66, 95%CI: 7.84-23.79) in the TVS group. The positive likelihood ratio and negative likelihood ratio of the MRI group were 9.56 (95%CI: 8.82-15.72) and 0.05 (95%CI: 0.03-0.07), while those of the TVS group were 3.21 (95%CI:2.18-4.74) and 0.24 (95%CI: 0.18-0.31), respectively. In the MRI and TVS groups, the area under the curve (AUC) of the summary receiver operating characteristic was 0.9497 and 0.86, respectively. The results of Mann-Whitney U-tests of the two groups showed significant differences in the pooled sensitivity (Z= -3.311, p < 0.001), specificity (Z= -2.123, p = 0.034), and DOR (Z= -3.272, p = 0.001). CONCLUSION Both MRI and TVS can effectively diagnose CSP. However, compared with TVS, MRI has better diagnostic accuracy for CSP, with higher sensitivity and specificity. Considering the good diagnostic accuracy of ultrasound, patients with ultrasound suspicion of CSP should be sent to a reference center where MRI can express its full diagnostic potential regarding depth, topography of invasion and myometral residue, which is useful for subsequent management.
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Affiliation(s)
- Xiao Han
- Department of Ultrasound, the First Affiliated Hospital of Hainan Medical College, Haikou, Hainan, China
| | - Boyang Zhang
- Department of Ultrasound, the First Affiliated Hospital of Hainan Medical College, Haikou, Hainan, China
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Aldali F, Deng C, Nie M, Chen H. Advances in therapies using mesenchymal stem cells and their exosomes for treatment of peripheral nerve injury: state of the art and future perspectives. Neural Regen Res 2025; 20:3151-3171. [PMID: 39435603 DOI: 10.4103/nrr.nrr-d-24-00235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 08/26/2024] [Indexed: 10/23/2024] Open
Abstract
"Peripheral nerve injury" refers to damage or trauma affecting nerves outside the brain and spinal cord. Peripheral nerve injury results in movements or sensation impairments, and represents a serious public health problem. Although severed peripheral nerves have been effectively joined and various therapies have been offered, recovery of sensory or motor functions remains limited, and efficacious therapies for complete repair of a nerve injury remain elusive. The emerging field of mesenchymal stem cells and their exosome-based therapies hold promise for enhancing nerve regeneration and function. Mesenchymal stem cells, as large living cells responsive to the environment, secrete various factors and exosomes. The latter are nano-sized extracellular vesicles containing bioactive molecules such as proteins, microRNA, and messenger RNA derived from parent mesenchymal stem cells. Exosomes have pivotal roles in cell-to-cell communication and nervous tissue function, offering solutions to changes associated with cell-based therapies. Despite ongoing investigations, mesenchymal stem cells and mesenchymal stem cell-derived exosome-based therapies are in the exploratory stage. A comprehensive review of the latest preclinical experiments and clinical trials is essential for deep understanding of therapeutic strategies and for facilitating clinical translation. This review initially explores current investigations of mesenchymal stem cells and mesenchymal stem cell-derived exosomes in peripheral nerve injury, exploring the underlying mechanisms. Subsequently, it provides an overview of the current status of mesenchymal stem cell and exosome-based therapies in clinical trials, followed by a comparative analysis of therapies utilizing mesenchymal stem cells and exosomes. Finally, the review addresses the limitations and challenges associated with use of mesenchymal stem cell-derived exosomes, offering potential solutions and guiding future directions.
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Affiliation(s)
- Fatima Aldali
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Chunchu Deng
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Mingbo Nie
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Hong Chen
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
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Yin L, Xu Y, Mu J, Leng Y, Ma L, Zheng Y, Li R, Wang Y, Li P, Zhu H, Wang D, Li J. CNKSR2 interactome analysis indicates its association with the centrosome/microtubule system. Neural Regen Res 2025; 20:2420-2432. [PMID: 39359098 PMCID: PMC11759008 DOI: 10.4103/nrr.nrr-d-23-01725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/27/2024] [Accepted: 03/04/2024] [Indexed: 10/04/2024] Open
Abstract
JOURNAL/nrgr/04.03/01300535-202508000-00031/figure1/v/2024-09-30T120553Z/r/image-tiff The protein connector enhancer of kinase suppressor of Ras 2 (CNKSR2), present in both the postsynaptic density and cytoplasm of neurons, is a scaffolding protein with several protein-binding domains. Variants of the CNKSR2 gene have been implicated in neurodevelopmental disorders, particularly intellectual disability, although the precise mechanism involved has not yet been fully understood. Research has demonstrated that CNKSR2 plays a role in facilitating the localization of postsynaptic density protein complexes to the membrane, thereby influencing synaptic signaling and the morphogenesis of dendritic spines. However, the function of CNKSR2 in the cytoplasm remains to be elucidated. In this study, we used immunoprecipitation and high-resolution liquid chromatography-mass spectrometry to identify the interactors of CNKSR2. Through a combination of bioinformatic analysis and cytological experiments, we found that the CNKSR2 interactors were significantly enriched in the proteome of the centrosome. We also showed that CNKSR2 interacted with the microtubule protein DYNC1H1 and with the centrosome marker CEP290. Subsequent colocalization analysis confirmed the centrosomal localization of CNKSR2. When we downregulated CNKSR2 expression in mouse neuroblastoma cells (Neuro 2A), we observed significant changes in the expression of numerous centrosomal genes. This manipulation also affected centrosome-related functions, including cell size and shape, cell proliferation, and motility. Furthermore, we found that CNKSR2 interactors were highly enriched in de novo variants associated with intellectual disability and autism spectrum disorder. Our findings establish a connection between CNKSR2 and the centrosome, and offer new insights into the underlying mechanisms of neurodevelopmental disorders.
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Affiliation(s)
- Lin Yin
- Institute for Translational Medicine, The Affiliated Hospital of Qingdao University, Medical College, Qingdao University, Qingdao, Shandong Province, China
- School of Basic Medicine, Qingdao University, Qingdao, Shandong Province, China
| | - Yalan Xu
- Institute for Translational Medicine, The Affiliated Hospital of Qingdao University, Medical College, Qingdao University, Qingdao, Shandong Province, China
- School of Basic Medicine, Qingdao University, Qingdao, Shandong Province, China
| | - Jie Mu
- Institute for Translational Medicine, The Affiliated Hospital of Qingdao University, Medical College, Qingdao University, Qingdao, Shandong Province, China
- College of Life Sciences, and School of Pharmacy, Medical College, Qingdao University, Qingdao, Shandong Province, China
| | - Yu Leng
- Institute for Translational Medicine, The Affiliated Hospital of Qingdao University, Medical College, Qingdao University, Qingdao, Shandong Province, China
- School of Basic Medicine, Qingdao University, Qingdao, Shandong Province, China
| | - Lei Ma
- Institute for Translational Medicine, The Affiliated Hospital of Qingdao University, Medical College, Qingdao University, Qingdao, Shandong Province, China
- School of Basic Medicine, Qingdao University, Qingdao, Shandong Province, China
| | - Yu Zheng
- Institute for Translational Medicine, The Affiliated Hospital of Qingdao University, Medical College, Qingdao University, Qingdao, Shandong Province, China
- School of Basic Medicine, Qingdao University, Qingdao, Shandong Province, China
- Department of Urology, Qingdao Municipal Hospital Affiliated to Qingdao University, Qingdao, Shandong Province, China
| | - Ruizhi Li
- Institute for Translational Medicine, The Affiliated Hospital of Qingdao University, Medical College, Qingdao University, Qingdao, Shandong Province, China
- School of Basic Medicine, Qingdao University, Qingdao, Shandong Province, China
| | - Yin Wang
- Institute for Translational Medicine, The Affiliated Hospital of Qingdao University, Medical College, Qingdao University, Qingdao, Shandong Province, China
| | - Peifeng Li
- Institute for Translational Medicine, The Affiliated Hospital of Qingdao University, Medical College, Qingdao University, Qingdao, Shandong Province, China
| | - Hai Zhu
- Department of Urology, Qingdao Municipal Hospital Affiliated to Qingdao University, Qingdao, Shandong Province, China
| | - Dong Wang
- Institute for Translational Medicine, The Affiliated Hospital of Qingdao University, Medical College, Qingdao University, Qingdao, Shandong Province, China
| | - Jing Li
- Institute for Translational Medicine, The Affiliated Hospital of Qingdao University, Medical College, Qingdao University, Qingdao, Shandong Province, China
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Anand R, Nag DS, Patel R, Sharma P, Uppalapati VK, Singh UK. Comparative efficacy of hyperbaric bupivacaine vs hyperbaric ropivacaine in spinal anesthesia for cesarean section: A meta-analysis. World J Methodol 2025; 15:99300. [DOI: 10.5662/wjm.v15.i2.99300] [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: 07/19/2024] [Revised: 10/11/2024] [Accepted: 11/15/2024] [Indexed: 11/27/2024] Open
Abstract
BACKGROUND Intrathecal bupivacaine is the traditional anesthetic drug used in spinal anesthesia for caesarean sections (CSs), but ropivacaine has emerged as a potential alternative. This meta-analysis compares the efficacy and safety of intrathecal hyperbaric bupivacaine vs hyperbaric ropivacaine for cesarean sections.
