Search

Purpose: To retrospectively determine the cumulative survival rate (CSR) and marginal bone level change (ΔMBL) around novel hybrid design tissue-level (TL) dental implants that support multiple-screw-retained restorations. Materials and Methods: Implant CSRs were analyzed at the implant and patient level using Kaplan-Meier estimates. ΔMBL was measured by comparing the periapical loading and follow-up visit radiographs using an improved standardized digital methodology based on image gray levels. ΔMBL outcomes were subject to linear mixed regression to identify potential risk factors. Results: A total of 301 TL implants in 69 patients with an average age of 62.6 ± 11.7 years (range: 36 to 87 years) at the time of implant placement were considered for the analysis. All 301 implants were successfully restored and loaded. The 54-month CSRs at the implant and patient levels were 98.9% (95% CI: 96.7 to 99.6) and 95.3% (95% CI: 86.1 to 98.5), respectively. ΔMBL after a mean follow-up of 22 ± 10.7 months after loading was 0.00 ± 0.57 mm. None of the implant sites showed marginal bone loss exceeding 1.5 mm. Multivariate regression analysis revealed a significant association between ΔMBL and the loading protocol (P = .027) but not between ΔMBL and age or transgingival height. Conclusions: The high CSRs and stable peri-implant marginal bone levels support the use of recent TL implants, which have a hybrid design inherited from the bone-level implant-abutment connection, as a suitable treatment option for restoring partially or fully edentulous patients with a good mid-term prognosis. These results should be complemented by further prospective studies in a real-world multicenter private practice setup that represents the daily realities of implant treatment. [ABSTRACT FROM AUTHOR]

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.

Introduction: Patients with myasthenia gravis (MG) display strong treatment heterogeneity. Recent studies have indicated that low-dose steroids or immunosuppressants are effective. However, factors affecting the add-on of non-corticosteroid immunosuppressants to corticosteroids remain unknown. Method: Consecutive patients with MG were retrospectively reviewed from May 15, 2015, to December 29, 2020. We included one group of patients with steroid treatment alone and another group who transitioned to non-steroid immunosuppressant therapy. Clinical features of the included patients were analyzed. Univariate and multivariate Cox regression models were used to identify potential influential factors. Results: A total of 107 patients with MG were analyzed, including 66 receiving corticosteroid treatment alone and 41 who subsequently also received non-corticosteroid immunosuppressant therapy. Eight potential factors were primarily selected in univariate analysis (Ps < 0.1). Achieving minimal symptom expression (MSE) within 6 months (HR: 4.424, 95%CI: 2.102–11.865), body mass index (BMI) (HR: 0.385, 95% CI: 0.186–0.797), quantitative MG (QMG) bulbar muscle score (HR: 1.553, 95% CI: 1.140–2.118), disease duration (HR: 0.987, 95% CI: 0.977–0.997) and relapse (HR: 2.638, 95% CI: 1.031–6.750) were finally identified as potential influencing factors. Discussion: We found multifactorial clinical factors were highly associated with the add-on of non-steroid immunosuppressants after steroid treatment in patients with MG. Achieving MSE within 6 months, BMI, QMG bulbar muscle score at baseline before steroid treatment, disease duration, and disease relapse may represent crucial influencing factors, which should be considered to improve the long-term prognosis for patients with MG in future studies and practice. [ABSTRACT FROM AUTHOR]

Aim: To determine whether three-dimensional measurements can assess symmetry and mandibular position with greater accuracy than traditional two-dimensional measurements. Methods: Mimics 19 software was used for three-dimensional measurements of 20 adult female patients' cone-beam computed tomography with deep overbite before and after flat bite plate treatment. Differences in mandible position and bilateral symmetry were assessed using the paired t test. Results: Three-dimensional measurements showed that the condylar distance in the pogonion–Frankfort horizontal, pogonion–coronal, right and left gonion–coronal planes was significantly higher after flat bite plate treatment. However, flat bite treatment did not affect the distance between the vertex of the condyles and the gonion of each measurement reference plane. After flat bite plate treatment, the mandibles of adult female patients had rotated backward and downward, with the condyle as the centre; the chin had been backward. Bilateral symmetry remained unchanged. Conclusions: Flat bite plate treatment in adult female patients resulted in a downward and downward rotation of the mandible, with the condyle as the centre, chin backward, and no significant change in bilateral symmetry. [ABSTRACT FROM AUTHOR]

Background: As the number of HIV-infected patients increased, the number of patients requiring general surgery has subsequently increased. However, impairment of immune function due to HIV infection increases the risk of postoperative surgical-site infection and significant harm to patient health. This study aimed to examine the risk factors for surgical-site infection after general surgery. Methods: The patients' data were from Zunyi fourth hospital medical information system. Machine learning based Boruta algorithm were used for variable screening. Univariable and multivariable logistic regression and restricted cubic spline analysis were performed to examine the relationship between significant variables and surgical-site infection. Results: A total of 125 general surgery postoperative HIV-infected patients participated in the study. Surgical-site pathogen culture identified Escherichia coli, Klebsiella pneumoniae, and mixed bacteria as the three most common pathogens causing Surgical-site infection. Univariable and multivariable logistic regression analysis to adjust for risk factors identified type III surgical incision (OR = 9.92, 95% CI = 1.28–76.75) and elevated preoperative white blood cell (WBC) count (OR = 1.30, 95% CI = 1.12–1.51) as independent risk factors for postoperative surgical-site infection, whereas CD4 + T lymphocyte count greater than 400 cells/µL was identified as a protective factor (OR = 0.23, 95% CI = 0.09–0.60) while. The restricted cubic spline analysis results directly reflected the dose-response relationship between continuous variables and postoperative surgical-site infection. Conclusions: Type III incision and an elevated WBC count pose a higher risk of postoperative surgical-site infection. A CD4 + T lymphocyte counts greater than 400 cells/µL provided a protective effect of lower risk of surgical site infection. Preoperative serum neutrophil percentage, albumin level, red blood cell count, and serum urea level within a specific range were beneficial in reducing the risk of incisional infections. Our research provides a theoretical basis for clinical practice. [ABSTRACT FROM AUTHOR]

Background: The management of anterior colliculus fractures in combination with deltoid ligament injuries is a topic of debate, and there is a need to improve surgical outcomes. The purpose of the present study was to describe the application of a modified double-row suture bridge technique and evaluate its early clinical outcomes in the management of anterior colliculus fracture combined with deltoid ligament injury. Methods: From 2020 to 2022, 12 patients with anterior colliculus fracture combined with deltoid ligament injury were treated using a modified double-row suture bridge technique. For clinical outcome evaluation, objective data are presented through clinical examination findings; radiographic assessments, including X-rays and computed tomography (CT); and follow-up analysis utilizing American Orthopaedic Foot & Ankle Society ankle‒hindfoot (AOFAS) scores, Olerud Molander Ankle Scores (OMAS), and visual analogue scale (VAS) scores. Preoperative and follow-up scores were compared with Student's t test. (p <.05). Results: The mean age of the patients was 52.67 ± 9.42 years (range: 39–74). The mean duration of follow-up was 14.42 ± 1.51 months (range: 12–17). At the final follow-up, the mean AOFAS score (P < 0.001) improved to 91.50 ± 2.65 points (range: 87–96), the mean OMAS (P < 0.001) improved to 77.08 ± 3.97 points (range: 70–85), and the mean VAS score (P < 0.001) improved to 0.25 ± 0.45 points (range: 0–1). Nine patients achieved excellent outcomes, and three achieved good outcomes according to the AOFAS score. Follow-up imaging evaluation indicated satisfactory alignment of the fracture and complete healing. Clinical examination suggested good mobility of the ankle. At the last follow-up, ankle dorsiflexion mobility was 14–18 degrees, plantar flexion mobility was 42–45 degrees, inversion mobility was 27–32 degrees, and eversion mobility was 22–25 degrees. Conclusions: The modified double-row suture bridge technique is effective for achieving anatomic reduction of anterior colliculus fractures, and the technique also provides substantial benefit to the injured deltoid ligament. With this technique, the clinical outcomes can be significant and encouraging, indicating a new stage in its application and development. [ABSTRACT FROM AUTHOR]

