Search

INTRODUCTION: Information on whether race and ethnicity are associated with a greater risk of recurrent hyperkalemia is limited. The aim of this study was to examine the association between race or ethnicity and recurrent hyperkalemia in a population of US veterans. METHODS: This retrospective study used the US Veterans Affairs database to identify adults (aged ≥18 years) with at least one serum potassium measurement during the study period who ever experienced hyperkalemia (serum potassium > 5.0 mmol/L). The proportion of patients with hyperkalemia recurrence (≥1 subsequent event) within one year was determined for different race and ethnicity groups. The association between patient race and ethnicity and the risk of hyperkalemia recurrence within one year after the index hyperkalemia event was analyzed using competing risk regression. RESULTS: Among a total of 1,493,539 veterans with incident hyperkalemia (median age (interquartile range): 61.0 years (54.0, 71.0)), recurrence within one year occurred in 19.1% of Black, 16.0% of Native Hawaiian/other Pacific Islander, 15.1% of White, 14.9% of American Indian/Alaska Native, and 13.1% of Asian patient groups. Recurrent hyperkalemia occurred in 18.1% of Hispanic and 15.6% of non-Hispanic patient groups. In a fully-adjusted regression model, recurrent hyperkalemia risk was significantly higher in Black versus White patient groups (subhazard ratio (sHR), 1.17; 95% confidence interval (CI), 1.16-1.19; p< 0.0001) and in Hispanic versus non-Hispanic patient groups (sHR, 1.30; 95% CI, 1.28-1.33; p< 0.0001). DISCUSSION/CONCLUSION: Among US veterans with incident hyperkalemia, the risk of recurrent hyperkalemia was higher in Black and Hispanic patient groups. This information may be useful for health system screenings to risk stratify patient groups and both guide the frequency of serum potassium monitoring and better understand the root causes of group differences.

Background: Large type 3 (diameter ≥ 8 cm) and type 4 gastric cancers have been arbitrarily combined in Japan as a single entity. However, whether these two types are oncologically similar remain unclear. This study aimed to clarify this issue. Methods: In this retrospective study, we analyzed a database of 3,575 patients from nine institutions who underwent gastrectomy between 2010 and 2014. Using propensity scores to balance significant variables, we compared prognoses and tumor recurrences. Results: Of patients with clinical T3/T4 who underwent R0 resection, 75 and 73 had large type 3 and 4 tumors, respectively. Patients with type 4 tumors had significantly lower overall survival rates than those of patients with large type 3 tumors (hazard ratio [HR] 1.77; 95% confidence interval [CI] 1.14–2.74). However, among the large type 3 tumors, a remarkable difference in prognosis was observed between the differentiated and undifferentiated histological types. A comparison was made between large type 3 with undifferentiated phenotype and type 4, each with 39 patients after propensity score matching. Outcomes in both groups were similar in terms of overall survival (HR 1.28; 95% CI 0.73–2.25) and relapse-free survival (HR 1.34; 95% CI 0.80–2.27). No statistically significant differences were observed in the incidence of peritoneal recurrence (35.9% vs. 46.1%, P = 0.36) and lymph node recurrence (25.6% vs. 12.8%, P = 0.15). Conclusions: Large type 3 tumors with undifferentiated phenotype and type 4 tumors were oncologically similar. This subgroup could be considered as a new entity for future clinical trials. [ABSTRACT FROM AUTHOR]

Simple Summary: This study explores the effectiveness and safety of a common breast cancer treatment in elderly patients, a group often overlooked in clinical trials. Specifically, it focuses on using CDK4/6 inhibitors with hormone therapy for treating metastatic HR+/HER2- breast cancer in patients aged 70 and older. This research aims to understand how well this treatment works and how tolerable it is for this vulnerable population, which faces unique challenges due to age and other health conditions. The results of this study may provide valuable insights for clinicians, enabling more informed treatment decisions which optimize therapeutic outcomes and enhance the quality of life for elderly patients with breast cancer. Background: Metastatic HR+/HER2- breast cancer is commonly treated with CDK4/6 inhibitors in combination with endocrine therapy. However, the efficacy and safety of this approach in elderly patients (≥70 years) remain unclear, particularly in the context of real-world clinical practice. This study aims to evaluate the clinical outcomes and tolerability of CDK4/6 inhibitor treatments in this fragile population, which is often under-represented in randomized clinical trials. Patients and methods: This retrospective multicenter study included elderly patients with metastatic HR+/HER2-negative breast cancer receiving first-line CDK4/6 inhibitors. The primary endpoint was progression-free survival (PFS). The secondary endpoints focused on the overall survival (OS), safety, and tolerability, considering variables such as tumor subtype, age, comorbidities, and treatment specifics. Results: The median PFS and OS were slightly lower than those reported in clinical trials, reflecting the inclusion of a more fragile population. The luminal B subtype was linked to a poorer PFS, while other factors like age, BMI, and ECOG status did not significantly affect the outcomes. A safety analysis indicated a higher incidence of grade 3 or higher toxicities, especially in frail patients, leading to dose reductions. Despite these challenges, CDK4/6 inhibitors were generally well-tolerated, allowing most patients to continue therapy. Conclusions: CDK4/6 inhibitors with endocrine therapy are effective in elderly patients with metastatic HR+/HER2- breast cancer, though careful management is crucial to balance efficacy and minimize adverse events. [ABSTRACT FROM AUTHOR]

Background/objectives: Understanding the factors that influence physiotherapy (PT) service use among patients with nonspecific lower back pain (LBP) is necessary to optimize treatment strategies, healthcare resource allocation, and the planning of value-based initiatives. We report factors that influence the number of PT visits per episode of care (defined as a referral from a physician) for an LBP population in Saudi Arabia, and compare them with patients experiencing their first and recurrent episodes of LBP. Methods: LBP patients were retrospectively enrolled from a clinical dataset derived from an outpatient PT clinic in Saudi Arabia. The primary outcome variable was the number of PT visits performed per episode of care. Multiple linear regression analysis was performed to examine the relationships between the numbers of PT visits per episode of care and independent variables. Results: The number of PT sessions per week (β 0.34, p < 0.001), compliance with PT sessions (β 0.31, p < 0.001), and pre-pain scores (β 0.29, p < 0.001) explained 41.8% (adjusted R2 0.32) of the variance in the total number of PT visits per episode of care (p < 0.001). Conclusions: Factors that might improve value-based care for LBP patients are reported. The more PT sessions per week, compliance with these sessions, and higher baseline pain scores predict a higher number of PT visits per episode of care among these patients. While reported for a Saudi Arabian population, there is no reason to believe that these findings do not apply internationally. [ABSTRACT FROM AUTHOR]

Simple Summary: Cancer is becoming a bigger health issue for cats, much like it is for humans. However, most research has focused on dogs, leaving a gap in our understanding of how cancer affects cats, especially in countries like Korea. In this study, we looked at ten years of data on cats diagnosed with tumors in Korea, aiming to find out which factors—like age, breed, or where the tumor is located—might increase the risk of the cancer being serious or malignant. We discovered that older cats were much more likely to have aggressive cancers, especially in areas like the mammary glands and digestive system. On the other hand, some types of cancer, like squamous cell carcinoma (a type of skin cancer), were much less common in Korea than in other countries. These findings can help veterinarians better understand which cats are at higher risk and encourage early diagnosis and treatment. This research adds to what we know about feline cancer and helps improve the care we provide for cats around the world. Feline cancer is increasingly recognized as a major cause of mortality, yet data on tumor prevalence and behavior in cats, particularly in non-Western regions, remain limited. This study analyzed a decade of feline tumor data in Korea from 2012 to 2022, focusing on age, breed, and anatomical location as predictors of malignancy. Data were collected from 683 cats, with regression analysis applied to determine significant associations. Older cats exhibited a markedly higher risk of malignancy, particularly in mast cell and mammary tumors. Tumors in the mammary gland and alimentary tract had malignancy rates exceeding 90%, underscoring the need for early detection in these regions. Interestingly, squamous cell carcinoma was rare in the skin, in stark contrast to Western studies, likely reflecting differences in environmental exposure. While breed was not a statistically significant predictor, certain breeds, including Persians and Russian Blues, showed a higher frequency of malignancy. These findings highlight the importance of regional tumor research in cats and the need for larger, multicenter datasets that incorporate environmental, genetic, and lifestyle factors. Understanding these influences will help refine veterinary care and improve cancer treatment outcomes in feline populations. [ABSTRACT FROM AUTHOR]

Background: Invasive pulmonary aspergillosis (IPA) is a serious fungal infection. However, current diagnostic methods have limitations. The purpose of this study was to use artificial intelligence to achieve a more accurate diagnosis of IPA. Methods: Totally 263 patients (148 cases of IPA, 115 cases of non-IPA) were retrospectively enrolled from a single institution and randomly divided into training and test sets at a ratio of 7:3. Clinic-radiological independent risk factors for IPA were screened using univariate analysis and multivariate logistic regression analysis, after which a clinic-radiological model was constructed. The optimal radiomics features were extracted and screened based on CT images to construct the radiomics label score (Rad-score) and radiomics model. The optimal DL features were extracted and screened using four pre-trained convolutional neural networks, respectively, followed by the construction of the DL label score (DL-score) and DL model. Then, the radiomics-DL model was constructed. Finally, the combined model was constructed based on clinic-radiological independent risk factors, the Rad-score, and the DL-score. LR was adopted as the classifier. Receiver operating characteristic (ROC) curves were drawn, and the areas under the curve (AUC) were calculated to evaluate the efficacy of each model in predicting IPA. Additionally, based on the best-performing model on the LR classifier, four other machine learning (ML) classifiers were constructed to evaluate the predictive value for IPA. Results: The AUC of the clinic-radiological model for predicting IPA in the training and test sets was 0.845 and 0.765, respectively. The AUC of the radiomics-DL and combined models in the training set was 0.871 and 0.932, while in the test set was 0.851 and 0.881, respectively. The combined model showed better predictive performance than all other models. DCA showed that taking 0.00–1.00 as the threshold, the clinical benefit of the combined model was higher than that of all other models. Then, the combined model was trained on four other machine learning classifiers, all of which achieved AUC values above 0.80 in the test set, showing good performance in predicting IPA. Conclusion: Clinic, CT radiomics, and DL combined model could be used to predict IPA effectively. [ABSTRACT FROM AUTHOR]

