Paulo Lopes, Georg Dutschke*, Cláudia Pereira, Elsa Belo, Diogo Morais, Paulo Caldeira, Filipa Barata, Emília Leitão, R Tato Marinho, Paula Peixe, José Vera and Rodrigo Coutinho
Published on: 9th September, 2024
The World Drug Report highlights that the prevalence of hepatitis C virus (HCV) is one of the leading causes of cirrhosis and hepatocellular carcinoma globally. This report estimates that HCV is responsible for the annual death of around 700,000 people due to liver disease and is associated with high levels of morbidity and mortality with high health and socio-economic costs. This exploratory study aims to evaluate the socio-economic return provided by HCV treatment of individuals integrated into the MOP developed by the NGO Ares do Pinhal in Portugal. Using the SROI (Social Return on Investment) methodology is estimated that for every euro invested in this program, the return for society is 3,75€. This is a significantly positive SROI value, highlighting the importance of this investment in the creation of monetized value for society, as well as to provide greater well-being to those who need it and to society as a whole.
Objectives: This study aims to introduce and differentiate between traditional craze lines and a newly identified type of line in enamel, termed an “internal craze line.” This novel classification enhances diagnostic precision and carries significant clinical implications for treatment strategies. The goal is to provide a clear description of these two types of lines, discuss their unique clinical implications, and highlight their differing appearances and staining characteristics, contributing to improved understanding and management of enamel anomalies.Method and materials: Four extracted teeth exhibiting visible and internal craze lines were selected and examined using a stereo microscope to observe the structural characteristics of the lines. Cross-sections of the coronal parts of the teeth were prepared to document the differences between traditional craze lines (extending from the dentin-enamel junction [DEJ] to the enamel surface) and internal craze lines (originating at the DEJ but terminating midway through the enamel). Additionally, intraoral observations were conducted under high magnification to identify the visual differences between the two types of lines, noting that traditional craze lines can be stained while internal craze lines cannot.Results: Microscopic examination revealed two distinct types of lines: traditional craze lines extending from the DEJ to the enamel surface and internal craze lines terminating within the enamel. Intraoral observations confirmed that these lines could be distinguished under high magnification. Traditional craze lines appear as continuous lines reaching the enamel surface and can be stained, whereas internal craze lines are shorter, do not extend to the surface, and cannot be stained.Conclusion: The identification of internal craze lines presents significant clinical implications. Differentiating between traditional and internal craze lines can enhance diagnostic accuracy and inform treatment decisions. Recognizing internal craze lines might indicate different etiologies or risk profiles compared to traditional craze lines, influencing preventive and therapeutic strategies in dental practice. Further research is needed to explore the prevalence, causes, and long-term impacts of internal craze lines.
Tapas K Makar, Joseph Bryant, Bosung Shim, Kaspar Keledjian, Harry Davis, Manik Ghosh, Ajay Koirala, Ishani Ghosh, Shreya Makar, Alonso Heredia, Malcolm Lane, J Marc Simard, Robert C Gallo, Volodymyr Gerzanich* and Istvan Merchenthaler*
Published on: 18th September, 2024
Treatment for HIV-associated neurocognitive disorders (HAND) remains elusive. 7,8-dihydroxyflavone (DHF), an analog of brain-derived neurotrophic factor (BDNF) and a high-affinity TrkB agonist, has been proposed as a viable therapeutic alternative to BDNF in crossing the Blood-Brain Barrier (BBB) and promoting growth, differentiation, maintenance, and survival of neurons. Here, we expand on our previous study investigating the therapeutic role of DHF on the cortical and hippocampal brain regions of the Tg26 mice, an animal model of HAND. We detected increased immunoreactivity for ion channels (SUR1, TRPM4) and the water channel aquaporin-4 (AQP4), suggesting an ionic and osmotic imbalance in the brains of Tg26 mice. Tg26 mice also exhibited loss of synaptic stability (SYN, SYP) and nicotinamide metabolism (NAMPT, SIRT1) that were associated with astrogliosis. Furthermore, Tg26 mice demonstrated increased iNOS and reduced HO-1/NRF2 expressions, implicating increased ER and oxidative stress. DHF treatment in Tg26 mice reversed these pathological changes. These data suggest crosstalk among TrkB, Akt, and related transcription factors (NF-κB, STAT3, and NRF2) as an underlying mechanism of Tg26-associated pathology in the brain. Finally, taken together with our prior study, these results further highlight a therapeutic role of DHF in promoting neuroprotection in HAND that may be applied in conjunction with current antiviral therapies.