Background: This study aims to analyse the clinical characteristics of different types of odontogenic jawbone cysts (OJCs) and to provide a theoretical basis for prevention and clinical treatment. Methods: Data from 1,038 patients with OJCs were collected, and relevant information, such as sex, age, clinical symptoms and signs, imaging data, number of lesions, lesion location, pathological diagnosis, clinical treatment and prognosis, was statistically analysed. Results: According to the World Health Organization (WHO) classification of OJCs in 2022, the highest incidence rate was observed for radicular cysts (RCs), accounting for 58.96% of the total number of cases, followed by dentigerous cysts (DCs), accounting for approximately 23.22% of cases. lateral periodontal cysts (LPCs) and calcifying odontogenic cysts (COCs) comprised the lowest number of cases. The age distribution of patients was between 4 and 89 years, and the high incidence age group was youth and middle age, accounting for 66.67% of the total number of cases. The male-to-female ratio of patients was 1.51:1, and there was a statistically significant difference between the sexes(p < 0.05).In terms of the site of incidence, odontogenic keratocysts (OKCs) were prevalent in the mandibular molar region. In addition, mandibular ramus, inflammatory collateral cysts (ICCs) and dentigerous cysts (DCs) were more common in the mandibular third molar, and radicular cysts (RCs) and calcifying odontogenic cysts (COCs) were prevalent in the maxillary anterior region. On imaging, 955 (92.0%) lesions were solitary, and 83 (8.0%) were multiple. The treatment included four types of surgery, including simple curettage, marsupialization, marsupialization followed by secondary curettage, and partial resection of the jaw, and a total of 921 patients were followed up, with a recurrence rate of 2.82%. Conclusions: OJCs are more common in males than in females, and a statistically significant difference is observed in the most prevalent types of cysts occurring at different ages and in various regions of the jawbone (p < 0.05). Early diagnosis should be made with the help of X-rays, age, location, and clinical symptoms. In addition, appropriate treatment methods should be selected, and long-term follow-up observation is needed. [ABSTRACT FROM AUTHOR]

Objectives: This study compared the ischemic cardiovascular events (iCVEs) effectiveness and safety of initiating empagliflozin or dapagliflozin with those of dipeptidyl peptidase-4 inhibitors (DPP-4is), as well as the comparative effects between empagliflozin and dapagliflozin. Methods: Using data from the National Health Insurance Service in Korea, patients with type 2 diabetes mellitus (T2DM) who were newly prescribed empagliflozin, dapagliflozin, or DPP-4is from 2016 to 2019 and who did not have a recent CVE history were included. A Cox proportional hazards regression model was used to estimate the adjusted hazard ratio (aHR) with 95% confidence intervals (CIs) for iCVEs and safety events. Results: Empagliflozin and dapagliflozin significantly reduced the risks of ischemic stroke (aHR 0.568, 95% CI 0.408–0.791; aHR 0.612, 95% CI 0.476–0.786, respectively) and all-cause mortality (aHR 0.590, 95% CI 0.442–0.788; aHR 0.730, 95% CI 0.603–0.884, respectively) compared with DPP-4is. Initiating dapagliflozin or empagliflozin was associated with significantly lower incidence of severe hypoglycemia, bone fracture, urinary tract infection, and acute kidney injury than that of DPP-4is. No significant differences were observed between empagliflozin and dapagliflozin in iCVEs and most safety outcomes. Conclusion: Empagliflozin and dapagliflozin showed significant preventive effects on ischemic stroke and all-cause mortality compared with DPP-4is in patients with T2DM, and their protective effects were similar. Both empagliflozin and dapagliflozin were not related to the harmful effects on most safety events. These results suggest that it may be beneficial to initiate empagliflozin or dapagliflozin for ischemic stroke prevention in patients with T2DM. However, further validation studies, such as randomized controlled trials, are needed to generalize these results. [ABSTRACT FROM AUTHOR]

Introduction: Maternal filicide, the murder of a child by a mother, is a complex phenomenon. Relatively little is known of filicide on the African continent, especially in eSwatini. This study highlights the complex dynamics at play when these crimes are committed. Methods: This retrospective study explored offense characteristics of maternal filicide cases in eSwatini from 2005 to January 2024. Thirty-one cases were identified through court documents and news reports. Content analysis was conducted on these cases. Results: The study revealed that socio-cultural factors such as the role of a woman in society and traditional beliefs contributed to these crimes. Poverty and contextual challenges also contributed to the systemic reasons for these murders. Relationship challenges featured prominently. A unique finding in this study was the use of poison by biological mothers in all the filicide-suicide attempts. Discussion: We argue for the inclusion of an additional socio-cultural category to Resnick's classification model. Ultimately, there is a need for further exploration of filicide in eSwatini and other contexts. This would aid in identifying risk factors in pregnant mothers, in young mothers, among couples, and within socio-cultural practices. [ABSTRACT FROM AUTHOR]

Purpose: The feasibility of transarterial infusion chemotherapy and embolization (TAICE) in the treatment of advanced gastric cancer remains unclear. This study explored the value of TAICE in patients with unresectable locally advanced or metastatic cancer of stomach or gastroesophageal junction (GEJ). Methods: Patients with unresectable gastric cancer who received TAICE for tumor hemorrhage cessation were enrolled in this retrospective study. TAICE was performed using the Seldinger method. The tumor feeding artery was selected for infusion chemotherapy and then was embolized by microspheres or gelatin sponge. Patients involved in this study received one to four cycles TAICE with one to three drugs in the regimen. The possibility of surgery was evaluated after TAICE. Objective response rate (ORR), disease control rate (DCR), R0 resection rate, pathological complete remission (pCR) rate, major pathological remission (MPR) rate, progression‐free survival (PFS), overall survival (OS), and safety were analyzed. Results: Between January 2015 and December 2020, a total of 27 patients received a median of 2 (range, 1–4) cycles of TAICE. ORR and DCR were 33.3% and 74.0%, respectively. Eighteen patients received surgery, and 15 of them underwent gastrectomy and D2 lymph node dissection, with an R0 resection rate of 83.3% (15/18). Four (26.7%, 4/15) patients achieved MPR, but none achieved pCR. The median PFS was 19.8 months (95%CI, 12.1–40.0), and the median OS was 36.1 months (95%CI, 21.0–not reached). Patients with gastrectomy had significantly longer PFS (40.0 vs. 9.5 months, p < 0.0001) and OS (not reached vs. 16.6 months, p < 0.0001) than those without gastrectomy. All the TAICE‐related adverse events were manageable, with the most common being fatigue (100%), nausea (63.0%), and vomiting (55.6%). No severe surgical complications occurred. Conclusion: TAICE was well‐tolerated and could be a potential therapy to provide opportunity of surgery for patients with unresectable advanced gastric or GEJ cancer. [ABSTRACT FROM AUTHOR]

