Cancer has become a consistent concern globally and increasingly fatal. Malignant melanoma is a rising concern, with its increased mortality. Kaempferia parviflora Wall. ex Baker (K. parviflora (KP)), commonly known as black ginger, is well known for its medicinal contributions. For the first time, in the following study we investigated the antimelanoma potential of Laos KP extracts in human cell lines. KP extracts (KPE) in methanol, DCM, and ethyl acetate showed strong cell inhibition in both melanomas, with KPE-DCM being particularly effective in inhibiting melanoma cell migration, invasion, and proliferation by inducing cell cycle arrest and apoptosis, while KPE-Hexane exhibited a low cell inhibition rate and a more limited effect. KPE affected the increased expression of caspase-3, PARP andBax and the decreased expression of the BcL-2, Mu-2-related death-inducing gene (MUDENG, MuD) protein. Furthermore, KPE enhanced apoptotic cells in the absence and presence of the pancaspase inhibitor Z-VAD-FMK. Interestingly, these apoptotic cells were significantly suppressed by the caspase inhibitor. Moreover, elevated mitochondrial membrane potential (MMP) and intracellular reactive oxygen species (ROS) levels, suggestive of KPE's mitochondrial-mediated apoptosis in melanoma cells, were also confirmed. KPE treatment increased MMP levels, and upregulated the generation of ROS in A375 cells but not in A2058 cells. However, pretreatment with an ROS scavenger (NAC) suppressed KPE-induced cell death and ROS generation. These results clearly pointed out KPE-induced mitochondrial-mediated apoptotic cell death as the mechanism behind the inhibition of the human melanoma cells. Future studies exploring the role of specific ROS sources and their interaction with mitochondrial dynamics could deepen the existing understanding on KPE-induced apoptosis.
{"title":"Evaluating the Diverse Anticancer Effects of Laos <i>Kaempferia parviflora</i> (Black Ginger) on Human Melanoma Cell Lines.","authors":"Gyun Seok Park, Juhyun Shin, Seongwoo Hong, Ramesh Kumar Saini, Judy Gopal, Jae-Wook Oh","doi":"10.3390/medicina60081371","DOIUrl":"https://doi.org/10.3390/medicina60081371","url":null,"abstract":"<p><p>Cancer has become a consistent concern globally and increasingly fatal. Malignant melanoma is a rising concern, with its increased mortality. <i>Kaempferia parviflora</i> Wall. ex Baker (<i>K. parviflora</i> (KP)), commonly known as black ginger, is well known for its medicinal contributions. For the first time, in the following study we investigated the antimelanoma potential of Laos KP extracts in human cell lines. KP extracts (KPE) in methanol, DCM, and ethyl acetate showed strong cell inhibition in both melanomas, with KPE-DCM being particularly effective in inhibiting melanoma cell migration, invasion, and proliferation by inducing cell cycle arrest and apoptosis, while KPE-Hexane exhibited a low cell inhibition rate and a more limited effect. KPE affected the increased expression of caspase-3, PARP andBax and the decreased expression of the BcL-2, Mu-2-related death-inducing gene (MUDENG, MuD) protein. Furthermore, KPE enhanced apoptotic cells in the absence and presence of the pancaspase inhibitor Z-VAD-FMK. Interestingly, these apoptotic cells were significantly suppressed by the caspase inhibitor. Moreover, elevated mitochondrial membrane potential (MMP) and intracellular reactive oxygen species (ROS) levels, suggestive of KPE's mitochondrial-mediated apoptosis in melanoma cells, were also confirmed. KPE treatment increased MMP levels, and upregulated the generation of ROS in A375 cells but not in A2058 cells. However, pretreatment with an ROS scavenger (NAC) suppressed KPE-induced cell death and ROS generation. These results clearly pointed out KPE-induced mitochondrial-mediated apoptotic cell death as the mechanism behind the inhibition of the human melanoma cells. Future studies exploring the role of specific ROS sources and their interaction with mitochondrial dynamics could deepen the existing understanding on KPE-induced apoptosis.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11356165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-22DOI: 10.3390/medicina60081374
Sedat Yildirim, Ozkan Alan, Zeynep Yuksel Yasar, Tugba Kaya, Goncagul Akdag, Oguzcan Kinikoglu, Gonca Gul Gecmen, Alper Yasar, Deniz Isik, Heves Surmeli, Tugba Basoglu, Ozlem Nuray Sever, Mahmut Emre Yildirim, Hatice Odabas, Nedim Turan
Background and Objectives: Lung cancer is the leading cause of cancer-related deaths. Spread through air spaces (STAS) is an adverse prognostic factor that has become increasingly known in recent years. This study aims to investigate the impact of STAS presence on overall survival (OS) and disease-free survival (DFS) in patients with surgically resected stage IA-IIIA lung cancer and to identify clinicopathological features associated with STAS. Materials and Methods: This research involved 311 lung cancer surgery patients. The relationship between the presence of STAS in the patients' surgical pathology and OS and DFS values was examined. Clinicopathological features associated with the presence of STAS were determined. Results: There were 103 (33%) STAS-positive patients. Adenocarcinoma histological subtype, perineural invasion (PNI), and lymphovascular invasion (LVI) were significantly correlated with being STAS positive. STAS significantly predicted DFS and OS. One-year and five-year DFS rates were significantly lower in the STAS-positive group compared to the STAS-negative group (65% vs. 88%, 29% vs. 62%, respectively, p ≤ 0.001). Similarly, one-year and five-year OS rates were significantly lower in the STAS-positive group compared to the STAS-negative group (92% vs. 94%, 54% vs. 88%, respectively, p ≤ 0.001). In multivariate analysis, STAS was found to be an independent prognostic factor for both DFS and OS (HR: 3.2 (95%CI: 2.1-4.8) and 3.1 (95%CI: 1.7-5.5), p < 0.001 and <0.001, respectively). Conclusions: In our study, STAS was found to be an independent prognostic biomarker in operated stage IA-IIIA lung cancer patients. It may be a beneficial pathological biomarker in predicting the survival of patients and managing their treatments.
