Medicina
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Background: Mitral regurgitation (MR) is a common condition observed in patients undergoing transcatheter aortic valve implantation (TAVI) for the treatment of aortic stenosis (AS). However, the impact of TAVI on MR outcomes and the factors predicting MR improvement remains uncertain. Understanding these predictors can enhance patient management and guide clinical decisions. ⋯ No significant association was found between MR reduction at 6 months and one-year mortality. (p = 0.65). Conclusions: Baseline echocardiographic parameters are valuable in predicting MR improvement post-TAVI, with LVMI emerging as a novel predictor. However, MR reduction did not independently predict survival, underscoring the need for further research to optimize patient selection and management strategies in TAVI candidates.
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Background and Objectives: Although a wide range of hematological parameters are used as blood-based inflammatory biomarkers, the role of complete blood count-derived inflammatory biomarkers in infection after acute ischemic stroke (AIS) is modest. Therefore, this study aimed to explore complete blood count-derived inflammatory biomarkers as predictors of infection after AIS. Materials and Methods: A single-center retrospective cross-sectional study was carried out at the National Brain Center Hospital Prof. ⋯ According to the status of infection after AIS, the subjects were categorized into two groups, including 24 patients in the infection group and 139 patients in the non-infection group. Biomarkers that had significant accuracy (higher sensitivity and specificity, respectively) in predicting infection were the leukocyte count (LC; 70.8%, 74.1%, p < 0.001), absolute neutrophil count (ANC; 66.7%, 79.9%, p < 0.001), absolute monocyte count (AMC; 75.0%, 63.3%, p = 0.001), neutrophil to lymphocyte ratio (NLR; 62.5%, 71.9%, p = 0.003), derivative NLR (dNLR; 50.0%, 78.4%, p = 0.003), monocyte-granulocyte to lymphocyte ratio (MGLR; 62.5%, 73.0%, p = 0.003), systemic inflammatory response index (SIRI; 62.5%, 79.0%, p = 0.001), and systemic immune inflammation index (SII; 87.5%, 44.0%, p = 0.012) with chances of 74.4%, 75.4%, 71.0%, 69.0%, 68.7%, 69.3%, 73.4%, and 66.2%, respectively. Conclusions: Considering the overall ROC curve used to evaluate the complete blood count-derived inflammatory biomarkers, ANC has a better ability to predict infection in AIS patients, as denoted by the highest AUC, suggesting a 75.4% chance of correctly discriminating patients with infection after stroke.
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Background and Objectives: Compared to the general population, rheumatoid arthritis (RA) patients have additional disease-specific risk factors for osteoporosis that include chronic exposure to systemic inflammation. The current study aimed to investigate the prevalence of osteoporosis and its associated risk factors, such as age, sex, body mass index (BMI), uric acid (UA), and vitamin D status, but also the coexistence of type 2 diabetes mellitus (DMT2) and breast cancer (Ca breast) in patients with RA in Bahrain. Material and Methods: Data from DEXA scans were collected retrospectively from the patient's electronic health records. ⋯ However, no association was found between RA and BMI, DMT2, or vitamin D status. Conclusions: RA patients had a high prevalence of low BMD (72.3%) and low vitamin D (63.10%) but high serum UA (20.85%). The risk of osteoporosis, hypovitaminosis, and gout must be kept in mind during the evaluation of any case with RA.
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Background and Objectives: This study investigated associated meniscus and ligament injuries in tibial plateau fractures using magnetic resonance imaging (MRI) and assessed soft tissue injuries in relation to the Schatzker classification and Tscherne classification. Materials and Methods: The data of 185 patients who sustained tibial plateau fractures from January 2010 to April 2021 were retrospectively reviewed. Fractures were classified according to the Schatzker classification system. ⋯ High-energy fractures tended to exhibit higher Tscherne classification grades and showed an increased incidence of meniscus and ligament injuries. The Tscherne classification appears to be a helpful system for predicting soft tissue injuries in tibial plateau fractures. And preoperative MRI can be a helpful tool.
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Background and Objectives: The role of surgery in pancreatic metastases of renal cell carcinoma (PM_RCC) is highly controversial, particularly in the context of modern systemic therapies and the conflicting results of studies published so far. This study aims to explore a single surgical center experience (including mainly pancreatic resections) regarding the indications, the type of pancreatectomies, and early and long-term outcomes for PM_RCC. Materials and Methods: The data of all patients with surgery for PM_RCC (from 1 January 2002 to 31 December 2023) were retrospectively assessed, and potential predictors of survival were explored. ⋯ Body/tail, asymptomatic PM_RCC, and an interval after initial nephrectomy > 2 were favorable prognostic factors for the overall survival after initial nephrectomy for RCC. Conclusions: Pancreatectomies for PM_RCC can achieve long-term survival whenever complete resection is feasible, with acceptable complication rates. Patients with left kidney RCC, body/tail, and asymptomatic PM_RCC and an interval of more than 2 years after nephrectomy exhibit the best survival rates.