Acta Informatica Medica最新文献

Background: Minimally invasive coronary artery bypass grafting (MICS CABG) via left anterior thoracotomy has emerged as a less invasive alternative to conventional open sternotomy (OPEN CABG), offering potential benefits in perioperative outcomes and complication rates.

Objective: The aim of this study was to compare procedural characteristics, ventilation duration, drainage volumes, and postoperative complications between MICS CABG and OPEN CABG in a single-center cohort in Bosnia and Herzegovina.

Methods: This retrospective cross-sectional study included 262 patients who underwent surgical revascularization between January 2019 and June 2023.

Results: MICS CABG was associated with a shorter median procedure time (2.5 vs. 3.5 hours, p<0.001) and reduced mechanical ventilation duration (11.0 vs. 14.0 hours, p<0.001). Although ICU stay was similar (3.0 days, p=0.001), total hospitalization was shorter for MICS CABG (6.0 vs. 7.0 days, p<0.001). Postoperative drainage was significantly lower at all measured time points (p<0.05), and transfusion requirements were reduced for red blood cells (0 vs. 2 units, p<0.001), fresh frozen plasma (0 vs. 2.5 units, p<0.001), and platelets (p=0.035). Use of inotropic agents was less frequent in MICS CABG, both at low (50.4% vs. 62.8%, p=0.043) and medium doses (4.0% vs. 16.0%, p=0.001). Wound infections were numerically lower in the MICS group (p=0.437).

Conclusions: Compared to open sternotomy, MICS CABG demonstrated significant advantages in operative time, ventilation duration, blood loss, and complication rates, supporting its role as a safe and effective alternative for coronary revascularization.

Background: Cardiovascular disease (CVD) remains a leading cause of morbidity and mortality worldwide, especially in low- and middle-income countries like Vietnam. Risk stratification models such as the original SCORE model have been widely used to guide preventive strategies. Recently, the updated SCORE2 model has been developed to enhance prediction accuracy by incorporating non-fatal events and recalibration for different European regions.

Objective: This study aims to compare the performance and applicability of SCORE2 versus the original SCORE in a Vietnamese population undergoing general health check-ups.

Methods: We conducted a cross-sectional study on individuals attending general health check-ups at Cho Ray Hospital, a leading tertiary hospital in Vietnam, from January 2024 to July 2024. Demographic, clinical, and laboratory data were collected to calculate cardiovascular risk scores using both the original SCORE and the updated SCORE2 models.

Results: Among 477 individuals undergoing general health check-ups, 317 patients met the inclusion criteria with a median age of 54.5 years (IQR: 47-62) and 35% were male. Risk stratification using the original SCORE model classified 87.1% as low-to-moderate risk, 9.1% as high risk, and 3.8% as very high risk. In contrast, SCORE2 reclassified 48.6% as low-to-moderate risk, while high and very high-risk categories increased to 35.6% and 15.8%, respectively (p < 0.001). Notably, 122 out of 276 patients (44.2%) initially classified as low-to-moderate risk by SCORE were reclassified by SCORE2 into higher risk categories - 101 (high risk) and 21 (very high risk). Similarly, 58.6% (n = 17) of patients classified as high risk by SCORE were upgraded to very high risk by SCORE2. SCORE2 also identified more high and very high-risk individuals under 50 years old, particularly among male patients.

Conclusion: Compared to the original SCORE model, SCORE2 significantly increased the detection of high and very high cardiovascular risk in Vietnamese individuals undergoing routine health check-ups. The findings suggest that SCORE2 may provide improved risk stratification, especially in younger and male populations, and may better support preventive cardiovascular strategies in clinical practice.

Background: Diabetes mellitus (DM) is a significant health concern, affecting a large portion of the global population, including Jordan. DM is characterized by hyperglycemia and leads to a wide range of complications and comorbidities. Hyperglycemia influences blood components and parameters, which is a major area of medical research. However, there is no consensus on how hyperglycemia impacts hematological parameters among different types of DM in Jordan.

Objective: In this study, we examined the effects of T1DM, T2DM, and prediabetes on selected hematological, inflammatory, and metabolic markers.

Methods: This study population consisted of one hundred and twenty samples and divided into 4 distinct groups as follows: 40 samples for prediabetic individuals, 40 samples for T2DM patients, 10 samples for T1DM, and 30 samples for normoglycemic individuals as controls. Hematological, inflammatory, and metabolic markers were measured using flow cytometric analysis and ELISA. Results: Our results showed that individuals with T2DM and prediabetes have higher levels of leukocytes, erythrocytes, and platelets compared to healthy controls. Consistently, complete blood count (CBC)-derived parameters in T2DM were also elevated, but this was not significant in prediabetic and T1DM groups. Hyperglycemia in T1DM increased platelet counts but did not affect leukocyte and erythrocyte counts. Additionally, diabetic patients exhibited inflammatory phenotypes, indicated by an elevated neutrophil-to-lymphocyte ratio in T2DM patients and circulating IL-6 levels in both T2DM and T1DM. The positive effects of hyperglycemia on insulin resistance and secretion were consistent across all three forms.