{"title":"Prognostic Impact and Clinical Features of Spread through Air Spaces in Operated Lung Cancer: Real-World Analysis.","authors":"Sedat Yildirim, Ozkan Alan, Zeynep Yuksel Yasar, Tugba Kaya, Goncagul Akdag, Oguzcan Kinikoglu, Gonca Gul Gecmen, Alper Yasar, Deniz Isik, Heves Surmeli, Tugba Basoglu, Ozlem Nuray Sever, Mahmut Emre Yildirim, Hatice Odabas, Nedim Turan","doi":"10.3390/medicina60081374","DOIUrl":"https://doi.org/10.3390/medicina60081374","url":null,"abstract":"<p><p><i>Background and Objectives</i>: Lung cancer is the leading cause of cancer-related deaths. Spread through air spaces (STAS) is an adverse prognostic factor that has become increasingly known in recent years. This study aims to investigate the impact of STAS presence on overall survival (OS) and disease-free survival (DFS) in patients with surgically resected stage IA-IIIA lung cancer and to identify clinicopathological features associated with STAS. <i>Materials and Methods</i>: This research involved 311 lung cancer surgery patients. The relationship between the presence of STAS in the patients' surgical pathology and OS and DFS values was examined. Clinicopathological features associated with the presence of STAS were determined. <i>Results</i>: There were 103 (33%) STAS-positive patients. Adenocarcinoma histological subtype, perineural invasion (PNI), and lymphovascular invasion (LVI) were significantly correlated with being STAS positive. STAS significantly predicted DFS and OS. One-year and five-year DFS rates were significantly lower in the STAS-positive group compared to the STAS-negative group (65% vs. 88%, 29% vs. 62%, respectively, <i>p</i> ≤ 0.001). Similarly, one-year and five-year OS rates were significantly lower in the STAS-positive group compared to the STAS-negative group (92% vs. 94%, 54% vs. 88%, respectively, <i>p</i> ≤ 0.001). In multivariate analysis, STAS was found to be an independent prognostic factor for both DFS and OS (HR: 3.2 (95%CI: 2.1-4.8) and 3.1 (95%CI: 1.7-5.5), <i>p</i> < 0.001 and <0.001, respectively). <i>Conclusions</i>: In our study, STAS was found to be an independent prognostic biomarker in operated stage IA-IIIA lung cancer patients. It may be a beneficial pathological biomarker in predicting the survival of patients and managing their treatments.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11356374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-22DOI: 10.3390/medicina60081368
Mohammed A Aljunaid, Rayan Mesfer Alosaimi, Essa Ahmed Alazmi, Ahmad Abdulaziz Afandi, Mohammed Talal Musslem, Mohammed Mohsen Aljarameez, Hosam Husain Alzobaidi
Background and Objectives: Caregiving for geriatric patients is essential for ensuring the well-being and quality of life of older adults. Family caregivers play a crucial role, but they often face a significant burden that can lead to adverse mental health outcomes, including depression. This study aimed to estimate the prevalence of depression among caregivers of geriatric patients in Jeddah, Saudi Arabia, and to analyze its association with caregiver burden and various socio-demographic and caregiving parameters. Methods: A cross-sectional study was conducted in Jeddah, Saudi Arabia, between January and March 2024. Adult caregivers of geriatric patients were recruited through various social media platforms. Data were collected via an electronic questionnaire that included demographic information, caregiving parameters, the Patient Health Questionnaire-9 (PHQ-9) for depression screening, and the Zarit Burden Interview (ZBI-12) for caregiver burden assessment. Data were analyzed using descriptive statistics, chi-square tests, and multivariate logistic regression. Results: Of the 269 participants, the average age was 32 years, and the gender distribution was nearly balanced. The prevalence of depression (PHQ-9 score ≥ 10) among caregivers was 45.4% (95% CI: 39.3, 51.5%). Significant factors associated with higher depression scores included younger age, female gender, single status, being a student, low income, and caregiving burden. In the multivariate analysis, female gender (OR 2.50, 95% CI 1.30-4.80) and caregiving burden (mild-to-moderate burden: OR 6.18, 95% CI 2.94-13.00; high burden: OR 22.75, 95% CI 8.75-59.13) were independent predictors of depression. Conclusions: The study highlights the high prevalence of depression among caregivers of geriatric patients in Jeddah and underscores the significant impact of caregiving burden on mental health. These findings emphasize the need for targeted interventions, such as mental health support, respite care programs, and culturally sensitive educational training, to mitigate caregiver burden and enhance the well-being of caregivers.