Background: Status asthmaticus is a severe, life-threatening asthma exacerbation requiring urgent medical intervention. This study aims to examine its epidemiology in Timis County, Romania, over 11 years. Methods: A retrospective analysis was conducted using hospital records from 2013 to 2023, focusing on demographic, geospatial, and temporal distributions. Network analysis of the recorded comorbidities was used to identify phenotypic clusters among patients. Results: Females and older adults were disproportionately affected. Several triggers and geospatial patterns were identified. Five phenotypic clusters were determined: two in the T2-high endotype, two in T2-low, and a mixed one. Conclusions: The findings highlight the need for personalized asthma management strategies and public healthcare interventions in Timiș County, addressing specific demographic and geospatial factors. This study also provides a valuable reference for similar regions. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this long‐term retrospective study was to evaluate the fracture rate and the risk factors associated with the fracture of 3.3 mm narrow diameter implants (NDIs). Materials and Methods: A total of 524 records of patients rehabilitated with 3.3 mm NDIs between 1997 and 2015 were assessed. Data on patients, implants, and prostheses were collected, and descriptive analysis of the variables was performed. NDIs were separated into 2 groups: "fractured" and "non‐fractured", and a multilevel logistic regression model was applied to identify the risk factors associated with NDI fracture. Results: Eighty‐four patients were removed from the analysis for interrupting follow‐up or presenting failures other than fractures. Of the 440 patients included (64.66 ± 13.4 years), 272 were females (61.8%), and 168 males (38.2%), and mean follow‐up time was 129 ± 47.1 months. Of the 1428 NDIs, 15 (1.05%) in 9 patients (2.04%) fractured during the studied period. Ten fractures (66.66%) happened in 6 patients (66.66%) showing signs of parafunction. NDI with modified sandblasted, large grit, acid‐etched surface was the only implant variable to show a protective statistical significance (p =.0439). Conclusions: NDI fracture was a rare event in the studied sample. NDIs manufactured with modified sandblasted, large grit, acid‐etched surface may provide extra protection against NDI fracture. Patient‐specific factors and implant characteristics should be carefully considered to limit the risk of fracture of 3.3 mm NDIs. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the postoperative outcomes of the all‐inside technique in arthroscopic anterior cruciate ligament reconstruction (ACLR). Methods: Patients who underwent ACLR using the all‐inside technique between 2018 and 2021 were retrospectively assessed. All patients were followed up for at least 2 years. Functional recovery and pain relief were assessed using the International Knee Documentation Committee (IKDC) score, Lysholm score, Knee Injury and Osteoarthritis Outcome Score (KOOS) and visual analogue scale (VAS). Instrumented laxity was assessed via side‐to‐side difference using the Kneelax3 arthrometer. Graft maturity was estimated using the signal‐to‐noise quotient value based on magnetic resonance imaging (MRI). Adverse events during and after the surgery were recorded. Results: A total of 78 patients were included in this study, with a mean age of 28.1 ± 7.6 years. The IKDC (p < 0.001), Lysholm (p < 0.001) and KOOS (p < 0.001 for all subgroups) scores at the final follow‐up were significantly higher than those before the surgery. The VAS scores (p < 0.05) were significantly lower than those before surgery. The side‐to‐side difference results indicated that 50 patients had a difference of less than 3 mm, indicating a tight graft, whereas only 1 patient had a difference of >5 mm, indicating a loose graft. The median signal‐to‐noise quotient of the graft on MRI was 1.4 (P25, P75: 1.0, 2.0). No intraoperative adverse events were observed. Postoperative adverse events included three cases of infection, three cases of graft rerupture, two cases of cyclops lesion and one case of surgical intervention for a meniscal tear. Conclusion: ACLR using the all‐inside technique offers promising results in patients with ACL rupture. Level of Evidence: Level IV. [ABSTRACT FROM AUTHOR]

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]

Objectives: To investigate tooth-specific, clinical tooth-, and patient-related factors associated with tooth loss (TL) in patients with mild to severe periodontitis treated in a periodontal practice-based research network (Perio-PBRN) over at least 5 years. Materials and methods: The Perio-PBRN consists of five German periodontal practices where clinical data were collected regarding patient age, tooth type, bleeding on probing (BOP), pocket probing depth (PPD), furcation involvement (FI), number of attended appointments, and other variables of interest. The data were evaluated regarding factors influencing TL. Results: Data from 687 patients (aged 54.5 ± 11.1 years) with mild (N = 23, 3.35%), moderate (N = 247, 35.95%) or severe (N = 417, 60.70%) periodontitis and 15,931 teeth over a mean observation period of 6.83 ± 1.40 years per patient were gathered via the Perio-PBRN. In this period, a total of 657 teeth were lost (4.12%, overall TL: 0.14 ± 0.22 teeth/patient/y). The risk of TL was significantly increased for teeth with persistent PPD ≥ 6 mm (hazard ratio: 6.81 [95% confidence interval: 5.07–9.15] in comparison to PPD < 4 mm. Additionally, BOP (3.90 [2.46–6.19]), furcation involvement, jaw, age and tooth type showed a significant influence on TL, while number of visits were not significantly associated with TL. Conclusions: Periodontal care of patients with moderate to severe disease in specialized practices was associated with a low rate of TL. Known tooth-related prognostic factors were confirmed. However, the results must be interpreted cautiously without knowledge of risk factors such as smoking and diabetes. Clinical relevance: PBRNs can help gather large amounts of periodontal practice-level data. Trial registration: The study was registered in the German Clinical Trials Register (DRKS 00011448). [ABSTRACT FROM AUTHOR]

Aim: To examine the level of adherence to best‐practice guidelines of interprofessional teams with acute care nurse practitioners (ACNPs) compared to interprofessional teams without ACNPs. Design: A retrospective observational study was conducted in 2023. Method: A retrospective cohort was created including 280 patients who underwent a coronary artery bypass graft and/or a valve repair and hospitalised in a cardiac surgery unit of a university affiliated hospital in Québec (Canada) between 1 January 2019 to 31 January 2020. The level of adherence to best‐practice guidelines was measured from a composite score in percentage. The composite score was created from a newly developed tool including 99 items across six categories (patient information, pharmacotherapy, laboratory tests, post‐operative assessment, patient and interprofessional teams' characteristics). Multivariate linear and logistic regression models were computed to examine the effect of interprofessional teams with ACNPs on the level of adherence to best‐practice guidelines. Results: Most of the patients of the cohort were male and underwent a coronary artery bypass graft procedure. Patients under the care of interprofessional teams with ACNP were 1.72 times more likely to reach a level of adherence higher than 80% compared to interprofessional teams without ACNPs and were 2.29 times more likely to be within the highest quartile of the scores for the level of adherence to best‐practice guidelines of the cohort. Impact: This study provides empirical data supporting the benefits of ACNP practice for patients, interprofessional teams and healthcare organisations. Relevance for Practice: Our findings identify the important contributions of interprofessional teams that include ACNPs using a validated instrument, as well as their contribution to the delivery of high quality patient care. Reporting Method: This study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for reporting observational studies guidelines. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Purpose: The primary objective of this study was to explore the potential disparity in postoperative fistula occurrence rates between patients who undergo (partial) lateral parotidectomy and those who undergo the extracapsular dissection technique for the management of benign parotid gland tumours. Methods: A consecutive series of 363 patients treated with (partial) lateral parotidectomy and extracapsular dissection technique for benign parotid gland tumours at one tertiary centre between 2018 and 2022 were included. To evaluate the impact of the surgical technique and possible other risk factors (tumour location, tumour size, Body Mass Index, age, smoking, diabetes mellitus, arterial hypertension) for the development of fistulas, multivariate logistic regression analyses using backward lection were applied to estimate odds ratios (ORs) and 95%‐confidence intervals (CIs). Results: In 363 patients, 21 patients (5.8%) developed a fistula. Patients who underwent (partial) lateral parotidectomy had three times higher chance of developing a fistula compared to patients who were operated using the extracapsular dissection technique (ORadjusted = 2.6, 4.1% vs. 12.5%, p = 0.044). In the multivariate analyses, no other risk factors for the development of fistulas were statistically significant in this cohort. The incidence of facial nerve paralysis was not significantly different between the extracapsular dissection and lateral parotidectomy group (5/73 = 6.8% vs. 11/290 = 3.8%, p = 0.333). Conclusion: Fistulas occur more often in patients treated by means of a (partial) lateral parotidectomy approach compared to patients treated using the extracapsular dissection technique. Therefore, surgeons should be vigilant about postoperative fistula risks in lateral parotidectomy and consider preventive measures. [ABSTRACT FROM AUTHOR]

