Medicina
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Review
Management of Coronary Artery Diseases in Systemic Vasculitides: Complications and Strategies.
Coronary artery disease (CAD) presents a significant risk for patients with systemic vasculitides, a group of disorders characterized by the inflammation of blood vessels. In this review, we focus on the pathophysiological mechanisms, complications, and management strategies for CAD in systemic vasculitides. ⋯ Key strategies in managing CAD in this patient population include using medicine treatments to mitigate vascular inflammation while balancing the risk of promoting cardiovascular events and lifestyle modifications. Understanding the nuanced relationship between systemic vasculitides and CAD is crucial for improving patient outcomes and guiding therapeutic approaches.
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Review
The Neutrophil-to-Lymphocyte Ratio in Patients with Spinal Cord Injury: A Narrative Review Study.
Background and Objectives: Traumatic spinal cord injury (SCI) is a devastating condition that occurs in two phases: primary and secondary injury. These phases contribute to changes in blood vessels and the influx of inflammatory cells such as neutrophils and lymphocytes. The biomarker known as the neutrophil-to-lymphocyte ratio (NLR) has been suggested as being highly valuable in predicting outcomes for patients with traumatic brain injury, acute ischemic stroke, and traumatic spinal cord injury. ⋯ It is still debatable whether the NLR can serve as a cost-effective, readily available, and independent predictive factor for both mortality and recovery outcomes in patients with traumatic spinal cord injuries. Conclusions: Our study demonstrates that NLR, a readily available and inexpensive marker, can serve as an independent predictor of both mortality and recovery outcomes in patients with traumatic spinal cord injury. To reach a conclusive decision, additional data are required.
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This review discusses recent advances in robotic surgery for urologic tumors, focusing on three key areas: robotic systems, assistive technologies, and artificial intelligence. The Da Vinci SP system has enhanced the minimally invasive nature of robotic surgeries, while the Senhance system offers advantages such as tactile feedback and eye-tracking capabilities. ⋯ Additionally, the development of artificial intelligence lays the groundwork for automated robotics. As these technologies continue to evolve, we are entering an era of minimally invasive, precise, and intelligent robotic surgery.
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Background: To prevent hypoxic-ischemic brain damage in patients with post-cardiac arrest syndrome (PCAS), international guidelines have emphasized performing targeted temperature management (TTM). However, the most optimal targeted core temperature and cooling duration reached no consensus to date. This study aimed to clarify the optimal targeted core temperature and cooling duration, selected according to the time interval from collapse to return of spontaneous circulation (ROSC) in patients with PCAS due to cardiac etiology. ⋯ In patients with ROSC within 20 min, the favorable neurological outcome rates at 30 days following cardiac arrest were 75.6% and 86.4% in Groups A and C, respectively (p = 0.315). In patients with ROSC ≥ 21 min, the favorable neurological outcome rates at 30 days following cardiac arrest were 29.3% and 18.2% in Groups B and D, respectively (p = 0.233). Conclusions: Selecting the optimal target core temperature and the cooling duration for TTM, according to the time interval from collapse to ROSC, may be helpful in patients with PCAS due to cardiac etiology.
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Background and Objectives: Diagnosis of myocarditis remains a challenge in clinical practice; however, magnetic resonance imaging (CMRI) can ease the diagnostic approach by providing various parameters. The prevalence of right ventricular involvement in acute myocarditis is suggested to be more frequent than previously hypothesized. In this study, we sought to investigate subclinical RV involvement in patients with acute myocarditis and preserved RV ejection fraction (EF), using CMRI RV speckle-tracking imaging. ⋯ No significant differences were present between parameters used for conventional assessment of RV. However, RV strain absolute values were significantly lower in the acute myocarditis group in comparison with that of the control group (18.4 ± 5.4 vs. 21.8 ± 2.8, p = 0.018). Conclusions: Subclinical RV dysfunction detected by CMR-derived strain may be present in patients with acute myocarditis even with preserved RVEF.