Background: Lower segment caesarean section (LSCS) is one of the most common surgical procedures done in obstetrics. The growing rate of caesarean sections globally, particularly in India, highlights the need for effective methods to assess the scar integrity. This study aims to compare the clinical findings (presence of scar tenderness) with radiological assessment (scar thickness) to predict intraoperative scar status in women with a history of previous LSCS. Methodology: This retrospective study involved 60 antenatal women with a history of previous LSCS. Data collection was done over six months, including clinical evaluation and transabdominal ultrasonography to measure scar thickness. Intraoperative findings were classified into normal, thinnedout, dehiscent, or scar rupture. Statistical analysis was performed to determine the correlation between clinical and radiological findings and results were tabulated. Results: In this study, the mean duration since the last LSCS was 4.02 ± 2.9 years. Intraoperative scar status was categorised as normal (31.6%), thinned-out (56.6%), scar dehiscence (11.66%), and no cases of scar rupture. Clinical assessment showed scar tenderness with a sensitivity of 36.58%, specificity of 94.73%, positive predictive value (PPV) of 93.75%, and negative predictive value (NPV) of 40.90%. Radiological assessment of scar thickness had a sensitivity of 17.07%, specificity of 89.47%, PPV of 77.77%, and NPV of 33.33%. Scar tenderness demonstrated a significant correlation with intraoperative findings (p-value 0.011), whereas scar thickness did not (p-value 0.705). Conclusion: In this study, clinical examination for scar tenderness was a more reliable predictor of intraoperative scar status compared to radiological assessment of scar thickness. This study suggests that clinical evaluation remains a crucial tool for predicting scar integrity in women with previous LSCS, however the role of measurement of scar thickness radiologically has also shown promising results in a few studies. Also the measurement of scar thickness depends upon inter-observer and intra-observer error. Hence further research is needed to explore the potential role of radiological evaluation involving methods ensuring greater degree of precision. [ABSTRACT FROM AUTHOR]

Background: Undesirable injuries during the intraoperative period, such as pressure injuries caused by improper positioning, medical devices, or adhesive tapes, can lead to patient harm and decreased satisfaction. This study aims to identify the risk factors of pressure injuries during the intraoperative period and the characteristics of these injuries. Methods: A retrospective case‑control study was conducted at King Khaled University Hospital in Riyadh, Saudi Arabia. Data were collected from the hospital incident reporting system and electronic medical records for incidents reported from January 1, 2022 to December 31, 2022. Inclusion criteria consisted of all patients with a reported pressure injury, including pressure ulcers, medical adhesive‑related skin injuries, or medical device‑related pressure injuries, occurring at least once during surgery. Results: Among the 113 patients, 57 (50.44%) had intraoperative pressure injuries (cases), while 56 (49.56%) did not (controls). The most common locations for pressure injuries were the lips (33.33%). Most of these injuries were classified as Medical Adhesive‑Related Skin Injury (61.40%). Stage 1 injuries were observed in 47 cases (82.46%), while Stage 2 injuries were observed in 10 cases (17.54%). Duration of surgery and device tightness were identified as significant risk factors (P < 0.001). Conclusion: This case‑control study identified the duration of surgery and device tightness as significant risk factors for intraoperative pressure injuries. The findings emphasize the importance of implementing evidence‑based prevention strategies. Healthcare professionals should prioritize staff education and training, while future research should focus on conducting prospective, multicenter studies and developing risk assessment tools and innovative medical devices. [ABSTRACT FROM AUTHOR]

2016 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) primary Sjögren's syndrome (SS) diagnostic criteria did not incorporate radiographic examination while staging SS according to salivary gland imaging and serological autoantibody tests was not discussed. The aim is to study the value of parotid sialography for diagnosing SS, and to initially explore the method of staging SS based on the results of imaging and serological autoantibody tests. 287 patients' clinical records were included. The sensitivity and specificity of parotid sialography in the diagnosis of SS were investigated. SS patients were categorized into early stage (autoantibody positive, imaging does not support SS), active stage (autoantibody positive, imaging supports SS), and quiescent stage (autoantibody negative, imaging supports SS), clinical characteristics of different stages were compared. The sensitivity of parotid sialography for the diagnosis of SS was 82.6%, the specificity was 71.5%. 10-minute USFR of the patients in the active stage (0.18 ± 0.38 ml/10min) was significantly lower than that of early stage (0.34 ± 0.47 ml/10min) and quiescent stage (0.54 ± 0.52 ml/10min), P = 0.010, and the rate of confirmed SS was significantly higher in the active stage (82.9%) than that in the early stage (44.4%) and the quiescent stages (14.8%), P < 0.001. Parotid sialography remains valuable in the diagnosis of SS. Performing imaging and serological autoantibody tests before lip gland biopsy may reduce invasive examinations for patients without significantly increasing the rate of missed diagnosis. According to imaging and serological autoantibody tests, SS can be categorized into early, active, and quiescent stages. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate the effect of respiratory motion on hepatic steatosis quantification using ultrasound attenuation imaging (ATI) or ultrasound-guided attenuation parameter (UGAP) in pediatric patients. Materials and Methods: Pediatric patients (aged ≤18 years) who underwent liver ultrasonography (US) with ATI or UGAP between May 2022 and February 2023 were included retrospectively. Median, interquartile range (IQR), and IQR/median values were calculated in both free-breathing (FB) and breath-holding (BH) states. Subjects were divided into normal and fatty liver groups according to grayscale US. Wilcoxon signed rank test, intraclass correlation coefficient (ICC), and linear regression test were used. Results: A total of 83 patients (M:F=46:37, median age 10 years, range 6-17 years) was included, with 55 patients in the ATI group and 28 patients in the UGAP group. The measured values of ATI and UGAP were not significantly different between FB and BH. The ICC values between FB and BH states were 0.950 [95% confidence interval (CI) 0.916-0.971] for median ATI and 0.786 (95% CI 0.591-0.894) for median UGAP. FB and BH status did not significantly affect the median ATI and UGAP (p=0.852, 0.531, respectively). The IQR/median value showed a significant association with age only in the FB status of the normal group using ATI (β= -0.014, p=0.042). Conclusion: Respiratory motion does not significantly affect the measurement of ATI or UGAP. Median ATI value showed excellent agreement in FB and BH status, while UGAP showed good agreement. Younger age may affect measurement variability in FB status of the normal group using ATI. [ABSTRACT FROM AUTHOR]

This study aims to objectively assess the effect of three surgical approaches for posterior uterine fibroid resection: transumbilical laparoendoscopic single-site surgery (LESS), vaginal natural orifice transluminal endoscopic surgery (vNOTES) in prone position (vNOTES-P), and vNOTES in the lithotomy position (vNOTES-L). A retrospective analysis was conducted on data pertaining to all patients who underwent vNOTES and LESS for single posterior fibroids at our institution from January 2023 to July 2023. Patients were categorized into three groups based on the surgical approach: vNOTES-P group (n = 30), vNOTES-L group (n = 17), and LESS group (n = 32). Comparative analysis was performed on the demographic characteristics and perioperative outcomes among the three groups of patients. All 79 patients underwent surgery without the need for conversion to laparotomy. There were no statistically significant differences among the LESS group, vNOTES-P group, and vNOTES-L group in terms of operative time, intraoperative blood loss, and perioperative complication rates. In the vNOTES-L group, two patients required conversion to LESS during surgery. Patients had faster return of bowel function (less time to flatus) in the vNOTES group compared to the LESS group (P < 0.05). However, three cases of postoperative infection occurred in the vNOTES group, while none were reported in the LESS group. Compared to LESS, vNOTES demonstrates significant advantages in alleviating postoperative pain, shortening time to passage of flatus, speeding recovery and enhancing cosmetic outcomes. Particularly, vNOTES-P for posterior uterine fibroid resection, as an emerging surgical approach, offers certain advantages in facilitating surgical maneuverability and reducing operative time, rendering it more suitable for posterior uterine fibroid resection. [ABSTRACT FROM AUTHOR]