AIM To systematically evaluate and compare the efficacy and safety of intrathecal hyperbaric bupivacaine and hyperbaric ropivacaine for spinal anesthesia in CSs.
METHODS A thorough search of electronic databases was carried out to find pertinent randomized controlled trials (RCTs) comparing intrathecal hyperbaric ropivacaine and hyperbaric bupivacaine during CSs. PubMed, Cochrane database, Google Scholar, and Scopus were searched, and papers from January 2000 to January 2024 were deemed eligible and filtered using predetermined inclusion and exclusion criteria. Studies were assessed for methodological quality, and data were extracted for time to adequate anesthesia (sensory and motor blockade), duration of sensory and motor block, hemodynamic changes and side effect profile. The standardized mean difference with 95%CI was used for continuous data. Dichotomous variables were assessed using the Mantel-Haenszel test and the random effect model to compute the odds ratio.
RESULTS Total 8 RCTs were selected from a pool of 119 search results for meta-analysis. The meta-analysis evaluated pooled effect sizes and assessed heterogeneity among the studies. The primary objective was to compare key outcomes to identify any significant variances in efficacy and safety profiles between two local anesthetics. The analysis revealed that the difference in the onset of sensory blockade between the two local anesthetics was statistically insignificant (P = 0.1586). However, the onset of motor blockade appeared to be faster with bupivacaine (P = 0.03589). Additionally, the regression of sensory and motor blockade occurred earlier in the ropivacaine group. Furthermore, the duration of the first analgesic effect was shorter with a significance level of P < 0.05. Regarding side effects profile, including hypotension, nausea, and shivering, the study did not observe any significant differences between the two groups.
CONCLUSION This meta-analysis offers insights into the effectiveness and safety of hyperbaric bupivacaine vs ropivacaine for cesarean sections. Hyperbaric ropivacaine had a comparable safety profile and faster regression of sensory and motor blockade than hyperbaric bupivacaine, perhaps aiding early mobilization of parturient and facilitating mother-child bonding. Choosing ropivacaine may offer benefits beyond efficacy for cesarean section patients and short surgical procedures.
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Affiliation(s)
- Rishi Anand
- Department of Anaesthesiology, Tata Main Hospital, Jamshedpur 831001, Jhārkhand, India
| | - Deb Sanjay Nag
- Department of Anaesthesiology, Tata Main Hospital, Jamshedpur 831001, Jhārkhand, India
| | - Roushan Patel
- Department of Anaesthesiology, Tata Main Hospital, Jamshedpur 831001, Jhārkhand, India
| | - Prashant Sharma
- Department of Anaesthesiology, Tata Main Hospital, Jamshedpur 831001, Jhārkhand, India
| | | | - Umesh Kumar Singh
- Department of Anaesthesiology, Tata Main Hospital, Jamshedpur 831001, Jhārkhand, India
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Grewal H, Dhillon G, Buddhavarapu V, Verma RK, Munjal RS, Sharma P, Sidhu G, Kashyap R, Surani S. Strategic insights of telehealth platforms and strengths, weaknesses, opportunities, and threats analysis of Amazon's clinical endeavors. World J Methodol 2025; 15:98513. [DOI: 10.5662/wjm.v15.i2.98513] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Revised: 07/23/2024] [Accepted: 07/31/2024] [Indexed: 11/27/2024] Open
Abstract
BACKGROUND The adoption of telehealth services surged after the coronavirus disease 2019 pandemic, revolutionizing traditional healthcare delivery models. Amazon Clinic's recent nationwide launch marks a significant milestone in this trend. This study aims to offer a strengths, weaknesses, opportunities, and threats (SWOT) analysis of Amazon Clinic and compare its features with leading virtual healthcare platforms.
AIM To evaluate Amazon Clinic's telehealth services through a SWOT analysis and compare its features with other leading virtual healthcare platforms.
METHODS The initial search terms included were, amazon clinic odds ratio (OR) amwell OR Teladoc OR Walmart virtual health service OR CVS minute clinic OR CirrusMD OR brightside health, from 2000 to 2023. This search yielded 111 articles, from which duplicates were removed, and unrelated titles were filtered out. Eight articles were retained for a final review, including comparative studies, usability research, retrospective analyses, observational studies, and review articles. The data was organized and analyzed using Rayyan software and summarized in a table and PRISMA flowcharts.
RESULTS The review included eight articles focusing on various aspects of telehealth. Comparative studies highlighted differences between Teladoc and traditional physician offices, noting lower diagnostic imaging orders and antibiotic prescriptions for Teladoc. User demographics for Teladoc showed younger, less engaged patients. Usability studies emphasized the importance of website design for telemedicine adoption. Tele-mental health platforms like Brightside showed superior outcomes in treating depression compared to traditional methods. Telemedicine for specialized fields like skin reconstruction demonstrated cost efficiency and reduced waiting times. The SWOT analysis identified Amazon Clinic's strengths, such as its vast consumer base and transparent pricing, and weaknesses like the lack of pediatric care. Opportunities included potential partnerships and service expansions, while threats involved competition and regulatory challenges.
CONCLUSION Amazon Clinic's entry into the telehealth sector represents a significant development with various strengths and opportunities. However, it faces challenges from established healthcare providers and regulatory landscapes. The future success of Amazon Clinic will depend on strategic collaborations, addressing service gaps, and navigating competition and regulations. Telemedicine's impact will hinge on its ability to effectively leverage these opportunities and overcome inherent challenges in the ever-evolving healthcare landscape.
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Affiliation(s)
- Harpreet Grewal
- Department of Radiology, Ascension Sacred Heart Hospital, Pensacola, FL 32503, United States
| | - Gagandeep Dhillon
- Department of Medicine, UM Baltimore Washington Medical Center, Glen Burnie, MD 21061, United States
| | - Venkata Buddhavarapu
- Department of Medicine, Banner Baywood Medical Center, Banner Health, Mesa, AZ 85206, United States
| | - Ram Kishun Verma
- Department of Sleep Medicine, Parkview Health System, Fort Wayne, IN 46845, United States
| | - Ripudaman Singh Munjal
- Department of Medicine, Touro university College of Osteopathic Medicine, Vallejo, CA 94592, United States
| | - Pranjal Sharma
- Department of Nephrology, Northeast Ohio Medical Center, Rootstown, OH 44272, United States
| | - Gurmanpreet Sidhu
- Department of Pathology, Government Medical College Patiala, Patiala 147001, Punjab, India
| | - Rahul Kashyap
- Department of Research, Wellspan Health, York, PA 17403, United States
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN 55905, United States
| | - Salim Surani
- Department of Medicine & Pharmacology, Texas A&M University, College Station, TX 77843, United States
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Kim E, Tanzi RE, Choi SH. Therapeutic potential of exercise-hormone irisin in Alzheimer's disease. Neural Regen Res 2025; 20:1555-1564. [PMID: 38993140 PMCID: PMC11688551 DOI: 10.4103/nrr.nrr-d-24-00098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 05/20/2024] [Accepted: 06/04/2024] [Indexed: 07/13/2024] Open
Abstract
Irisin is a myokine that is generated by cleavage of the membrane protein fibronectin type III domain-containing protein 5 (FNDC5) in response to physical exercise. Studies reveal that irisin/FNDC5 has neuroprotective functions against Alzheimer's disease, the most common form of dementia in the elderly, by improving cognitive function and reducing amyloid-β and tau pathologies as well as neuroinflammation in cell culture or animal models of Alzheimer's disease. Although current and ongoing studies on irisin/FNDC5 show promising results, further mechanistic studies are required to clarify its potential as a meaningful therapeutic target for alleviating Alzheimer's disease. We recently found that irisin treatment reduces amyloid-β pathology by increasing the activity/levels of amyloid-β-degrading enzyme neprilysin secreted from astrocytes. Herein, we present an overview of irisin/FNDC5's protective roles and mechanisms against Alzheimer's disease.
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Affiliation(s)
- Eunhee Kim
- Genetics and Aging Research Unit, MassGeneral Institute for Neurodegenerative Disease, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
- McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, USA
| | - Rudolph E. Tanzi
- Genetics and Aging Research Unit, MassGeneral Institute for Neurodegenerative Disease, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
- McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, USA
| | - Se Hoon Choi
- Genetics and Aging Research Unit, MassGeneral Institute for Neurodegenerative Disease, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
- McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, USA
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Afandi B, Hassanein M, Suliman M, Hafidh K. Personalized risk reduction strategies utilizing the diabetes and ramadan risk calculator: a narrative review. J Diabetes Metab Disord 2025; 24:30. [PMID: 39735174 PMCID: PMC11680539 DOI: 10.1007/s40200-024-01506-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2024] [Accepted: 11/26/2024] [Indexed: 12/31/2024]
Abstract
The Diabetes and Ramadan Risk Calculator, developed in 2021, is a pivotal tool for assessing fasting-related risks among patients with diabetes. This ground-breaking innovation offers a quantitative assessment of risk scores during fasting, revolutionizing the landscape of diabetes management during Ramadan. Many components assessed by the calculator are amenable to modification, presenting an opportunity for year-round intervention to mitigate risk scores and subsequent fasting risks. By targeting modifiable risk factors and adapting strategies over time, individuals with diabetes can proactively diminish their fasting-related risks, safeguarding their physical well-being and spiritual engagement and potentially improving their overall diabetes control. This review aims to elucidate the evolution of the strategies for addressing modifiable risk factors, reducing risk scores and levels, and ensuring safe fasting practices.