背景和目的:照顾老年病人对于确保老年人的福祉和生活质量至关重要。家庭护理人员发挥着至关重要的作用,但他们往往面临着巨大的负担,可能导致不良的心理健康后果,包括抑郁症。本研究旨在估算沙特阿拉伯吉达市老年患者护理者中抑郁症的患病率,并分析其与护理者负担以及各种社会人口和护理参数之间的关系。研究方法一项横断面研究于 2024 年 1 月至 3 月在沙特阿拉伯吉达进行。研究人员通过各种社交媒体平台招募老年病患者的成年护理人员。数据通过电子问卷收集,其中包括人口统计学信息、护理参数、用于抑郁筛查的患者健康问卷-9(PHQ-9)和用于护理者负担评估的扎里特负担访谈(ZBI-12)。数据分析采用了描述性统计、卡方检验和多变量逻辑回归。研究结果在 269 名参与者中,平均年龄为 32 岁,性别分布基本平衡。护理人员中抑郁症(PHQ-9 评分≥ 10 分)的患病率为 45.4%(95% CI:39.3-51.5%)。与抑郁得分较高相关的重要因素包括年龄较小、女性、单身、学生、低收入和护理负担。在多变量分析中,女性性别(OR 2.50,95% CI 1.30-4.80)和护理负担(轻度至中度负担:OR6.18,95% CI 2.94-13.00;高负担:OR22.75,95% CI 8.75-59.13)是抑郁症的独立预测因素。结论本研究强调了吉达老年患者护理人员中抑郁症的高发率,并突出了护理负担对心理健康的重大影响。这些发现强调了有必要采取有针对性的干预措施,如心理健康支持、临时护理计划和文化敏感性教育培训等,以减轻护理人员的负担并提高他们的幸福感。
{"title":"Determinants of Depression in Caregivers of Geriatric Patients in Jeddah, Saudi Arabia: A Cross-Sectional Study.","authors":"Mohammed A Aljunaid, Rayan Mesfer Alosaimi, Essa Ahmed Alazmi, Ahmad Abdulaziz Afandi, Mohammed Talal Musslem, Mohammed Mohsen Aljarameez, Hosam Husain Alzobaidi","doi":"10.3390/medicina60081368","DOIUrl":"https://doi.org/10.3390/medicina60081368","url":null,"abstract":"<p><p><i>Background and Objectives</i>: Caregiving for geriatric patients is essential for ensuring the well-being and quality of life of older adults. Family caregivers play a crucial role, but they often face a significant burden that can lead to adverse mental health outcomes, including depression. This study aimed to estimate the prevalence of depression among caregivers of geriatric patients in Jeddah, Saudi Arabia, and to analyze its association with caregiver burden and various socio-demographic and caregiving parameters. <i>Methods</i>: A cross-sectional study was conducted in Jeddah, Saudi Arabia, between January and March 2024. Adult caregivers of geriatric patients were recruited through various social media platforms. Data were collected via an electronic questionnaire that included demographic information, caregiving parameters, the Patient Health Questionnaire-9 (PHQ-9) for depression screening, and the Zarit Burden Interview (ZBI-12) for caregiver burden assessment. Data were analyzed using descriptive statistics, chi-square tests, and multivariate logistic regression. <i>Results</i>: Of the 269 participants, the average age was 32 years, and the gender distribution was nearly balanced. The prevalence of depression (PHQ-9 score ≥ 10) among caregivers was 45.4% (95% CI: 39.3, 51.5%). Significant factors associated with higher depression scores included younger age, female gender, single status, being a student, low income, and caregiving burden. In the multivariate analysis, female gender (OR 2.50, 95% CI 1.30-4.80) and caregiving burden (mild-to-moderate burden: OR 6.18, 95% CI 2.94-13.00; high burden: OR 22.75, 95% CI 8.75-59.13) were independent predictors of depression. <i>Conclusions</i>: The study highlights the high prevalence of depression among caregivers of geriatric patients in Jeddah and underscores the significant impact of caregiving burden on mental health. These findings emphasize the need for targeted interventions, such as mental health support, respite care programs, and culturally sensitive educational training, to mitigate caregiver burden and enhance the well-being of caregivers.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11356660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-22DOI: 10.3390/medicina60081370
Raminder Kaur, Brian Greeley, Alexander Ciok, Kashish Mehta, Melody Tsai, Hilary Robertson, Kati Debelic, Lan Xin Zhang, Todd Nelson, Travis Boulter, William Siu, Luis Nacul, Xiaowei Song
Background/Objectives: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a neurological disorder characterized by post-exertional malaise. Despite its clinical relevance, the disease mechanisms of ME/CFS are not fully understood. The previous studies targeting brain function or metabolites have been inconclusive in understanding ME/CFS complexity. We combined single-voxel magnetic resonance spectroscopy (SV-MRS) and functional magnetic resonance imaging (fMRI). Our objectives were to examine the feasibility of the multimodal MRI protocol, identify possible differences between ME/CFS and healthy controls (HCs), and relate MRI findings with clinical symptoms. Methods: We enrolled 18 female ME/CFS participants (mean age: 39.7 ± 12.0 years) and five HCs (mean age: 45.6 ± 14.5 years). SV-MRS spectra were acquired from three voxels of interest: the anterior cingulate gyrus (ACC), brainstem (BS), and left dorsolateral prefrontal cortex (L-DLPFC). Whole-brain fMRI used n-back task testing working memory and executive function. The feasibility was assessed as protocol completion rate and time. Group differences in brain metabolites and fMRI activation between ME/CFS and HCs were compared and correlated with behavioral and symptom severity measurements. Results: The completion rate was 100% regardless of participant group without causing immediate fatigue. ME/CFS appeared to show a higher N-Acetylaspartate in L-DLPFC compared to HCs (OR = 8.49, p = 0.040), correlating with poorer fatigue, pain, and sleep quality scores (p's = 0.001-0.015). An increase in brain activation involving the frontal lobe and the brainstem was observed in ME/CFS compared to HCs (Z > 3.4, p's < 0.010). Conclusions: The study demonstrates the feasibility of combining MRS and fMRI to capture neurochemical and neurophysiological features of ME/CFS in female participants. Further research with larger cohorts of more representative sampling and follow-ups is needed to validate these apparent differences between ME/CFS and HCs.