Conclusion: Our findings provide insights into using hematological parameters as valuable tools for understanding the pathophysiology of hyperglycemia.

Background: Vascular endothelial growth factor (VEGF) plays a crucial role in bladder cancer progression. Brolucizumab, an anti-VEGF agent, has been studied in various diseases; however, its potential in bladder cancer remains largely unexplored.

Objective: This study aimed to analyze the molecular docking and dynamic stability of Brolucizumab as a VEGF inhibitor in bladder cancer.

Methods: Target protein and ligand data mining were conducted. Proteins were prepared by removing water molecules using Discovery Studio 2019. Ligand energy minimization was performed using Pyrx v.0.9.8. Protein-ligand docking was conducted, and protein-protein docking was performed using the HADDOCK server. The interactions between compounds and proteins were visualized with BioVia Discovery Studio 2019. Molecular dynamics simulations were carried out using the YASARA Dynamic program.

Results: Brolucizumab binding induced smaller conformational changes compared to VEGFR2 binding. When VEGFR2 interacted with the VEGFA-Brolucizumab complex, significant conformational changes occurred, suggesting an inhibitory and blocking effect of Brolucizumab. Bond relaxation was observed when Brolucizumab bound to VEGFA and VEGFR, initiating conformational changes as part of its inhibitory activity. Brolucizumab demonstrated strong and competitive binding to VEGFA, with greater affinity than VEGFR2.

Conclusion: Brolucizumab exhibits inhibitory and blocking activity against VEGFR2, suggesting its potential as a therapeutic agent in bladder cancer.

Background: The study investigates the expression of Carbonic Anhydrase-II (CA-II) antibodies in both blood and tissue samples to understand their systemic and local effects.

Objective: The research aims to identify effective dosages and assess the differences in antibody levels across various treatment groups of undescended testes Sprague Dawley model. To measure and compare the levels of CA-II antibodies in blood and tissue samples, determine the most effective dosage for reducing tissue CA-II levels, and analyze the systemic versus local impacts of these antibodies.

Methods: The study employed immunohistochemistry to assess CA-II antibody expression in undescended testes model of Sprague Dawley tissue and blood, with brown-colored cells indicating positive expression. Levene's test confirmed homogeneity of variance (p=0.660), allowing for ANOVA to identify significant differences in CA-II levels among groups (p=0.000). Tukey's post hoc test was used to pinpoint specific group differences. Results: The analysis revealed significant differences in CA-II expression between groups. The dosage of 10 mg/KgBB was found to be most effective in reducing tissue CA-II levels. Blood CA-II concentrations were consistently higher than tissue levels across all groups, indicating a strong systemic presence.

Conclusion: The study highlights the significant distinctions in CA-II antibody levels between blood and tissue samples. It underscores the importance of dosage in managing CA-II levels and the need to consider both systemic and local impacts in clinical settings. These findings provide a basis for future research into targeted therapies for conditions mediated by CA-II.

Background: The proportion of individuals utilizing the Internet has increased rapidly, and as a result, cyberbullying has garnered significant attention across various communities, emerging as a critical public health concern.

Objective: This study aimed to validate the Vietnamese version of the Cyberbullying Scale (CBS) within the Vietnamese context.

Methods: A cross-sectional study was conducted with 257 students at University of Medicine and Pharmacy, Vietnam National University (VNU-UMP) in Hanoi , Vietnam, from November 2023 to March 2024. The Cyberbullying Scale was administered through the RedCap software platform.

Result: Among the 257 students, 64.9% were female. The average time spent using social networks per day was 5.6 ± 3.3 hours. The factor loadings for all items ranged from 0.76 to 0.92. The Cronbach's Alpha coefficient was calculated to be 0.98. The final measurement model of the CBS-M demonstrated good fit with the data, yielding acceptable fit indices: Comparative Fit Index (CFI) = 0.93, Tucker-Lewis Index (TLI) = 0.91, Standardized Root Mean Square Residual (SRMR) = 0.03, and Root Mean Square Error of Approximation (RMSEA) = 0.06.

Conclusion: The Cyberbullying Scale was identified as a reliable and valid instrument for assessing cyberbullying in Vietnam.

Background: Subtotal cholecystectomy (SC) is considered a safe option for a bailout in the presence of a difficult laparoscopic cholecystectomy with a low incidence of complications.

Objective: This report aims to describe the challenges in diagnosing and managing remnant gallbladder.

Case presentation: Case 1 is a 31-year-old male who presented with right upper quadrant abdominal pain ten years following SC. Abdominal ultrasound (US) and computed tomography (CT) scan confirmed a ruminant gallbladder. He underwent successful completion of laparoscopic cholecystectomy. Case 2 is a 40-year-old male who was admitted as a case of ascending cholangitis. He had a history of subtotal cholecystectomy one year prior to his presentation. CT scan, Magnetic resonance cholangiography (MRCP), and US all confirmed the presence of a remnant gallbladder. The patient underwent endoscopic retrograde cholangiopancreatography (ERCP), followed by the completion of laparoscopic cholecystectomy.