To compare oncologic outcomes after laparoscopic or laparotomic surgery to treat epithelial ovarian carcinoma in FIGO Stage I. Retrospective cohort study. Gynecological cancer ward in a tertiary hospital. A total of 85 patients with FIGO Stage I epithelial ovarian carcinoma who underwent laparoscopic staging surgery and 206 who underwent laparotomic staging surgery at West China Second Hospital, Sichuan University (Chengdu, China) between January 1, 2013 and December 31, 2019. Laparoscopic surgery or laparotomic staging surgery. Before propensity score-based matching, the laparotomy group showed higher prevalence of preoperative elevated CA125 level (48.5% vs 35.3%, p =.045) and tumors >15 cm (27.2% vs 5.9%, p <.001). Multivariate analysis associated higher body mass index with better overall survival (adjusted HR 0.83, 95% CI 0.70–0.99, p =.043). Among propensity score-matched patients (82 per group) who were matched to each other according to propensity scoring based on age, body mass index, CA125 level, largest tumor diameter, FIGO stage, history of abdominal surgery, and American Society of Anesthesiologists grade, the rate of progression-free survival at 5 years was similar between the laparoscopy group (87.1%, 95% CI 79.3–95.7%) and the laparotomy group (90.9%, 95% CI 84.7–97.6%, p =.524), as was the rate of overall survival at 5 years (93.9%, 95% CI 88.0–100.0% vs 94.7%, 95% CI 89.8–99.9%, p =.900). Regardless of whether patients were matched, the two groups showed similar rates of recurrence of 9–11% during follow-up lasting a median of 54.9 months. Rates of recurrence and survival may be similar between laparoscopy or laparotomy to treat Stage I epithelial ovarian cancer. Since laparoscopy is associated with less bleeding and faster recovery, it may be a safe, effective alternative to laparotomy for appropriate patients. [ABSTRACT FROM AUTHOR]

• This study delves into acute coronary syndrome recognition at triage and its effect on timely treatment. • Emergency triage pivotal in treatment delays, impacting clinical outcomes for ACS cases significantly. • Triage non-compliance leads to delays in crucial treatments, stressing accurate and timely triage importance. • Urgent need to improve triage guideline adherence, crucial for enhancing patient outcomes in emergencies. Triage nurses' pivotal role in initial assessment makes their competence crucial. However, the specific impact on Acute Coronary Syndrome (ACS) recognition and outcomes remains unclear in Jordanian healthcare. Understanding this relationship could enhance ACS management and patient outcomes in Jordanian Emergency Departments (EDs). To assess how triage nurses' recognition of ACS diagnosis affects patient outcomes in Jordan. This retrospective study examined records of 150 ACS patients admitted to the coronary care unit (CCU). Data extraction assessed triage nurses' accuracy in recognizing ACS symptoms and the timelines for diagnosis procedures (e.g., electrocardiogram [ECG]) and treatment provision (e.g., thrombolytic) based on triage decisions. It also evaluated the impact on treatment outcomes, including length of stay in the ED and hospital. Multiple linear regression analyses quantified the influence of under-triage on treatment outcomes. The sample comprised 150 patients. Most were female (78.7%), aged 45-59.9 years (37.3%). ACS classifications: unstable angina (52.0%), STEMI (38.0%), NSTEMI (10.0%). The study included a cohort of ACS patients, with findings indicating varying degrees of under-triage by triage nurses. Analysis of timelines revealed significant delays in diagnosis and treatment initiation for patients subjected to under-triage. Multiple linear regression analyses demonstrated a robust association between under-triage and prolonged time to essential treatment outcomes, including delays in physician assessment, ECG performance, thrombolytic administration, and extended ED length of stay. Triage nurses' knowledge and competency are crucial determinants of accurate ACS recognition and subsequent clinical outcomes for patients presenting to the ED in Jordan. Investing in ongoing education and training programs for triage nurses may lead to improved ACS recognition rates and better patient outcomes in Jordanian healthcare settings. [ABSTRACT FROM AUTHOR]

Introduction: Symptom burden management is a major goal of pancreatic cancer care given that most patients are diagnosed late. Early palliative care is recommended in addition to concurrent active treatment; however, disparities exist. We sought to determine the factors associated with inpatient palliative treatment among pancreatic cancer patients and compare treatment outcomes in terms of mortality, discharge disposition and resource utilization. Methods: We conducted a retrospective study of 22,053 pancreatic cancers using the National Inpatient Sample (NIS) database (January - December 2020). Patient and hospital characteristics, mortality, discharge disposition, length of stay (LOS), hospital costs and charges were compared between pancreatic cancer patients based on palliative treatment. Multivariate regression was used to evaluate patient and hospital characteristics and outcomes associated with palliative treatment. Results: A total number of 3839 (17.4%) patients received palliative care. Patients who received palliative care were more likely to be older, Medicaid insured, and nonobese. Patients were less likely to receive palliative care if they are males, Medicare insured, had a lower Charlson comorbidity score, or treated in Urban nonteaching hospitals. Patients who received palliative care displayed higher odds of in-hospital mortality and prolonged LOS. The adjusted additional mean hospital cost and charges in patients who received palliative care were lower by $1459, and $4222 respectively. Conclusions: Inpatient palliative treatment in pancreatic cancer patients is associated with an older age, a higher comorbidity burden, non-obesity, insurance status and urban teaching hospitals. Our study suggests that inpatient palliative treatment decreased hospital resource utilization without prolonging survival. [ABSTRACT FROM AUTHOR]

Background: Long-term health conditions are major challenges for care systems. Social prescribing link workers have been introduced via primary care networks (PCNs) across England since 2019 to address the wider determinants of health by connecting individuals to activities, groups, or services within their local community. Aim: To assess whether the rollout of social prescribing link workers was in areas with the highest need. Design and setting: A retrospective study of social prescribing link workers in England from 2019 to 2023. Method: Workforce, population, survey, and area-level data at the PCN-level from April 2020 to October 2023 were combined. Population need before the rollout of link workers was measured using reported lack of support from local services in the 2019 General Practice Patient Survey. To assess if rollout reflected need, linear regression was used to relate provision of link workers (measured by full-time equivalent [FTE] per 10 000 patients) in each quarter to population need for support. Results: Populations in urban, more deprived areas and with higher proportions of people from minority ethnic groups had the highest reported lack of support. Geographically these were in the North West and London. Initially, there was no association between need and provision; then from July 2022, this became negative and significant. By October 2023, a 10-percentage point higher need for support was associated with a 0.035 (95% confidence interval = −0.634 to −0.066) lower FTE per 10 000 patients. Conclusion: Rollout of link workers has not been sufficiently targeted at areas with the highest need. Future deployments should be targeted at those areas. [ABSTRACT FROM AUTHOR]

Background: Ear and temporal bone squamous cell carcinoma (ETBSCC) is a rare and aggressive malignant tumor with minimal clinicopathological studies. The object of this study was to retrospectively evaluate the predictive effect of clinicopathological variables on the 5‐year overall survival (OS) rate of ETBSCC patients in a single tertiary medical center in Tianjin, China. Methods: A cohort of 44 patients with diagnosed ETBSCC from December 2012 to August 2022 were retrospectively studied. Univariate and multivariate analysis were, respectively, performed for the assessment of clinicopathological predictors, including sex, age, history of chronic suppurative otitis media (CSOM), lesion side, diameter, the choice of surgical approach, parotidectomy, neck dissection, adjuvant therapies, T stage, lymph node metastasis, tumor grade, margin, perineural invasion (PNI), and Ki‐67 index. Results: Seventeen females and 27 males were included, with the mean age of 65 years old, ranging from 36 to 89 years. The 5‐year OS rate was 43% (mean 51 months, 95% confidence interval [CI] = 39–64). Significant prediction of a worse prognosis for 5‐year OS rate was observed under univariate analysis for advanced T stage, positive margin, identified PNI, and higher Ki‐67 index, respectively. Advanced T stage was confirmed to be an independent prognostic factor strongly affecting 5‐year OS rate among this cohort of patients using a multivariate cox proportional hazard model. Conclusion: We found that clinicopathological parameters, especially postoperative pathological parameters, play a critical role in predicting the prognosis of ETBSCC patients. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Orofacial Orthopedics/Fortschritte der Kieferorthopadie is the property of Springer Nature 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.)