Background: Several studies have advocated the use of ultrasound to diagnose distal forearm fractures in children. However, there is limited data on the diagnostic accuracy of ultrasound for distal forearm fractures when conducted by pediatric surgeons or trainees who manage orthopedic injuries in children. The objective of this study was to determine the diagnostic accuracy of point-of-care ultrasound (POCUS) for pediatric distal forearm fractures when conducted by pediatric surgeons and trainees after minimal training. Methods: This diagnostic study was conducted in a tertiary hospital emergency department in Germany. Participants were children and adolescents under 15 years of age who presented to the emergency department with an acute, suspected, isolated distal forearm fracture requiring imaging. Pediatric surgeons and trainees, after minimal training for sonographic fracture diagnosis, performed 6-view distal forearm POCUS on each participant prior to X-ray imaging. All data was retrospectively collected from the hospital's routine digital patient files. The primary outcome was the diagnostic accuracy of POCUS compared to X-ray as the reference standard. Results: From February to June 2021, 146 children under 15 met all inclusion and exclusion criteria, and 106 data sets were available for analysis. Regarding the presence of a fracture, X-ray and Wrist-POCUS showed the same result in 99.1%, with 83/106 (78.3%) fractures detected in both modalities and one suspected buckle fracture on POCUS not confirmed in the radiographs. Wrist-POCUS had a sensitivity of 100% (95% CI [0.956, 1]) and a specificity of 95.8% (95% CI [0.789, 0.999]) compared to radiographs. In 6 cases, there were minor differences regarding a concomitant ulnar buckle. The amount of prior ultrasound training had no influence on the accuracy of Wrist-POCUS for diagnosing distal forearm fractures. All fractures were reliably diagnosed even when captured POCUS images did not meet all quality criteria. Conclusion: Pediatric surgeons and trainees, after minimal training in POCUS, had excellent diagnostic accuracy for distal forearm fractures in children and adolescents using POCUS compared to X-ray. [ABSTRACT FROM AUTHOR]

Background: The National Academy of Medicine has formally identified transgender adults as an understudied population in critical need of health research. While national surveys, like the US Transgender survey, have characterized higher rates of depression, anxiety, suicidality and socioeconomic need in the transgender community, studies have not examined the impact of sociodemographic and clinical characteristics on mental health related outcomes. Objective: To describe the sociodemographic and mental health characteristics of transgender adults seen at a large Midwest transgender clinic and to determine factors associated with self-reported mental health conditions. Methods: Descriptive, retrospective, cross-sectional study of new transgender patients 18 years and older seen at a large Midwest transgender clinic between December 2019 and June 2022. Results: A total of 482 charts were reviewed. During their initial evaluation, 11.6% (56/482) reported having a history of suicide attempt and 81.3% (392/482) reported a mental health diagnosis with the most common being depression, anxiety, attention deficit disorder, and post-traumatic stress disorder. Multivariable logistic regression results show no single factor was significantly associated with mental health diagnosis after adjusting for the effect of age and race. Patients who were new to gender affirming hormone therapy (54%, 254/ 468) are 2.0 (95% CI 1.4-2.9) times more likely to report having a mental health care provider than patients who were seen for continuation of therapy (46%, 214/ 468). Ten records with race not disclosed, 3 records with gender identity "other" and 2 records with gender identity not disclosed were excluded from analysis. Conclusion: This study reinforces the finding that transgender adults have an increased lifetime prevalence of mental health conditions. The higher prevalence of mental health conditions in our clinic was not associated with sociodemographic factors included in the study. Furthermore, transgender patients are less likely to have seen mental healthcare providers after initiation of gender affirming hormone therapy. [ABSTRACT FROM AUTHOR]

Objectives: To assess the impact of an Artificial Intelligence (AI) limb bone fracture diagnosis software (AIS) on emergency department (ED) workflow and diagnostic accuracy. Materials and Methods: A retrospective study was conducted in two phases—without AIS (Period 1: 1 January 2020–30 June 2020) and with AIS (Period 2: 1 January 2021–30 June 2021). Results: Among 3720 patients (1780 in Period 1; 1940 in Period 2), the discrepancy rate decreased by 17% (p = 0.04) after AIS implementation. Clinically relevant discrepancies showed no significant change (−1.8%, p = 0.99). The mean length of stay in the ED was reduced by 9 min (p = 0.03), and expert consultation rates decreased by 1% (p = 0.38). Conclusions: AIS implementation reduced the overall discrepancy rate and slightly decreased ED length of stay, although its impact on clinically relevant discrepancies remains inconclusive. Key Point: After AI software deployment, the rate of radiographic discrepancies decreased by 17% (p = 0.04) but this was not clinically relevant (−2%, p = 0.99). Length of patient stay in the emergency department decreased by 5% with AI (p = 0.03). Bone fracture AI software is effective, but its effectiveness remains to be demonstrated. [ABSTRACT FROM AUTHOR]

Aims Methods Results Conclusion Immune checkpoint inhibitors, such as nivolumab, combined with small molecule antiangiogenic receptor tyrosine kinase inhibitors (TKIs), present a promising strategy for future immunotherapy. However, combination therapy can lead to specific adverse drug reactions (ADRs) in various clinical settings. Current research on the ADRs associated with combination therapy is limited. Our study aims to assess the safety of combination therapy.We extracted ADR reports on combination therapy from the Food and Drug Administration (FDA) Adverse Event Reporting System database, covering the period from the first quarter of 2012 to the third quarter of 2023, and conducted a large‐scale retrospective study. We evaluated ADR risk signals using the reporting odds ratio (ROR) and calculated the Ro/e ratio to compare the differences in the risk of fatal ADRs among various tumour types.We comprehensively reported the occurrence of ADRs in pan‐cancer patients undergoing combination therapy. The combination therapy significantly increased the risk of sensitive skin (ROR: 231.43, 95% CI: 55.01–973.72, P < .05), metastatic renal cell carcinoma (ROR: 220.71, 95% CI: 28.99–1695.41, P < .05) and renal cell carcinoma (ROR: 188.22, 95% CI: 44.24–800.85, P < .05). We also compared the differences in ADRs resulting from different small molecule drug combinations, as well as the differences in ADRs among patients with different types of tumours under combination therapy. Furthermore, we analysed the characteristics of patients prone to experiencing fatal ADRs.These results can help enhance understanding of the ADRs commonly associated with combination therapy and assist oncologists in formulating screening protocols. [ABSTRACT FROM AUTHOR]

This study aims to assess the presence and progression of TMD in adult patients undergoing orthognathic surgery to correct dentoskeletal open bite and evaluate whether these changes can be attributed to the intervention. A retrospective cohort study was conducted on 44 adult patients (14 males and 30 females) aged 18 to 43 years. Articular assessments were performed to evaluate temporomandibular joint (TMJ) health and functionality before (T0) and after (T1) combined orthodontic-surgical treatment. TMJ health was assessed by maximum mouth opening, joint noises, parafunctions (bruxism or clenching), joint locking, TMJ pain, masticatory muscle pain, and headaches. Statistical analyses used McNemar's Exact Test and paired T-tests. The study shows a significant reduction (p < 0.05) in symptoms, except for locking, with the most substantial decrease in headaches (p = 0.0001). Overall, articular symptoms markedly decreased post-surgery, with sustained joint functionality. Restoring physiological occlusion in patients with anterior open bite is crucial for maintaining the stomatognathic system's balance. Orthognathic surgery, when indicated, appears beneficial in alleviating articular symptoms while preserving TMJ function. [ABSTRACT FROM AUTHOR]

Introduction: Lithium is a key medication for treating various neuropsychiatric disorders, with a narrow therapeutic index and significant drug interactions. Monitoring lithium blood levels is crucial. This study aims to investigate the relationship between lithium blood levels and demographic characteristics such as age and gender, as well as possible drug interactions, in patients with a history of lithium use who applied to various services and outpatient clinics. Materials & Methods: The files of 438 patients who were admitted to various services and outpatient clinics of Kırklareli Training and Research Hospital between January 1 and December 31, 2023, were retrospectively reviewed. Patients' blood lithium levels, gender, age, service/outpatient clinic they admitted to, other medications used, urea, creatinine, and eGFR values were recorded. Results: When the demographic characteristics of 438 patientswere examined, 62% were female (270), 38%weremale (168), and the average agewas 46.3 ± 14.8 years, showing a normal distribution. It was found that 192 patients (71 males, 121 females) had therapeutic lithium blood levels, while 244 patients (97 males, 147 females) had levels below 0.6 mmol/L. Two female patients had blood levels above the therapeutic range (1.23 and 1.43 mmol/L). Among the clinics and services, the four most frequented were the psychiatry clinic (314 patients), internalmedicine clinic (36 patients), emergency service (27 patients), and medical oncology clinic (17 patients). Of the 314 patients admitted to the psychiatry clinic, 168 had therapeutic drug levels; only 7 of the 36 admitted to internal medicine had therapeutic levels; 12 of the 27 patients in the emergency service had therapeutic levels; and all 17 patients in medical oncology had levels below therapeutic limits. Discussion: The data emphasize the importance of regular blood level monitoring to ensure lithium treatment's efficacy and patient safety. It is noteworthy that most patients in the psychiatry clinic had therapeutic drug levels, while those in other clinics had lower levels. Conclusion: In conclusion, this study highlights the importance of regular blood level monitoring to ensure the efficacy and safety of lithium treatment. [ABSTRACT FROM AUTHOR]