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Affiliation(s)
- Bachar Afandi
- Endocrine Division, Tawam Hospital & UAE University, AlAin, UAE
| | - Mohammed Hassanein
- Endocrine Department, Dubai Hospital, Mohammed Bin Rashid University, Dubai, UAE
| | | | - Khadija Hafidh
- Diabetes Unit, Rashid Hospital, Mohammed Bin Rashid University, Dubai, UAE
- Diabetes Unit, Medical Department, Rashid Hospital, Dubai Academic Health Corporation, Oud Metha Street, PO Box 4545, Dubai, UAE
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11
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He YC, Wang NX, Zhong T. Reference diagnosis and treatment process of juvenile hemochromatosis patients. World J Clin Cases 2025; 13:99198. [DOI: 10.12998/wjcc.v13.i15.99198] [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: 07/16/2024] [Revised: 12/18/2024] [Accepted: 01/11/2025] [Indexed: 01/21/2025] Open
Abstract
The compelling case report by Xie et al, published in a renowned medical journal, is an excellent example of meticulous clinical evaluation, comprehensive laboratory testing, advanced imaging, and genetic analysis. The authors identified novel compound heterozygous mutations in the hemojuvelin gene of a patient diagnosed with juvenile hemochromatosis. They suggested that long-term, strategic phlebotomy might offer a novel therapeutic strategy for severe juvenile hemochromatosis, challenging the traditional treatment paradigms.
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Affiliation(s)
- Yan-Chun He
- College of Medicine, Jining Medical University, Jining 272067, Shandong Province, China
| | - Nan-Xue Wang
- Center for Reproductive Medicine, Affiliated Hospital of Jining Medical University, Jining 272029, Shandong Province, China
| | - Tao Zhong
- College of Medicine, Jining Medical University, Jining 272067, Shandong Province, China
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12
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Xu R, Sun LX, Chen Y, Ding C, Zhang M, Chen TF, Kong LY. Stoma occlusion caused by abdominal cocoon after abdominal abscess surgery: A case report. World J Clin Cases 2025; 13:98608. [DOI: 10.12998/wjcc.v13.i15.98608] [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: 06/30/2024] [Revised: 11/27/2024] [Accepted: 01/02/2025] [Indexed: 01/21/2025] Open
Abstract
BACKGROUND Abdominal cocoons (ACs) lack characteristic clinical manifestations and are mainly intestinal obstructions that are difficult to distinguish from intestinal obstruction caused by other causes, resulting in difficult preoperative diagnosis and misdiagnosis and mistreatment. There are no reports of enterostomy occlusion caused by ACs in the literature at home and abroad.
CASE SUMMARY Here, we report a 16-year-old female patient with intestinal obstruction due to AC. She was treated with abdominal surgery three times. First, she underwent a laparotomy for peritonitis after trauma from a traffic accident. During the procedure, pelvic empyema, severe intestinal adhesions, and damage to the serous layer of the rectum were found, but no significant intestinal rupture and perforation were found. As a precaution, she underwent a prophylactic ileostomy after a flush in her abdomen. The second and third surgeries were for treatment of recurrent stoma obstruction. The patient’s condition was complicated for a long period, but after comprehensive treatment by our department, the patient was successfully discharged from the hospital and is currently recovering well.
CONCLUSION Currently, abdominal contrast-enhanced computed tomography is the best imaging modality for preoperative evaluation of AC, but most patients are diagnosed only after intraoperative exploration. For the treatment of typical or severe ACs, the primary method of removal and healing of ACs is complete removal of the abdominal fibrous membrane. Finding a breakthrough in the anatomy is the key to the success of the surgery.
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Affiliation(s)
- Rui Xu
- Department of General Surgery, The People’s Hospital of Suqian City, Suqian 223800, Jiangsu Province, China
| | - Li-Xin Sun
- Department of General Surgery, The People’s Hospital of Suqian City, Suqian 223800, Jiangsu Province, China
| | - Yan Chen
- Department of General Surgery, The People’s Hospital of Suqian City, Suqian 223800, Jiangsu Province, China
| | - Chuang Ding
- Department of General Surgery, The People’s Hospital of Suqian City, Suqian 223800, Jiangsu Province, China
| | - Ming Zhang
- Department of General Surgery, The People’s Hospital of Suqian City, Suqian 223800, Jiangsu Province, China
| | - Teng-Fei Chen
- Department of General Surgery, The People’s Hospital of Suqian City, Suqian 223800, Jiangsu Province, China
| | - Ling-Yong Kong
- Department of General Surgery, The People’s Hospital of Suqian City, Suqian 223800, Jiangsu Province, China
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13
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Boini A, Grasso V, Taher H, Gumbs AA. Artificial intelligence and the impact of multiomics on the reporting of case reports. World J Clin Cases 2025; 13:101188. [DOI: 10.12998/wjcc.v13.i15.101188] [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: 12/31/2024] [Accepted: 01/11/2025] [Indexed: 01/21/2025] Open
Abstract
The integration of artificial intelligence (AI) and multiomics has transformed clinical and life sciences, enabling precision medicine and redefining disease understanding. Scientific publications grew significantly from 2.1 million in 2012 to 3.3 million in 2022, with AI research tripling during this period. Multiomics fields, including genomics and proteomics, also advanced, exemplified by the Human Proteome Project achieving a 90% complete blueprint by 2021. This growth highlights opportunities and challenges in integrating AI and multiomics into clinical reporting. A review of studies and case reports was conducted to evaluate AI and multiomics integration. Key areas analyzed included diagnostic accuracy, predictive modeling, and personalized treatment approaches driven by AI tools. Case examples were studied to assess impacts on clinical decision-making. AI and multiomics enhanced data integration, predictive insights, and treatment personalization. Fields like radiomics, genomics, and proteomics improved diagnostics and guided therapy. For instance, the “AI radiomics, genomics, oncopathomics, and surgomics project” combined radiomics and genomics for surgical decision-making, enabling preoperative, intraoperative, and postoperative interventions. AI applications in case reports predicted conditions like postoperative delirium and monitored cancer progression using genomic and imaging data. AI and multiomics enable standardized data analysis, dynamic updates, and predictive modeling in case reports. Traditional reports often lack objectivity, but AI enhances reproducibility and decision-making by processing large datasets. Challenges include data standardization, biases, and ethical concerns. Overcoming these barriers is vital for optimizing AI applications and advancing personalized medicine. AI and multiomics integration is revolutionizing clinical research and practice. Standardizing data reporting and addressing challenges in ethics and data quality will unlock their full potential. Emphasizing collaboration and transparency is essential for leveraging these tools to improve patient care and scientific communication.
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Affiliation(s)
- Aishwarya Boini
- Davao Medical School Foundation, Davao Medical School Foundation, Davao 8000, Philippines
| | - Vincent Grasso
- Department of Computer Engineering, Department of Electrical and Computer Engineering University of New Mexico, Albuquerque, NM 87106, United States
| | - Heba Taher
- Department of Pediatric Surgery, Cairo University Hospital, Cairo 11441, Egypt
| | - Andrew A Gumbs
- Department of Minimally Invasive Digestive Surgery, Hospital Antoine Beclère, Assistance Publique-Hospitals of Paris, Clamart 92140, France
- Department of Surgery, University of Magdeburg, Magdeburg 39130, Saxony-Anhalt, Germany
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14
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Farsakoury R, Nashwan AJ. Revitalizing upper blepharoplasty: Preserving volume. World J Clin Cases 2025; 13:100563. [DOI: 10.12998/wjcc.v13.i15.100563] [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: 08/20/2024] [Revised: 12/27/2024] [Accepted: 01/09/2025] [Indexed: 01/21/2025] Open
Abstract
Blepharoplasty is a frequently performed aesthetic surgery today aimed at enhancing eyelid appearance and correcting age-related changes. The traditional method of subtraction blepharoplasty, which involved removing fat and excess skin, is now considered outdated. This letter explores Gorgy et al's commentary on Miotti et al's study, highlighting a shift in upper eyelid blepharoplasty towards a more conservative, volume-preserving approach. The study systematically reviewed 10 publications, including three retrospective studies, five comparative studies, and two clinical trials. It emphasizes the trend towards preserving the patient's natural anatomy and focusing on enhancement rather than alteration. However, the study's limitations, such as the lack of long-term comparative research, a relatively small sample size, and a single-center design, indicate that further research with extended follow-up is necessary to validate the safety and effectiveness of these techniques. The focus is increasingly on preserving and augmenting volume in upper blepharoplasty rather than removing tissue.
