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Loon MM, Goshe M, Rashid M, Shehryar A, Rehman A, Abdallah S, Baluch SK, Ahmed A, Batat H, Quinn M. Impact of Preoperative Nutritional Support on Surgical Outcomes in Gastrointestinal Surgeries: A Systematic Review. Cureus 2024; 16:e56416. [PMID: 38638718 PMCID: PMC11024386 DOI: 10.7759/cureus.56416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2024] [Indexed: 04/20/2024] Open
Abstract
Malnutrition presents a significant risk to patients undergoing gastrointestinal surgery, with direct consequences on postoperative complication rates, recovery times, and mortality. Our systematic review, guided by PRISMA protocols, examined the impact of preoperative nutritional support on these surgical outcomes. We scrutinized publications from PubMed, Medline, Embase, and the Cochrane Library up to April 2023, including randomized controlled trials, cohort studies, and systematic reviews. The stringent selection process narrowed to 10 studies demonstrating the efficacy of preoperative nutritional support, from oral supplements to enteral and parenteral nutrition, in reducing postoperative complications and length of hospital stays while enhancing recovery rates. The benefits varied, indicating a pressing need for customized nutritional regimens based on patient demographics and surgical specifics. Our findings advocate incorporating individualized nutritional strategies into preoperative care, enhancing patient outcomes. Future research should aim to refine these strategies, focusing on the optimal timing, duration, and type of nutritional support.
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Affiliation(s)
| | - Mulusew Goshe
- Medicine, Jimma University, Jimma, ETH
- Orthopedic Surgery, Addis Ababa University, Addis Ababa, ETH
| | | | | | | | | | - Shariq K Baluch
- Internal Medicine, Universidad Autonoma de Guadalajara, Guadalajara, MEX
| | - Arslan Ahmed
- Internal Medicine, King Edward Medical University, Lahore, PAK
| | - Hanen Batat
- Faculty of Medicine, Yarmouk University, Irbid, JOR
| | - Maria Quinn
- Internal Medicine, Jinnah Hospital Lahore, Lahore, PAK
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Zafar F, Wadhwa A, Kumar K, Ahmed M, Khokhar AS, Sajjad S, Oliveira Souza Lima SR, Baluch SK, Srour AK, Al-Deir SS, Shehryar A, Rehman A, Abubakar M. Smoke Signals: Unraveling the Paradoxical Impact of Smoking on Stroke Prognosis and Treatment Efficacy. Cureus 2024; 16:e52346. [PMID: 38361733 PMCID: PMC10867546 DOI: 10.7759/cureus.52346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2024] [Indexed: 02/17/2024] Open
Abstract
Smoking is a well-established risk factor for stroke, yet its impact on stroke prognosis remains complex and multifaceted. This systematic review aims to elucidate the relationship between smoking and various stroke outcomes, including response to treatment and long-term recovery. We conducted a comprehensive analysis of four fundamental studies that examined the prognosis of stroke in smokers, focusing on clinical outcomes post-endovascular treatment, response to antiplatelet therapy, incidence of post-stroke delirium, and the effectiveness of thrombolysis treatment. The studies varied in design, including observational, retrospective, and post hoc trial analyses. The review reveals that smoking may paradoxically predict better clinical outcomes in specific treatment scenarios, such as post-endovascular treatment and when using clopidogrel. However, smokers also demonstrated higher rates of ischemic stroke and post-stroke delirium. Notably, the smoker's paradox in thrombolysis treatment was not supported. These findings highlight the need for personalized treatment approaches based on smoking status. Smoking has a complex and significant impact on stroke prognosis. While some benefits in specific treatment contexts were observed, the overall evidence strongly advises against smoking due to its adverse health consequences. This review underscores the importance of personalized stroke management in smokers and the integration of smoking cessation programs in post-stroke care. Future research should focus on larger, longitudinal studies to explore these associations further.