Background: Plasma cell leukemia (PCL) is a rare monoclonal gammopathy, associated with short survival. Because of its very low incidence, only a few cohorts have been reported and thus, information on this disease is scarce. The goal of this study was to better understand the clinical features, prognostic factors, and efficacy of modern treatments in both primary PCL (pPCL) and secondary PCL (sPCL). Methods: We performed a retrospective, multicenter study of patients diagnosed with PCL, defined as circulating plasma cells ≥20% of total leukocytes and/or ≥2 × 109/L. Results: We identified 99 eligible PCL patients, of whom 33 were pPCL and 66 were sPCL. The median progression‐free survival (PFS) to frontline treatment and overall survival (OS) were, respectively, 4.8 (95% CI, 0.4–9.2) and 18.3 months (95% CI, 0.0–39.0) for pPCL and 0.8 (95% CI, 0.5–1.1) and 1.2 months (95% CI, 0.9–1.5) for sPCL (both p < 0.001). We observed no improvement in OS over time (2005–2012 vs. 2013–2020, p = 0.629 for pPCL and p = 0.329 for sPCL). Finally, our data suggested that sPCL originates from a high‐risk multiple myeloma (MM) population with a short OS (median 30.2 months), early relapse after stem cell transplant (median 11.9 months) and a high proportion of patients with multiple cytogenetic abnormalities (36% with ≥2 abnormalities). Conclusions: This study is one of the largest PCL cohorts reported. We are also the first to investigate characteristics of MM before its transformation into sPCL and demonstrate that high‐risk biologic features already present at the time of MM diagnosis. Moreover, our data highlights the lack of improvement in PCL survival in recent years and the urgent need for better treatment options. [ABSTRACT FROM AUTHOR]

Copyright of Acta Odontologica Turcica is the property of Acta Odontologica Turcica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: To examine the distribution, clinical characteristics, and management of priapism in a Saudi Arabian tertiary care setting to provide a regional perspective. Subjects and Methods: This retrospective chart review included 29 male patients presenting with priapism at a tertiary care hospital in Riyadh, Saudi Arabia, from January 2011 to June 2023. Data were collected on patient demographics, clinical presentation, treatment modalities, and outcomes. Results: The study found recurrent episodes of priapism in many patients, with a significant number associated with hematological diseases, notably sickle cell disease. Most treatments involved non-surgical methods. A notable finding was the correlation between the duration of priapism episodes and the likelihood of hospital admissions, suggesting that prolonged episodes often required more extensive medical attention. Conclusions: Priapism often presents as a chronic and recurrent condition requiring personalized management strategies. This study emphasizes the importance of recognizing regional occurrence patterns to enhance the management of priapism and suggests a need for further research in regions where this condition is less common. [ABSTRACT FROM AUTHOR]

Ana Faria Pereira,1 Ana Gama e Castro,1 Rita Teixeira-Martins,1 Inês Coelho-Costa,1 Sónia Torres-Costa,1 Marta Silva,1 Ana Catarina Pedrosa,1 Joana Araújo,1 Luís Figueira,1– 3 Cláudia Oliveira-Ferreira1,4 1Department of Ophthalmology, Unidade Local de Saúde de São João, Porto, Portugal; 2Unit of Pharmacology and Therapeutics, Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal; 3MedInUP - Center for Drug Discovery and Innovative Medicines, Faculty of Medicine, University of Porto, Porto, Portugal; 4Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, PortugalCorrespondence: Ana Faria Pereira, Department of Ophthalmology, Unidade Local de Saúde de São João, Avenida Prof. Hernâni Monteiro, Porto, 4202 – 451, Portugal, Email acfariapereira@gmail.comPurpose: Syphilis is a re-emerging infectious disease with various systemic manifestations, including ocular involvement, which can lead to significant morbidity if untreated. This study aims to analyze the ocular manifestations of syphilis in patients treated at a Portuguese tertiary center over a 14-year period.Patients and Methods: A retrospective review of patients diagnosed with syphilis who presented with ocular symptoms from 2010 to 2023 was conducted. Data collected included demographic information, clinical presentation, ophthalmologic findings, serologic test results, treatment regimens and outcomes.Results: A total of 47 patients with ocular syphilis were identified. The mean age of the cohort was 45, with a male predominance of 78.7%. The most common ocular manifestations included uveitis (mostly posterior and panuveitis), optic neuritis, acute syphilitic posterior placoid chorioretinitis and vitritis. Best corrected visual acuity (BCVA) at presentation was highly variable, ranging from hand movements to no impairment of visual acuity. At the end of the follow-up period, the majority of the study eyes achieved a BCVA between 0 and 0.1 (p< 0,000). Acute syphilitic posterior placoid chorioretinitis was associated with poorer visual outcomes after treatment, indicating its presence is a poor prognosis factor. HIV status, the presence of vitritis, vasculitis and papillitis at presentation, a positive syphilis serology in cerebrospinal fluid and treatment regimen did not appear to have a significant impact on the final BCVA.Conclusion: Ocular syphilis, though rare, remains a significant cause of visual morbidity. Early recognition and prompt treatment are crucial for preventing permanent vision loss. Regular screening and increased awareness among clinicians are essential to manage this potentially sight-threatening condition effectively. Further research is needed to optimize treatment protocols and improve patient outcomes.Keywords: syphilis, uveitis, optic neuritis, retinal vasculitis, retrospective study, penicillin

Abstract Background The incidence of musculoskeletal diseases is increasing in clinical practice, leading to a growing demand for rehabilitation medicine. However, education in musculoskeletal education is lacking in the training of physical medicine and rehabilitation students. This study aims to evaluate the impact of musculoskeletal education on medical students’ learning of rehabilitation medicine and analyze the correlation between influencing factors and education. Objectives The primary objective of this study is to evaluate the impact of musculoskeletal education on medical students’ learning of rehabilitation medicine. Furthermore, the authors aim to analyze the correlation between various influencing factors and the effectiveness of this education, with the goal of informing future educational interventions and enhancing student outcomes. Methods A comprehensive search was conducted across the Pubmed, Ovid, and Cochrane Central Register of Controlled Trials (CENTRAL) databases for relevant articles published from January 2012 to September 2024. The search focused on medical students as the research subjects and musculoskeletal education as the intervention method. Both randomized controlled trials (RCTs) and non-randomized controlled trials (non-RCTs) were included. The selected studies underwent a systematic review, and meta-analysis was performed using R 3.4.4 software. Results After a thorough search, 41 studies were included. The retrospective study indicated that the most common impacts were knowledge acquisition, self-confidence, and satisfaction. The subsequent meta-analysis revealed significant increases in students’ knowledge acquisition [standardized mean differences (SMD) = 2.15, 95% confidence interval [CI] (1.36, 2.94), I 2 = 97%, random effect model] and self-confidence [SMD = 5.81, 95% CI (2.88, 8.75), I 2 = 97%, random effect model]. Compared with the general teaching control group, the knowledge acquisition of students in the observation group improved [SMD = 0.25, 95% CI (0.00, 0.51), I 2 = 83%, in the random effect model]; However, no significant difference in satisfaction occurred [SMD = 0.27, 95% CI (-0.47, 1.01), P > 0.05, I 2 = 89%, in the random effects model]. Conclusion Musculoskeletal education primarily impacts knowledge acquisition self-confidence, and satisfaction among physical medicine and rehabilitation students. The meta-analysis further establishes that musculoskeletal education significantly enhances knowledge acquisition and confidence in these students. Trial registration CRD42024563899 (completed on July 17, 2024).

Abstract Background Invasive pulmonary aspergillosis (IPA) is a serious fungal infection. However, current diagnostic methods have limitations. The purpose of this study was to use artificial intelligence to achieve a more accurate diagnosis of IPA. Methods Totally 263 patients (148 cases of IPA, 115 cases of non-IPA) were retrospectively enrolled from a single institution and randomly divided into training and test sets at a ratio of 7:3. Clinic-radiological independent risk factors for IPA were screened using univariate analysis and multivariate logistic regression analysis, after which a clinic-radiological model was constructed. The optimal radiomics features were extracted and screened based on CT images to construct the radiomics label score (Rad-score) and radiomics model. The optimal DL features were extracted and screened using four pre-trained convolutional neural networks, respectively, followed by the construction of the DL label score (DL-score) and DL model. Then, the radiomics-DL model was constructed. Finally, the combined model was constructed based on clinic-radiological independent risk factors, the Rad-score, and the DL-score. LR was adopted as the classifier. Receiver operating characteristic (ROC) curves were drawn, and the areas under the curve (AUC) were calculated to evaluate the efficacy of each model in predicting IPA. Additionally, based on the best-performing model on the LR classifier, four other machine learning (ML) classifiers were constructed to evaluate the predictive value for IPA. Results The AUC of the clinic-radiological model for predicting IPA in the training and test sets was 0.845 and 0.765, respectively. The AUC of the radiomics-DL and combined models in the training set was 0.871 and 0.932, while in the test set was 0.851 and 0.881, respectively. The combined model showed better predictive performance than all other models. DCA showed that taking 0.00–1.00 as the threshold, the clinical benefit of the combined model was higher than that of all other models. Then, the combined model was trained on four other machine learning classifiers, all of which achieved AUC values above 0.80 in the test set, showing good performance in predicting IPA. Conclusion Clinic, CT radiomics, and DL combined model could be used to predict IPA effectively.