This article examines the relationship between Premenstrual Dysphoric Disorder (PMDD), neurovascular dynamics, and sensory sensitivities in autistic women during menstruation. The redirection of blood flow to the uterus during the menstrual cycle has been found to exacerbate cerebral perfusion deficits in neurodivergent individuals, particularly in the Prefrontal Cortex (PFC), which contributes to the mood dysregulation and emotional instability characteristic of PMDD. Autistic women, who often exhibit heightened sensory sensitivities, experience intensified discomfort during menstruation, as sensory overload and altered pain perception compound the emotional challenges of PMDD. These findings emphasize the need for neurodivergent-friendly menstrual products that mitigate both physical and emotional discomfort. Additionally, innovations using biodegradable materials, smart fabrics, and custom-fit menstrual solutions are discussed as potential breakthroughs to improve the quality of life for autistic women managing PMDD. This research highlights the importance of addressing both neurobiological and sensory aspects when designing interventions for PMDD in neurodivergent populations.
The main rice-grown crop was found severely affected by sheath blight in the south Gujarat region. Sheath blight of rice symptoms were noticed on leaf blades and the sheath just above the water level. The isolation was done from infected parts and purified by the hyphal tip method on PDA which was maintained at 4 oC. The seven different panchgavya formulations of five cow products such as cow urine, dung, curd, ghee, and milk that designed as PG1, PG2, PG3, PG4, PG5, PG6, and PG7. The PG against test pathogen Rhizoctonia solani in vitro condition by the poisoned food technique and that tested at 2, 4, 6, 8, and 10 percent concentrations. It was observed that panchgavya were able to suppress the growth of R. solani. Among the different formulations, PG1 was significantly effective at all concentrations as compared to other PG formulations against R. solani.
Venous Thromboembolism (VTE) is a major public health concern, affecting approximately 900,000 people annually in the United States. In rare cases, a Patent Foramen Ovale (PFO) may allow a venous thrombus to cross into the arterial circulation, causing a paradoxical embolism. This case report presents a 46-year-old male who developed left renal artery stenosis after a paradoxical embolism, likely triggered by a prolonged flight and binge alcohol consumption. The patient was found to have a moderate-sized PFO and renal infarction, confirmed by imaging studies. Despite initial anticoagulation therapy and a planned stenting procedure, intraoperative findings revealed only mild stenosis, leading to cancellation of the stent placement. The patient ultimately underwent PFO closure with an Amplatzer Talisman device. This case underscores the diagnostic challenges in managing paradoxical embolism and the need for individualized treatment, particularly concerning anticoagulation duration, the decision for PFO closure, and post-procedural antithrombotic therapy. Further research is required to establish optimal management strategies for cryptogenic embolic events.
Flooding is a significant natural hazard impacting societies worldwide, with increasing severity in urbanized regions. This paper presents a case study of Lagos, Nigeria, examining flood risk management efforts in the city. The purpose is to evaluate the effectiveness of current strategies and suggest improvements for reducing the impacts of flooding. Findings highlight the roles of government and private stakeholders, as well as policy challenges. Recommendations for sustainable flood management practices are provided, with implications for other high-risk areas.