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Affiliation(s)
- Rana Farsakoury
- Department of Plastic and Reconstructive Surgery, Hamad Medical Corporation, Doha 3050, Qatar
| | - Abdulqadir J Nashwan
- Department of Nursing and Midwifery Research, Hamad Medical Corporation, Doha 3050, Qatar
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15
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Fu XP. Dual benefits of sodium-glucose cotransporter 2 inhibitors in metabolic diseases: Diabetes control and gout management. World J Clin Cases 2025; 13:100262. [DOI: 10.12998/wjcc.v13.i14.100262] [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: 08/11/2024] [Revised: 12/22/2024] [Accepted: 12/30/2024] [Indexed: 01/15/2025] Open
Abstract
The study by Lin et al delves into the clinical impact of dapagliflozin, a representative sodium-glucose cotransporter 2 (SGLT2) inhibitor, on chronic heart failure complicated by hyperuricemia. This investigation highlights dapagliflozin’s efficacy in lowering serum uric acid levels, enhancing cardiac function, and reducing cardiovascular events. This work not only provides a comprehensive analysis of dapagliflozin’s sustained benefits in these patients but also introduces novel insights for managing chronic heart failure exacerbated by elevated uric acid. Furthermore, this review examines the potential role of SGLT2 inhibitor in the context of gout, evaluating its mechanisms and clinical application prospects in the management of hyperuricemia, thereby further enriching the medical community’s understanding of SGLT2 inhibitor.
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Affiliation(s)
- Xiao-Peng Fu
- College of Traditional Chinese Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou 350122, Fujian Province, China
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16
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Finsterer J, Mehri S. Electromyography biofeedback training for post-stroke dysphagia. World J Clin Cases 2025; 13:97380. [DOI: 10.12998/wjcc.v13.i14.97380] [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: 10/08/2024] [Accepted: 01/07/2025] [Indexed: 01/15/2025] Open
Abstract
Dysphagia is a common complication of ischemic stroke and is usually difficult to treat. The mainstay of standard therapy of post-stroke dysphagia (PSD) is effortful swallowing. Since its introduction in 2004, there is increasing evidence that surface electromyography-guided biofeedback training (EMGBT) can enhance the therapeutic effect of standard LE. In this editorial, we comment on the article by Meng et al published in the recent issue of the World Journal of Clinical Cases, which provided evidence that particularly extensive EMGBT with an increased number of sessions is definitively more effective than the standard speech therapy or ordinary EMGBT. Among the 90 PSD patients with ischemic stroke or intracerebral bleeding, those who underwent EMGBT in more sessions than usual particularly benefited from the approach. It was concluded that EMGBT is more effective than traditional swallowing training in improving dysphagia and swallowing disorders as well as hyoid-laryngeal complex movement speed in PSD patients.
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Affiliation(s)
- Josef Finsterer
- Department of Neurology, Neurology and Neurophysiology Center, Vienna 1180, Austria
| | - Sounira Mehri
- Laboratory of Nutrition and Vascular Health, Faculty of Medicine, Monastir 5000, Tunisia
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17
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Xu LY, Yu Y, Cen LS. Insight into the efficacy and safety of pirfenidone: The treatment of idiopathic pulmonary fibrosis. World J Clin Cases 2025; 13:98769. [DOI: 10.12998/wjcc.v13.i14.98769] [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: 07/05/2024] [Revised: 12/09/2024] [Accepted: 01/02/2025] [Indexed: 01/15/2025] Open
Abstract
Idiopathic pulmonary fibrosis (IPF) has a poor prognosis if left untreated; therefore, early treatment with pirfenidone is crucial. Lei et al conducted a retrospective analysis to evaluate the effectiveness of early pirfenidone treatment on lung function in 113 patients with IPF. In addition to other research, pirfenidone has demonstrated efficacy in patients at all stages of IPF once correct diagnosis has been made. In advanced IPF, we include the requirement for pirfenidone. Therefore, it is essential to choose an appropriate method of administration method, such as inhalation. This may circumvent the drawbacks of the high cost and possible adverse effects of this drug.
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Affiliation(s)
- Li-Ying Xu
- Department of Medical Administration, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou 310006, Zhejiang Province, China
| | - Yi Yu
- The First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou 310051, Zhejiang Province, China
| | - Lu-Sha Cen
- Department of Ophthalmology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou 310006, Zhejiang Province, China
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18
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Cheng CY, Hao WR, Cheng TH. Bivalirudin for anticoagulation in elderly acute coronary syndrome: Effects on myocardial microcirculation and adverse events. World J Clin Cases 2025; 13:98008. [DOI: 10.12998/wjcc.v13.i13.98008] [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: 06/15/2024] [Revised: 11/08/2024] [Accepted: 12/25/2024] [Indexed: 01/11/2025] Open
Abstract
The management of acute coronary syndrome (ACS) in older patients remains challenging because standard anticoagulants often fail to yield optimal outcomes. Bivalirudin, a direct inhibitor of thrombin, serves as an alternative to traditional therapies. This drug is particularly effective in enhancing myocardial microcirculation and reducing adverse events after clinical interventions. The present article explores the findings of a recent study that highlighted the clinical benefits of bivalirudin by investigating its effects on myocardial microcirculation and adverse cardiac events after percutaneous coronary intervention in older patients with ACS. Compared with unfractionated heparin, bivalirudin markedly reduced the emergency response time and improved cardiac function indicators. It further mitigated the risks of cardiovascular events and recurrent myocardial infarctions. These findings suggest that bivalirudin can enhance myocardial perfusion and reduce bleeding complications, thus serving as a safe, effective anticoagulation agent for older patients with ACS. Nonetheless, further large-scale, high-quality trials are needed to establish optimal usage guidelines and assess long-term outcomes. Integrating bivalirudin into ACS treatment protocols for older patients may help optimize patient care, balancing efficacy and safety. Continual research and consensus building are necessary for the widespread clinical application of bivalirudin and the improvement of ACS outcomes in older patients.
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Affiliation(s)
- Chun-Yao Cheng
- Department of Ophthalmology, Cathay General Hospital, Taipei 10633, Taiwan
- Department of Medical Education, National Taiwan University Hospital, Taipei 100225, Taiwan
| | - Wen-Rui Hao
- Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Ministry of Health and Welfare, Taipei Medical University, New Taipei City 23561, Taiwan
- Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei City 11002, Taiwan
| | - Tzu-Hurng Cheng
- Department of Biochemistry, School of Medicine, College of Medicine, China Medical University, Taichung City 404328, Taiwan
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19
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Yang S, Hui TL, Wang HQ, Zhang X, Mi YZ, Cheng M, Gao W, Geng CZ, Li SN. Correction to: High expression of autophagy-related gene EIF4EBP1 could promote tamoxifen resistance and predict poor prognosis in breast cancer. World J Clin Cases 2025; 13:100700. [DOI: 10.12998/wjcc.v13.i13.100700] [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: 08/23/2024] [Revised: 10/12/2024] [Accepted: 10/22/2024] [Indexed: 01/11/2025] Open
Abstract
This is an erratum to the published paper titled, “High expression of autophagy-related gene EIF4EBP1 could promote tamoxifen resistance and predict poor prognosis in breast cancer.” We have removed the citations to certain articles in subsequent revisions of the manuscript. However, owing to our oversight, the citation marker in the upper right corner was not removed. We apologize for any confusion this may have caused.
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Affiliation(s)
- Shan Yang
- Department of Breast Center, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, China
| | - Tian-Li Hui
- Department of Breast Center, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, China
| | - Hao-Qi Wang
- Department of Breast Center, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, China
| | - Xi Zhang
- Department of Breast Center, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, China
| | - Yun-Zhe Mi
- Department of Breast Center, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, China
| | - Meng Cheng
- Department of Breast Center, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, China
| | - Wei Gao
- Department of Breast Center, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, China
| | - Cui-Zhi Geng
- Department of Breast Center, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, China
| | - Sai-Nan Li
- Department of Breast Center, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, China
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20
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Bhowmik S, Hajra A, Bandyopadhyay D. Genetic insights in infectious diseases: Insights from a case report and implications for personalized medicine. World J Clin Cases 2025; 13:101438. [DOI: 10.12998/wjcc.v13.i13.101438] [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: 09/14/2024] [Revised: 12/10/2024] [Accepted: 12/23/2024] [Indexed: 01/11/2025] Open
Abstract
The relationship between genetics and infectious diseases is important in shaping our understanding of disease susceptibility, progression, and treatment. Recent research shows the impact of genetic variations, such as heme-oxygenase promoter length, on diseases like malaria and sepsis, revealing both protective and inconclusive effects. Studies on vaccine responses highlight genetic markers like human leukocyte antigens, emphasizing the potential for personalized immunization strategies. The ongoing battle against drug-resistant tuberculosis (TB) illustrates the complexity of genomic variants in predicting resistance, highlighting the need for integrated diagnostic tools. Additionally, genome-wide association studies reveal antibiotic resistance mechanisms in bacterial genomes, while host genetic polymorphisms, such as those in solute carrier family 11 member 1 and vitamin D receptor, demonstrate their role in TB susceptibility. Advanced techniques like metagenomic next-generation sequencing promise detailed pathogen detection but face challenges in cost and accessibility. A case report involving a highly virulent Mycobacterium TB strain with the pks1 gene further highlights the need for genetic insights in understanding disease severity and developing targeted interventions. This evolving landscape emphasizes the role of genetics in infectious diseases, while also addressing the need for standardized studies and accessible technologies.