Background: No data exist on the efficacy and safety of anlotinib plus camrelizumab doublet as second-line therapy for advanced esophageal squamous cell carcinoma (ESCC). Although anlotinib and the programmed death-1 (PD-1) inhibitor camrelizumab are used as treatments for ESCC, the combined use of anlotinib and camrelizumab as a second-line therapy has not been reported. Therefore, this study explored the efficacy and toxicity of anlotinib plus camrelizumab as second-line therapy for advanced ESCC. Methods: Fifty-eight patients with advanced ESCC undergoing second-line therapy, either with anlotinib plus camrelizumab or anlotinib plus S-1, were enrolled and retrospectively analyzed at Jiangsu Province Hospital of Chinese Medicine from January 2020 to December 2021. The primary endpoint was progression-free survival (PFS), with secondary endpoints including the objective response rate (ORR), disease control rate (DCR), and assessment of toxicity. Results: In patients with advanced ESCC, the anlotinib plus camrelizumab group (N = 32) exhibited longer PFS (8.00 vs. 4.53 months, P

Background/purpose: 2016 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) primary Sjögren's syndrome (SS) diagnostic criteria did not incorporate radiographic examination while staging SS according to salivary gland imaging and serological autoantibody tests was not discussed. The aim is to study the value of parotid sialography for diagnosing SS, and to initially explore the method of staging SS based on the results of imaging and serological autoantibody tests. Materials and methods: 287 patients’ clinical records were included. The sensitivity and specificity of parotid sialography in the diagnosis of SS were investigated. SS patients were categorized into early stage (autoantibody positive, imaging does not support SS), active stage (autoantibody positive, imaging supports SS), and quiescent stage (autoantibody negative, imaging supports SS), clinical characteristics of different stages were compared. Results: The sensitivity of parotid sialography for the diagnosis of SS was 82.6%, the specificity was 71.5%. 10-minute USFR of the patients in the active stage (0.18 ± 0.38 ml/10min) was significantly lower than that of early stage (0.34 ± 0.47 ml/10min) and quiescent stage (0.54 ± 0.52 ml/10min), P = 0.010, and the rate of confirmed SS was significantly higher in the active stage (82.9%) than that in the early stage (44.4%) and the quiescent stages (14.8%), P

AIM: Urolithiasis is the most prevalent urinary tract disease, posing a global public health concern. The escalating prevalence and recurrence rates of urolithiasis are attributed to lifestyle modifications, such as reduced physical activity and dietary habits. This retrospective study aims to explore the risk factors associated with urolithiasis among individuals diagnosed with this condition. Method: A retrospective hospital-based study involving 60 participants meeting the inclusion criteria was conducted. The participants were selected through convenience sampling from the urology, nephrology, and medical wards at Saveetha Medical College and Hospital. Demographic variables were collected, and the risk factors were assessed using a checklist on one-to-one interviews. Results: The study unveiled that most participants (68%) were male. Eighty percent of participants had the risk factor of decreased water intake, 74% consumed excess tomatoes, 56% had a history of recurrent urinary tract infections, 64% consumed an excessive amount of salt daily, 72% experienced a decreased urine output, 53% had a habit of alcohol consumption, and 45% included milk and milk products in their daily diet. A small percentage (5%) had a family history of urolithiasis. Additionally, 6% were undergoing Siddha treatment. Conclusion: The findings from this study underscore the significant factors contributing to urolithiasis. They can inform public health campaigns to raise awareness about lifestyle modifications, dietary changes, and hydration protocols contributing to kidney stone formation.

Abstract This study aims to objectively assess the effect of three surgical approaches for posterior uterine fibroid resection: transumbilical laparoendoscopic single-site surgery (LESS), vaginal natural orifice transluminal endoscopic surgery (vNOTES) in prone position (vNOTES-P), and vNOTES in the lithotomy position (vNOTES-L). A retrospective analysis was conducted on data pertaining to all patients who underwent vNOTES and LESS for single posterior fibroids at our institution from January 2023 to July 2023. Patients were categorized into three groups based on the surgical approach: vNOTES-P group (n = 30), vNOTES-L group (n = 17), and LESS group (n = 32). Comparative analysis was performed on the demographic characteristics and perioperative outcomes among the three groups of patients. All 79 patients underwent surgery without the need for conversion to laparotomy. There were no statistically significant differences among the LESS group, vNOTES-P group, and vNOTES-L group in terms of operative time, intraoperative blood loss, and perioperative complication rates. In the vNOTES-L group, two patients required conversion to LESS during surgery. Patients had faster return of bowel function (less time to flatus) in the vNOTES group compared to the LESS group (P

Most gastrointestinal polyps are asymptomatic; therefore, assessing symptoms associated with cancer and precancerous polyps is essential.

Shanshan Chen,1,2 Youjia Duan,2 Yongchao Zhang,2 Long Cheng,2 Liang Cai,2 Xiaopu Hou,2 Xiaojun Wang,3 Wei Li1,2 1Cancer Center, Beijing Tongren Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Cancer Center, Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China; 3Department of Integrated Traditional Chinese and Western Medicine, Beijing Youan Hospital, Capital Medical University, Beijing, People’s Republic of ChinaCorrespondence: Wei Li, Cancer Center, Beijing Tongren Hospital, Capital Medical University, Beijing, People’s Republic of China, Email weili8989@ccmu.edu.cn Xiaojun Wang, Department of Integrated Traditional Chinese and Western Medicine, Beijing Youan Hospital, Capital Medical University, Beijing, People’s Republic of China, Email w_xiaojun@ccmu.edu.cnPurpose: To determine the effect of aspirin on hepatocellular carcinoma (HCC) recurrence and survival after thermal ablation.Methods: A retrospective analysis was performed to evaluate the efficacy and safety of aspirin in combination with thermal ablation. The clinical data were collected for the enrolled patients. Progression-free survival (PFS), overall survival (OS), and adverse events were analyzed.Results: A total of 174 patients with HCC were enrolled. The median PFS was 11.1 (95% confidence interval [CI]: 8.1− 14.0) months for patients who took aspirin and 8.6 (95% CI: 5.5− 11.8) months for patients who did not take aspirin. The median OS of patients in the aspirin group was 76.7 (95% CI: 58.1− 95.3) months and that in the non-aspirin group was 53.5 (95% CI: 42.7− 64.3) months. In patients with non-viral HCC, OS was significantly better for the aspirin group (P = 0.03) after ablation. The PFS of patients who underwent ablation alone in the aspirin group was obviously superior to that of patients in the non-aspirin group (P = 0.002). Stratified Cox regression analysis demonstrated that aspirin use after ablation might be a protective factor in specific HCC patient subgroups. The incidence of major adverse events did not significantly differ between the two groups.Conclusion: Low-dose aspirin use was associated with better OS in patients with non-viral HCC after thermal ablation. In patients who received thermal ablation alone, the administration of low-dose aspirin could improve PFS. Aspirin use might be a protective factor in some patients after ablation.Keywords: thermal ablation, aspirin, hepatocellular carcinoma, survival analysis, retrospective study

Background: As a chronic inflammatory process, chronic osteomyelitis is caused by bacterial infections that lead to bone destruction. This disease is more common in patients with open fractures and those undergoing multiple surgical procedures after trauma. We aimed to provide a comprehensive overview and critical assessment of the therapeutic efficacy of the anterolateral thigh (ALT) perforator flap in the management of chronic osteomyelitis with dermatologic and soft tissue imperfections localized in the lower extremity. Methods: A retrospective analysis involving a cohort of 16 patients who underwent ALT perforator flap reconstruction for the management of chronic osteomyelitis in the calf region that manifested with integumentary deficiencies was conducted. Results: During the follow-up period spanning from 4 months to 2 years, all 16 patients who underwent ALT perforator flap transplantation exhibited flap viability. Among these cases, 15 patients made a full recovery from the infection and 1 patient had partial survival. Among the 15 cases, 2 patients developed vascular crisis (owing to venous thrombosis during surgical exploration). One patient had a relapse of the disease 1-year post-surgery. The success rate of this surgical method was 15/16, and the surgical complications included flap crisis, flap necrosis, delayed wound healing, and recurrence of infection. Conclusion: The ALT perforator flap, which can cover bone and soft tissues and effectively control infections, can be applied to the treatment of chronic osteomyelitis of the lower limbs with skin defects. Overall, the muscle flap fills the dead space and medullary cavity and skin flap covers the skin defect.

Purpose: This study aimed to evaluate the effectiveness of a novel technique for securing the tibial component in cementless total knee arthroplasty (TKA) by utilizing resected cancellous bone to fill the peg holes. It was hypothesized that this method would reduce the incidence of radiolucent lines (RLLs) on plain radiographs. To test this hypothesis, a retrospective comparison of plain radiographs from patients who underwent the bone-filling technique (bone filling group) versus those who did not receive this treatment (conventional group) was conducted. Methods: Participants were 151 patients (213 joints) who underwent TKA with the NexGen trabecular metal (TM) modular tibia (Zimmer Biomet) from 2011 to 2016 [bone filling group, 54 patients (69 joints); conventional group, 100 patients (144 joints); 3 patients had 1 joint in each group]. Clinical evaluations, plain radiographs, and operative time were compared between groups. Results: The mean follow-up period was 5 years and 5 months. Knee Society Scores and Knee Society Functional Scores did not differ significantly between groups; however, the bone filling group had a significantly lower incidence of RLLs (p ​

Abstract We aimed to assess long-term disease progression in patients with severe keratoconus (KC). Clinical records of 125 patients (201 eyes) with severe KC followed-up for > 12 months were retrospectively analyzed. From these, 28 patients (31 eyes) were included. Corneal topography parameters evaluated included thinnest corneal thickness (TCT), maximum keratometry (Kmax), anterior and posterior mean corneal radii of 3 mm (aKM, pKM), steep keratometry, and KC screening indices. All patients wore rigid gas permeable contact lenses (RGPCLs) for an extended period. The median patient age and follow-up period were 20 (interquartile range [IQR] 17–22) years and 25 (15–38) months, respectively. Compared to baseline, the aKM, Kmax, and KC screening indices on the anterior corneal surface were reduced at the final follow-up (P