Neha Sahay*, Atia Aziz and SD Poddar and Suneeta Singh
Published on: 18th October, 2024
Previable Preterm Premature Rupture of Membranes (PPROM) before 24 weeks of gestation in dichorionic diamniotic (DCDA) twin pregnancies is a rare and challenging obstetric complication. Three cases are presented in this case series, all involving prolonged latency periods of 74, 98, and 158 days following membrane rupture. The management strategy employed was expectant, utilizing antibiotic prophylaxis and close monitoring to prevent infection. Neonatal outcomes varied, with pulmonary hypoplasia and respiratory distress observed in some cases. One twin from Case 2 died due to sepsis, while the remaining twins in all three instances survived after extended neonatal intensive care. This series highlights the potential for extended latency and favorable outcomes in select cases, though neonatal morbidity remains a significant risk, underscoring the need for individualized counseling and vigilant care.
Omaima Taie*, Najlaa Taie, Yassine Eddich and Hassan Chtata
Published on: 24th October, 2024
Pseudotumoral calcinosis (CPT) is a condition characterized by the deposition of calcium phosphate crystals in the periarticular tissues, forming large calcified masses. Although the pathophysiology of CPT is not fully understood, an increase in the calcium-phosphate product beyond the precipitation threshold and severe hyperparathyroidism appear to play a significant role. Treatment remains controversial, with surgical excision often recommended. We report a case of CPT in a 74-year-old diabetic patient undergoing chronic hemodialysis who experienced progressively worsening pain in the left hip for six months, along with mobility difficulties. A CT scan revealed a calcified mass on the posterior thigh, likely explaining the electric shock-like pain, as well as compression of the superficial femoral artery causing decubitus pain resembling critical limb ischemia. The biological assessment showed elevated calcium-phosphate levels and hyperparathyroidism. Surgical excision is not indicated due to the mass’s proximity to vascular and nerve structures. This case highlights the diagnostic and therapeutic challenges of CPT, emphasizing the need for iterative angioplasties, considering that this condition is rare in chronic hemodialysis patients with calcified periarticular masses.
Janusz Wolny, Radosław Strzałka* and Ireneusz Bugański
Published on: 25th October, 2024
The external force in the relativistic equation of motion can be separated into two components: Fr and Fp. The first is expressed by the physical force divided by the square of the relativistic Lorentz factor, i.e γ2. This force dominates for non-relativistic velocities and vanishes for velocities approaching the speed of light c. On the other hand, the second term increases from zero with increasing velocity and dominates for velocities close to c. It is then a purely relativistic component. The characteristic feature of this component is its zero power, Fp ⋅ v = 0, but it is responsible for the relativistic precession. The effect was confirmed by numerical solutions of the equation of motion. Relativistic formulas for the precession frequency for point objects moving in selected fields of central forces were also derived analytically. It has been shown that for weak gravitational interactions, the correction for relativistic precession is small, negligibly small for Earth, and relatively small, though measurable, for Mercury. In turn, for the microworld and electrostatic forces (e.g., for the hydrogen atom), relativistic precession can fundamentally affect the movement of the electron.
The SARS-CoV-2 pandemic, which began in late 2019, initially manifested with acute respiratory symptoms, including bilateral pneumonia, and later emerged as a systemic disease. This brief report assesses changes in the clinical profiles of psychiatric outpatients before, during, and after the pandemic’s most severe periods, focusing on mood, anxiety, and cognitive symptoms. Data from a private psychiatric facility in Rome reveal that both pandemic-related stressors and SARS-CoV-2 infection itself may contribute to enduring affective and cognitive symptoms in both older and younger adult subgroups. Notably, during the pandemic, older patients showed elevated psychopathology scores (BPRS-24) compared to younger individuals. In the post-pandemic period, younger adults exhibited increased positive symptoms on the PANSS Positive subscale, suggesting a gradual worsening in symptoms post-pandemic ( = 0.47). Cognitive assessments (MMSE and PM38) further highlighted fluctuating performance over time, with older adults showing two distinct declines during the pandemic and in 2024. This work underscores the importance of sustained mental health interventions to address the pandemic’s psychosocial and neuroinflammatory legacy. This perspective also considers new data on the CNS effects of “toxin-like peptides” synthesized by microbiome bacteria.