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Affiliation(s)
- Suryasnata Bhowmik
- Department of Medicine, Nilratan Sircar Medical College, Kolkata 700156, West Bengal, India
| | - Adrija Hajra
- Department of Medicine, Brigham and Women’s Hospital/Mass General Brigham, Boston, MA 02115, United States
| | - Dhrubajyoti Bandyopadhyay
- Department of Cardiovacular Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States
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21
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Pérez-Holanda S. Life-threatening bleeding caused by artery pseudoaneurysm after endoscopic procedure successfully treated by artery embolization. World J Clin Cases 2025; 13:99278. [DOI: 10.12998/wjcc.v13.i13.99278] [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: 07/23/2024] [Revised: 12/17/2024] [Accepted: 12/25/2024] [Indexed: 01/11/2025] Open
Abstract
The Kakinuma et al’s case report shows that non-pregnancy-related arterial pseudoaneurysm is a relatively rare, little known by some gynecologists, endoscopists, surgeons or radiologists, which can cause massive bleeding. Arterial pseudoaneurysm is a condition in which the wall of a blood vessel collapses due to some invasive event, and the resulting leaked blood is engulfed by soft tissues, forming a cavity that is in communication with the vessel. It is a potentially life-threatening complication that could occurs after some deliveries and some gynecological invasive procedures. Remarkably, an undetermined percentage of pseudoaneurysms are asymptomatic, and in an asymptomatic patient it is difficult to predict the risk of haemorrhage and the attitude to follow, which depends on several factors, such as, the size and location of the vessel involved, changes in the size of the pseudoaneurysm, or the available therapeutic resources to be offered to patients, among others circumstances. The management of abdominal arterial pseudoaneurysm does not have consistent scientific evidence, but it seems that, regardless of the associated circumstances, the pseudoaneurysm could be treated at least initially, and mainly, through endovascular procedures, as done by Kakinuma et al.
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Affiliation(s)
- Sergio Pérez-Holanda
- Office of Regional Vice-ministry of Health, Regional Vice-ministry of Health, Oviedo 33005, Asturias, Spain
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22
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Liu XC, Liu YX, Liu C. Concurrent occurrence of adenocarcinoma and urothelial carcinoma of the prostate: Coexistence mechanisms from multiple perspectives. World J Clin Cases 2025; 13:100248. [DOI: 10.12998/wjcc.v13.i12.100248] [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: 08/11/2024] [Revised: 11/29/2024] [Accepted: 12/19/2024] [Indexed: 01/07/2025] Open
Abstract
This article discusses the coexistence of prostate adenocarcinoma and prostate urothelial carcinoma. Combining existing literature and research results, the potential mechanisms of the co-occurrence of these two cancers are explored, including the role of androgen receptor, gene mutations, and their complex interactions in cell signaling pathways, etc. Also, the hypothesis of prostate cancer transformation into urothelial carcinoma is explained from some perspectives, including tumor multipotent stem cell differentiation, epithelial-mesenchymal transition, mesenchymal-epithelial transition, and other mechanisms. Ultimately, the goal is to provide more accurate diagnoses and more personalized treatments in clinical practice, as well as to lay the foundation for improving patient prognoses in the future.
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Affiliation(s)
- Xu-Chang Liu
- The No. 1 Clinical Medical School, Shanxi Medical University, Taiyuan 030001, Shanxi Province, China
| | - Yu-Xiang Liu
- Department of Nephrology, Shanxi Provincial People’s Hospital, Taiyuan 030012, Shanxi Province, China
| | - Chun Liu
- The No. 1 Clinical Medical School, Shanxi Medical University, Taiyuan 030001, Shanxi Province, China
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23
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Byeon H. Enhancing orthodontic osteodilated arch treatment through comprehensive nursing interventions and cognitive behavioral therapy. World J Clin Cases 2025; 13:99301. [DOI: 10.12998/wjcc.v13.i12.99301] [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: 07/19/2024] [Revised: 09/19/2024] [Accepted: 12/18/2024] [Indexed: 01/07/2025] Open
Abstract
Orthodontic osteodilated arch treatment represents a pivotal approach in dental orthodontics to address dental crowding and misalignment. Integrating cognitive behavioral therapy (CBT) into comprehensive nursing interventions (CNI) aims to address these issues holistically. This editorial explores the effectiveness of CBT-based CNI in improving patient outcomes in orthodontic care. Innovations in remote CBT delivery, such as virtual reality, have also shown potential in reducing pain, anxiety, and depression, emphasizing CBT's adaptability in orthodontic settings. The findings underscore the importance of integrating psychological support into orthodontic care to enhance patient adherence, satisfaction, and overall treatment success. The editorial advocates for a holistic approach that combines psychological and physiological care, highlighting the transformative potential of CBT-based interventions in orthodontic treatment.
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Affiliation(s)
- Haewon Byeon
- Department of Digital Anti-aging Healthcare (BK21), Inje University, Gimhae 50834, South Korea
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24
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Lan B, Qiang Z. Small bowel obstruction due to intra-abdominal hernia: New thoughts on diagnosis and treatment. World J Clin Cases 2025; 13:102204. [DOI: 10.12998/wjcc.v13.i12.102204] [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: 10/11/2024] [Revised: 11/04/2024] [Accepted: 12/16/2024] [Indexed: 01/07/2025] Open
Abstract
Internal herniation (IH) refers to the movement of intra-abdominal organs or tissues out of their original position through normal or abnormal orifices and fissures in the peritoneum or mesentery and into an anatomic space within the abdominal cavity. Although the incidence of small bowel obstruction (SBO) caused by IH is very low (approximately 0.2% to 0.9%), its incidence may be increased in certain specific populations or in postoperative patients. Recently Kaw et al shared their 13-year experience of managing IHs in a tertiary care hospital in India. This retrospective study analyzed and determined the clinico-demographic profiles, radiological and operative findings and postoperative course of patients with IH and the association with SBO. The results provide valuable insights into early diagnosis and establishment of a timely treatment regimen for this condition and emphasize the importance of combining rapid imaging evaluation with the traditional therapeutic approach of laparoscopic surgery, thus providing a novel perspective on the diagnosis and treatment of SBO caused by IH.
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Affiliation(s)
- Bo Lan
- Department of Pharmacology and Toxicology, Sichuan-Chongqing Joint Key Laboratory of New Chinese Medicine Creation Laboratory, Chongqing Academy of Chinese Materia Medica, Chongqing 400061, China
| | - Zhe Qiang
- Department of Pharmacology and Toxicology, Sichuan-Chongqing Joint Key Laboratory of New Chinese Medicine Creation Laboratory, Chongqing Academy of Chinese Materia Medica, Chongqing 400061, China
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25
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Shulkin A, Efanov JI. Enhancing outcomes in severe lymphedema through combined treatment strategies. World J Clin Cases 2025; 13:98825. [DOI: 10.12998/wjcc.v13.i12.98825] [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: 07/06/2024] [Revised: 11/19/2024] [Accepted: 12/17/2024] [Indexed: 01/07/2025] Open
Abstract
Lymphedema, particularly in its advanced stages, presents significant challenges in treatment, often necessitating a combination of therapies to manage symptoms effectively and improve patient outcomes. This article reviews the findings of Wang et al, regarding the use of lymphovenous anastomosis and complex decongestive therapy in treating severe, deformed stage III lymphedema with recurrent infections. The case report details the promising results achieved through this combined therapy, highlighting substantial reductions in limb volume and the complete resolution of recurrent lymphangitis. The patient experienced notable improvements in weight loss, physical function, and quality of life. Despite its strengths, the study has several limitations. It lacks specific details on the types of lymphovenous anastomoses performed and complex decongestive therapy protocols, such as frequency and adherence, making reproducibility difficult. The short follow-up period of six months limits understanding of long-term efficacy, and more consistent reporting of key metrics such as weight loss and body mass index would enhance outcome assessments. This article emphasizes the importance of integrating minimally invasive surgical techniques with conservative therapies to address both the symptoms and underlying causes of lymphedema. Further research is essential to standardize protocols and refine combined treatment strategies.
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Affiliation(s)
- Aidan Shulkin
- Plastic and Reconstructive Surgery, Department of Surgery, Centre hospitalier de l’Université de Montréal, Montreal H2X3E4, Quebec, Canada
| | - Johnny I Efanov
- Plastic and Reconstructive Surgery, Department of Surgery, Centre hospitalier de l’Université de Montréal, Montreal H2X3E4, Quebec, Canada
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Sridhar GR, Yarabati V, Gumpeny L. Predicting outcomes using neural networks in the intensive care unit. World J Clin Cases 2025; 13:100966. [DOI: 10.12998/wjcc.v13.i11.100966] [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: 08/31/2024] [Revised: 11/21/2024] [Accepted: 12/12/2024] [Indexed: 12/26/2024] Open
Abstract
Patients in intensive care units (ICUs) require rapid critical decision making. Modern ICUs are data rich, where information streams from diverse sources. Machine learning (ML) and neural networks (NN) can leverage the rich data for prognostication and clinical care. They can handle complex nonlinear relationships in medical data and have advantages over traditional predictive methods. A number of models are used: (1) Feedforward networks; and (2) Recurrent NN and convolutional NN to predict key outcomes such as mortality, length of stay in the ICU and the likelihood of complications. Current NN models exist in silos; their integration into clinical workflow requires greater transparency on data that are analyzed. Most models that are accurate enough for use in clinical care operate as ‘black-boxes’ in which the logic behind their decision making is opaque. Advances have occurred to see through the opacity and peer into the processing of the black-box. In the near future ML is positioned to help in clinical decision making far beyond what is currently possible. Transparency is the first step toward validation which is followed by clinical trust and adoption. In summary, NNs have the transformative ability to enhance predictive accuracy and improve patient management in ICUs. The concept should soon be turning into reality.
