Acta Informatica Medica最新文献

Background: Uncontrolled hypertension (UHT) is associated with an increased risk of target organ damage (TOD). Matrix metalloproteinase-2 (MMP-2) plays a role in vascular remodeling, and the rs243866 (-1575G/A) polymorphism has been implicated in cardiovascular diseases.

Objective: This study aimed to evaluate the association between rs243866 and TOD in UHT patients.

Methods: A cross-sectional study was conducted on 134 UHT patients at two hospitals in Vietnam. Genotyping of rs243866 was performed using PCR, and TOD was assessed via echocardiography (left ventricular hypertrophy - LVH), renal function tests (eGFR, albuminuria), and carotid ultrasound (carotid atherosclerosis).

Results: The genotypic distribution was GG (79.9%), GA (18.6%), and AA (1.5%), with allele frequencies of 89.2% (G) and 10.8% (A). The A allele was associated with higher risks of LVH (OR=2.553, 95% CI: 1.052-6.196, p=0.035), CKD (OR=2.639, 95% CI: 0.986-7.066, p=0.048), and carotid atherosclerosis (OR=6.806, 95% CI: 2.203-21.024, p<0.001). These associations remained significant after adjusting for confounders.

Conclusion: The rs243866 polymorphism of MMP-2 is independently associated with TOD in UHT, particularly LVH, CKD, and carotid atherosclerosis. Genetic screening for rs243866 may provide insights into risk stratification and personalized hypertension management.

This review is remembrance on occasion of 35 years of MIE '90 held in Glasgow which organized by UK and Scottish Association of Medical Informatics, and chaired by John Bryden and his team with support by European Federation for Medical Informatics (EFMI). It was my first participation at MIE Conferences, in that time as General Secretary of Yugoslav Association of Medical Informatics (YAMI) and officially accepted as a member of EFMI and IMIA. Besides our President of YAMI, Professor Gjuro Dezelic, one of founders YAMI (with Izet Masic, Stefan Adamic, Rajko Vukasinovic, as presidents of Bosnia and Herzegovina, Slovenian and Serbian Societies of Medical Informatics in 1987) participants at MIE '90 have been, also, our colleagues: Josipa Kern, Nada Dezelic, Silvije Vuletic, Visnja Lovrek, Miroslav Madjaric, etc. It was my first active participation at MIE Conferences, and after this meeting, year by year I continued until today. Let me say some important facts about it as my personal story -"Medical Informatics Journey", during the last 35 years, from Glasgow 1990 until today.

Background: Aortic stenosis (AS) is the most common form of valvular disease in the elderly population, with degenerative calcified valves remaining the primary cause of this condition. Due to the progressive nature of the disease, a significant reduction in aortic valve area leads to increased left ventricular (LV) pressure overload, resulting in adaptive but ultimately maladaptive concentric hypertrophy and progressive myocardial remodeling.

Objective: The main objectives of the study were to assess the regression of left ventricular (LV) hypertrophy.

Methods: This retrospective study included 150 patients who underwent surgical aortic valve replacement (AVR) with the Sorin Freedom Solo (SFS) stentless bioprosthesis and the St. Jude Regent (STJ) mechanical valve. Patients were divided into three groups based on follow-up duration: six months, one year, and two years. changes in transvalvular gradient, perioperative outcomes, and survival rates.

Results: The results showed a significant reduction in the transvalvular gradient for both valves (p < 0.0001), with a more pronounced decrease in patients with the SFS valve. The thickness of the interventricular septum (IVS) continuously decreased in SFS patients across all groups, whereas a significant reduction was observed only in Group 2 for STJ valves. Left ventricular ejection fraction (LVEF) showed a significantly greater increase in patients with the SFS valve (p < 0.024), particularly in Group 2. Overall mortality was 5.30% for STJ valves and 6.66% for SFS valves, with no statistically significant differences in Kaplan-Meier survival analysis (p > 0.05).

Conclusion: The SFS valve demonstrated superior hemodynamic performance and more pronounced LV hypertrophy regression, making it a suitable option for high-risk patients. The STJ valve ensures stable long-term function and remains the preferred choice for younger patients with acceptable operative risk. These findings highlight the importance of a personalized approach in selecting valvular prostheses.

Background: Aortic stenosis is a prevalent disease affecting approximately 10% of the population by the eighth decade, it is a fatal disease without treatment, with an annual mortality rate reaching 25%. Valve replacement, either through surgical or transcatheter approach, is the only therapeutic option. Over the last 15 years, the indications for transcatheter aortic valve replacement (TAVR) have spread to include young and low surgical risk patients.

Objective: Our study aims to address this gap in the literature by comparing the adverse outcome after TAVR through axillary versus femoral access in heart failure reduce ejection fraction (HFrEF) patients who underwent TAVR within 30 days of the procedure.

Methods: We used data from TriNetX US collaborative network database, including HFrEF patients who had TAVR through axillary or femoral access between 2015 and 2025. Propensity score matching was done to minimize the difference in baseline characteristics between the two cohorts. Outcomes were observed within the first 30 days of TAVR.

