Journal of Clinical Medicine

Background/Objectives: The optimal intracoronary drug delivery strategy for the management of the no-reflow phenomenon (NRP) during percutaneous coronary intervention (PCI) remains uncertain. We compared distal and proximal intracoronary drug administration for the treatment of NRP. Methods: This retrospective single-center study included 212 consecutive patients who developed NRP following drug-…

Objectives: This study evaluated the association between maintenance therapy and survival outcomes following first-line bevacizumab-based combination chemotherapy in metastatic colorectal cancer (mCRC) using real-world data. Methods: This retrospective study included 94 mCRC patients achieving disease control, defined as complete response (CR), partial response (PR), or stable disease (SD), after…

Background: Severe obesity is a chronic condition that adversely affects physical health and quality of life, including sexual function. However, its impact on multidimensional psychosexual outcomes remains unexplored. This study aimed to assess changes in erectile function, genital self-image, and psychological distress in men who underwent bariatric surgery. Methods: This prospective cohort stu…

Objectives: This systematic review synthesized the existing literature to evaluate the associations between maternal Selenium (Se) exposure during pregnancy and neonatal outcomes, specifically focusing on parameters of mortality, morbidity, and neurobehavioral development. Methods: PubMed, Embase, and the Cochrane Library were systematically searched from inception through December 2025. For qual…

Background/Objectives: The implementation of tattoo-free radiotherapy (RT) for breast cancer reflects an effort to mitigate the psychological distress of permanent marks through surface-guided techniques, while simultaneously evaluating its utility in meeting setup precision requirements. Methods: In this prospective trial, patients were positioned for breast cancer RT including regional nodal ir…

Background/Objectives: This study aimed to evaluate whether artificial intelligence-derived vertebral volumetric bone mineral density (AI-vBMD) and paraspinal intermuscular adipose tissue (IMAT) ratio from routine computed tomography (CT) could identify moderate-to-severe vertebral compression fractures (VCFs) in breast cancer survivors, and whether paraspinal IMAT ratio and routinely available c…

Background: Kasai hepatoportoenterostomy (KPE) remains first-line therapy for biliary atresia(BA), yet the majority of patients will ultimately require liver transplantation. In centres where both KPE and paediatric liver transplantation are performed, KPE has been understood since the early 2000s as the first stage of a two-stage strategy, and the individual technical elements described here are…

Background/Objectives: Fetal hepatosplenomegaly is an uncommon but clinically significant prenatal finding associated with a wide range of heterogeneous conditions, including congenital infections, fetal anemia, genetic syndromes, metabolic disorders, and other, less common abnormalities. Because of its nonspecific presentation and diverse etiologies, it represents a diagnostic challenge that req…

Background/Objectives: Identifying geriatric hip fracture patients who will require postoperative intensive care unit (ICU) admission remains a clinical challenge. The American Society of Anesthesiologists Physical Status (ASA-PS) classification and the Clinical Frailty Scale (CFS) are both used in preoperative risk stratification, yet their comparative utility for this purpose has not been well …

Background: Coagulopathy in sepsis represents a dynamic continuum ranging from sepsis-induced coagulopathy (SIC) to disseminated intravascular coagulation (DIC), but its early evolution and clinical determinants remain poorly defined. Objectives: To assess the temporal dynamics of SIC and DIC and examine factors associated with their evolution during the early phases of sepsis. Methods: A prospec…

Background/Objectives: Postoperative infection is the leading cause of limb loss after microsurgical reconstruction of diabetic foot ulcers (DFUs), and povidone-iodine alone neither disrupts wound-bed biofilm nor penetrates hyperkeratotic debris. We assessed the feasibility of whole-field preoperative antisepsis with a pH-optimized sodium hypochlorite (NaOCl) cleanser applied before povidone-iodi…

Background/Objectives: Cisplatin is used as treatment for various malignant tumors; nevertheless, this anticancer drug frequently causes side effects such as renal damage and hypomagnesemia. Hypomagnesemia has been suggested to cause renal damage, and preventing hypomagnesemia through magnesium supplementation is necessary to continue treatment while maintaining treatment intensity. Although the …

Background/Objectives: Infertility is associated with considerable psychological distress and impaired quality of life; however, gender-related differences in these outcomes remain unclear. This study aimed to compare anxiety, depression, and fertility-related quality of life between women and men in infertile couples and to examine the relationships between psychological distress and fertility-s…

Background/Objectives: Cardiac comorbidities are increasingly common among liver transplant candidates, particularly those with metabolic dysfunction-associated steatohepatitis (MASH)-related cirrhosis. Although the Liver Transplant Comorbidity Index identifies coronary artery disease (CAD) as a predictor of post-transplant mortality, the impact of overall cardiac comorbidity burden on early outc…

Background/Objectives: Cardiac arrest and fluid, electrolyte, and acid–base disorders frequently coexist in critically ill patients and are associated with poor clinical outcomes. However, long-term population-level trends in mortality involving both conditions remain poorly characterized. This study evaluated temporal trends and demographic disparities in mortality involving cardiac arrest and f…

Background/Objectives: Infective endocarditis (IE) is a life-threatening cardiovascular infection with in-hospital mortality of 15–30% despite modern therapy. Contemporary IE demonstrates non-random valve involvement: aortic and mitral 35–45%, tricuspid 5–10% (30–50% in intravenous drug users [IVDU]), and pulmonary < 1%. These patterns implicate valve-specific anatomy and hemodynamics as centr…

Background: Computed tomography (CT)-derived body composition has emerged as a promising prognostic biomarker in pancreatic ductal adenocarcinoma (PDAC). However, most previous studies have relied on baseline measurements and evaluated either resected or metastatic disease separately. We aimed to investigate the prognostic significance of both baseline and longitudinal CT-derived body composition…

Background: Vaspin (SERPINA12) is an adipokine implicated in the regulation of insulin sensitivity and metabolic homeostasis. Evidence regarding its association with obesity-related metabolic disturbances remains inconsistent, and potential sex-specific differences are not fully understood. Methods: This cross-sectional study included 81 adults aged 30–60 years (38 women and 43 men), divided into…

Background/Objectives: Blunt thoracic aortic injury (BTAI) is a rare, highly lethal trauma typically occurring at the aortic isthmus. Advanced BTAI is primarily treated with thoracic endovascular aortic repair (TEVAR). Because emergent surgical debranching is rarely feasible, management depends heavily on patient anatomy, especially regarding the left subclavian artery (LSA). Patient-specific com…

Background: Evidence regarding the association between indocyanine green angiography (ICGA) use and flap necrosis remains inconsistent. This inconsistency may partly reflect differences in how studies define comparison groups, particularly whether classification is based on ICGA use or on whether ICGA findings informed the final intraoperative decision. We therefore compared flap necrosis primari…