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Affiliation(s)
- Gumpeny R Sridhar
- Department of Endocrinology and Diabetes, Endocrine and Diabetes Centre, Visakhapatnam 530002, India
| | - Venkat Yarabati
- Chief Architect, Data and Insights, AGILISYS, London W127RZ, United Kingdom
| | - Lakshmi Gumpeny
- Department of Internal Medicine, Gayatri Vidya Parishad Institute of Healthcare and Medical Technology, Visakhapatnam 530048, India
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Hao SY, Muhetaer Y, Zheng X, Long YL, Song JQ, Zhong M. Rapid improvement in postpartum pulmonary hypertension associated with hereditary hemorrhagic telangiectasia: A case report and review of literature. World J Clin Cases 2025; 13:98128. [DOI: 10.12998/wjcc.v13.i11.98128] [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: 06/18/2024] [Revised: 11/18/2024] [Accepted: 12/10/2024] [Indexed: 12/26/2024] Open
Abstract
BACKGROUND Postpartum pulmonary arterial hypertension (PAH) complicated with hereditary hemorrhagic telangiectasia (HHT) is a rare condition. Diagnosing and treating PAH in patients with HHT can be challenging. To the best of our knowledge, no previous reports have investigated the efficacy of pulmonary vasodilators in improving hemodynamics in postpartum patients with this disease.
CASE SUMMARY In this paper, we report a postpartum case of HHT combined with PAH, presenting with worsening dyspnea. Genetic testing revealed that the patient carried a heterozygous variant of activin receptor-like kinase 1. The patient received various treatments, including diuretics, anticoagulants, sildenafil, macitentan, inhalation of nitric oxide, and iloprost. Changes in PaO2/FiO2, pulmonary artery systolic pressure as assessed by echocardiography, and N-terminus pro-brain natriuretic peptide levels suggested that, except for iloprost inhalation, the other treatments appeared to have limited efficacy.
CONCLUSION To our knowledge, this is the first report on efficacy of pulmonary vasodilators in postpartum patients with HHT and PAH.
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Affiliation(s)
- Sheng-Yu Hao
- Department of Critical Care Medicine, Zhongshan Hospital Affiliated to Fudan University, Shanghai 200032, China
| | - Yaxiaerjiang Muhetaer
- Department of Critical Care Medicine, Zhongshan Hospital Affiliated to Fudan University, Shanghai 200032, China
| | - Xin Zheng
- Department of Critical Care Medicine, Zhongshan Hospital Affiliated to Fudan University, Shanghai 200032, China
| | - Yu-Liang Long
- Department of Cardiology, Zhongshan Hospital Affiliated to Fudan University, Shanghai 200032, China
| | - Jie-Qiong Song
- Department of Critical Care Medicine, Zhongshan Hospital Affiliated to Fudan University, Shanghai 200032, China
| | - Ming Zhong
- Department of Critical Care Medicine, Zhongshan Hospital Affiliated to Fudan University, Shanghai 200032, China
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Posa A, Genco E. High-grade pancreatic intraepithelial neoplasia: A commentary of magnetic resonance cholangiopancreatography findings. World J Clin Cases 2025; 13:98854. [DOI: 10.12998/wjcc.v13.i11.98854] [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: 10/18/2024] [Accepted: 12/16/2024] [Indexed: 12/26/2024] Open
Abstract
Commentary on the role of magnetic resonance cholangiopancreatography findings in diagnosing high grade pancreatic intraepithelial neoplasms.
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Affiliation(s)
- Alessandro Posa
- Department of Diagnostic Imaging, Oncologic Radiotherapy and Hematology, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome 00168, Italy
| | - Enza Genco
- Department of Diagnostic Imaging, Oncologic Radiotherapy and Hematology, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome 00168, Italy
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29
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Okasha HH, Tag-Adeen M, Shaaban HE. Role of pancreatic juice cytology in diagnosis of high-grade pancreatic intraepithelial neoplasia. World J Clin Cases 2025; 13:94437. [DOI: 10.12998/wjcc.v13.i10.94437] [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: 03/18/2024] [Revised: 11/05/2024] [Accepted: 12/03/2024] [Indexed: 12/19/2024] Open
Abstract
High-grade pancreatic intraepithelial neoplasia is a challenging diagnosis and it does not exhibit mass lesions. It is suspected based on changes in the main pancreatic duct in magnetic resonance cholangiopancreatography. Sometimes only an unclear duct shows in magnetic resonance cholangiopancreatography with no focal strictures and upstream dilatation of the main pancreatic duct. Serial pancreatic juice cytology is valuable in diagnosis of those patients.
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Affiliation(s)
- Hussein Hassan Okasha
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kasr Al-Aini School of Medicine, Cairo University, Cairo 11562, Egypt
| | - Mohammed Tag-Adeen
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Qena Faculty of Medicine, South Valley University, Qena 83523, Egypt
| | - Hossam Eldin Shaaban
- Department of Internal Medicine and Gastroenterology, National Hepatology and Tropical Medicine Research Institute, Cairo 11796, Egypt
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30
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Nguyen PD, Lam TK. Schistosomal appendicitis: A serious and often misdiagnosed condition. World J Clin Cases 2025; 13:102022. [DOI: 10.12998/wjcc.v13.i10.102022] [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: 10/05/2024] [Revised: 11/05/2024] [Accepted: 12/05/2024] [Indexed: 12/19/2024] Open
Abstract
Schistosomal appendicitis (SA) is a rare but serious complication of schistosomiasis, a parasitic disease affecting over 250 million people worldwide. A recent retrospective study by Wang et al provides important insights into the clinicopathological characteristics of SA. The study compared 136 cases of SA to 5418 cases of non-SA over a ten-year period. Key findings include a higher average age of SA patients (61.73 years vs 35.8 years for non-SA), a higher proportion of acute on chronic appendicitis (33.1% vs 16%), and a significantly higher incidence of colorectal cancer (11.7% vs 2.2%). Despite these differences, SA remains a diagnostic challenge due to its nonspecific clinical presentation and lack of specific laboratory findings. The study also highlights the persistent prevalence of SA, accounting for 1.6%-3.4% of all appendicitis cases each year from 2013 to 2023. These findings underscore the need for enhanced awareness, early detection, and prompt treatment of SA in endemic regions. Given the association with colorectal cancer, patients with SA require thorough screening and follow-up. Further research into the pathogenesis and diagnostic markers of SA is warranted. As the global battle against schistosomiasis continues, targeted efforts to diagnose and manage SA can significantly improve patient outcomes.
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Affiliation(s)
- Phi Duong Nguyen
- Orthopaedic-Burn-Plastic Surgery, City Children’s Hospital, Ho Chi Minh City 71815, Viet Nam
| | - Thanh Kien Lam
- The Faculty of Medical Technology, Van Lang University, Ho Chi Minh City 700000, Viet Nam
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Onishi S, Iwashita T, Tezuka Y, Kojima K, Takada J, Kubota M, Ibuka T, Shimizu M. Recurrence rates and risk factors in obscure gastrointestinal bleeding. DEN OPEN 2025; 5:e70011. [PMID: 39253626 PMCID: PMC11382536 DOI: 10.1002/deo2.70011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2024] [Revised: 08/22/2024] [Accepted: 08/26/2024] [Indexed: 09/11/2024]
Abstract
Obscure gastrointestinal bleeding (OGIB), defined in 2010, involves bleeding from the GI tract that remains unexplained after standard diagnostic procedures. OGIB, which accounts for about 5% of all GI bleeds, poses diagnostic and management challenges, particularly due to the anatomical features of the small intestine. Advances in capsule endoscopy (CE) and balloon-assisted endoscopy have improved the diagnostic and therapeutic landscape for small intestinal lesions. Objective To determine the recurrence rate and identify risk factors for recurrence following diagnostic and therapeutic interventions using CE and balloon-assisted endoscopy in patients with OGIB. Methods A retrospective cohort study at Gifu University Hospital analyzed CE procedures for patients with OGIB from 2008 to 2022. Patients underwent CE with subsequent treatments based on the findings. Statistical analyses, including Kaplan-Meier and Cox proportional hazards models, were used to estimate cumulative recurrence rates and identify recurrence risk factors. Results Out of 417 patients, 65.2% had positive CE findings, leading to therapeutic interventions in 16.3% of cases. The cumulative recurrence rates at 12, 24, and 36 months were 4.3%, 9.0%, and 13.9%, respectively. Liver cirrhosis (hazard rate: 4.15, 95% confidence interval 1.88-9.18, p < 0.01) was identified as a significant risk factor for recurrence. Conclusions A significant recurrence rate in OGIB patients, with liver cirrhosis being a major risk factor. Despite diagnostic and therapeutic advances, a comprehensive approach including careful follow-up and consideration of risk factors is essential for management.