María Elena Trujillo Ortega, Selene Fernández Hernández, Montserrat Elemi García Hernández, Rolando Beltrán Figueroa, Francisco Martínez Castañeda, Claudia Itzel Vergara Zermeño, Sofía Lizeth Alcaráz Estrada, Elein Hernández Trujillo and Rosa Elena Sarmiento Silva*
Published on: 13th November, 2024
Porcine Epidemic Diarrhea Virus (PEDV) can infect pigs of any age, but the disease severity varies significantly, particularly affecting neonatal piglets due to their immature immune system. Various vaccination strategies have been questioned for their efficacy, especially since outbreaks have occurred even on vaccinated farms. Recent suggestions indicate that exposure to the virus may enhance the effectiveness of inactivated vaccines, highlighting the potential benefits of using attenuated viruses to generate immunity in sows without prior exposure. This study aimed to evaluate the humoral and cytokine responses in pregnant sows and their piglets after inoculation of affected piglet intestinal contents and a virus isolated. We measured immune parameters such as IL-12, IL-22, IgG, and IgA, as well as neutralizing antibodies in serum, colostrum, and milk. Notably, higher titers of neutralizing antibodies were found in sows immunized with the viral inoculum, while IL-12 and IL-22 levels showed no significant differences. Additionally, we assessed productive parameters like total piglets born, weaning mortality, average birth weight, and stillborn rates. The results indicated that sows treated with affected piglet intestinal contents had higher mortality (48.31%) and stillborn rates (20.96%) compared to those receiving the isolated virus (30.02% and 10.44%, respectively). These findings suggest that using an isolated virus can offer a safe, long-lasting, and specific immune response, underscoring the importance of thorough analysis of both systemic and mucosal immune responses against PEDV.
Seyed Hamed Mousavi*, Fateme Khorramroo and Hooman Minoonejad
Published on: 14th November, 2024
Excessive ankle stiffness can greatly impact mobility, leading to discomfort, difficulty in walking, and limited Range of Motion (ROM). We aimed to identify and address the symmetry of shank muscle strength, ankle passive stiffness, and plantar pressure distribution, in a patient with unilateral excessive ankle stiffness, utilizing Instrument-Assisted Soft Tissue Mobilization (IASTM) accompanied by Faradic Electrical Stimulation (FES).The patient’s muscle strength and ROM which had diminished due to 3.5 years of ankle immobilization post-rescue from amputation, underwent a 12-week program involving IASTM and FES. The plantar and dorsiflexion muscles’ torque, ROM, and plantar pressure were measured using an isokinetic and plantar distribution system before and after the intervention. Symmetry of muscle torque, ROM, and plantar pressure between two limbs were calculated for pre and post-test.Results indicated improvement in the ratio index of the concentric/eccentric dorsi- and plantar-flexion peak torque and dorsi- and plantar-flexion work, ROM, gait line length, and contact time after a 12-week intervention.The study suggests that IASTM and FES are effective interventions for restoring symmetry in a patient with post-operation complications, highlighting the need for further research on similar cases.