Objective: Investigate associations between socioeconomic indicators of healthcare access with family compliance with cleft-related otologic and audiologic care within an interdisciplinary model. Design: Retrospective case series. Subjects and Setting: Children born 2005–2015 who presented to the Cleft-Craniofacial Clinic (CCC) at a quaternary care children's hospital. Interventions: Associations between main outcome measures and Area Deprivation Index (ADI), median household income for zip code, distance from hospital, and insurance status were evaluated. Main Outcome Measures: Cleft types, ages at presentation to outpatient clinic (cleft, otolaryngology, and audiology), and ages at procedures (first tympanostomy tube insertion (TTI), lip repair, and palatoplasty) were measured. Results: Most patients were male (147/230, 64%) with cleft lip and palate (157/230, 68%). Median age at first cleft, otolaryngology, and audiology visits were 7 days, 86 days, and 5.9 months, respectively. Private insurance predicted lower no-show rates (p =.04). Age at first CCC visit was younger for patients with private insurance (p =.04) and older for those who lived further from the hospital (p =.002). Age at lip repair was positively correlated with national ADI (p =.03). However, no socioeconomic status (SES) proxy or proximity to hospital was associated with delays in first otolaryngology or audiology examination or TTI. Conclusion: Once children become established within an interdisciplinary CCC, SES appears to bear little influence on cleft-related otologic and audiologic care. Future efforts should aim to elucidate which aspects of the interdisciplinary model maximize multisystem cleft care coordination and increase access for higher risk populations. [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]

ABSTRACT Aims Background Methods Results Conclusion Relevance to Clinical Practice Patient or Public Contribution To explore the incidence and factors influencing medication administration errors (MAEs) among nurses.Medication administration is a global concern for patient safety. Few studies have assessed the incidence of MAEs or explored factors that considered the interplay between behaviour, the individual and the environment.This retrospective study included 342 MAEs reported in the electronic nursing adverse event reporting system between January 2019 and September 2023 at a university‐affiliated teaching hospital in China. Data on nurses' demographics and medication administration were extracted from the nursing adverse event reports. The reports were classified according to the severity of patient harm. The causes of the 342 MAEs were retrospectively analysed using content analysis based on Bandura's social cognitive theory. Descriptive statistics were used to calculate the proportion of medication errors and the distribution of subcategories.In total, 74.3% of MAEs were adverse events owing to mistakes and resulted in no harm or only minor consequences for patients. Nurses aged 26–35 years and those with 6–10 years of experience were the most common groups experiencing MAEs. Factors influencing MAEs included personal (‘knowledge and skills’ and ‘physical state’), environmental (‘equipment and infrastructure,’ ‘work settings’ and ‘workload and workflow’) and behavioural (‘task performance’ and ‘supervision and communication’) factors. The study further highlighted the interrelationships among personal, behavioural and environmental factors.Multiple factors influence MAEs among nurses. Nurse‐related MAEs and the relationship between behaviours, individual factors and the environment, as well as ways to reduce the occurrence of MAEs, should be considered in depth.Understanding the factors influencing MAEs can inform training programs and improve the clinical judgement of healthcare professionals involved in medication administration, ultimately improving patient prognoses and reducing MAEs.The findings can help develop clinical guidelines for preventing MAEs. [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: The management of large distal penile calculi has evolved with the advent of endoscopic techniques. However, open surgical management remains a viable option, particularly in resource-limited settings. This study aimed to evaluate the efficacy and safety of open surgical management for large distal penile calculi and compare the results with the existing literature on endoscopic management. Methods: A retrospective review of 25 patients who underwent open surgical management for large distal penile calculi (>1.5 cm) was conducted. Patient demographics, stone characteristics, intraoperative data, postoperative outcomes, and complications were analyzed. The results were compared with the existing literature on endoscopic management. Results: The mean age of the patients was 45.6 ± 8.2 years, and the mean stone size was 1.8 ± 0.3 cm. The success rate of open surgical management was 96%, with intraoperative and postoperative complication rates of 12% each. Stricture formation and recurrence rates were 4% and 0%, respectively. The mean operative time was 35.6 ± 8.4 minutes, and the patient satisfaction rate was 92%. Compared to endoscopic management, open surgery demonstrated lower stricture formation rates (4% vs. 5- 10%, p = 0.04) and recurrence rates (0% vs. 2-5%, p = 0.02). Conclusion: Open surgical management is a safe and effective approach for treating large distal penile calculi, with high success rates, low complication rates, and minimal risk of long-term complications. It may be a preferred option, particularly in resource-limited settings. Further prospective comparative studies are needed to establish the role of open surgical management in the contemporary era of endoscopic surgery. [ABSTRACT FROM AUTHOR]

Background: Depression is frequently associated with unsuccessful smoking cessation. Objective: In this study, we investigated the impact of depression history on smoking cessation success in a clinical setting. Methods: This retrospective study included 726 patients who visited our smoking cessation clinic between January 1, 2001, and December 31, 2018. Kaplan–Meier analyses and Cox proportional hazards regression models were used to perform univariate and multivariate analyses of smoking cessation success factors. Results: Among the 726 patients, 76 had a history of depression and demonstrated significantly lower 12-week quit rate compared to those without (33.6% vs. 69.6%, p <.001). Multivariate Cox analysis revealed a significant association between abstinence rate and history of depression (hazard ratio 2.251, 95% CI 1.505–3.315, p <.001), history of schizophrenia (hazard ratio 2.716, 95% CI 1.427–4.840, p =.003), and Fagerström Nicotine Dependence Test scores (hazard ratio 1.519, 95% CI 1.053–2.197, p =.025). Conclusions: Our findings suggested that a history of depression is a significant prognostic factor for smoking cessation, underscoring the need for targeted interventions for patients with a history of depression. The findings of this study are subject to potential selection bias due to recruitment from a single hospital, which may limit the generalizability of our results. This study highlights the necessity for novel, specialized smoking cessation therapies to support patients with a history of depression in their cessation journey. [ABSTRACT FROM AUTHOR]