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Affiliation(s)
- Sachiyo Onishi
- First Department of Internal MedicineGifu University HospitalGifuJapan
| | - Takuji Iwashita
- First Department of Internal MedicineGifu University HospitalGifuJapan
| | - Yukari Tezuka
- First Department of Internal MedicineGifu University HospitalGifuJapan
| | - Kentaro Kojima
- First Department of Internal MedicineGifu University HospitalGifuJapan
| | - Jun Takada
- First Department of Internal MedicineGifu University HospitalGifuJapan
| | - Masaya Kubota
- First Department of Internal MedicineGifu University HospitalGifuJapan
| | - Takashi Ibuka
- First Department of Internal MedicineGifu University HospitalGifuJapan
| | - Masahito Shimizu
- First Department of Internal MedicineGifu University HospitalGifuJapan
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Ishihara Y, Ichita C, Jinushi R, Sasaki A. Clinical assessment of computed tomography for detecting ingested blister packs: A single-center retrospective study. DEN OPEN 2025; 5:e406. [PMID: 39011510 PMCID: PMC11248714 DOI: 10.1002/deo2.406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 06/24/2024] [Accepted: 06/30/2024] [Indexed: 07/17/2024]
Abstract
Objectives Blister pack (BP) ingestion poses serious risks, such as gastrointestinal perforation, and accurate localization by computed tomography (CT) is a common practice. However, while it has been reported in vitro that CT visibility varies with the material type of BPs, there have been no reports on this variability in clinical settings. In this study, we investigated the CT detection rates of different BPs in clinical settings. Methods This single-center retrospective study from 2010 to 2022 included patients who underwent endoscopic foreign body removal for BP ingestion. The patients were categorized into two groups for BP components, the polypropylene (PP) and the polyvinyl chloride (PVC)/polyvinylidene chloride (PVDC) groups. The primary outcome was the comparison of CT detection rates between the groups. We also evaluated whether the BPs contained tablets and analyzed their locations. Results This study included 61 patients (15 in the PP group and 46 in the PVC/PVDC group). Detection rates were 97.8% for the PVC/PVDC group compared to 53.3% for the PP group, a significant difference (p < 0.01). No cases of BPs composed solely of PP were detected by CT. Blister packs were most commonly found in the upper thoracic esophagus. Conclusions Even in a clinical setting, the detection rates of PVC and PVDC were higher than that of PP alone. Identifying PP without tablets has proven challenging in clinical. Considering the risk of perforation, these findings suggest that esophagogastroduodenoscopy may be necessary, even if CT detection is negative.
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Affiliation(s)
- Yo Ishihara
- Department of Gastroenterology Medicine CenterShonan Kamakura General HospitalKanagawaJapan
- Department of Palliative MedicineInternational University of Health and Welfare Narita HospitalChibaJapan
| | - Chikamasa Ichita
- Department of Gastroenterology Medicine CenterShonan Kamakura General HospitalKanagawaJapan
- Department of Health Data ScienceYokohama City UniversityKanagawaJapan
| | - Ryuhei Jinushi
- Department of Gastroenterology Medicine CenterShonan Kamakura General HospitalKanagawaJapan
- Department of GastroenterologySaitama Medical University International Medical CenterSaitamaJapan
| | - Akiko Sasaki
- Department of Gastroenterology Medicine CenterShonan Kamakura General HospitalKanagawaJapan
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33
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Takeda T, Sasaki T, Okamoto T, Mie T, Sato Y, Maegawa Y, Hirai T, Suzuki Y, Furukawa T, Ozaka M, Sasahira N. Outcomes of multi-hole self-expandable metal stents versus fully covered self-expandable metal stents for malignant distal biliary obstruction in unresectable pancreatic cancer. DEN OPEN 2025; 5:e70014. [PMID: 39323619 PMCID: PMC11422663 DOI: 10.1002/deo2.70014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2024] [Revised: 08/29/2024] [Accepted: 09/05/2024] [Indexed: 09/27/2024]
Abstract
Objectives The multi-hole self-expandable metal stent (MHSEMS) is a novel SEMS with multiple small side holes on the covering membrane to prevent stent migration while minimizing tumor ingrowth. This study aimed to evaluate the clinical outcomes of MHSEMS in comparison with conventional covered SEMS (c-CMS). Methods Consecutive patients with unresectable pancreatic cancer who underwent initial SEMS placement (MHSEMS or c-CMS) for malignant distal biliary obstruction were analyzed. Technical success, clinical success, causes of recurrent biliary obstruction (RBO), non-RBO adverse events, time to RBO (TRBO), and endoscopic reintervention were compared between groups. Results A total of 65 patients were included (MHSEMS: 27, c-CMS: 38). The technical success, clinical success, and non-RBO adverse event rates were similar between groups. Although stent migration was less frequently observed in the MHSEMS group (0% vs. 17.6%, p = 0.032), overall RBO rates were similar between groups (53.8% vs. 55.9%, p > 0.99). The most common cause of RBO within 14 days in the MHSEMS group was non-occlusion cholangitis. Median TRBO was significantly shorter in the MHSEMS group (101 vs. 227 days, p = 0.030) and MHSEMS was an independent predictor for shorter TRBO in multivariate analysis (hazard ratio, 2.27; 95% confidence interval, 1.06-4.86; p = 0.034). Outcomes after endoscopic interventio were not significantly different between groups. Stent removal was successful in all attempted cases in both groups. Conclusions MHSEMS was associated with a significantly shorter TRBO compared to c-CMS. Further modifications of the present MHSEMS may be needed.
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Affiliation(s)
- Tsuyoshi Takeda
- Department of Hepato‐Biliary‐Pancreatic MedicineCancer Institute Hospital of Japanese Foundation for Cancer ResearchTokyoJapan
| | - Takashi Sasaki
- Department of Hepato‐Biliary‐Pancreatic MedicineCancer Institute Hospital of Japanese Foundation for Cancer ResearchTokyoJapan
| | - Takeshi Okamoto
- Department of Hepato‐Biliary‐Pancreatic MedicineCancer Institute Hospital of Japanese Foundation for Cancer ResearchTokyoJapan
| | - Takafumi Mie
- Department of Hepato‐Biliary‐Pancreatic MedicineCancer Institute Hospital of Japanese Foundation for Cancer ResearchTokyoJapan
| | - Yoichiro Sato
- Department of Hepato‐Biliary‐Pancreatic MedicineCancer Institute Hospital of Japanese Foundation for Cancer ResearchTokyoJapan
| | - Yuri Maegawa
- Department of Hepato‐Biliary‐Pancreatic MedicineCancer Institute Hospital of Japanese Foundation for Cancer ResearchTokyoJapan
| | - Tatsuki Hirai
- Department of Hepato‐Biliary‐Pancreatic MedicineCancer Institute Hospital of Japanese Foundation for Cancer ResearchTokyoJapan
| | - Yukari Suzuki
- Department of Hepato‐Biliary‐Pancreatic MedicineCancer Institute Hospital of Japanese Foundation for Cancer ResearchTokyoJapan
| | - Takaaki Furukawa
- Department of Hepato‐Biliary‐Pancreatic MedicineCancer Institute Hospital of Japanese Foundation for Cancer ResearchTokyoJapan
| | - Masato Ozaka
- Department of Hepato‐Biliary‐Pancreatic MedicineCancer Institute Hospital of Japanese Foundation for Cancer ResearchTokyoJapan
| | - Naoki Sasahira
- Department of Hepato‐Biliary‐Pancreatic MedicineCancer Institute Hospital of Japanese Foundation for Cancer ResearchTokyoJapan
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Vaishya R, Vaish A, Scarlat MM, Jain VK. The crucial role and challenges of medical journal editors in the modern era. J Clin Orthop Trauma 2025; 63:102918. [PMID: 39902340 PMCID: PMC11787446 DOI: 10.1016/j.jcot.2025.102918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2024] [Revised: 12/30/2024] [Accepted: 01/09/2025] [Indexed: 02/05/2025] Open
Abstract
There is an evolving role of medical journal editors in the 21st century, highlighting the challenges they face in ensuring the quality, accuracy, and relevance of published research. As gatekeepers of medical information, editors are inundated with a high volume of submissions, necessitating efficient triage and a keen understanding of diverse scientific fields. The peer review process presents its hurdles, particularly in securing timely assessments from busy experts, while ethical considerations around bias and misconduct demand rigorous scrutiny. Additionally, the emergence of artificial intelligence in research poses both opportunities and complications, calling for clear guidelines to maintain the value of human authorship. Overall, the findings emphasize the critical role of editors in sustaining the integrity of medical publishing amidst an increasingly complex landscape.
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Affiliation(s)
- Raju Vaishya
- Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi, 110076, India
| | - Abhishek Vaish
- Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi, 110076, India
| | - Marius M. Scarlat
- Clinique Chirurgicale St Michel, Groupe ELSAN, 83100, Toulon, France
| | - Vijay Kumar Jain
- Atal Bihari Vajpayee Institute of Medical Scineces and Dr RML Hospital, New Delhi, India
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Itonaga M, Ashida R, Kitano M. Updated techniques and evidence for endoscopic ultrasound-guided tissue acquisition from solid pancreatic lesions. DEN OPEN 2025; 5:e399. [PMID: 38911353 PMCID: PMC11190023 DOI: 10.1002/deo2.399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2024] [Accepted: 06/03/2024] [Indexed: 06/25/2024]
Abstract
Endoscopic ultrasound-guided tissue acquisition (EUS-TA), including fine-needle aspiration (EUS-FNA) and fine-needle biopsy (EUS-FNB), has revolutionized specimen collection from intra-abdominal organs, especially the pancreas. Advances in personalized medicine and more precise treatment have increased demands to collect specimens with higher cell counts, while preserving tissue structure, leading to the development of EUS-FNB needles. EUS-FNB has generally replaced EUS-FNA as the procedure of choice for EUS-TA of pancreatic cancer. Various techniques have been tested for their ability to enhance the diagnostic performance of EUS-TA, including multiple methods of sampling at the time of puncture, on-site specimen evaluation, and specimen processing. In addition, advances in next-generation sequencing have made comprehensive genomic profiling of EUS-TA samples feasible in routine clinical practice. The present review describes updates in EUS-TA sampling techniques of pancreatic lesions, as well as methods for their evaluation.