{"title":"A Multimodal Magnetic Resonance Imaging Study on Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Feasibility and Clinical Correlation.","authors":"Raminder Kaur, Brian Greeley, Alexander Ciok, Kashish Mehta, Melody Tsai, Hilary Robertson, Kati Debelic, Lan Xin Zhang, Todd Nelson, Travis Boulter, William Siu, Luis Nacul, Xiaowei Song","doi":"10.3390/medicina60081370","DOIUrl":"https://doi.org/10.3390/medicina60081370","url":null,"abstract":"<p><p><i>Background/Objectives</i>: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a neurological disorder characterized by post-exertional malaise. Despite its clinical relevance, the disease mechanisms of ME/CFS are not fully understood. The previous studies targeting brain function or metabolites have been inconclusive in understanding ME/CFS complexity. We combined single-voxel magnetic resonance spectroscopy (SV-MRS) and functional magnetic resonance imaging (fMRI). Our objectives were to examine the feasibility of the multimodal MRI protocol, identify possible differences between ME/CFS and healthy controls (HCs), and relate MRI findings with clinical symptoms. <i>Methods</i>: We enrolled 18 female ME/CFS participants (mean age: 39.7 ± 12.0 years) and five HCs (mean age: 45.6 ± 14.5 years). SV-MRS spectra were acquired from three voxels of interest: the anterior cingulate gyrus (ACC), brainstem (BS), and left dorsolateral prefrontal cortex (L-DLPFC). Whole-brain fMRI used n-back task testing working memory and executive function. The feasibility was assessed as protocol completion rate and time. Group differences in brain metabolites and fMRI activation between ME/CFS and HCs were compared and correlated with behavioral and symptom severity measurements. <i>Results</i>: The completion rate was 100% regardless of participant group without causing immediate fatigue. ME/CFS appeared to show a higher N-Acetylaspartate in L-DLPFC compared to HCs (OR = 8.49, <i>p</i> = 0.040), correlating with poorer fatigue, pain, and sleep quality scores (<i>p</i>'s = 0.001-0.015). An increase in brain activation involving the frontal lobe and the brainstem was observed in ME/CFS compared to HCs (Z > 3.4, <i>p</i>'s < 0.010). <i>Conclusions</i>: The study demonstrates the feasibility of combining MRS and fMRI to capture neurochemical and neurophysiological features of ME/CFS in female participants. Further research with larger cohorts of more representative sampling and follow-ups is needed to validate these apparent differences between ME/CFS and HCs.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11356663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-22DOI: 10.3390/medicina60081372
Goncagul Akdag, Deniz Isik, Akif Dogan, Sedat Yildirim, Oguzcan Kinikoglu, Alper Topal, Sila Oksuz, Ezgi Turkoglu, Heves Surmeli, Tugba Basoglu, Ozlem Nuray Sever, Hatice Odabas, Mahmut Emre Yildirim, Nedim Turan
Background and Objectives: Colorectal cancer (CRC) poses a major global health challenge, with high incidence rates and ongoing treatment debates. Adjuvant chemotherapy benefits for high-risk subgroups, particularly stage II disease, remain controversial. This study seeks to clarify this issue by specifically examining the impact of adjuvant chemotherapy on disease-free survival (DFS) and overall survival (OS) in patients diagnosed with T4 colon cancer. Materials and Methods: This retrospective study analyzed patients undergoing radical surgery for T4 colon cancer between 2002 and 2023. Results: Our study of 184 pT4 pN0 colon cancer patients revealed that 79.3% received adjuvant chemotherapy. Multivariate analysis demonstrated significant DFS improvement: a 60% reduction in risk for those who received adjuvant therapy (0.40 95% CI: 0.25-0.62, p < 0.001). Lymphovascular invasion (LVI) and adjuvant treatment were also significantly associated with OS. Adjuvant treatment reduced mortality by 60% (HR: 0.40, 95% CI: 0.23-0.68, p = 0.001). Patients with LVI had a 1.9-fold increase in mortality (HR: 1.94, 95% CI: 1.17-3.20, p = 0.011). These findings underscore the potential value of adjuvant chemotherapy and highlight the importance of treatment completion in managing T4 colon cancer. Conclusions: Our study identifies LVI and adjuvant chemotherapy as key prognostic factors in T4 colon cancer patients. These results support the consideration of adjuvant chemotherapy in this patient population.