Narimane Kebieche*, Farzana Liakath Ali, Seungae Yim, Mohamed Ali, Claude Lambert and Rachid Soulimani
Published on: 15th November, 2024
Neurotoxicity is increasingly recognized as a critical factor impacting long-term health, with growing evidence linking it to both neurodevelopmental and neurodegenerative diseases. Pesticides, widely used in agriculture and industry, have emerged as significant contributors to neurotoxic risk, given their capacity to disrupt key neurodevelopmental processes at low exposure levels. As conventional animal models present limitations in interspecies translation, human-derived neuron-based in vitro screening strategies are urgently needed to assess potential toxicants accurately. Human-induced pluripotent stem cells (hiPSCs) offer an innovative and scalable source for human-specific neuronal models that complement traditional animal-based approaches and support the development of predictive assays for neurotoxicity. Recent various stem cell models, including 2D cultures, 3D organoids, and microfluidic systems, are now available, advancing predictive neurotoxicology by simulating key aspects of human neural development and function. With the integration of High-Throughput (HT) and High-Content (HC) screening methodologies, these hiPSC-based systems enable efficient, large-scale evaluation of chemical effects on neural cells, enhancing our ability to detect early biomarkers of neurotoxic effects. Identifying early biomarkers of neurotoxic is essential to developing therapeutic interventions before irreversible damage occurs. This is particularly crucial in the context of developmental neurotoxicity, where early exposure to toxicants can have lifelong consequences. This review specifically presents an in-depth overview of the current progress in hiPSC-derived neural models and their applications in neurotoxicity testing, with a specific focus on their utility in assessing pesticide-induced neurotoxicity. Emphasizing future research priorities, we highlight the potential of these models to transform predictive toxicology, offering more human-relevant assessments and advancing the field toward a more precise evaluation of environmental neurotoxicants.
Background: Atrial fibrillation (A-Fib) poses a significant clinical challenge, particularly in the elderly and those with hypertension. If A-Fib represents one stage in the spectrum of electrical degeneration caused by aging-induced remodeling of the left atrial wall, catheter ablation is not an essential treatment. The efficacy of Vaughan Williams Class IC drug in preventing the progression of multiple premature atrial contractions (mPAC) toward paroxysmal atrial fibrillation (PAF) and A-Fib in the earlier stage of histological change was investigated.Method and results: Group A (4 patients with mPAC) and Group B (9 patients with PAF) were treated with Class IC drugs. Treatment outcomes were compared between these two Groups and Group C (8 patients with chronic A-Fib). Follow-up assessments were performed to evaluate the maintenance of sinus rhythm. All mPAC patients maintained sinus rhythm during the follow-up period. In the PAF group, 8 out of 9 patients maintained their sinus rhythm. Conclusion: Early treatment with Class IC drugs shows promise in preventing the progression of A-Fib and maintaining sinus rhythm in patients with mPAC and PAF. These findings highlight the potential role of pharmacological therapy in delaying the onset of A-Fib, thereby improving clinical outcomes and reducing the need for invasive procedures such as ablation.
MT Manes*, A Mannarini, D Pavan, D Aschieri, G Khoury, B Scardovi, N Bruno, S Cocozza, D Gabrielli, Furio Colivicchi, Massimo Grimaldi and Fabrizio Oliva
Published on: 26th November, 2024
The increasing reliance on digital health services, particularly in light of recent global health crises, has highlighted the importance of eHealth literacy. This study explores the role of eHealth literacy in managing health outcomes, with a specific focus on gender disparities. Using data from the “Truck Tour-Banca del Cuore 2023” survey, which included 354 participants, we examined how integrated technology influences health monitoring and management strategies. Our findings underscore the critical role of eHealth literacy in improving health outcomes and reducing gender disparities, particularly in the context of digital health interventions.