Results: A total of 206 patients in each cohort (axillary vs. femoral) were studied after propensity score matching. The incidence of permanent pacemaker (PPM) insertion was comparable between groups (5.0% vs. 5.1%; OR: 0.984, 95% CI: 0.400-2.419; HR: 0.365, 95% CI: 0.097-1.376; p = 0.157). Secondary outcomes showed no significant differences between the axillary and femoral approaches, including major vascular complications (OR: 0.542, 95% CI: 0.238-1.231; HR: 0.448, 95% CI: 0.192-1.046), acute kidney injury (OR: 0.922, 95% CI: 0.430-1.976; HR: 0.940, 95% CI: 0.459-1.922), all-cause mortality (OR: 1.010, 95% CI: 0.411-2.482; HR: 1.040, 95% CI: 0.433-2.498), cerebrovascular accident (OR: 0.980, 95% CI: 0.390-2.460; HR: 1.142, 95% CI: 0.384-3.399), and acute coronary syndrome (OR: 0.885, 95% CI: 0.355-2.208; HR: 1.211, 95% CI: 0.271-5.412).

Conclusion: Our study finding showed no difference in the permanent pacemaker insertion or secondary outcomes (Major vascular complications, Acute Kidney Injury, Cerebrovascular accident, Acute coronary syndrome, and All-cause mortality) within the first 30 days of TAVR in patients with HFrEF, whether the access axillary or femoral.

Background: Chest tube insertion (CTI) is a vital procedure in the management of chest trauma and pleural diseases. Challenges associated with CTI often stem from an inadequate understanding of relevant anatomy and unsafe procedural practices. Despite is importance, there is a noticeable lack of data on the current state of CTI competence and knowledge among medical students and interns in Saudi Arabia.

Objective: This study aims to investigate the knowledge and competency of CTI among medical students and interns in Saudi Arabia.

Methods: In 2024, a cross-sectional study was conducted among medical students and interns across various locations in Saudi Arabia. Data were collected through a comprehensive questionnaire that evaluated participants' knowledge, practical experience, training and education, as well as their attitudes and beliefs regarding CTI.

Results: A total of 413 medical students and interns in Saudi Arabia participated in the study, with 58.1% currently in their clinical years (Years 4-5). The findings revealed that only 35.6% demonstrated adequate knowledge about CTI. Regarding training and education, 53.5% of participants believed that the instruction they received on CTI was sufficient. Additionally, the majority (61.0%) expressed a positive attitude towards CTI, recognising its importance. However, a striking 88.4% reported having no experience performing a CTI independently, with the most commonly reported challenge being "insufficient practice opportunities" (73.6%).

Conclusion: The results emphasize the necessity for targeted education to address knowledge deficits and enhance procedural competency, thereby improving clinical safety.

Background: Emergency medicine conferences play a pivotal role in advancing clinical knowledge, fostering professional networks, and improving patient outcomes. However, traditional large-scale formats face challenges in ensuring diversity, inclusivity, and participant engagement. This study investigates the effect of different medical conference experiences - traditional versus interactive - on the overall experience ratings of 143 healthcare professionals. The research also examines how professional role, experience level, and primary motivation for attendance influence these ratings.

Objective: This study aims to assess the impact of alternative conference formats on engagement, inclusivity, and knowledge dissemination, with the goal of informing strategies to design more equitable and impactful emergency medicine conferences.

Methods: Data were analyzed using a two-way mixed-design analysis of variance (ANOVA) and a paired-samples t-test. The findings indicate a statistically significant preference for interactive sessions over traditional ones across the entire sample (M=4.06 vs. M=3.75, p<.001). This preference was particularly strong among participants motivated by networking.

Results: However, the study also revealed a nuanced relationship between professional experience and satisfaction, with late-career professionals (20+ years) rating their overall experience significantly lower than their less-experienced counterparts. The consistently high ratings for hands-on workshops across all groups highlight their universal value. These results suggest that tailoring conference content to meet the diverse needs of attendees, especially by incorporating more interactive and applied learning opportunities, can significantly enhance engagement and satisfaction.

Conclusion: The results revealed generational differences in satisfaction between "Millennials" and " Generation X" suggesting that future conferences should be tailored to diverse audience needs. Ultimately, the findings provide strong evidence that prioritizing interactive, applied learning can significantly boost engagement and knowledge retention.

Background: Artificial intelligence has become an important aspect in medicine, especially in radiology.

Objective: The aim of this article was to investigate the legal liability for AI-assisted radiographic diagnosis errors in view of French, Jordanian, and UAE Law.

Methods: The authors analyze medical liability in the U.A.E, France and Jordan, focusing on how errors in diagnosis are handled, and if artificial intelligence plays a role in the diagnosis. The researchers tested many jurisdictions for demonstrating wrong doing so nothing happens to the person.