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Affiliation(s)
- Masahiro Itonaga
- Second Department of Internal MedicineWakayama Medical UniversityWakayamaJapan
| | - Reiko Ashida
- Second Department of Internal MedicineWakayama Medical UniversityWakayamaJapan
| | - Masayuki Kitano
- Second Department of Internal MedicineWakayama Medical UniversityWakayamaJapan
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Arcuri PP, Aiello V, Antonelli S, Roccia S, Manti F, Laganà D. Pituitary enlargement and hypopituitarism in patient with lung cancer treated with immune checkpoint inhibitors: Metastasis or hypophysitis? Role of imaging. Radiol Case Rep 2025; 20:1942-1947. [PMID: 39911623 PMCID: PMC11794044 DOI: 10.1016/j.radcr.2025.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2024] [Revised: 01/01/2025] [Accepted: 01/05/2025] [Indexed: 02/07/2025] Open
Abstract
Pituitary gland metastasis is an unusual event, and pituitary metastasis from lung adenocarcinoma is extremely rare and associated with poor prognosis. To date, approximately 16 cases have been reported. Symptoms of these lesions can mimic hypophysitis, that is a possible immune-related adverse event of ICIs (Immune Checkpoint Inhibitors). Pituitary metastases and hypophisitis are life-threatening diseases and making differential diagnosis is important, because therapy of these conditions is quite different. Differentiating a condition from the other one is difficult, because many imaging features are not specific. In this presented case, cross-sectional imaging, in particular Magnetic Resonance Imaging (MRI), has revealed itself helpful to suggest the diagnosis of pituitary metastasis rather than hypophysitis.
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Affiliation(s)
- Pier Paolo Arcuri
- Radiology Unit “De Lellis”, Azienda Ospedaliero-Universitaria “Renato Dulbecco”, 88100, Catanzaro, Italy
| | - Vincenzo Aiello
- Rheumatology Clinic “Madonna dello Scoglio” Cotronei, 88836 Crotone, Italy
| | - Simonetta Antonelli
- Radiology Unit “De Lellis”, Azienda Ospedaliero-Universitaria “Renato Dulbecco”, 88100, Catanzaro, Italy
| | - Simona Roccia
- Total Quality Unit, Lamezia Terme Hospital, ASP Catanzaro, 88100, Catanzaro, Italy
| | - Francesco Manti
- Radiology Unit “Mater Domini”, Azienda Ospedaliero-Universitaria “Renato Dulbecco”, 88100 Catanzaro, Italy
| | - Domenico Laganà
- “Magna Græcia” Università di Catanzaro, 88100, Catanzaro, Italy
- Radiology Unit “Mater Domini”, Azienda Ospedaliero-Universitaria “Renato Dulbecco”, 88100 Catanzaro, Italy
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Hanatani J, Kitagawa K, Tomooka F, Asada S, Mitoro A, Fujinaga Y, Nishimura N, Sato S, Shibamoto A, Fujimoto Y, Kubo T, Iwai S, Tsuji Y, Namisaki T, Akahane T, Kaji K, Tanaka M, Koizumi A, Yorioka N, Matsuda T, Masuda H, Takami M, Kikuchi M, Kawanishi M, Ohoka K, Watanabe D, Kawasaki A, Yoshiji H. Impact of the COVID-19 pandemic on the treatment of acute cholangitis caused by choledocholithiasis: A single-center retrospective study in Japan. DEN OPEN 2025; 5:e371. [PMID: 38694541 PMCID: PMC11058682 DOI: 10.1002/deo2.371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 03/31/2024] [Accepted: 04/08/2024] [Indexed: 05/04/2024]
Abstract
Objectives This study aimed to determine the impact of the coronavirus disease 2019 (COVID-19) pandemic on the treatment of acute cholangitis caused by choledocholithiasis. Methods The Japanese government declared a state of emergency in April 2020 due to the COVID-19 pandemic. We retrospectively reviewed the medical records of 309 patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) for acute cholangitis caused by choledocholithiasis between April 2017 and December 2022. Results Patients were categorized into a pregroup (n = 134) and a postgroup (n = 175), depending on whether they were diagnosed before or after the state of emergency declaration. The total number of ERCP cases and the number of ERCP cases with endoscopic stone removals increased after the state of emergency declaration. Compared with the pregroup, the numbers of patients with performance status of 0-1 and surgically altered anatomy increased, whereas the numbers of patients taking oral antiplatelets or anticoagulants and those with cerebrovascular disease decreased in the postgroup. The number of single-stage endoscopic stone removals increased and hospital stays were significantly shorter in the postgroup. No differences in adverse event rates were detected between the two groups. Conclusions Although our hospital provides tertiary care, the number of patients with cholangitis in good general condition and no underlying disease increased after the state of emergency declaration. The COVID-19 pandemic resulted in an increase in the number of single-stage endoscopic treatments and shortened hospital stays for patients with acute cholangitis caused by choledocholithiasis. No safety issues with ERCP were detected, even during the pandemic.
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Affiliation(s)
| | - Koh Kitagawa
- Department of GastroenterologyNara Medical UniversityNaraJapan
| | | | - Shohei Asada
- Department of GastroenterologyNara Medical UniversityNaraJapan
| | - Akira Mitoro
- Division of EndoscopyNara Medical UniversityNaraJapan
| | | | | | - Shinya Sato
- Department of GastroenterologyNara Medical UniversityNaraJapan
| | | | - Yuki Fujimoto
- Department of GastroenterologyNara Medical UniversityNaraJapan
| | - Takahiro Kubo
- Department of GastroenterologyNara Medical UniversityNaraJapan
| | - Satoshi Iwai
- Department of GastroenterologyNara Medical UniversityNaraJapan
| | - Yuki Tsuji
- Department of GastroenterologyNara Medical UniversityNaraJapan
| | | | - Takemi Akahane
- Department of GastroenterologyNara Medical UniversityNaraJapan
| | - Kosuke Kaji
- Department of GastroenterologyNara Medical UniversityNaraJapan
| | - Misako Tanaka
- Department of GastroenterologyNara Medical UniversityNaraJapan
| | | | | | - Takuya Matsuda
- Department of GastroenterologyNara Medical UniversityNaraJapan
| | - Hiroyuki Masuda
- Department of GastroenterologyNara Medical UniversityNaraJapan
| | | | - Mayuko Kikuchi
- Department of GastroenterologyNara Medical UniversityNaraJapan
| | | | - Kazutaka Ohoka
- Department of GastroenterologyNara Medical UniversityNaraJapan
| | | | - Akane Kawasaki
- Department of GastroenterologyNara Medical UniversityNaraJapan
| | - Hitoshi Yoshiji
- Department of GastroenterologyNara Medical UniversityNaraJapan
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Sunstrum FN, Khan JU, Li NW, Welsh AW. Wearable textile sensors for continuous glucose monitoring. Biosens Bioelectron 2025; 273:117133. [PMID: 39808994 DOI: 10.1016/j.bios.2025.117133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2024] [Revised: 12/17/2024] [Accepted: 01/03/2025] [Indexed: 01/16/2025]
Abstract
Diabetes and cardiovascular disease are interlinked chronic conditions that necessitate continuous and precise monitoring of physiological and environmental parameters to prevent complications. Non-invasive monitoring technologies have garnered significant interest due to their potential to alleviate the current burden of diabetes and cardiovascular disease management. However, these technologies face limitations in accuracy and reliability due to interferences from physiological and environmental factors. This review investigates electronic textiles (e-textiles) that integrate biomedical sensors into wearable fabrics that can enable a multimodal platform for non-invasive continuous glucose monitoring (CGM). Current advancements in e-textiles show the potential of four key methods for glucose monitoring: optical, biochemical, biomechanical, and thermal sensing techniques. Biochemical sensing through sweat-based glucose detection has demonstrated potential for accurate and non-invasive monitoring but still faces numerous challenges. While optical, biomechanical and thermal sensing are less explored in e-textiles, they offer additional physiological and environmental insights that can improve the precision of glucose readings by providing cross-validation of data. This review proposes that integrating multiple sensing modalities into a single multimodal e-textile wearable can address the accuracy and reliability challenges by providing cross-validation of data. The development of such multimodal e-textiles has the potential to revolutionise diabetes and cardiovascular disease management by providing continuous, accurate, and holistic monitoring in real-time, which could significantly improve patient outcomes and quality of life. Further research and development are crucial to fully realise the potential of these integrated systems in clinical and everyday settings.
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