Hypertensive disorders in pregnancy remain a leading cause of maternal and perinatal morbidity and mortality globally, affecting approximately 5-10% of pregnancies according to WHO estimates. This systematic review evaluates the efficacy and safety of acupressure as a nonpharmacological intervention for managing hypertension in pregnant women. Following PRISMA guidelines, a comprehensive search of Scopus, PubMed, and Web of Science databases from 2010 to 2023 retrieved 285 records.. Quantitative and qualitative analyses were conducted based on the PICO framework to assess intervention effectiveness. Acupressure applied at key points LI4 (Hegu), ST36 (Zusanli), SP6 (Sanyinjiao), and auricular sites such as Shenmen demonstrated statistically significant reductions in systolic (10-15 mmHg) and diastolic (5-8 mmHg) blood pressure (p < 0.05). This review highlights the opportunity to incorporate acupressure into community-based maternal health services, especially in low-resource settings where access to pharmacologic treatment may be limited. However, the development of standardized clinical protocols, professional training programs, and long-term outcome evaluations is essential before widespread clinical adoption.

Age-related macular degeneration (AMD) is a leading cause of central vision loss involving retinal microvascular dysfunction. Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), a hereditary small vessel disease caused by NOTCH3 mutations, primarily affects the cerebral vasculature but may also involve the retinal microvasculature. This study investigated the association between the NOTCH3 R544C variant and AMD using the Taiwan Biobank and validated the findings in a hospital-based cohort.

In the Taiwan Biobank, individuals carrying the NOTCH3 R544C variant were matched with noncarriers (1:10) by demographic and cardiovascular factors. Odds ratios (ORs) for self-reported AMD and other eye diseases were calculated. Validation was performed in the Taiwan-Associated Genetic and Non-Genetic Small Vessel Disease (TAG-SVD) cohort, including 64 NOTCH3 R544C carriers and 84 age-matched controls who underwent ophthalmic evaluation.

In the Taiwan Biobank, NOTCH3 R544C carriers (n = 1134) had higher prevalence rates of stroke (OR = 2.23; 95% confidence interval [CI], 1.30-3.84), family history of stroke (OR = 2.05; 95% CI, 1.78-2.35), and AMD (OR = 2.26; 95% CI, 1.38-3.71) compared with matched controls (n = 11,340), but not of other eye diseases. Individuals with AMD were older and more likely to have diabetes, higher fasting glucose, HbA1c, total cholesterol, and low-density lipoprotein levels. Multivariate analysis identified age (OR = 1.06; 95% CI, 1.01-1.11) and diabetes (OR = 5.51; 95% CI, 1.84-14.79) as independent correlates. In the TAG-SVD cohort, AMD prevalence was higher in carriers (23.4%) than in controls (13.1%), although not statistically significant (P = 0.10).

The NOTCH3 R544C variant may be associated with an increased risk of AMD, warranting further studies to clarify the underlying mechanisms.

To compare perioperative outcomes between resuscitative endovascular balloon occlusion of the aorta (REBOA) and non-REBOA management in ruptured abdominal aortic aneurysm (rAAA) repair, and to perform an exploratory comparison of REBOA outcomes between open surgical repair (OSR) and endovascular aortic repair (EVAR).

A retrospective analysis was conducted of 107 consecutive rAAA patients (2013-2022), stratified by surgical approach (OSR vs EVAR) and REBOA utilization. Propensity score matching (1:2) was performed based on preoperative shock, comorbidities, and aneurysm morphology, yielding 22 REBOA and 44 non-REBOA patients. Outcomes were compared statistically.

Resuscitative endovascular balloon occlusion of the aorta was utilized in 22 patients (10/45 [22.2%] OSR and 12/62 [19.4%] EVAR), with a 100% technical success rate. One Clavien-Dindo grade I access site hematoma occurred (4.5%). No instances of aortic injury, distal embolization, limb ischemia, or balloon failure were observed. After matching, 30-day mortality did not differ significantly (13.6% vs 22.7%, p=0.555). Resuscitative endovascular balloon occlusion of the aorta was associated with a significantly reduced rate of major adverse cardiovascular event (MACE) (4.5% vs 20.5%, p=0.043) and a higher intraoperative diastolic blood pressure (BP) (mean difference+6.7 mm Hg, p=0.031). Blood loss, intensive care unit stay length, and costs were comparable between groups. Long-term survival was similar (log-rank p=0.375). In an exploratory analysis, outcomes between REBOA-OSR (n=10) and REBOA-EVAR (n=12) subgroups showed no significant differences in mortality or MACE, although this analysis was underpowered.