Results: In the United Arab Emirates, fault is closely tied to the idea of "critical doctor mistakes," where a tool is accidentally used which leads to great harm. In France the penalties of a law are made up of the bias comment and how well professionally they knew how to do their job. In Jordan, the outdate laws reflects a change in the way the government is running things. They got another used law to government things correctly. The criminal liability framework including Penal Code and Medical Liabilidad Law protect the patient more than protecting the doctors. While these systems are supposed to balance how well you will take care of the patient and you, the caregiver, something goes wrong and the machines aren't perfect and we cannot keep trusting in them.

Conclusion: Because of the fact that this is an important emergent technology, a bunch of recommendations must be met for several reasons. Some of these guidelines are to review important regulatory actions to give a setting for this kind of technology.

Background: Peripheral arterial disease (PAD) is a chronic condition of reduced blood flow through the arteries. Early detection and prevention of PAD, especially in at-risk populations, is crucial to reducing morbidity and mortality.

Objective: The aim of the study was to examine the clinical feasibility of vascular ultrasound screening for early detection of PAD, as well as potential financial savings through preventive measures.

Methods: The study was conducted as a prospectively designed cross-sectional study with retrospective sample analysis, in which the sample consisted of 826 patients over 60 years of age, of both sexes, divided into two groups, conducted from January 2023 to May 2024.

Results: The study included 826 patients aged 60 and over, divided into two groups after ultrasound examination of the arteries (Group A with atherosclerosis /63.8%/; Group B - without atherosclerosis /36.2%/). The average age was 65.44±5.9 years, 60-65 years was 64.3%, and over 65 years was 35.7%. A statistically significant difference was recorded between the analyzed groups in terms of comorbidities and risk factors. We found that age, gender, hypertension, hyperlipidemia, diabetes, smoking and chronic obstructive disease have a significant relationship with the degree of atherosclerosis. Multivariate analysis showed that the age of the subjects, hyperlipidemia, hypertension and smoking are significant predictors of atherosclerosis. The prevalence for hemodynamically significant stenosis of ACI/ACC was 5.0%, for peripheral arteries 4.2%, the prevalence of aneurysm abdominal aorta (>3 cm) was 2.3%, and 0.5% for diameter >5 cm.

Conclusion: The results show the high efficiency of ultrasound diagnostics in identifying asymptomatic patients with advanced atherosclerosis, emphasizing the need for better organization of preventive programs, which could lead to potential savings in healthcare costs through earlier detection and treatment.

Background: Elevated levels of circulating 25-hydroxyvitamin D (25 (OH) D) are correlated with reduced levels of circulating thyroid-stimulating hormone (TSH).

Objective: The aim of this study was to evaluate the relationship between vitamin D and circulating TSH levels based on sex and age, with a focus on thyroid autoimmunity and thyroid hormone levels.

Methods: Fifty samples were obtained from patients with hypothyroidism (Hashimoto's thyroiditis, HT) aged 18-59 years (49.4% men, 50.6% women). The samples were tested for serum vitamin D and TSH levels using the enzyme-linked immunosorbent assay.

Results: The mean TSH level in the HT group (5.97 ± 0.18) was significantly higher than that in the control group (1.61 ± 0.1) (P < 0.001). Conversely, the mean vitamin D level was significantly lower in the HT group (40.5 ± 0.72) than in the control group (57.3 ± 0.72) (P < 0.001). Differences based on sex were not statistically significant (P = 0.096). Similarly, no differences were observed in age group distributions. Overall, moderate and strong positive correlations were observed in the control (r = 0.4767, P = 0.0009) and HT (r = 0.7493, P < 0.0001) groups, respectively.

Conclusion: This study showed a negative correlation between serum vitamin D and TSH levels in both healthy controls and patients with HT, regardless of age and sex.

Background: The purpose of this study is to evaluate the change in disc herniation over time, as assessed on MRI images, in those patients who are receiving epidural steroid injections. The concept of reduction in the size of the disc, in other words, spontaneous resorption/regression will be explored and whether it has any link with administration of epidural steroid injections.

Objective: The purpose of this study is to evaluate the change in disc herniation over time, as assessed on MRI images, in those patients who are receiving epidural steroid injections. The concept of reduction in the size of the disc, in other words, spontaneous resorption/regression will be explored and whether it has any link with administration of epidural steroid injections.

Methods: This retrospective study investigates the potential link between changes in the natural history of disc morphology, specifically disc resorption, and various IPM treatments. For 449 patients the inclusion criteria encompassed LDH patients who Underwent IPM at KAUH from the period between January 2022 and January 2024 for the patient who had at least two lumbar spine MRI scans (one before and one after IPM). Patients with disc surgery after IPM and pre-or post-MRI follow-up exceeding two years were excluded.

Results: Among the 128 LDH patients included in the study, 48 cases (37.5%) exhibited varying degrees of LDH resorption following IPM treatments, while 80 cases (62.5%) showed no significant change in LDH size.

Conclusion: The findings suggest that IPM therapies may influence the natural history of LDH morphology by decreasing disc size in a subset of patients. These results underscore the potential benefits of IPM treatments in LDH management and warrant further exploration in clinical practice and research settings.