Abstract Objective Serum lipoprotein(a) [Lp(a)] is a risk factor of cardiovascular diseases. However, the relationship between the serum Lp(a) and clinical outcomes has been seldom studied in Chinese hospitalized patients with cardiovascular diseases. Methods We retrospectively collected the clinical data of hospitalized patients with cardiovascular diseases in the Cardiovascular Department of Dongguan People’s Hospital from 2016 to 2021 through the electronic case system. Patients were divided into 4 groups based on Lp(a) quartiles: Quartile1 (≤ 80.00 mg/L), Quartile 2 (80.01 ~ 160.90 mg/L), Quartile 3 (160.91 ~ 336.41 mg/L), Quartile 4 (> 336.41 mg/L). Cox proportional hazard regression models were constructed to examine the relationship between Lp(a) and cardiovascular events. Results A total of 8382 patients were included in this study. After an average follow-up of 619 (320 to 1061) days, 1361 (16.2%) patients developed major adverse cardiovascular events, and 125 (1.5%) all-cause death were collected. The incidence of MACEs was 7.65, 8.24, 9.73 and 10.75 per 100 person-years in each Lp(a) quartile, respectively; the all-cause mortality was 0.48, 0.69, 0.64 and 1.18 per 100 person-years in each Lp(a) quartile, respectively. The multivariate Cox regression analysis suggested that high Lp(a) level was an independent risk factor for MACEs (HR: 1.189, [95% CI: 1.045 to 1.353], P = 0.030) and all-cause death (HR: 1.573, [95% CI: 1.009 to 2.452], P = 0.046). Conclusion In addition to traditional lipid indicators, higher Lp(a) exhibited higher risks of adverse cardiovascular events and death, indicated worse prognosis. Lp(a) may be a new target for the prevention of atherosclerotic diseases.

Abstract Background Studies on oral health status of adults are sparse and rarely include data on endodontic treatment and trauma. In the military, those data are available because recruits are routinely assessed with a clinical and radiological examination at the start of their career. This study aimed to identify differences in oral health status of Dutch Armed Forces recruits between cohorts, departments, sex, age and rank, with DMF-T, endodontic treatment and dental trauma as outcome measures. Methods Data from Electronic Patient Files from all recruits enlisted in 2000, 2010 and 2020 were used for analysis in a hurdle model resulting in the estimated cohort effect, controlled for the demographic variables. The total number of recruits was 5,764. Due to the retrospective character of the study a proxy was used to compose D-T and dental trauma. Results The mean DMF-T number in recruits decreases from 5.3 in cohort 2000 to 4.13 in cohort 2010 and 3.41 in cohort 2020. The percentage of endodontically treated teeth increases from 6% in cohort 2000 to respectively 9% in 2010 and 8% in 2020. The percentage of recruits showing signs of dental trauma did not change significantly between cohort 2000 (3.1%) and cohort 2010 and 2020 (both 2.7%). Conclusions Oral health in Armed Forces recruits is improving over the years, following a similar trend as the general population in the Netherlands. Lower SES represented by enlisted rank showed substantial lower oral health status.

Background/purpose: Endoscopic stenting at malignant distal duodenum stenosis (MDDS) is challenging because of the duodenal C-loop configuration, the acute angle of the duodenojejunal junction, and the limited length of the endoscope. Few studies have investigated the clinical outcomes of stenting at the distal duodenum. Therefore, this study aimed to investigate the clinical outcomes of treating MDDS with different types of metallic stents. Methods: From January 2012 to December 2020, fifty-six patients with MDDS who underwent duodenal stenting were enrolled for analysis. Thirty-five patients received uncovered self-expandable metallic stents (UC-SEMS), and twenty-one patients received partially covered self-expandable metallic stents (PC-SEMS). All patients were followed up till death or for 18 months. The clinical success rate, stent dysfunction rate, and stent patency were compared between the groups. Multivariate analysis was conducted to identify factors related to stent dysfunction. Results: The clinical success rates were 85.7 % in both the UC-SEMS and PC-SEMS groups. Stent dysfunction rates (UC-SEMS: 34.3 %, PC-SEMS: 38.1 %, p = 0.773) and the average stent patency (UC-SEMS: 117.2 days, PC-SEMS: 100.0 days, p = 0.576) were not statistically different between the groups. Multivariate analysis disclosed the age ≥65 years was significantly related to stent dysfunction (odds ratio: 4.78, p = 0.031). Conclusion: Both UC-SEMS and PC-SEMS are safe and effective treatment options for MDDS. However, stent dysfunction remains a significant issue to overcome, particularly in the elderly. Further research is needed to explore novel strategies that can improve the effectiveness of stent placement and reduce the risk of stent dysfunction.

Background: Injury related death is a leading cause of death globally. Abdominal injuries may occur in up to one third of patients with trauma. Road traffic accidents have become the commonest mechanism of trauma. Materials and Methods: This was a hospital based retrospective descriptive study conducted at Dhulikhel Hospital-Kathmandu University Hospital. Patients admitted with abdominal trauma from July 2021 to December 2023 were included in this study. Results: This study included 60 patients with abdominal trauma. Mean age of patients was 35.60 ± 15.81 (10-76) years. Majority of patients belonged to age group 21-40 years (n=32, 53.3%) with male predominance (Male:female ratio=3.6:1). Blunt abdominal trauma (n=58, 96.7%) was more common than penetrating abdominal trauma (n=2, 3.3%). Road traffic accident (n=31, 51.7%), fall from height (n=22, 36.7%) and physical assaults (n=7, 11.7%) were the mechanisms of injury. In our study, commonly injured organs were spleen(n=19, 30.64%), liver(n=15, 24.19%) and small bowel(n=14, 22.58%). Among the patients with penetrating abdominal trauma, one patient had rectal injury and next patient had stab injury with protruding omentum through the wound. Thirty four patients (56.7%) were managed conservatively and 26 patients (43.3%) underwent operative management. The mortality rate was 8.33% (n=5) of which 4 (80%) had undergone operative management and 1 (20%) was being managed conservatively. Conclusion: Majority of patients with solid organ injury can be managed conservatively while hollow viscus injury undergoes operative treatment. Physically active male population is the most affected group. Road traffic accidents are the leading cause of abdominal trauma followed by fall from height and physical assaults.

Abstract Background Paediatric solid tumours, both benign and malignant, present significant health challenges, particularly in Sub-Saharan Africa where comprehensive data is limited. This study aims to elucidate the prevalence, distribution, and treatment outcomes of paediatric solid neoplasms in a tertiary hospital in South-East Nigeria over a seven-year period. Methods A retrospective cohort study was conducted at Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Nigeria. Clinical details and histological slides of confirmed cases from January 2016 to December 2022 were reviewed. Data extraction focused on socio-demographic variables and treatment outcomes, analysed using statistical methods. Results The study included 293 children diagnosed with solid tumours (58.1% malignant, 41.9% benign), with a female predominance (61.8%). The median age at diagnosis was 12 years. Fibroadenoma was the most common benign tumour (61.8% of benign cases), while non-Hodgkin lymphoma was the predominant malignant tumour (18.2% of malignant cases). Treatment abandonment rates differed significantly between benign (13.8%) and malignant (51.2%) tumours. Significant associations were found between treatment outcomes and factors such as gender (p = 0.0001 for benign tumours), age category (p = 0.0001 for benign tumours), and specific diagnoses (p = 0.0001 for both benign and malignant tumours). Conclusion This study underscores the substantial burden of paediatric solid tumours in South-East Nigeria and highlights the critical need for improved treatment adherence strategies, particularly for malignant cases. The findings emphasize the importance of tailored interventions based on tumour type, age, and gender. These insights can inform future research, policy formulation, and healthcare strategies aimed at enhancing the management and outcomes of paediatric solid neoplasms in resource-limited settings.

Abstract Background The influence of home obesogenic environments, as assessed by the validated Family Nutrition and Physical Activity (FNPA) tool, and child obesity during the COVID pandemic were evaluated using electronic health records in this retrospective cohort study. Methods Historical data on BMI and the FNPA screening tool were obtained from annual well-child visits within the Geisinger Health System. The study examined youth ages 2–17 that had a BMI record and an FNPA assessment prior to the pandemic (BMI 3/1/19–2/29/20), 1 BMI record 3 months into the pandemic (6/1/20–12/31/20) and 1 BMI in the second year of the pandemic (1/1/21–12/31/21). Tertiles of obesity risk by FNPA score were examined. Mixed-effects linear regression was used to examine change in BMI slope (kg/m2 per month) pre-pandemic to pandemic using FNPA summary and subscales scores as predictors and adjusting for confounding factors. Results The analyses included 6,746 children (males: 51.7%, non-Hispanic white: 86.6%, overweight:14.8%, obesity:10.3%, severe obesity: 3.9%; mean(SD) age: 5.7(2.8) years). The rate of BMI change in BMI was greatest from early pandemic compared to pre-pandemic for children in lowest versus highest tertiles of FNPA summary score (0.079 vs. 0.044 kg/m2), FNPA-Eating (0.068 vs. 0.049 kg/m2), and FNPA-Activity (0.078 vs. 0.052 kg/m2). FNPA summary score was significantly associated with change in BMI from the pre-pandemic to early pandemic period (p = 0.014), but not associated with change in BMI during the later pandemic period. Conclusions This study provides additional insight into the changes in the rate of BMI change observed among children and adolescents in the United States during the COVID-19 pandemic. The FNPA provides ample opportunity to continue our exploration of the negative impact of the COVID-19 pandemic on the longitudinal growth patterns among children and adolescents.

