Home Uterine fibroid embolization: An analysis of clinical outcomes and impact on patients’ quality of life
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Uterine fibroid embolization: An analysis of clinical outcomes and impact on patients’ quality of life

  • Nicolò Ubaldi , Marcello Andrea Tipaldi EMAIL logo , Andrea Giannini , Tullio Golia D’Augè , Donatella Caserta , Antonio Simone Laganà , Giacomo Grasso , Aleksejs Zolovkins , Edoardo Ronconi and Michele Rossi
Published/Copyright: August 7, 2025

Abstract

Background

Uterine fibroids (UF) affect up to 70–80% of women by age 50 and are associated with heavy menstrual bleedings, pelvic discomfort, and reduced quality of life. Uterine artery embolization (UAE) is a minimally invasive procedure that aims to reduce fibroid-related symptoms and improve patients’ quality of life.

Materials and methods

A prospective single-center study was conducted on 40 women who underwent UAE between November 2018 and June 2023. Primary outcomes were evaluated using the Uterine Fibroid Symptom and Quality-of-Life (UFS-QoL) questionnaire to assess symptom severity and health-related quality-of-life scores. Secondary outcomes include pain intensity, complications, requirement of additional treatments, and duration of symptoms after discharge.

Results

Thirty-three patients completed the follow-up UFS-QoL questionnaire. The mean age and the mean follow-up time were 47 years (SD 14 years) and 10 months (SD 4 months), respectively. Substantial improvements were observed within all domains of the UFS-QoL questionnaire (p < 0.001), particularly in symptom severity, where 94% of patients experienced a benefit. All Health Related Quality-of-Life (HRQL) domains statistically significantly improved (73–91%; p < 0.001). 67% of patients did not require further treatments. Pelvic pain, according to VAS, improved by 2.1 (0 = much better; 5 = no change; 10 = worse). Post-procedural complications were minor, 70% of patients reported symptoms persisted up to 5 days after discharge, and 88% resolved within 2 weeks. Despite a 45.5% rate of minor complications, including pain and transitory bleeding, 88% of patients would recommend UAE, underlining its safety and effectiveness.

Discussion and conclusion

UAE offers substantial benefits for symptomatic fibroids, significantly improving HRQoL, symptom severity and pelvic pain scores, making it a valuable alternative to surgery. Complications were minor and short-lived, and the majority of patients were satisfied with the results, with no need for additional treatments. Further research is warranted to generate peri-procedural pain management consensus guidelines, clinical outcomes of radial access, and fertility-related outcomes.

1 Introduction

Uterine fibroids (UF), the most common benign tumors in reproductive-aged women, affect 70–80% of women by age 50 and significantly impact the quality of life through symptoms such as menorrhagia, pelvic pain, and fertility challenges [1,2,3,4]. Many fibroids regress post-menopause; thus, observant waiting is viable for perimenopause patients with manageable symptoms. Despite the availability of various treatments, the global need for minimally invasive alternatives to surgery remains unmet.

Uterine artery embolization (UAE), first described in 1995, has emerged as a minimally invasive, valuable option, but data on its long-term efficacy and global applicability are limited [5]. Arterial access is typically through the common femoral artery or left radial artery, the latter being associated with improved post-procedural pain management [6]. Some prefer bilateral femoral access for embolizing both uterine arteries, which is theoretically correlated with a reduced time of the procedure [7]. Notably, UAE shares technical principles with hemorrhoidal artery embolization, a minimally invasive technique that has gained attention for its promising outcomes in treating hemorrhoidal disease [8]. Both procedures rely on selective arterial embolization to reduce vascular supply to the pathological tissue, leading to symptom relief and long-term control. The technical success rate of UAE is very high (>95%), depending on the tortuous anatomy, leading to a measurable elimination of abnormal uterine bleeding associated with fibroids in over 90% of treated women, a substantial improvement in subjective mass symptoms, and an 80–90% satisfaction rate among treated women [9,10].

