Annals of medicine
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The triglyceride-glucose (TyG) index, a novel reliable biomarker for IR that incorporates blood glucose and triglyceride, is linked to intracranial atherosclerotic stenosis (ICAS). In this study, we aimed to further investigate the association between the TyG index and the outcomes of ICAS patients following extracranial-to-intracranial (EC-IC) bypass grafting. ⋯ Higher TyG levels were associated with poorer outcomes in ICAS patients after EC-IC bypass. TyG could be a key factor in managing ICAS risk and standardizing the indications for EC-IC bypass.
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Whole brain radiotherapy (WBRT) is the mainstay of treatment for patients with non-small cell lung cancer (NSCLC) with multiple brain metastases (BMs); however, the BRAIN study showed that the efficacy of WBRT is unsatisfactory. This prospective phase II study aimed to evaluate the efficacy and safety of WBRT combined with anlotinib, a novel anti-angiogenic multi-target tyrosine kinase inhibitor (TKI), in patients with multiple BMs (>3) from advanced NSCLC. ⋯ Anlotinib combined with WBRT is effective and well-tolerated in patients with NSCLC with multiple BMs.
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Recent studies suggest that adult cardiac surgery performed in the morning increases the risk of major adverse cardiac events, but it is unclear whether this association exists in pediatric cardiac surgery. This study aimed to determine whether the composite outcome of in-hospital mortality and low cardiac output syndrome (LCOS) differs between morning and afternoon pediatric cardiac surgeries. ⋯ Our study supports the selective afternoon scheduling of specific pediatric cardiac surgeries, but further investigation is needed in a multicenter cohort.KEY MESSAGESThis study reviewed 23,433 consecutive pediatric patients who underwent cardiac surgery between August 2014 and December 2021.This study suggested that afternoon surgery was associated with a lower risk of the composite outcomes of in-hospital mortality and low cardiac output syndrome.The above association was also determined in children aged 3 to 18 years, weighted between 6.1 and 8.7 kg, or more than 13 kg, and with STAT category 4-5 subgroups.The restricted cubic spline plot showed that the adjusted risk of the composite outcome decreased with a delay in the start time of surgery.Our findings support selective afternoon scheduling for specific pediatric cardiac surgery.
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Intracranial aneurysm (IA) is a cerebrovascular disease with a high mortality rate due to ruptured subarachnoid hemorrhage. While Krüppel-like factor 6 (KLF6) dysregulation has been implicated in cancer and cardiovascular diseases, its role in IA remains unclear. ⋯ KLF6 may be a potential target for IA treatment, with melatonin-mediated KLF6 effects playing a crucial role in the development of IA.
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Aorto-ostial (AO) coronary interventions may be associated with multiple problems, including the potential embolization of atherothrombotic debris into the aorta and systemic circulation. Such embolization could theoretically lead to stroke or silent brain injury (SBI). In this study, we aimed to investigate whether there is an increased risk of SBI in patients undergoing AO stent implantation. ⋯ This study suggests that AO stenting may be associated with an increased risk of SBI if the lesion in the ostium is significant.