Abstract Background Spinal intradural tumors are rare and heterogeneous in histological type, aggressiveness, and symptomatology, and there is a lack of data about them. This study investigated the epidemiological features of spinal intradural tumors. Methods This retrospective analysis included patients with spinal intradural tumors who underwent surgical treatment at the Myelopathy and Spondylosis Ward Beijing Jishuitan Hospital between January 2012 and December 2022. Results This study included 1321 patients [aged 47.19 ± 14.90 years, 603 (45.65%) males] with spinal intradural tumors. The most common histological subtype was schwannoma [n = 511 (38.68%)], followed by spinal meningioma [n = 184 (13.93%)] and ependymoma [n = 101 (7.65%)]. Fifteen (1.14%) patients were diagnosed with metastatic spinal intradural tumors as a presentation of another primary cancer type. The spinal intradural tumors were mostly found in the lumbar region [n = 436 (33.01%)], followed by the thoracic vertebrae [n = 390 (29.52%)], cervical vertebrae [n = 154 (11.66%)], and thoracolumbar region [n = 111 (8.40%)]. Schwannomas mostly affected the lumbar region [n = 256 (52.64%)], spinal meningiomas in the thoracic region [n = 153 (83.15)], and ependymomas in the lumbar region [56 (55.45%)]. The de novo metastases were mostly found in the lumbar region [n = 8 (53.33%)]. Conclusion According to the results of our single-center study, the most common spinal intradural tumor in Northern China is schwannoma, followed by spinal meningioma and ependymoma.

Objective Currently, there is no established guideline on whether to opt for percutaneous endoscopic lumbar discectomy (PELD) or traditional transforaminal lumbar interbody fusion (TLIF) surgery based on specific types of lumbar disc herniation (LDH). Based on the Michigan State University (MSU) classification system, this study conducted a medium‐ to long‐term follow‐up analysis of two surgical methods over 5 years for the first time, aiming to provide empirical evidence to assist in making more informed decisions before surgery for LDH treatment. Methods This was a retrospective study that included 273 patients with single‐level LDH who underwent PELD or TLIF treatment at our hospital between January 1, 2016, and December 31, 2018. Detailed metrics included preoperative and postoperative visual analogue scale (VAS) scores and Oswestry disability index (ODI) at 1‐day, 1‐week, 1‐year, and 5‐year follow‐ups. Complications, recurrences, and 5‐year postoperative modified MacNab criteria scores were also recorded. Statistical methods included independent sample t‐tests, repeated measures analysis of variance (ANOVA), and χ2 tests. Results Classified into seven groups according to the MSU classification, it was found that there was an improvement in the VAS and ODI scores at four postoperative follow‐ups (p

Introduction: The winter climate in Delhi is severe, with temperatures dropping below 10°C. As a result, individuals often resort to utilizing diverse heat sources such as electrical heating appliances, coal and gas geysers. Unfortunately, these sources are commonly associated with the emission of carbon monoxide (CO) which can accumulate in inadequately ventilated spaces. Exposure to this noxious gas can lead to acute lethargy and debilitation, leaving individuals in a state of helpless distress. Materials and Methods: The present study utilized a retrospective descriptive analysis to examine cases of fatal carbon monoxide exposure retrieved from the Department of Forensic Medicine archives at the esteemed All India Institute of Medical Sciences, New Delhi. Autopsy records were thoroughly examined with respect to various parameters including age, gender, seasonality of the incident, circumstances surrounding the death, source of carbon monoxide generation, post mortem observations, as well as toxicological analysis reports. Results and Discussion: This study entailed an analysis of 56 individuals who fell victim to carbon monoxide poisoning, with a staggering 95% of fatalities occurring during the winter season. The majority of the individuals affected belonged to the age bracket of 21–30 years. The most common sources of carbon monoxide exposure were linked to the use of coal-burning earthen or iron vessels for room heating, as well as structural fires. With the exception of one case, all incidents were accidental in nature. Additionally, nearly all of the victims were discovered in enclosed spaces with heating equipment in close proximity, and evidence of a struggle was noted on the crime scene or with the deceased. Conclusion: The findings of this study indicate that the principal contributor to the inadvertent build-up of lethal concentrations of carbon monoxide gas is the utilization of heating appliances within inadequately ventilated, enclosed spaces. Due to the scentless and non-irritating properties of this gas, individuals who are asleep may be unable to detect its presence in their surroundings, thereby leading to a silent death. To mitigate such risks, the installation of carbon monoxide detectors is crucial. Additionally, it is of utmost importance to raise public awareness regarding the perils associated with using fire pots, coal burning and electrical heating appliances in areas with insufficient ventilation.

Chi Pan,1,&ast; Yawen Gu,2,&ast; Qingtao Ni2 1Department of General Surgery, The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, 225300, People’s Republic of China; 2Department of Oncology, The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, 225300, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Qingtao Ni, Department of Oncology, Jiangsu Taizhou People’s Hospital, Taihu Road 366, Taizhou, 225300, People’s Republic of China, Tel +8618852656280, Email niqingtao@njmu.edu.cnObjective: This study examined the potential risk value of the serum albumin to globulin ratio (AGR) in patients with breast cancer (BC).Methods: This study employed a retrospective design, enrolling 332 patients with BC and 38 patients without BC treated at Taizhou People’s Hospital between September 2015 and May 2021. Multivariate Cox proportional hazard regression models were used to identify potential risk factors. A prognostic nomogram was developed based on the multivariate analyses. The receiver operating characteristic curve determined the optimal cutoff value for AGR.Results: The results indicated a statistically significant decrease in AGR among patients with BC. Significant disparities were observed in globulin and AGR levels between the two cohorts. AGR was significantly associated with tumor size and stage, with a marked decline in advanced stages of BC. Additionally, AGR and aspartate transaminase/Alanine aminotransferase (AST/ALT) emerged as significant diagnostic indicators for invasive carcinoma and advanced stages (II–IV) of BC. Specifically, AGR exhibited an area under the curve of 0.645 (P < 0.003), highlighting the discriminatory capacity of serum globulin levels in distinguishing between BC and non-BC cohorts.Conclusions: The AGR, routinely assessed due to its simplicity, objectivity, and cost-effectiveness, holds promise as a potential risk factor for BC and may have practical implications in clinical settings.Keywords: albumin to globulin ratio, risk factor, breast cancer, retrospective study

Abstract Objectives This study aimed to comprehensively analyze the prevalence and influencing factors of Zygomatic Air Cell Defects (ZACD) among pediatric and adolescent populations in Saudi Arabia and Yemen. Materials and methods A cross-sectional retrospective study was conducted, utilizing digital panoramic radiographs of dental outpatients aged 6 to 18 years. The data were collected from registered digital databases of dental clinics in Al-Qassim, Saudi Arabia, and an oral and maxillofacial radiology center in Sana’a, Yemen, covering the period from July 2018 to September 2022. The radiographs were evaluated based on inclusion and exclusion criteria, and ZACD was assessed using standardized descriptions. Statistical analysis, including logistic regression, was employed to examine the impact of the associated factors. Results The study encompassed a total of 3,169 participants, revealing an overall ZACD prevalence of 28.5%. Age emerged as a significant predictor (p ≤ 0.0001), with the likelihood of ZACD increasing as the age of the individual advances. Gender and geographic region did not exhibit statistically significant differences in ZACD prevalence. Conclusion This study provides crucial insights into the prevalence of Zygomatic Air Cell Defects among pediatric and adolescent populations in Saudi Arabia and Yemen. It underscores the prevalence of ZACD and the notable influence of age on its occurrence. Additionally, the research challenges prior notions of gender and regional variations in ZACD prevalence, emphasizing the complexity of the factors involved. Early detection is essential to avoid unwanted complications during any surgical intervention in this area.