{"title":"Does Adjuvant Chemotherapy Benefit Patients with T4 N0 Colon Cancer?","authors":"Goncagul Akdag, Deniz Isik, Akif Dogan, Sedat Yildirim, Oguzcan Kinikoglu, Alper Topal, Sila Oksuz, Ezgi Turkoglu, Heves Surmeli, Tugba Basoglu, Ozlem Nuray Sever, Hatice Odabas, Mahmut Emre Yildirim, Nedim Turan","doi":"10.3390/medicina60081372","DOIUrl":"https://doi.org/10.3390/medicina60081372","url":null,"abstract":"<p><p><i>Background and Objectives</i>: Colorectal cancer (CRC) poses a major global health challenge, with high incidence rates and ongoing treatment debates. Adjuvant chemotherapy benefits for high-risk subgroups, particularly stage II disease, remain controversial. This study seeks to clarify this issue by specifically examining the impact of adjuvant chemotherapy on disease-free survival (DFS) and overall survival (OS) in patients diagnosed with T4 colon cancer. <i>Materials and Methods</i>: This retrospective study analyzed patients undergoing radical surgery for T4 colon cancer between 2002 and 2023. <i>Results</i>: Our study of 184 pT4 pN0 colon cancer patients revealed that 79.3% received adjuvant chemotherapy. Multivariate analysis demonstrated significant DFS improvement: a 60% reduction in risk for those who received adjuvant therapy (0.40 95% CI: 0.25-0.62, <i>p</i> < 0.001). Lymphovascular invasion (LVI) and adjuvant treatment were also significantly associated with OS. Adjuvant treatment reduced mortality by 60% (HR: 0.40, 95% CI: 0.23-0.68, <i>p</i> = 0.001). Patients with LVI had a 1.9-fold increase in mortality (HR: 1.94, 95% CI: 1.17-3.20, <i>p</i> = 0.011). These findings underscore the potential value of adjuvant chemotherapy and highlight the importance of treatment completion in managing T4 colon cancer. <i>Conclusions</i>: Our study identifies LVI and adjuvant chemotherapy as key prognostic factors in T4 colon cancer patients. These results support the consideration of adjuvant chemotherapy in this patient population.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11356621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-22DOI: 10.3390/medicina60081367
Marwa S Ismael, Marwa O Elgendy, Ammena Y Binsaleh, Asmaa Saleh, Mohamed E A Abdelrahim, Hasnaa Osama
Background and Objectives: It is well known that depression, anxiety, and impulsiveness are interrelated; however, studies that have assessed their association with the coronavirus outbreak are scarce. Hence, our study aimed to evaluate the impulsivity incidence and its correlation with anxiety and depression following COVID-19 infection between November 2022 and June 2023. Materials and Methods: The 201 participants completed the Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HAM-A), Sheehan Disability Scale (SDS), and short UPPS-P scales (urgency, premeditation, perseverance, sensation seeking, and positive urgency) to allow us to determine their anxiety and depression symptoms, functional impairment, and impulsivity, respectively. Results: Among our respondents, 22%, and 26.7% had moderate to severe anxiety and depression. The short UPPS-P scale significantly correlated with the HAM-A and HDRS scales. Participants with positive COVID-19 infection showed significantly higher functional impairment scores, especially in the work/study domain (mean (SD): 3.12 (2.2) vs. 2.43 (2.3); p = 0.037). COVID-19-related disruption significantly correlated with negative and positive urgency, HAM-A, HDRS, and the SDS total and subscales. Conclusions: Our findings showed a notable increase in anxiety, depression, and functional impairment among the population following COVID-19 infection. Our research highlights the correlation between impulsivity and the psychological distress experienced following the pandemic.
{"title":"Impulsivity and Its Association with Depression and Anxiety in the Normal Egyptian Population Post COVID-19 Pandemic.","authors":"Marwa S Ismael, Marwa O Elgendy, Ammena Y Binsaleh, Asmaa Saleh, Mohamed E A Abdelrahim, Hasnaa Osama","doi":"10.3390/medicina60081367","DOIUrl":"https://doi.org/10.3390/medicina60081367","url":null,"abstract":"<p><p><i>Background and Objectives:</i> It is well known that depression, anxiety, and impulsiveness are interrelated; however, studies that have assessed their association with the coronavirus outbreak are scarce. Hence, our study aimed to evaluate the impulsivity incidence and its correlation with anxiety and depression following COVID-19 infection between November 2022 and June 2023. <i>Materials and Methods:</i> The 201 participants completed the Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HAM-A), Sheehan Disability Scale (SDS), and short UPPS-P scales (urgency, premeditation, perseverance, sensation seeking, and positive urgency) to allow us to determine their anxiety and depression symptoms, functional impairment, and impulsivity, respectively. <i>Results:</i> Among our respondents, 22%, and 26.7% had moderate to severe anxiety and depression. The short UPPS-P scale significantly correlated with the HAM-A and HDRS scales. Participants with positive COVID-19 infection showed significantly higher functional impairment scores, especially in the work/study domain (mean (SD): 3.12 (2.2) vs. 2.43 (2.3); <i>p</i> = 0.037). COVID-19-related disruption significantly correlated with negative and positive urgency, HAM-A, HDRS, and the SDS total and subscales. <i>Conclusions:</i> Our findings showed a notable increase in anxiety, depression, and functional impairment among the population following COVID-19 infection. Our research highlights the correlation between impulsivity and the psychological distress experienced following the pandemic.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11356745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-22DOI: 10.3390/medicina60081369
Shin Rui Ng, Jui-Chih Chang, Jin-You Jhan
Cancer-associated venous thromboembolism (CAT) poses a severe threat, disrupting ongoing cancer management and adversely impacting treatment outcomes. CAT often leads to a two- to six-fold increase in mortality rates when it progresses to venous total occlusion. The primary modalities employed in addressing this life-threatening complication include anticoagulant therapy only or coupled with strategic endovascular interventions. Aggressive endovascular interventions, such as mechanical thrombectomy and venous stent implantation, are crucial in mitigating thrombotic complications, relieving symptoms, and improving this vulnerable population's overall quality of life and life expectancy. This case report presents a CAT case extending to the total occlusion of the inferior vena cava. Our goal is to provide valuable insights into the evolving management of CAT and its sequelae, showcasing treatment approaches that lead to improved outcomes and a better quality of life for cancer patients facing these additional challenges.