Objective The study aimed to elucidate the evolution of the syndromes in Traditional Chinese Medicine ( TCM ) and TCM syndrome elements in different chronic stages of psoriasis vulgaris. Methods A database was constructed using electronic medical records collected from July 2019 to March 2024 from 1, 049 patients with psoriasis vulgaris. The study used Sankey diagrams and network association graphs to analyze the evolution of TCM syndromes and their elements in patients at the different stages: initial diagnosis, progressive stage (Week 2-3), progressive stage (Week 4-5), skin lesion improvement stage ( Week 6 - 7 ), and remission stage. The syndrome elements network was constructed using community detection algorithms, and the association rules between local skin lesion syndrome difierentiation and overall syndrome difierentiation were displayed using heatmaps. Results ( i) Initial diagnosis. In the syndrome differentiation of local skin lesions, blood heat syndrome was the most common (79.79%); among the disease location of TCM syndrome elements (called " disease location, , ）, liver was the most prevalent ( 35.62%); and among the pathological factors of TCM syndrome elements ( called " pathological factors " ), fire (heat) was the most common (75. 48%). ( ii) Active stage (Week 2-3). In the syndrome differentiation of local skin lesions, blood heat syndrome remained the most prevalent (73. 13%) ； among the disease location, liver was still the most prevalent (31.71%); and among the pathological factors, fire ( heat) continued to be the most common (82. 11%), while dampness (22. 26%) and qi stagnation (8. 39%) began to increase. ( 111) Active stage ( Week 4-5). The syndrome differentiation of local skin lesions was dominated by blood heat syndrome (45. 91%) and blood dryness syndrome (37. 19%) ； among disease location, the interior was the most prevalent ( 15. 25%) ； and among the pathological factors, fire (heat) remained the most common ( 50. 66%), with an increase in yin deficiency ( 34. 26%). ( iv) Skin lesion improvement stage (Week 6 - 7 ). In the syndrome differentiation of local skin lesions, both blood dryness syndrome (49.44%) and blood stasis syndrome ( 33.33%) increased; among the disease location, meridians increased most significantly and became the most prevalent (13.44%); and among the pathological factors, blood stasis increased most significantly and became the most prevalent (28.20%). ( V ) Remission stage. In the syndrome difierentiation of local skin lesions, blood stasis syndrome became the primary (55.69%), while the percentage of blood dryness syndrome decreased ( 21. 16%) ； meridians (25.71%) and blood stasis ( 62. 34%) remained the most predominant syndrome elements related to disease location or pathological factors. Conclusion The overall pattern of TCM syndromes in psoriasis vulgaris evolved from excess to deficiency. From the initial diagnosis to the active phase (Week 2-3), heat syndrome dominated ； during the active phase ( Week 4-5), heat syndrome coexisted with damp syndrome or yin deficiency syndrome; changes in the syndrome element network were the most significant during the lesion improvement phase, with blood stasis gradually increasing and peaking during the remission phase. Blood stasis, dampness, and qi stagnation were pervasive throughout psoriasis vulgaris ； qi stagnation and blood stasis may be the main elements causing further deterioration and prolonged course of the disease during the active phase in patients. [ABSTRACT FROM AUTHOR]

Aim: Given that metformin is often recommended for the management of type 2 diabetes mellitus, it is clinically significant to consider the potential interactions between metformin and other medications. In this study, we aimed to identify potential drug-drug interactions associated with metformin by retrospectively analyzing the prescriptions of patients taking metformin. Materials and Methods: Metformin-containing prescription data of five independent community pharmacies in Konya province for the year 2023 were analyzed retrospectively. Medscape®, Drugs® and LexiComp® software programs were used to detect potential drug-drug interactions. As a result of power analysis with the G Power program, 400 patients were included in the study with an effect size of 0.25, type 1 error of 0.05 and confidence interval of 0.95. Results: Kendall's W value indicating the agreement between Medscape®, Drugs®and LexiComp® software programs was calculated as 0.061. In terms of potential drug-drug interactions of metformin, the agreement between the software programs was observed to be slight. The highest agreement between the programs was observed between Medscape® and LexiComp® (Kappa coefficient=0.44). Conclusion: Since potential drug-drug interactions are common in prescriptions for patients taking metformin, these interactions should be carefully monitored. Clinicians should use multiple interaction programs to identify potential drug-drug interactions of metformin. [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]

Background: Ulcerative proctitis (UP) and ulcerative proctosigmoiditis (UPS) are special forms of ulcerative colitis. The disease burdens of UP and UPS are increasing. However, the natural history and prognosis of patients with mild-to-moderate UP or UPS have been poorly studied. Aims: The aim of this study is to evaluate the characteristics, short-term and long-term outcomes of patients with mild-to-moderate UP or UPS followed at a single center over a period of 3 years. Methods: A retrospective study of patients with UP and UPS followed at a single center from 2021 to 2023 was performed. After scanning for inclusion and exclusion criteria, patient demographics and clinical data were collected. Disease severity was accessed by Myao endoscopy scores and ulcerative colitis endoscopic index of severity. Endoscopic improvement was defined as decreased scores at the last follow-up. Disease extension was defined as endoscopic evidence of a greater extent of disease at the last follow-up. Results: A total of 414 patients were included for evaluation, of which 292 patients (70.53%) were at mild disease stage, and 122 patients (29.47%) had moderate diseases. At the last follow-up, 315 patients (76.09%) showed endoscopic improvement, and 247 patients (59.66%) showed endoscopic remission. An overall extension rate of 11.11% was observed at the last follow-up. Subgroup analysis revealed a better prognosis in younger patients. The disease extension rate was higher in moderate group and symptomatic patients. Conclusion: Promising outcomes were observed in patients with mild-to-moderate ulcerative proctitis or ulcerative proctosigmoiditis. Disease severity and symptoms are correlated with the risk of extension. [ABSTRACT FROM AUTHOR]

Aim: Peritonitis is the most common complication of peritoneal dialysis (PD). This study aimed to investigate changes in the incidence, risk factors, microbiology, and clinical outcomes of PD‐associated peritonitis in the past decades. Methods: This was a retrospective study that included children who initiated chronic PD at our institution between 2000 and 2017. The patients were divided into two groups according to the year of initiation: those who initiated PD between 2000 and 2008 and those who initiated PD between 2009 and 2017. The incidence and characteristics of peritonitis were compared between the groups. Results: A total of 184 patients with a median age of 10.2 years were included in this study. Of the patients, 92 experienced 210 episodes of peritonitis. The incidence rate of peritonitis decreased from 0.35 to 0.21 episodes/patient year during the study period (P = 0.001). During the 2000–2008 period, the 2‐year peritonitis‐free survival rate was significantly lower for patients under 2 years of age than for the other age groups (P = 0.004), whereas this was not observed during the 2009–2017 period. The multivariable Cox proportional hazard model showed that the <2 years age group had a significantly higher risk of developing peritonitis in the 2000–2008 period. However, this was not evident in the 2009–2017 period. Conclusions: The incidence of PD‐associated peritonitis decreased, particularly in children under 2 years of age. Thus, younger age may not be a risk factor for PD‐associated peritonitis. [ABSTRACT FROM AUTHOR]

Trying to better define Bipolar Disorder (BD) progression, different staging models have been conceptualized, each one emphasizing different aspects of illness. In a previous article we retrospectively applied the main staging models to a sample of 100 bipolar patients at four time points over a ten-year observation. In the present study, focusing on Kupka & Hillegers's model, we aimed to assess the transition of the same sample through the different stages of illness and to explore the potential role of clinical variables on the risk of progression. Multistate Model using the mstate package in R and Markov model with stratified hazards were used for statistical analysis. A high hazard of transition from stage 2 to 3 emerged, with a probability of staying in stage 2 decreasing to 14 % after 3 years. BD II was significantly associated with transition from stage 1 to 2, whereas the number of lifetime episodes >3 and the elevated predominant polarity with transition from stage 3 to 4. Our results corroborated the evidence on BD progression and contributed to outline its trajectory over time. Further effort may help to define a standardized staging approach towards ever increasing tailored interventions. • We retrospectively applied Kupka & Hillegers's model to a sample of 100 bipolar patients at 4 time-points over 10 years • We assessed the transition across stages and the role of clinical variables on the risk of progression • A high hazard of transition 2→3 emerged, with a probability of staying in stage 2 decreasing to 14% after 3 years • BD II was associated with transition 1→2; > 3 lifetime episodes and elevated predominant polarity with transition 3→4 [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]