Resuscitative endovascular balloon occlusion of the aorta demonstrated high technical success and an excellent safety profile in rAAA repair. Its use was associated with improved intraoperative hemodynamic stability (higher diastolic BP) and a reduced rate of MACE, although it did not significantly impact mortality or survival. Larger, prospective trials are warranted to confirm the observed reduction in MACE. The comparative outcomes of REBOA in OSR versus EVAR settings remain inconclusive due to the limited sample size.Clinical ImpactThis study demonstrates that resuscitative endovascular balloon occlusion of the aorta (REBOA) in ruptured abdominal aortic aneurysm (rAAA) repair is safe and feasible, and is associated with improved intraoperative hemodynamics and reduced major adverse cardiovascular events. For clinicians, these findings support its use for unstable rAAA patients, particularly those with refractory shock or challenging anatomy. Resuscitative endovascular balloon occlusion of the aorta may serve as both a resuscitative and a cardioprotective strategy by augmenting coronary perfusion. The innovation lies in validating its contemporary safety and proposing a mechanism for cardiac benefits, potentially changing risk-benefit assessments in emergency aortic surgery.

Heart failure (HF) remains a major public health challenge in India, with a need for effective and well-tolerated therapeutic strategies.

The RESTORE-HF study evaluated the real-world effectiveness and safety of torsemide-spironolactone fixed-dose combination (FDC) in Indian patients with HF.

Prospective, multicenter, observational study.

This study was conducted across 101 sites in India. Patients aged 18-75 years with HF with reduced ejection fraction and signs of congestion were enrolled and initiated on the torsemide-spironolactone FDC. Participants were followed over 3 weeks from baseline. The primary objective was the change in body weight. Secondary endpoints included changes in New York Heart Association (NYHA) functional class, edema, occurrence of adverse events (AEs), and physician and patient assessments of efficacy and tolerability.

Of the 1841 patients screened, 1752 were enrolled, and 1520 completed the study. The mean (SD) age of participants was 58.61 (9.45) years, of whom 61.05% were male. The study showed a significant reduction in mean body weight was observed from 75.54 kg at baseline to 73.13 kg at week 3 (mean difference: 2.41 kg; p < 0.0001). Additionally, an improvement in NYHA functional class and edema was observed over 3 weeks from baseline. Overall, 22.11% patients achieved no-edema stage. Only three mild AEs related to loose stools were reported, and no serious AEs or deaths occurred. Over 98% of physicians and patients rated the therapy favorably.

The RESTORE-HF study demonstrated that the torsemide-spironolactone FDC may be associated with a mean body weight reduction of 2.41 kg and may be generally well-tolerated in Indian heart failure patients. Furthermore, the FDC may be linked to significant symptomatic improvement over 3 weeks in real-world clinical practice.

Venous leg ulcers (VLU) are a major complication of chronic venous disease, with compression therapy as the gold-standard treatment. This 2 × 2 factorial randomised open-label trial assessed the effect and three-month sustainability of a one-hour training intervention on compression bandaging quality among 50 advanced practice nursing students (APNS) in France, using two different compression bandage types (system A or system B) on a mannequin leg. The primary outcome was the Control Score of compression bandaging (CCB score, 0-7). Secondary outcomes included installation conformity, application time, and satisfaction. At baseline, mean CCB score was 3.78, with 52% installation conformity. The intervention did not significantly improve the CCB score compared to controls (adjusted difference: -0.43; 95% CI: -1.01 to 0.15). A significant interaction between bandage type and intervention was found for installation conformity: a tendency to improve with system B and decrease with system A. Improvements observed at 1 month were not sustained at 3 months. Application time decreased over follow-up, and system B was applied more efficiently than system A. Brief, behaviourist-based training was insufficient to achieve lasting skill improvement. Findings highlight the need for repeated group practice, feedback, and integration into relevant clinical contexts to enhance compression bandaging proficiency.

To measure and compare the temporal variations in sub-bandage pressure compression systems in the Andalusian Health System (SAS). Additional objectives included assessing the relationship between pressure and healing, analysing the influence of the healthcare professional applying the bandage, and determining bandage stiffness. This prospective observational and multicentre study included 140 patients with active VLUs in Andalusia. Sub-bandage pressures were measured at three anatomical points in the leg for 96 h, under different positions and activities. The bandage application technique was standardised through specific training provided to advanced practice nurses. The initial pressures were higher than those recommended by guidelines, but showed a notable reduction within the first 24 h, stabilising within therapeutic ranges for the remainder of the 96-h study period. Most systems showed low dynamic and static stiffness. No significant pressure differences were found attributable to the nurses or the location of the injury. The observed pressure dynamics, initially high, with a subsequent drop and final stabilisation, suggest a high material settlement or application to compensate for the expected loss. The sustained pressure stability confirms the effectiveness of the systems over 96 h.