{"title":"Endovascular Interventions of Cancer-Associated Venous Thromboembolism with Symptomatic Iliocaval Venous Thrombosis: A Case Report.","authors":"Shin Rui Ng, Jui-Chih Chang, Jin-You Jhan","doi":"10.3390/medicina60081369","DOIUrl":"https://doi.org/10.3390/medicina60081369","url":null,"abstract":"<p><p>Cancer-associated venous thromboembolism (CAT) poses a severe threat, disrupting ongoing cancer management and adversely impacting treatment outcomes. CAT often leads to a two- to six-fold increase in mortality rates when it progresses to venous total occlusion. The primary modalities employed in addressing this life-threatening complication include anticoagulant therapy only or coupled with strategic endovascular interventions. Aggressive endovascular interventions, such as mechanical thrombectomy and venous stent implantation, are crucial in mitigating thrombotic complications, relieving symptoms, and improving this vulnerable population's overall quality of life and life expectancy. This case report presents a CAT case extending to the total occlusion of the inferior vena cava. Our goal is to provide valuable insights into the evolving management of CAT and its sequelae, showcasing treatment approaches that lead to improved outcomes and a better quality of life for cancer patients facing these additional challenges.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11356579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-22DOI: 10.3390/medicina60081375
You-Seung Chun, Kyeong-Eon Kwon, Se-Won Lee
Background and Objectives: Anterior sacroiliac fracture dislocation (ASFD), also known as locked pelvis, is a rarely reported diagnosis. The types of ASFDs are often misdiagnosed as lateral compression fractures due to the presence of crescent fractures. In this study, we distinguished ASFD from lateral compression fractures (LC 2) and studied their characteristics. Materials and Methods: This is a retrospective study involving patients from a Level 1 trauma center. Fifty-nine patients under the age of 65 years with crescent fractures caused by a high-energy mechanism were investigated. Results: The incidence of ASFD was 25% (15 of 59) in patients with crescent fractures. Among the 15 patients, 6 had override of the ilium over the sacrum, inhibiting reduction in the sacroiliac joint. Pre-operative radiographic evaluations revealed that vertical displacement of the ASFD was larger than that of lateral compression fracture (LC 2) in the outlet view (mean 9.5 vs. 1.9 mm, p = 0.013), and the pelvic asymmetry ratio was larger in ASFD (mean 7.8 vs. 4.1, p = 0.006) in the pelvis AP view. All patients achieved union after surgery. Post-operative radiography showed no significant vertical displacement difference. There was no difference in vascular injury or hemodynamic instability requiring embolization or preperitoneal pelvic packing (PPP) between the two groups. Conclusions: Patients with ASFD have greater vertical displacement and asymmetry compared to patients with LC 2 fractures. These fractures must be distinguished for appropriate reduction and anterior plate fixation.
{"title":"Anterior Sacroiliac Fracture Dislocation: A Comparative Radiologic analysis of Crescent Fractures in Pelvic Ring Injuries: A Retrospective Study.","authors":"You-Seung Chun, Kyeong-Eon Kwon, Se-Won Lee","doi":"10.3390/medicina60081375","DOIUrl":"https://doi.org/10.3390/medicina60081375","url":null,"abstract":"<p><p><i>Background and Objectives</i>: Anterior sacroiliac fracture dislocation (ASFD), also known as locked pelvis, is a rarely reported diagnosis. The types of ASFDs are often misdiagnosed as lateral compression fractures due to the presence of crescent fractures. In this study, we distinguished ASFD from lateral compression fractures (LC 2) and studied their characteristics. <i>Materials and Methods</i>: This is a retrospective study involving patients from a Level 1 trauma center. Fifty-nine patients under the age of 65 years with crescent fractures caused by a high-energy mechanism were investigated. <i>Results</i>: The incidence of ASFD was 25% (15 of 59) in patients with crescent fractures. Among the 15 patients, 6 had override of the ilium over the sacrum, inhibiting reduction in the sacroiliac joint. Pre-operative radiographic evaluations revealed that vertical displacement of the ASFD was larger than that of lateral compression fracture (LC 2) in the outlet view (mean 9.5 vs. 1.9 mm, <i>p</i> = 0.013), and the pelvic asymmetry ratio was larger in ASFD (mean 7.8 vs. 4.1, <i>p</i> = 0.006) in the pelvis AP view. All patients achieved union after surgery. Post-operative radiography showed no significant vertical displacement difference. There was no difference in vascular injury or hemodynamic instability requiring embolization or preperitoneal pelvic packing (PPP) between the two groups. <i>Conclusions</i>: Patients with ASFD have greater vertical displacement and asymmetry compared to patients with LC 2 fractures. These fractures must be distinguished for appropriate reduction and anterior plate fixation.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11356669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background and Objectives: Atopic dermatitis is a chronic inflammatory skin disorder with a significant burden on patients' quality of life. This systematic review aims to evaluate the restoration of skin barrier abnormalities with interleukin-4/interleukin-13 (IL-4/IL-13) inhibitors and Janus kinase (JAK) inhibitors in atopic dermatitis. Materials and Methods: A comprehensive review of the literature was conducted, focusing on studies that assess the use of IL-4/IL-13 inhibitors and JAK inhibitors for atopic dermatitis. We identified eligible studies by searching Medline via PubMed with a special focus on their effect on the restoration of the epidermal barrier. Included studies evaluated the transepidermal water loss (TEWL), the reduction in epidermal thickness (ET), the improvement in ceramide synthesis, and the increase in stratum corneum hydration (SCH) with IL-4/IL-13 inhibitors and JAK inhibitors. The quality of included studies was assessed using the ROBINS-I and the RoB 2.0 tool for assessing the risk of bias. Results: Ten of the included studies concern dupilumab, while two concern JAK inhibitors. Ten were observational studies and two were randomized controlled trials (RCTs). The total number of included participants was 378 concerning dupilumab and 38 concerning JAK inhibitors. Five studies did not include any comparison group, three included healthy volunteers, two were conducted versus placebo, and two compared dupilumab with other treatments. The follow-up period ranged between 29 days and 32 weeks. The results demonstrated a significant decrease in transepidermal water loss (TEWL) and an increase in SCH on eczematous lesions for patients with sustained response to dupilumab treatment and observed improvements in ET and filaggrin (FLG) staining, which further support the efficacy of JAK inhibitors in enhancing skin barrier function. Conclusions: This review underscores the efficacy of IL-4/IL-13 inhibitors in improving skin barrier function. However, the limited number of studies focusing on JAK inhibitors and the overall lack of RCTs highlight the need for further research to establish the definitive role of IL-4/IL-13 inhibitors and JAK inhibitors in the restoration of the skin barrier.