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Affiliation(s)
| | - Anesh Wadhwa
- Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Kabeer Kumar
- Medicine and Surgery, Chandka Medical College, Larkana, PAK
| | - Muhammad Ahmed
- Psychiatry and Behavioral Sciences, Dow University of Health Sciences, Karachi, PAK
| | | | | | | | - Shariq K Baluch
- Internal Medicine, Universidad Autonoma de Guadalajara, Guadalajara, MEX
| | - Abeer K Srour
- Internal Medicine, Palestine Medical Complex, Ramallah, PSE
| | - Shadi S Al-Deir
- Internal Medicine, Misr University for Science and Technology, Amman, JOR
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3
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Oliveira Souza Lima SR, Elamin AE, Al Balushi H, Shahzad K, Baluch SK, Khan FA, Shehryar A, Rehman A, Batu BJ, Ayalew BD, Abdullah Yahya N, Grezenko H. Intersecting Realms of Skin and Neurology in Systemic Lupus Erythematosus: A Systematic Review of Dermatological and Neurological Manifestations and Their Impact on Long-Term Prognosis. Cureus 2024; 16:e53142. [PMID: 38420059 PMCID: PMC10901037 DOI: 10.7759/cureus.53142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2024] [Indexed: 03/02/2024] Open
Abstract
Systemic Lupus Erythematosus (SLE) is a complex autoimmune disease characterized by diverse manifestations, notably in dermatological and neurological domains. This review aims to synthesize the current understanding of these manifestations and their impact on long-term prognosis. Adhering to PRISMA guidelines, we conducted a comprehensive search across multiple databases, focusing on studies exploring SLE's dermatological and neurological aspects. Selected studies were analyzed to understand their epidemiology, pathophysiology, clinical presentation, and impact on prognosis. Six pivotal studies were reviewed, highlighting the severity of neuropsychiatric SLE, the progression of skin diseases, and their systemic implications. Notably, studies underscored the role of high disease activity and specific antibodies in the development of neuropsychiatric symptoms and the progression of cutaneous manifestations. The review emphasizes the need for an interdisciplinary approach to managing SLE, considering the interplay between its dermatological and neurological manifestations. It suggests that tailored treatment strategies, early detection, and comprehensive care are crucial for improving patient outcomes. This synthesis provides a foundation for future research to develop integrated care protocols and advance patient care in SLE.
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Affiliation(s)
| | | | | | - Khalid Shahzad
- Internal Medicine, King Edward Medical University, Lahore, PAK
| | - Shariq K Baluch
- Internal Medicine, Universidad Autónoma de Guadalajara, Guadalajara, MEX
| | - Faraz A Khan
- Pediatrics, Hind Institute of Medical Sciences, Sitapur, IND
| | | | | | - Biniyam J Batu
- General Practice, St. Paul's Hospital Millennium Medical College, Addis Ababa, ETH
| | - Biruk D Ayalew
- Internal Medicine, St. Paul's Hospital Millennium Medical College, Addis Ababa, ETH
| | | | - Han Grezenko
- Neurology, Barrow Neurological Institute, Phoenix, USA
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Grezenko H, Zafar F, Nathaniel E, Aguirre G, Baluch SK, Abubakar M. Navigating Neurological and Cardiac Complexities: A Case Study on Viral Meningoencephalitis in a Patient With Ischemic Heart Disease. Cureus 2024; 16:e52763. [PMID: 38389596 PMCID: PMC10882189 DOI: 10.7759/cureus.52763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2024] [Indexed: 02/24/2024] Open
Abstract
We present a case of viral meningoencephalitis in a 40-year-old male with ischemic heart disease, a combination that is rare and presents unique diagnostic and therapeutic challenges. The patient's symptoms included high-grade fever, severe headache, projectile vomiting, and altered consciousness. The diagnosis was supported by MRI and CSF analysis. Management, complicated by the patient's cardiac condition, required a personalized approach, including antiviral therapy, corticosteroids, and vigilant monitoring of cardiac and neurological status. Treatment adjustments were made in response to the patient's evolving condition, leading to improvement within a week. This case underscores the need for a multidisciplinary approach in such complex scenarios, highlighting the significance of tailored care for patients with neurological symptoms and concurrent cardiac comorbidities. The report contributes to the literature on managing meningoencephalitis in patients with significant cardiac histories, underscoring personalized medicine's role in successful outcomes.
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Affiliation(s)
- Han Grezenko
- Translational Neuroscience, Barrow Neurological Institute, Phoenix, USA
| | | | | | - Guillermo Aguirre
- Internal Medicine, Ignacio A. Santos School of Medicine, Ciudad de México, MEX
| | - Shariq K Baluch
- Internal Medicine, Universidad Autonoma de Guadalajara, Guadalajara, MEX
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