Jianping Cheng,1 Chanjuan Fan,1 Zhen Li,1 Zhaojing Dong,2 Xiaolin Zhao,1 Yong Cai,1 Haiou Ding,3 Yan Dou,4 Xiaomei Zhang4 1Department of Gastroenterology and Oncology, Civil Aviation General Hospital, Beijing, People’s Republic of China; 2Department of Medical Record, Civil Aviation General Hospital, Beijing, People’s Republic of China; 3Department of Pharmacy, Civil Aviation General Hospital, Beijing, People’s Republic of China; 4Department of Gastroenterology and Hepatology, The First Medical Center, Chinese PLA General Hospital, Beijing, People’s Republic of ChinaCorrespondence: Jianping Cheng, Department of Gastroenterology and Oncology, Civil Aviation General Hospital, Beijing, 100123, People’s Republic of China, Tel +86 10 85762244, Email cjpczy2004@163.com Xiaomei Zhang, Department of Gastroenterology and Hepatology, The First Medical Center, Chinese PLA General Hospital, Beijing, 100112, People’s Republic of China, Email zhangxiaomeinew@163.comBackground and Objectives: The success rate of Helicobacter pylori (H. pylori) eradication in China is declining. The aim of this study was to evaluate eradication outcomes in clinical practice and identifies factors contributing to treatment failure.Methods: A retrospective review was conducted on patients treated for H. pylori infection with 14-day bismuth-containing quadruple therapy at a Beijing medical center from January 2020 to December 2023. We analyzed demographic and clinical data, eradication rates across regimens, and performed multivariate analysis to pinpoint predictors of failure.Results: Out of 3340 participants, 2273 (68.1%) achieved eradication. Amoxicillin-based combinations (69.2%) outperformed other antibiotic regimens (58.9%, p < 0.001), with amoxicillin plus doxycycline reaching a 71.4% success rate. Esomeprazole-based regimens were more effective (73.6%) than other PPI regimens (65.2%, p = 0.001), notably, a rabeprazole, amoxicillin, doxycycline, and bismuth combination had an 80.0% success rate. Age, gender, and smoking and drinking were significant eradication failure predictors.Conclusion: In real-world settings, 14-day amoxicillin and esomeprazole-based quadruple regimens have been demonstrated to be more effective than other regimens. Age, gender, and lifestyle habits are identified as independent risk factors for eradication failure.Registration: This study was registered in the Chinese Clinical Trial Registry on 08/01/2024 (clinical trial registration number: ChiCTR2400079647).Keywords: Helicobacter pylori, quadruple therapy, antibiotics, proton pump inhibitor, retrospective study

Seungheon Yang,1 Jun Won Kim1,2 1Department of Psychiatry, Daegu Catholic University Medical Center, Daegu, Republic of Korea; 2Department of Psychiatry, Daegu Catholic University School of Medicine, Daegu, Republic of KoreaCorrespondence: Jun Won Kim, Department of Psychiatry, 33 Duryugongwon-ro 17-gil, Nam-gu, Daegu, 42472, Republic of Korea, Tel +82-53-650-4780, Fax +82-53-623-7507, Email f_affection@hotmail.comPurpose: This study aimed to provide an objective means of predicting treatment responses in patients with schizophrenia using quantitative electroencephalography (qEEG) as an electrophysiological indicator. We obtained qEEG recordings from patients with schizophrenia and explored them for patterns indicative of treatment responsiveness.Patients and Methods: The study included 68 patients had been diagnosed with schizophrenia spectrum disorder. After retrospectively gathering demographic information, clinical data such as qEEG, Positive and Negative Syndrome Scale (PANSS), a multiple regression analysis was performed. This analysis employed baseline qEEG findings as independent variables and PANSS score changes as dependent variables to discern causal relationships.Results: The mean age of the participants was 38.4 years(SD =13.73). The mean PANSS score on admission was 92.97, decreasing to 67.41 at discharge. Multiple regression analysis revealed that delta waves in T4 (β=0.346, t=3.165, p=0.002), and high-beta waves in Fp2 (β=0.231, t=2.361, p=0.021) were associated with PANSS changes in absolute power. In addition, the delta waves of O2 (β=0.250, t=3.288, p=0.002); beta waves of T3 (β=− 1.463, t=− 5.423, p< 0.001) and O2 (β=0.551, t=3.366, p=0.001); high beta waves of Fp1 (β=0.307, t=4.026, p< 0.001), T3 (β=0.855, t=4.414, p< 0.001) and T6 (β=− 0.838, t=− 4.559, p< 0.001) of absolute power using the Z-score were also related to PANSS changes. Pearson’s correlation analysis showed that only delta waves at Cz (r= 0.246, p=0.043) in absolute power correlated with changes in the PANSS.Conclusion: We found that certain qEEG wave patterns in patients with schizophrenia prior to antipsychotic treatment were linked to PANSS changes before and after treatment. Delta waves and beta waves, primarily in the frontal and temporal regions, were found to be significantly associated with changes in PANSS scores. In the future, the qEEG indicators identified in this study could serve as electrophysiological markers for predicting antipsychotic treatment responses in patients with schizophrenia.Keywords: schizophrenia, treatment response, quantitative electroencephalography, electrophysiological marker, retrospective study

Objectives: This study aimed to discuss the health status and treatment requirements of children visiting the Department of Pediatric Dentistry at the Faculty of Dentistry. Materials and Methods: A retrospective study included the records of patients attending the Department of Pediatric Dentistry, from November 29, 2021, to December 14, 2023. Results: The study reviewed 2417 patient records, excluding 312. The majority of patients were primary school children aged 6 −

Background Diuretic resistance is associated with increased mortality in patients with heart failure (HF). Qi Li Qiang Xin Jiao Nang, a Traditional Chinese Medicine, are used in the treatment of HF. However, clinical evidence of their effectiveness in improving diuretic resistance is lacking. Objective To investigate whether Qi Li Qiang Xin Jiao Nang can reduce the risk of diuretic resistance and improve prognosis in patients with acute decompensated chronic heart failure (ADCHF) . Methods This study included 374 HF patients treated in the CICU ward of Tianjin University Chest Hospital from January 2018 to June 2022. Patients were divided into diuretic resistance (118 patients) and non-diuretic resistance groups (256 patients) based on the occurrence of diuretic resistance. Patient data and laboratory results were collected. A 12-month follow-up was conducted to observe rehospitalization due to cardiovascular events or all-cause mortality. Kaplan-Meyer survival curves were plotted for each group, and the Log-rank test was used for comparison. Multivariate Logistic regression analysis was performed to explore factors influencing diuretic resistance. Multivariable Cox regression analysis was used to explore factors affecting the occurrence of endpoint events in ADCHF patients. Results The diuretic resistance group showed higher age, body mass, NT-proBNP, blood urea nitrogen, creatinine, uric acid, and international normalized ratio (INR) but lower 24-hour fluid intake, estimated glomerular filtration rate (eGFR), lymphocyte count, and usage of Qi Li Qiang Xin Jiao Nang. Multivariate Logistic regression analysis indicated that the use of Qi Li Qiang Xin Jiao Nang (OR=0.363, 95%CI=0.186-0.708, P=0.003) and increased 24-hour fluid intake (OR=0.286, 95%CI=0.177-0.461, P

Aim The aim of this study was to examine the imaging manifestations of post-endoscopic retrograde cholangiopancreatography (ERCP) specific complications by computed tomography to aid in its early and successful diagnosis and timely intervention.

Background: Pediatric procedural dermatology is a broad and emerging aspect in the field of dermatology. Pediatric procedures require great expertise, skill, empathy, and confidence on the part of the treating physician. The challenging factors such as parental anxiety and doubts, the child’s cooperation, and the risks versus benefits are further contributory. Objective: The objective of the study was to summarize the risks of intra- and postoperative complications/side effects during diagnostic and therapeutic procedure in the pediatric population. Materials and Methods: We conducted a retrospective study in our hospital. Patients were taken between ages 0 and 18 years who had attended the dermatology outpatient department from January 2019 to March 2022. Results: In a total of 527 outpatient department patients, 267 (50.66%) were males and 260 (49.33%) were females (male:female ratio 1.02:1). Out of diagnostic procedures, the most commonly performed procedures were punch biopsy (14.61%), followed by autologous serum skin test (11.81%) and slit-skin smear (1.90%). Out of 15 therapeutic procedures, intralesional steroids (21.34%) were the most frequently performed therapeutic procedure, followed by radiofrequency cauterization (16.51%), autologous skin therapy (6.98%), cryotherapy (8.76%), nail surgery (2.79%), chemical peeling (2.79%), comedone extraction (2.66%), chemical cauterization (2.54%), neodymium-doped yttrium aluminum garnet laser (2.16%), platelet-rich plasma therapy (1.39%), diode laser (1.27%), measles, mumps, and rubella vaccine injection (0.89%), fractional carbon dioxide laser (0.63%), suction blister epidermal grafting (0.63%), and platelet-rich fibrin therapy (0.25%). Conclusions: This study provided comprehensive data on the various dermatological procedures done for pediatric cases in a tertiary care teaching hospital. Both diagnostic and therapeutic procedures caused mild and transient side effects such as pain, edema, erythema, burning sensations, and irritation that did not affect the patient’s lifestyle.

Abstract Objective We aimed to examine the factors associated with treatment outcomes in patients with Alzheimer's disease (AD) after 1 year of acetylcholinesterase inhibitors (AChEI) treatment. Method We obtained electronic medical records from a medical center in Southern Taiwan between January 2015 and September 2021. Participants aged ≥60 who were newly diagnosed with AD and had been prescribed AChEIs were included. Cognitive assessments were performed before the AChEIs were prescribed and at the 1 year follow‐up. Cognition progressors were defined as a Mini‐Mental State Examination decline of >3 or a Clinical Dementia Rating decline of ≥1 after 1 year of AChEI treatment. The relationship between the baseline characteristics and cognitive status after follow‐up was investigated using logistic regression analysis after adjusting for potential confounders. Results A total of 1370 patients were included in our study (mean age, 79.86 ± 8.14 years). After adjustment, the body mass index (BMI) was found to be significantly lower in the progressor group [adjusted odds ratio (AOR): 0.970, 95% confidence intervals (95% CIs): 0.943 to 0.997, P = 0.033]. The usage of antipsychotics was significantly higher in the progressor group (AOR: 1.599, 95% CIs: 1.202 to 2.202, P = 0.001). The usage of benzodiazepine receptor agonists also tended to be significantly higher in the progressor group (AOR: 1.290, 95% CIs: 0.996 to 1.697, p = 0.054). Conclusion These results suggest that patients with AD who receive 1 year of AChEI treatment and have a lower BMI or concurrent treatment with antipsychotics and benzodiazepine receptor agonists are more likely to suffer from cognitive decline.