背景和目的:特应性皮炎是一种慢性炎症性皮肤病,对患者的生活质量造成严重影响。本系统综述旨在评估白细胞介素-4/白细胞介素-13(IL-4/IL-13)抑制剂和Janus激酶(JAK)抑制剂对特应性皮炎患者皮肤屏障异常的修复作用。材料与方法:我们对文献进行了全面回顾,重点关注评估特应性皮炎使用IL-4/IL-13抑制剂和JAK抑制剂的研究。我们通过 PubMed 在 Medline 上进行搜索,确定了符合条件的研究,并特别关注了它们对恢复表皮屏障的作用。纳入的研究评估了IL-4/IL-13抑制剂和JAK抑制剂的经表皮失水率(TEWL)、表皮厚度(ET)的减少、神经酰胺合成的改善以及角质层水合作用(SCH)的增加。采用 ROBINS-I 和 RoB 2.0 工具对纳入研究的质量进行了评估,以评估偏倚风险。结果:纳入的研究中有 10 项涉及杜必鲁单抗,2 项涉及 JAK 抑制剂。十项为观察性研究,两项为随机对照试验(RCT)。纳入研究的总人数为378人,涉及dupilumab,38人涉及JAK抑制剂。五项研究未纳入任何对比组,三项研究纳入了健康志愿者,两项研究进行了安慰剂对比,两项研究将杜比单抗与其他治疗方法进行了对比。随访时间从 29 天到 32 周不等。结果表明,对杜比鲁单抗治疗有持续反应的患者经表皮失水(TEWL)明显减少,湿疹皮损上的SCH增加,并观察到ET和丝胶蛋白(FLG)染色有所改善,这进一步证实了JAK抑制剂在增强皮肤屏障功能方面的疗效。结论:本综述强调了IL-4/IL-13抑制剂在改善皮肤屏障功能方面的疗效。然而,关注 JAK 抑制剂的研究数量有限,而且总体上缺乏 RCT 研究,这突出表明需要进一步研究,以确定 IL-4/IL-13 抑制剂和 JAK 抑制剂在恢复皮肤屏障方面的确切作用。
{"title":"Restoration of Skin Barrier Abnormalities with IL4/13 Inhibitors and Jak Inhibitors in Atopic Dermatitis: A Systematic Review.","authors":"Isidora Chatzigeorgiou, Dimitra Koumaki, Efstratios Vakirlis, Ilias Papadimitriou, Stamatios Gregoriou","doi":"10.3390/medicina60081376","DOIUrl":"https://doi.org/10.3390/medicina60081376","url":null,"abstract":"<p><p><i>Background and Objectives</i>: Atopic dermatitis is a chronic inflammatory skin disorder with a significant burden on patients' quality of life. This systematic review aims to evaluate the restoration of skin barrier abnormalities with interleukin-4/interleukin-13 (IL-4/IL-13) inhibitors and Janus kinase (JAK) inhibitors in atopic dermatitis. <i>Materials and Methods</i>: A comprehensive review of the literature was conducted, focusing on studies that assess the use of IL-4/IL-13 inhibitors and JAK inhibitors for atopic dermatitis. We identified eligible studies by searching Medline via PubMed with a special focus on their effect on the restoration of the epidermal barrier. Included studies evaluated the transepidermal water loss (TEWL), the reduction in epidermal thickness (ET), the improvement in ceramide synthesis, and the increase in stratum corneum hydration (SCH) with IL-4/IL-13 inhibitors and JAK inhibitors. The quality of included studies was assessed using the ROBINS-I and the RoB 2.0 tool for assessing the risk of bias. <i>Results</i>: Ten of the included studies concern dupilumab, while two concern JAK inhibitors. Ten were observational studies and two were randomized controlled trials (RCTs). The total number of included participants was 378 concerning dupilumab and 38 concerning JAK inhibitors. Five studies did not include any comparison group, three included healthy volunteers, two were conducted versus placebo, and two compared dupilumab with other treatments. The follow-up period ranged between 29 days and 32 weeks. The results demonstrated a significant decrease in transepidermal water loss (TEWL) and an increase in SCH on eczematous lesions for patients with sustained response to dupilumab treatment and observed improvements in ET and filaggrin (FLG) staining, which further support the efficacy of JAK inhibitors in enhancing skin barrier function. <i>Conclusions</i>: This review underscores the efficacy of IL-4/IL-13 inhibitors in improving skin barrier function. However, the limited number of studies focusing on JAK inhibitors and the overall lack of RCTs highlight the need for further research to establish the definitive role of IL-4/IL-13 inhibitors and JAK inhibitors in the restoration of the skin barrier.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11356372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-22DOI: 10.3390/medicina60081373
Raluca Tocariu, Lucia Elena Niculae, Alexandru Ștefan Niculae, Andreea Carp-Velișcu, Elvira Brătilă
Background and Objectives: Although considerable research has been devoted to examining the distinctions between fresh and frozen embryo transfer regarding obstetric outcomes and rates of pregnancy success, there is still a scarcity of thorough analyses that specifically examine neonatal outcomes. The objective of our study was to provide an in-depth analysis of neonatal outcomes that occur after the transfer of fresh and frozen embryos (ET vs. FET) in IVF/ICSI cycles. Materials and Methods: Multiple databases (PubMed/MEDLINE, Cochrane Library, Web of Science, Wiley, Scopus, Ovid and Science Direct) were searched from January 1980 to February 2024. Two reviewers conducted the article identification and data extraction, meeting inclusion and exclusion criteria. The methodological quality was evaluated using the Newcastle-Ottawa Scale (NOS) or the revised Cochrane Risk of Bias Tool. The meta-analysis was performed using RevMan 5.4. Results: Twenty studies, including 171,481 participants in total, were subjected to qualitative and quantitative analyses. A significant increase in preterm birth rates was noted with fresh embryo transfer compared to FET in the overall IVF/ICSI population (OR 1.26, 95% CI 1.18-1.35, p < 0.00001), as well as greater odds of a low birth weight (OR 1.37, 95% CI 1.27-1.48, p < 0.00001) and small-for-gestational-age infants in this group (OR 1.81, 95% CI 1.63-2.00, p < 0.00001). In contrast, frozen embryo transfer can result in macrosomic (OR 0.59, 95% CI 0.54-0.65, p < 0.00001) or large-for-gestational-age infants (OR 0.64, 95% CI 0.60-0.69, p < 0.00001). No significant difference was observed regarding congenital malformations or neonatal death rates. Conclusions: This systematic review confirmed that singleton babies conceived by frozen embryo transfer are at lower risk of preterm delivery, low birthweight and being small for gestational age than their counterparts conceived by fresh embryo transfer. The data support embryo cryopreservation but suggest that elective freezing should be limited to cases with a proven indication or within the framework of a clinical study.