Post-stroke psychiatric disorders (PSPD), including depression, anxiety, and cognitive impairment, significantly hinder stroke survivors' rehabilitation and quality of life, with traditional interventions often showing limited efficacy. Brain-computer interface (BCI) technology has emerged as a promising tool for neurological regulation and rehabilitation, showing substantial potential in PSPD assessment and intervention. This narrative review comprehensively synthesizes the latest research advances in BCI applications for PSPD, covering underlying mechanisms, principal applications, clinical studies, technical challenges, and prospective directions. It highlights BCI's substantial potential in objective assessment, targeted neuromodulation, and promotion of neuroplasticity, while also addressing unresolved issues such as heterogeneous patient responses, technical limitations, and integration into routine clinical practice. By integrating current evidence and clarifying both achievements and gaps, this review provides theoretical insights and practical guidance for future basic and clinical research in the field.

As an initial therapy for Kawasaki disease, high-dose intravenous immunoglobulin (IVIG) is recommended. It is known that intravenous immunoglobulins are associated with hemolytic anemia. However, little is known about hemolytic anemia in Kawasaki disease (KD) patients treated with IVIG. This study was designed to investigate the incidence of hemolytic anemia and factors associated with the development of hemolysis in KD patients treated with IVIG.

We performed a 3-year single-center prospective study enrolling 105 KD patients treated with IVIG from January 2021 to May 2024 at Chungnam National University Hospital. Clinical characteristics and laboratory data were collected and analyzed. Hemolytic anemia was defined as a drop in hemoglobin levels or worsening of anemia after IVIG infusion greater than or equal to 2 g/dL with supporting biochemical studies.

Fifteen percent of KD patients (16/105) developed hemolytic anemia post-IVIG. Increased IVIG dose, prolonged duration of fever, high pre- and post-IVIG white blood cell counts, non-O blood groups, NT-ProBNP, and refractory KD were significantly associated with the hemolysis group (p < 0.05). However, erythrocyte sedimentation rate (ESR), C-reactive protein, and iron deficiency anemia parameters were not significant between the two groups.

This study suggests that a non-O blood group, a higher cumulative IVIG dose, elevated NT-ProBNP levels, and increased white blood cell counts may be associated with an increased risk of hemolysis following IVIG therapy. These findings are hypothesis-generating and support the need for closer monitoring and further investigation in larger, controlled studies.

Young and middle-aged patients with coronary heart disease who have undergone percutaneous coronary intervention often find it difficult to participate in secondary cardiac rehabilitation. This study examines patient experiences in cardiac rehabilitation using health empowerment theory as a framework. Purposive sampling was used to collect data through semi-structured interviews, which were analysed using Colaizzi's phenomenological approach. Five themes emerged from the data: (1) Personal growth, (2) Self-acceptance, (3) Life Purpose and motivation, (4) Social support, and (5) Utilisation of social services. The findings are consistent with all dimensions of health empowerment theory. The results of the study emphasise the importance of individualised empowerment and highlight the need to address the requirements for cardiac rehabilitation benefits, providing a new perspective for improving cardiac rehabilitation intervention programmes.

Alcohol consumption above recommended limits has been associated with increased cardiovascular disease (CVD) risk in observational studies. In particular, little is known about the association between high-risk drinking and cardiovascular health (CVH), as assessed by the American Heart Association's Life's Essential 8 (LE8) health metrics, in the context of community-based population datasets. Therefore, this study aimed to determine the relationship between high-risk drinking and CVH status using data from the 2016-2021 Korea National Health and Nutrition Examination Survey (KNHANES).

Cross-sectional secondary analysis study.

The 2016-2021 KNHANES.

This analysis included 18 500 adults aged 19 years or older.

High-risk drinking was defined as consuming seven or more drinks (or five cans of beer) in one sitting for men, and five or more drinks (or three cans of beer) for women, at least once a month. The frequency of high-risk drinking was categorised as follows: 'rarely or never', 'less than once per month', 'at least once per month', 'once a week' or 'nearly daily'. We calculated an LE8 score for each of eight composite metrics, with each metric ranging from 0 to 100. LE8 total scores were categorised as 0-49, 50-79 and 80-100, representing low, moderate and high CVH, respectively. We used weighted log-linear regression models to analyse the relationship between high-risk drinking and CVH.

Nearly daily or weekly high-risk drinking was reported by 37.3% of men and 14.7% of women. The mean CVH score of groups with more frequent high-risk drinking decreased linearly in both sexes. Using the 'nearly daily' drinking group as the reference group, the exponential coefficients (exp(B)) showed that the total CVH score increased progressively as the frequency of high-risk drinking decreased in both men and women. Compared with the 'nearly daily' group, the total CVH score was 5% higher in the 'once a week' group (exp(B)=1.05, p<0.001) and 14% higher in the 'rarely or never' group (exp(B)=1.14, p<0.001) for men. Similar trends were observed for female participants (once a week: exp(B)=1.04, p<0.001; rarely or never: exp(B)=1.13, p<0.001).

This study found that high-risk drinking was negatively associated with ideal CVH in Korean adults, and this association showed sex differences. Interventions targeting high-risk drinking may be more effective than focusing on overall alcohol consumption.