Background: The aim of this study was to evaluate the incidence of preloading crestal bone loss (PLCBL) and to identify the patient‐related and implant‐related factors associated with PLCBL. Methods: This retrospective cohort examined the dental records of patients who received at least one dental implant. PLCBL was defined as a reduction ⩾0.5 mm and severe PLCBL (primary variable) as a reduction ⩾1.5 mm in mesial and/or distal bone level, measured from the day of implant placement to uncovering or abutment installation/crown delivery. The incidence of PLCBL and patient and implant variables were recorded. Bivariate analysis and binary logistic regression identified factors associated with PLCBL ⩾0.5 mm and ⩾1.5 mm. Results: A total of 746 dental implants placed in 361 patients from January 2011 to July 2021 was included in the analyses. Of the implants assessed, 24.4% (n = 182) exhibited PLCBL ⩾ 0.5 mm and 10.5% (n = 78) presented severe PLCBL (i.e., ⩾1.5 mm). Males (odds ratio [OR] = 1.85, 95% confidence interval [CI] = 1.11–3.07), patients with diabetes (OR = 3.33, 95% CI = 1.73–6.42), and those allergic to penicillin (OR = 3.13, 95% CI = 1.57–6.22) were more likely to experience severe PLCBL (p < 0.05). Implants placed in the anterior area (OR = 2.08, 95% CI = 1.16–3.73), with bone‐level platform‐abutment connection (OR = 4.73, 95% CI = 1.94–11.49) and inserted supracrestally (OR = 3.77, 95% CI = 1.84–7.72), presented a greater risk of developing severe PLCBL (p < 0.05). Implants placed in a previously grafted area presented a lower likelihood of developing severe PLCBL (OR = 0.489, 95% CI = 0.28–0.84). Conclusion: The incidence of PLCBL ⩾ 0.5 mm and ⩾1.5 mm was 24.4% and 10.5%, respectively. Male sex, diabetes, allergy to penicillin, anterior location, bone‐level platform‐abutment connection, and supracrestal implant placement are potential risk factors for severe PLCBL. A previously grafted area is a potential protective factor. [ABSTRACT FROM AUTHOR]

This study reported on the outcome of the nonsurgical root canal treatment/retreatment of teeth with large apical periodontitis lesions. The influence of some variables on the prognosis was also evaluated. The study included 199 teeth with large apical periodontitis lesions from 184 patients, treated/retreated by a single operator. Most teeth were managed in a single visit using NaOCl irrigation. Cases were followed up periodically from >1 to 8 years. Treatment/retreatment outcome was evaluated by clinical and radiographic/tomographic criteria and categorized as healed, healing, or diseased. For statistical analysis, data were dichotomized in such a way that healing cases were considered as success in a loose criterion or failure in a rigid one. Clinical/radiographic analyses revealed that 67% of the initial treatment cases were classified as healed, 22.5% as healing, and 11% as diseased. Treatment success rates were 89% (loose) and 67% (rigid). Variables that influenced the treatment outcome included previous abscess and antibiotic use, very large lesions (≥10 mm), and a sinus tract. The median follow-up time for treatment was 31.5 months. As for retreatment cases, 47% were healed, 32% were healing, and 21% were diseased. Retreatment success rates were 79% (loose) and 47% (rigid), in a median follow-up of 32 months. Cases evaluated by cone-beam computed tomography had lower healed rates. Findings demonstrate that high favorable outcome rates can be achieved by nonsurgical root canal treatment or retreatment of teeth with large apical periodontitis lesions. [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]

Modified: Avian pox, a highly contagious disease affecting chickens, turkeys, and other birds, is caused by the Pox virus and presents as nodular lesions on the skin and diphtheritic lesions on mucous membranes. A seven-year retrospective study (2016-2022) was conducted on clinical cases of Avian pox presented at Aliyu Jodi Veterinary Clinic (AJVC) and the Veterinary Teaching Hospital, Usmanu Danfodiyo University Sokoto (VTH-UDUS). During this period, 7,014 cases of poultry infectious diseases were recorded, with 2,066 (28.34%) identified as Avian pox. Specifically, VTH-UDUS documented 1,269 infectious cases, with 622 (49.02%) being Avian pox, while AJVC recorded 6,020 cases, with 1,444 (23.99%) attributed to Avian pox. The highest annual occurrence of Avian pox was in 2016 (38.43%), with the lowest in 2020 (12.61%). Seasonally, the disease was more prevalent during the wet season (61.42%) compared to the dry season (38.58%). Among the affected birds, turkeys showed the highest incidence (60.60%), followed by chickens (23.09%), and pigeons (16.31%). The study concludes that Avian pox was the most prevalent infectious disease during this period, particularly in 2016, during the wet season, and among turkeys. The study recommends increased efforts in disease prevention through vector control and vaccination. [ABSTRACT FROM AUTHOR]

The main objectives of our study were to highlight the annual incidence of Canine Leishmaniasis (CanL) in Algeria. A retrospective study was conducted on CanL in Algeria between 2010–2019, by means of a questionnaire survey of 30 canine veterinarians practising in the North central region, Algiers. The retrospective study showed 78 cases of Canine Leishmaniasis (2010 and 2019), with an average of 13.73 per year. The highest mean was observed in 2013:3.400, [1.517–5.283] 95%, with a significant difference (p = 0.028). The cross-sectional survey showed that 44.4% of canine leishmaniasis cases are prevalent in spring and summer. Weight loss was the most frequent clinical sign of 88.9% and skin sampling was the most used diagnostic test to confirm this disease 66.9%. Our study provides a general view of the situation of this disease, particularly the number of cases, and their geographical distribution in Algeria. Canine leishmaniasis (CanL) is a serious zoonosis. Strict measures must be put in place. [ABSTRACT FROM AUTHOR]

Background: Optimising maintenance drug treatment selection for people with bipolar disorder is challenging. There is some evidence that clinical and demographic features may predict response to lithium. However, attempts to personalise treatment choice have been limited. Method: We aimed to determine if machine learning methods applied to electronic health records could predict differential response to lithium or olanzapine. From electronic United Kingdom primary care records, we extracted a cohort of individuals prescribed either lithium (19,106 individuals) or olanzapine (12,412) monotherapy. Machine learning models were used to predict successful monotherapy maintenance treatment, using 113 clinical and demographic variables, 8,017 (41.96%) lithium responders and 3,831 (30.87%) olanzapine responders. Results: We found a quantitative structural difference in that lithium maintenance responders were weakly predictable in our holdout sample, consisting of the 5% of patients with the most recent exposure. Age at first diagnosis, age at first treatment and the time between these were the most important variables in all models. Discussion: Even if we failed to predict successful monotherapy olanzapine treatment, and so to definitively separate lithium vs. olanzapine responders, the characterization of the two groups may be used for classification by proxy. This can, in turn, be useful for establishing maintenance therapy. The further exploration of machine learning methods on EHR data for drug treatment selection could in the future play a role for clinical decision support. Signals in the data encourage further experiments with larger datasets to definitively separate lithium vs. olanzapine responders. [ABSTRACT FROM AUTHOR]

Introduction: This study is designed to outline the likely patterns of treatment modalities based on patient demographics and mechanism of injury in eastern region of India (industrial area). Objective: To evaluate the various treatment patterns in eastern region of India and for better understanding of providing patient care. Materials and Methods: We conducted a retrospective study by collecting data from the records of the patients who reported at our institution from 2018 to 2020. The types of the major procedures done at the department were classified based on the type and the area of the trauma. The data were tabulated using Excel sheet and projected in percentages. Later with statistical analysis by one-way ANOVA, the different groups were compared with SPSS version 20.0. Results: The total number of patients observed were 197. The gender distribution was M/F = 1.31:1. Comminuted mandibular fracture had the highest incidence with RTA (road traffic accident) being the most prevalent etiology, whereas no significant difference was found between the types of procedures performed and demography of the patients. Conclusion: Being a dominant industrial area (Jharkhand), it can be concluded that facial trauma is seen predominant in this part of eastern India due to road traffic accidents with heavy, high-speed vehicles and lack of awareness in using protective safety accessories. This study helped us evaluate the various major surgical procedures performed in the department of Oral and Maxillofacial Surgery. Such data would also act as an educational tool for trainees and for enhancing multidisciplinary meets. [ABSTRACT FROM AUTHOR]