Ajay B Gadicha*, Vijay B Gadicha, Mayur S Burange and ZI Khan
Published on: 11th December, 2024
Sleep disorders represent a significant public health concern due to their widespread prevalence, impact on overall health, and the economic burden they impose. These disorders encompass a broad spectrum of conditions, ranging from insomnia and obstructive sleep apnea (OSA) to narcolepsy, restless legs syndrome (RLS), and parasomnias. They are often associated with comorbidities such as cardiovascular diseases, metabolic dysfunctions, and mental health disorders, making their identification and management critical.The publication of this work is of high interest as it contributes to the expanding body of literature focused on understanding the complex interplay between sleep disorders and health outcomes. By presenting detailed case reports, this study provides valuable insights into the diagnostic challenges, treatment modalities, and potential avenues for personalized interventions in sleep medicine. Case reports are particularly important in this field as they shed light on unique presentations and rare conditions that might otherwise go unnoticed in large-scale epidemiological studies. From an epidemiological perspective, sleep disorders are highly prevalent globally. According to the World Health Organization (WHO), approximately 30% - 45% of the global population experiences sleep disturbances. Obstructive sleep apnea, for instance, affects nearly 1 billion individuals worldwide, with varying prevalence across age, gender, and geographic regions. Insomnia affects roughly 10% - 30% of adults, with rates as high as 50% - 60% in older populations.Meanwhile, narcolepsy, though rare, is estimated to affect 1 in 2,000 people in the general population. These statistics underscore the pressing need for enhanced diagnostic methods, improved treatment strategies, and comprehensive patient management. By detailing real-world cases, this publication aims to bridge the gap between clinical observations and broader scientific understanding. The insights gained from these case studies have the potential to inform future research directions, improve clinical practices, and ultimately enhance patient outcomes in sleep medicine.Sleep disorders affect millions of individuals globally, disrupting physical, mental, and emotional well-being. Conditions such as insomnia, obstructive sleep apnea (OSA), narcolepsy, and restless legs syndrome (RLS) are among the most studied. This paper examines the etiology, diagnosis, and management of sleep disorders, presenting detailed case reports and integrating relevant sleep study findings. Figures such as polysomnography (PSG) outputs and statistical trends provide visual insights into diagnostic and therapeutic interventions. Sleep disorders encompass a wide range of conditions that significantly disrupt sleep quality and overall well-being. Common disorders such as insomnia, obstructive sleep apnea (OSA), narcolepsy, and restless legs syndrome (RLS) affect millions globally, posing risks to physical health, mental stability, and cognitive performance. This study explores the clinical presentation, diagnostic approaches, and management of sleep disorders through the lens of detailed case reports and sleep study data.Polysomnography (PSG), the gold standard for sleep disorder diagnosis, plays a pivotal role in identifying abnormal sleep patterns, respiratory irregularities, and neural disruptions. Multiple sleep latency tests (MSLT) and actigraphy complement PSG, offering insights into disorders like narcolepsy and circadian rhythm abnormalities. This paper presents three representative case reports: chronic insomnia, severe OSA, and narcolepsy with cataplexy. Each case is analyzed in-depth, highlighting patient history, PSG findings, treatment interventions, and outcomes. For chronic insomnia, cognitive-behavioral therapy for insomnia (CBT-I) and pharmacological intervention resulted in marked improvements in sleep latency and efficiency. In the OSA case, continuous positive airway pressure (CPAP) therapy significantly reduced the apnea-hypopnea index (AHI) and alleviated daytime symptoms. The narcolepsy case demonstrates the efficacy of modafinil and sodium oxybate in managing excessive daytime sleepiness and cataplexy.Despite advancements, challenges persist in the field, including patient adherence to therapy, accessibility to specialized sleep studies, and the ethical implications of AI-driven diagnostic tools. Future research should focus on scalable, patient-centric approaches and the role of emerging technologies in enhancing diagnostic accuracy and treatment efficacy. This paper aims to contribute to the evolving understanding of sleep disorders, bridging clinical case insights with the broader implications for sleep health and research.