背景和目的:尽管已有大量研究致力于探讨新鲜胚胎移植和冷冻胚胎移植在产科结果和妊娠成功率方面的区别,但专门研究新生儿结果的全面分析仍然很少。我们的研究旨在深入分析试管婴儿/卵胞浆内单精子显微注射(IVF/ICSI)周期中移植新鲜胚胎和冷冻胚胎(ET 与 FET)后的新生儿结局。材料与方法:检索了 1980 年 1 月至 2024 年 2 月期间的多个数据库(PubMed/MEDLINE、Cochrane Library、Web of Science、Wiley、Scopus、Ovid 和 Science Direct)。两名审稿人根据纳入和排除标准对文章进行了识别和数据提取。方法学质量采用纽卡斯尔-渥太华量表(NOS)或修订版 Cochrane 偏倚风险工具进行评估。荟萃分析使用 RevMan 5.4 进行。结果对 20 项研究进行了定性和定量分析,共有 171 481 人参与。在整个试管婴儿/ICSI人群中,新鲜胚胎移植比冷冻胚胎移植的早产率明显增加(OR 1.26,95% CI 1.18-1.35,p < 0.00001),而且这组人群中出现低出生体重儿(OR 1.37,95% CI 1.27-1.48,p < 0.00001)和小胎龄儿(OR 1.81,95% CI 1.63-2.00,p < 0.00001)的几率更大。与此相反,冷冻胚胎移植可导致巨大儿(OR 0.59,95% CI 0.54-0.65,p < 0.00001)或大胎龄儿(OR 0.64,95% CI 0.60-0.69,p < 0.00001)。在先天性畸形或新生儿死亡率方面没有观察到明显差异。结论该系统性综述证实,通过冷冻胚胎移植受孕的单胎婴儿与通过新鲜胚胎移植受孕的单胎婴儿相比,早产、低出生体重和胎龄偏小的风险较低。数据支持胚胎冷冻保存,但建议选择性冷冻应仅限于有明确适应症或在临床研究框架内的病例。
{"title":"Fresh versus Frozen Embryo Transfer in In Vitro Fertilization/Intracytoplasmic Sperm Injection Cycles: A Systematic Review and Meta-Analysis of Neonatal Outcomes.","authors":"Raluca Tocariu, Lucia Elena Niculae, Alexandru Ștefan Niculae, Andreea Carp-Velișcu, Elvira Brătilă","doi":"10.3390/medicina60081373","DOIUrl":"https://doi.org/10.3390/medicina60081373","url":null,"abstract":"<p><p><i>Background and Objectives</i>: Although considerable research has been devoted to examining the distinctions between fresh and frozen embryo transfer regarding obstetric outcomes and rates of pregnancy success, there is still a scarcity of thorough analyses that specifically examine neonatal outcomes. The objective of our study was to provide an in-depth analysis of neonatal outcomes that occur after the transfer of fresh and frozen embryos (ET vs. FET) in IVF/ICSI cycles. <i>Materials and Methods</i>: Multiple databases (PubMed/MEDLINE, Cochrane Library, Web of Science, Wiley, Scopus, Ovid and Science Direct) were searched from January 1980 to February 2024. Two reviewers conducted the article identification and data extraction, meeting inclusion and exclusion criteria. The methodological quality was evaluated using the Newcastle-Ottawa Scale (NOS) or the revised Cochrane Risk of Bias Tool. The meta-analysis was performed using RevMan 5.4. <i>Results</i>: Twenty studies, including 171,481 participants in total, were subjected to qualitative and quantitative analyses. A significant increase in preterm birth rates was noted with fresh embryo transfer compared to FET in the overall IVF/ICSI population (OR 1.26, 95% CI 1.18-1.35, <i>p</i> < 0.00001), as well as greater odds of a low birth weight (OR 1.37, 95% CI 1.27-1.48, <i>p</i> < 0.00001) and small-for-gestational-age infants in this group (OR 1.81, 95% CI 1.63-2.00, <i>p</i> < 0.00001). In contrast, frozen embryo transfer can result in macrosomic (OR 0.59, 95% CI 0.54-0.65, <i>p</i> < 0.00001) or large-for-gestational-age infants (OR 0.64, 95% CI 0.60-0.69, <i>p</i> < 0.00001). No significant difference was observed regarding congenital malformations or neonatal death rates. <i>Conclusions</i>: This systematic review confirmed that singleton babies conceived by frozen embryo transfer are at lower risk of preterm delivery, low birthweight and being small for gestational age than their counterparts conceived by fresh embryo transfer. The data support embryo cryopreservation but suggest that elective freezing should be limited to cases with a proven indication or within the framework of a clinical study.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11356234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}