Introduction: Coronoid process of mandible is seldom fractured during maxillofacial trauma. Majority of the cases of coronoid fracture are treated conservatively, but some lead to complications which are often overlooked. At present, the literature on coronoid fractures is inadequate for meta-analysis. Also, there exists no standardized classification in the literature. Hence, the purpose of this study was to analyze the incidence and establish a novel 'tripartite' classification. Material and Methods: In this study carried out at level 1 trauma center, all patients with coronoid fracture with or without associated maxillofacial fractures were included. Relevant data were noted from Hospital records and CT scans (computer tomographic scans). These cases were classified according to 'tripartite' classification and treated. Data feed was given to IBM® SPSS® statistics (version 21) for analysis. Results: Among 33 coronoid fracture patients, majority (57.57% cases) were from age group of 21–40 years with 82.85% cases attributed to road traffic accidents. 11.43% cases were bilateral, and the rest unilateral cases revealed right-side predilection. Conclusion: Novel tripartite classification allows us to easily categorize and visualize the coronoid fractures. Horizontal types 1 to 3 and vertical types 4 to 6 are in increasing order of incidence, which makes it easy for communication, treatment approach and record maintenance. [ABSTRACT FROM AUTHOR]

Introduction: Maxillofacial injuries are a common finding among the patients reporting to the Emergency Department. Aim: This study was conducted to evaluate the occurrence and characteristics of Oral and Maxillofacial injuries among the patients who reported to the Emergency Department at Vydehi Institute of Medical Sciences and Research Centre, Bengaluru. Materials and Method: The study was carried out retrospectively by analysing the medical records of patients who were presented with maxillofacial injuries, under the Department of Oral and Maxillofacial Surgery over a period of nine years. A total of 2831 patients were evaluated and segregated into different age groups. Standardized data was gathered on the number and location of lacerations, abrasions, fractures of facial bones, associated head injuries and treatment done. Result: It was found that the majority of the maxillofacial injuries reported to the emergency department are soft tissue injuries comprising of 71.49% of total cases among which 55.77% cases were with single or multiple lacerations and 15.72% cases with abrasions alone. The most common cause of facial injuries is road traffic accidents 56.8% followed by self-fall (33.8%) and assault (5.837%). The most common site of occurrence of laceration was noted to be forehead laceration (13.2%) followed by chin (10.97%), supraorbital (9.44%), upper lip (8.1%) and lower lip (5.97%). Among the fracture cases, Mid-facial fracture occurred in 58.84%, followed by mandibular fractures at 20.86% being the next most common occurrence. Conclusion: The results and understanding obtained from this study will be utilized to develop focused treatments for reducing the severity and frequency of maxillofacial trauma. Further, we believe that public awareness campaigns about enhanced safety measures can reduce the occurrence of maxillofacial injuries. [ABSTRACT FROM AUTHOR]

Background: Depression has been suggested to increase the risk of cardiovascular disease, but many studies assessed depression after heart disease onset. This study evaluated the association between depression and myocardial infarction (MI) using a large inpatient database. Methods: We analyzed patients from the National Inpatient Sample hospitals from 2005 to 2020, selecting those aged >30 with ICD-9 and ICD-10 codes for segment elevation (ST) elevation myocardial infarction (STEMI), non-ST elevation myocardial elevation (NSTEMI) and major depression. Results: Our data included 4413,113 STEMI patients (224,430 with depression) and 10,421,346 NSTEMI patients (437,058 with depression). No significant association was found between depression and MI. For STEMI, the 2005 odds ratio was 0.12 (95% CI: 0.10–0.15, p < 0.001) and the 2020 odds ratio was 0.71 (95% CI: 0.69–0.73, p < 0.001). Similar patterns were observed for NSTEMI. Conclusion: Depression may not independently be a significant risk factor for MI. Plain Language Summary Depression has been suggested to increase the risk of cardiovascular disease, but many studies assessed depression after heart disease onset. This study evaluated the association between depression and myocardial infarction (MI) using a large inpatient database. We analyzed patients from the National Inpatient Sample hospitals from 2005 to 2020, selecting those aged greater than 30. No significant association was found between depression and MI. Depression may not independently be a significant risk factor for MI. Our results suggest that patients with anxiety or depression have no association with the occurrence of MI. We suspect that the observed results may be related to the effects of selective serotonin reuptake inhibitors on platelets. Selective serotonin reuptake inhibitors primarily increase serotonin levels in the brain by inhibiting its reuptake. However, they can also affect platelet function by inhibiting serotonin reuptake by platelets. This inhibition of serotonin reuptake by platelets can lead to decreased platelet aggregation, which may confer some level of protection against certain conditions involving platelet dysfunction or excessive clotting. This effect is particularly relevant in cardiovascular diseases where abnormal platelet function can contribute to thrombotic events like heart attacks or strokes. Article highlights Background Depression and anxiety significantly impact nearly one-fourth of the USA population, with global prevalence contributing substantially to disability. These psychiatric conditions are associated with an increased risk of cardiovascular diseases due to various physiological mechanisms. Methods An extensive retrospective analysis was conducted using data from the National Inpatient Sample database from 2005 to 2020. Patients aged over 30 were selected using ICD-9 and ICD-10 codes for ST-segment elevation myocardial infarction, non-ST-segment elevation myocardial infarction and major depression. Results The study included 4413,113 ST-segment elevation myocardial infarction patients, 224,430 with depression and 10,421,346 non-ST-segment elevation myocardial infarction patients, 437,058 of whom had depression. No significant association was found between depression and any type of myocardial infarction (MI). A consistent trend over the 15-year period showed fewer MI incidents among patients with a diagnosis of depression compared with those without depression. Conclusion Our study did not identify an increased risk of MI associated with major depression. The findings suggest that depression may not independently be a significant risk factor for MI. Future research should consider prospective cohort studies to establish causality and further explore the impact of depression on cardiovascular health. Limitations The study's retrospective design and reliance on ICD-9 and ICD-10 coding within the National Inpatient Sample database may introduce biases. The duration of depression and a control group without depression were not included, limiting the ability to determine the independent impact of depression on MI. [ABSTRACT FROM AUTHOR]

Background: Substantial increases in UK consulting rates, mean consultation duration, and clinical workload were observed between 2007 and 2014. To the authors' knowledge, no analysis of more recent trends in clinical workload has been published to date. This study updates and builds on previous research, identifying underlying changes in population morbidity levels affecting demand for primary health care. Aim: To describe the changes in clinical workload in UK primary care since 2005. Design and setting: Retrospective cohort study using GP primary care electronic health records data from 824 UK general practices. Method: Over 500 million anonymised electronic health records were obtained from IQVIA Medical Research Data to examine consulting rates with GPs and practice nurses together with the duration of these consultations to determine total patient-level workload per person–year. Results: Age-standardised mean GP direct (face-to-face and telephone) consulting rates fell steadily by 2.0% a year from 2014 to 2019. Between 2005 and 2019 mean GP direct consulting rates fell by 5.8% overall whereas mean workload per person–year increased by 25.8%, owing in part to a 36.9% increase in mean consultation duration. Indirect GP workload almost tripled over the 15 years, contributing to a 48.3% increase in overall clinical workload per person–year. The proportion of the study population with ≥3 serious chronic conditions increased from 9.7% to 16.1%, accounting for over a third of total clinical workload in 2019. Conclusion: Findings show sustained increases in consulting rates, consultation duration, and clinical workload until 2014. From 2015, however, rising demand for health care and a larger administrative workload have led to capacity constraints as the system nears saturation. [ABSTRACT FROM AUTHOR]