Thiago Magalhães Resende*, Renata Albuquerque de Pino Maranhão, Ana Luisa Soares de Miranda, Lorenzo GTM Segabinazzi and Priscila Fantini
Published on: 10th December, 2024
This review aims to emphasize the scientific focus on platelet therapies by presenting the results already obtained in mares susceptible to Persistent Breeding-Induced Endometritis (PBIE), as well as highlighting opportunities for further improvement. The recent publication demonstrating the absence of bacterial growth in susceptible mares treated with PRP underscores the potential of regenerative therapies to control infections without promoting the emergence of multidrug-resistant bacteria. Alternative therapies have gained prominence in the current public health context, with the World Health Organization listing antimicrobial resistance among the ten most significant global threats. Endometritis is the leading cause of subfertility in mares, and empirical antibiotic therapies are commonly used in the field due to market pressures related to the high financial value of embryos, along with logistical challenges in obtaining laboratory-dependent diagnostic results. Platelet-Rich Plasma (PRP) is an alternative therapy derived from whole blood plasma with a high concentration of platelets. Its anti-inflammatory, regenerative, and antimicrobial properties are particularly tested when traditional therapies fail to achieve the desired effect. In recent years, research on the use of PRP in equine reproduction has primarily focused on endometritis, with a particular emphasis on persistent breeding-induced endometritis (PBIE). However, there is a growing interest in other platelet derivatives, such as lyophilized platelet-rich plasma and platelet lysate, which offer practical field applications.
The psychophysical impact of a high-complexity environment such as the dental office is not a novelty. This article outlines the organizational and human factors that impact the overall health of dentists, assistants, hygienists, and administrative staff. A careless organizational and human factors approach cannot only function as a stress and error trigger but also affect the highly precise requirements of dentistry and task performance in the daily demands of the office. Ergonomics and human factors principles guidelines should be structured and taught from the basics in dental schools and supported by prevention programs and interventions in the dental professional field, as in other industries, to promote safety, health, and efficiency within the integration of humans, systems, and environments.Usually, the main focus of dentistry research is the physical aspect of the job; the high rates of musculoskeletal disorders are a real problem, but the cognitive-organizational element of the job is not a minimal issue, which highly contributes to physical-emotional exhaustion in the work environment.A fatigued mind impacts the physical aspect of the job, and physical fatigue impacts the mental aspect of the job. This dual effect in a job that requires dealing with anxiety and fear patients, administrative situations in the office, financial aspects, and technical and skill aspects from the dentist, among other requirements, makes dentistry a unique profession.This article addresses the components of the factors that promote cognitive depletion in our field and provides simple tips on controlling them to avoid burnout among dentists. It highlights the importance of awareness of how we manage the organization in the office and the effect on human behavior and performance. It wants to bring to light a common problem for dental practitioners and the workforce to prevent health and performance decrease.
Zeynep Kumral, Halil İbrahim Yıldırım, Yağmur Kurşun, Fatmanur Kodal and Mehmet Kış
Published on: 16th December, 2024
Objective: Current guidelines favour radial access (TRA) over femoral access (TFA) for percutaneous coronary interventions due to lower bleeding risks and quicker patient recovery. This study compares patient satisfaction and complications between the two methods to identify the most suitable access route in coronary angiography (CAG).Materials and methods: A total of 152 patients who underwent CAG between February and June 2024 at our clinic were included. The operator and patient made access site decisions. Patients were surveyed 24 hours post-procedure, and complications were tracked for one month. The primary endpoint was patient satisfaction, while complications were classified as minor and major bleeding, pseudoaneurysm, hematoma, and spasm.Results: Of the 152 patients, 33% (n = 50) underwent TRA and 67% (n = 102) underwent TFA. Minor bleeding occurred in 16% (n = 24) and major bleeding in 0.02% (n = 3) patients. Pre-procedure anxiety, satisfaction with the access method, and awareness of TRA showed no significant differences between groups. However, post-procedure pain was higher in the TRA group (46% vs. 15%, p < 0.001), and systolic blood pressure was slightly elevated in the TRA group. Anxiety was more common in females, while elderly and obese patients showed no significant differences in bleeding or complications.Conclusion: Despite TRA’s benefits, no significant difference in satisfaction between TRA and TFA was observed. Patient preferences, radial artery spasms in females, and improved TFA techniques may influence outcomes. A shared decision-making process between operator and patient seems optimal for access site choice, with further investigation into patient satisfaction factors warranted.
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