Int J Med Sci
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Background and Objective: Acute type A aortic dissection (ATAAD) represents a critical and life-threatening condition requiring urgent surgical intervention, which is often life-saving. However, postoperative acute lung injury (ALI) has emerged as a prominent complication that significantly impacts patient outcomes and prognosis. This study aims to systematically analyze the risk factors associated with the development of severe ALI following ATAAD surgery, providing insights to improve postoperative management strategies. ⋯ ROC curve analysis revealed the diagnostic performance of preoperative OI, BMI, CRP, D-dimer, MHCA time, and CPB duration, with AUC values of 0.715, 0.844, 0.871, 0.955, 0.944, and 0.833, respectively (all P < 0.001). Conclusion: Preoperative oxygenation index, BMI, CRP, D-dimer levels, MHCA time, and CPB duration are independent risk factors for the development of severe ALI following ATAAD surgery. These findings underscore the importance of preoperative risk assessment and perioperative optimization to mitigate the risk of severe ALI and improve patient outcomes.
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Background: Antiepileptics and antidepressants are frequently prescribed for chronic pain, but their efficacy and potential adverse effects raise concerns, including dependency issues. Increased prescriptions, sometimes fraudulent, prompted reclassification of antiepileptics in some countries. Our aim is to comprehend opinions, perceptions, beliefs, and attitudes towards co-analgesics from online discussions on X (formerly known as Twitter), offering insights closer to reality than conventional surveys. ⋯ Non-medical content included challenges in dispensing (25%), complaints about high costs (15%), and trivialization of medication use (10%). Conclusions: This study offers valuable insights into public perceptions of co-analgesics. Findings aid in designing public health communications to raise awareness of associated risks, urging both healthcare providers and the public to optimize drug use.
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Background: The finger photoplethysmography fitness index (PPGF), a marker of peripheral vascular function, has been linked to heart rate (HR) variability. However, the influence of acute HR changes on resting PPGF, a purported indicator of local blood flow, remains unclear. Objective: This study aimed to determine the influence of acute HR changes on resting PPGF. ⋯ Conclusion: Our findings demonstrate that PPGF accurately reflects local blood flow, unaffected by short-term HR variations. This study supports the use of PPGF as a reliable marker for vascular health and age assessment, even in individuals with fluctuating HR, such as older adults with multiple comorbidities. Further research is warranted to establish the applicability of PPGF in younger, healthier populations.
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Objective: This research was designed to evaluate the efficacy and safety of ab-interno trabeculectomy (Trabectome and Kahook Dual Blade) combined with phacoemulsification, intraocular lens implantation, and goniosynechialysis in eyes with primary angle-closure glaucoma. Methods: A total of 47 patients were included in the study and all the patients received the combined surgery. Intraocular pressure, anti-glaucoma medications, best-corrected visual acuity, and the number of peripheral anterior synechiae quadrants were recorded at baseline and at various time points after surgery. ⋯ Best-corrected visual acuity improved from 0.39 ± 0.29 to 0.48 ± 0.34 at 1 month (P = 0.005). There were no vision‑threatening complications intraoperatively or postoperatively. Conclusion: The combined surgery has been proven to be effective and safe for patients with primary angle-closure glaucoma in the long term, suggesting that combined surgery may be beneficial for patients with primary angle-closure glaucoma, especially those with long-term and extensive peripheral anterior synechiae.
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RAC1, a member of the Rho family GTPases, has been implicated in various cancers, yet its pan-cancer landscape and role in the tumor immune microenvironment remain underexplored. This study presents a comprehensive analysis of RAC1 across 33 cancer types, revealing its high expression in a broad range of cancers and its association with poor prognosis. RAC1 expression correlates with genomic alterations, including CNVs, TMB, and MSI. ⋯ Functional enrichment analysis showed that high RAC1 expression is linked to lower enrichment in B cell activation and immune response pathways. Single-cell transcriptome analysis identified RAC1 expression primarily in epithelial cells, associated with tumor progression, and spatial transcriptome analysis showed a mutually exclusive co-localization between B cell infiltration regions and RAC1-expressing epithelial cells. Based on RAC1 expression and B cell interaction, a prognostic signature was established to predict prognosis at the pan-cancer level.