Conclusion: Recurring symptoms due to the remnant gallbladder are often challenging to diagnose and treat. Herein, we highlight the importance of adequate preoperative investigations and surgical planning prior to intervention.

Background: T Measles is a viral, highly contagious disease from the group of rash fevers, which mainly affects children. Persons suffering from measles are considered contagious four days before and four days during the period of the appearance of measles, which favors its faster spread. Clinical observation and laboratory diagnostics are essential for monitoring the course of the disease in order to prevent complications.

Objective: Our study aimed to analyze the significance and usefulness of laboratory tests on admission to hospital in pediatric patients with measles.

Methods: This prospective study included children with confirmed measles infection who came accompanied by parents to the Infectious Disease Clinic of the Clinical Center of the University of Sarajevo during nine months. Data on age, sex, symptoms and results of laboratory analyzes (biochemical, hematological and coagulation) were recorded.

Results: The study included a total of 302 subjects, including 122 healthy controls and 180 measles patients. Significantly lower values observed for aPTT, absolute number of eosinophils and basophils, RBC, hemoglobin, hematocrit, MCV, MCH, MCHC in measles patients. Significantly higher values were observed for fibrinogen, D-dimer, WBC, neutrophils, lymphocytes, monocytes, RDW and MPV in measles patients in contrast to controls. Significantly higher values were also observed for serum chloride, glucose, CRP, AST, ALT and LDH values. AST/ALT, NLR, PLR, NPR, LMR, LCR, SII and AISI also showed significant differences in measles patients compared to controls.

Conclusion: The results of our study showed that laboratory tests have great significance and potential in measles in pediatric patients admitted to the hospital. Lymphocyte/C-reactive protein ratio also showed good diagnostic potential.

Background: This study was to determine risk factors and prognostic models for mortality in elderly patients with Stenotrophomonas maltophilia bacteremia.

Objective: The aim of this study was to address this gap, we conducted this study to investigate the predictors of mortality and develop prognostic models for clinical practice.

Methods: A retrospective study was conducted on 195 patients ≥ 60 years of age (median age 78 (68-85) years, 59.5 % male) at Thong Nhat National Teaching Hospital in Vietnam between January 1st, 2017 and December 31st, 2022. Patients who were treated in the hospital with the first positive blood culture for Stenotrophomonas maltophilia bacteremia were chosen for enrolment in this study. This investigation evaluated demographic and clinical characteristics and prognostic models for mortality.

Results: The mortality rate was 37.4 %. Multivariate analysis showed that the significant independent risk factors for mortality were age (aOR, 1.08; 95 % CI, 1.04-1.13; p < 0.001), SOFA score (aOR, 1.38; 95 % CI, 1.14-1.68; p < 0.001), and APACHE II score (aOR, 1.10, 95 % CI, 1.03-1.17; p = 0.005). Bayesian model averaging method identified four clinically applicable models: age combined with both SOFA score and APACHE II score (AUC 0.884, R2 0.564), age combined SOFA score (AUC 0.874, R2 0.516), age combined APACHE II score (AUC 0.800, R2 0.340), SOFA score combined APACHE II (AUC 0.846, R2 0.507).

Conclusion: Stenotrophomonas maltophilia bacteremia was severe in elderly patients with high mortality. Risk factors for mortality included age, SOFA, and APACHE II scores. The model comprising age, SOFA, and APACHE II scores has the best predictive ability. However, the model including age and SOFA score was also clinically valid and simple.

Background: Diverting ileostomy is widely used to mitigate the consequences of anastomotic leakage after low anterior resection for rectal cancer. While its protective role is well established, the optimal timing of ileostomy closure remains controversial, with traditional delayed reversal exposing patients to stoma-related morbidity and potential permanent diversion.

Objective: The aim of this review is to synthesize randomized controlled trial (RCT) and meta-analysis evidence on early ileostomy closure, assess safety and outcomes, and evaluate whether a shift toward earlier reversal is justified in selected patients.

Methods: A narrative review of the published literature was conducted, including randomized trials, prospective studies, and systematic reviews identified through PubMed, Scopus, and Google Scholar. Outcomes of interest included perioperative morbidity, stoma-related complications, quality of life, and functional results.

Results and discussion: Evidence from RCTs shows heterogeneity. Trials such as EASY, Kłęk, and Lasithiotakis support early closure, reporting comparable morbidity and reduced stoma-related complications, whereas Bausys, Elsner, and Fukudome caution against indiscriminate application due to increased septic and wound-related morbidity. Meta-analyses consistently indicate that early closure reduces stoma-related complications but increases wound infections, with overall morbidity largely comparable between groups. Patient selection, confirmation of anastomotic integrity, and oncologic treatment schedules are central to outcomes. Cost-effectiveness analyses and retrospective series further support potential system-level and quality-of-life benefits.

Conclusion: Current evidence suggests that early ileostomy closure is feasible and safe in carefully selected patients, reducing the burden of stoma-related morbidity without compromising oncologic treatment. However, it should not yet be routine practice, as risks of septic complications persist in unselected populations. Future multicenter RCTs with standardized definitions, uniform imaging protocols, and long-term functional and cost-effectiveness endpoints are needed to guide practice.