Compared to surgical alternatives, UAE involves less blood loss, shorter hospital stays, less expensive procedures, and shorter recovery time [11]. The “FEMME” trial, which randomized 127 patients to myomectomy and 127 to UAE, assessed health-related quality of life using the Uterine Fibroid Symptom and Qualityof-Life (UFS-QoL) questionnaire [12]. At the two-year mark, myomectomy showed significantly better quality of life (p = 0.01), also related to the higher re-intervention rate associated with UAE (15–32% compared to 7% for surgery), despite a higher complication rate and longer hospital stays. However, by 4 years, there were no significant differences in quality of life between the two groups, and pregnancy rates were comparable for both treatments. A lower rate of complications may balance out the initial cost-benefit advantages of UAE over surgical treatment [11].

This study aims to assess the effectiveness of UAE treatment on health-related quality of life (HRQL) and symptom severity, according to the UFS-QoL questionnaire, along with other secondary outcomes, in patients with symptomatic UF.

2 Materials and methods

2.1 Study design

A prospective single-center single-cohort study was conducted. Data were collected over 5 years, from November 2018 to June 2023, involving a cohort of 40 patients with uterine fibromatosis, who underwent UAE at the Interventional Radiology Unit of Sant’Andrea Hospital in Rome, Italy. The diagnosis and evaluation of UF in women aged 25–55 years with symptomatic fibroids typically involves a thorough medical history, pelvic examination, and magnetic resonance imaging. Exclusion criteria encompassed pelvic infections or inflammatory disease, active cancer, pregnancy, significant adenomyosis, or contraindications to UAE. The mean age was 50 years ±11, the median parity was 1, the location of the largest fibroid was 2 (5%) in the submucosa, 8 (20%) in the subserosa, 27 (67.5%) in the muscle wall, and 3 (7.5%) were missing. The largest fibroid was <7 cm in 17 (42.4%) and >7 cm in 23 (57.5%), and the mean was 9 cm ± 3 cm. Follow-up was conducted in the time interval between 6- and 12-month post-procedure, assessing symptom severity and HRQL using the UFS-QoL questionnaire and the visual analogue scale (VAS). All methods or experimental protocols were approved by the local Institutional Review Board, and data were collected in accordance with the 1964 Helsinki declaration and its later modifications.

2.2 Outcome measures

The primary outcome was to compare the quality of life and symptom severity before UAE and at least 6 months after UAE, using the UFS-QoL questionnaire. The UFS-QoL questionnaire, developed by Spies et al. [13], is a validated 37-question survey designed to evaluate the severity of symptoms and health-related quality of life in patients with UF. The first eight questions are related to the domain of “Symptom Severity,” whilst the remaining 29 questions are related to the other six domains grouped under HRQL. Quality of life was assessed using the validated UFS-QoL questionnaire, which includes symptom severity and HRQoL domains. Raw scores were summed within each domain and transformed into a 0–100 scale, following the standardized scoring procedure. Higher scores indicate greater symptom severity (Symptom Severity Scale) and better quality of life (HRQoL subscales). No weighting was applied to individual domains. Score interpretation followed standard guidelines established in previous validation studies.

Other secondary outcomes were evaluated using a follow-up questionnaire, which included additional questions on pregnancies and spontaneous abortions before and after treatment. The questionnaire also assessed procedural characteristics such as complications, improvement in pelvic pain intensity (0–10 VAS scale), duration of symptoms after discharge, the need for additional treatments, and overall satisfaction with the treatment. The Numerical Pain Rating Scale (NPRS) was assessed in the short-term period in the hospital post-procedure.

2.3 Statistical analysis

Data were analyzed using SPSS version 27. Normality was tested with Kolmogorov–Smirnov and Shapiro–Wilk tests, followed by Wilcoxon signed-rank tests for non-parametric comparisons and chi-squared tests for categorical variables.

3 Results

3.1 Population

Out of the initial cohort of 40 patients, 7 patients were lost, leaving 33 patients who completed the UFS-QoL questionnaire before and after the procedure (Figure 1). Reasons for loss to follow-up included lack of response to follow-up communications, refusal post-procedure questionnaire completion and relocation. No specific patterns regarding baseline characteristics (such as age, baseline fibroid size, or symptom severity) were identified among those lost to follow-up compared to the overall study population. The mean follow-up time was 10 months (SD 4 months). In the final population, the mean age was 47 years ±14 (SD 6), and the majority of the women (85%) were in pre-menopause. The mean size of the largest fibroid was 8 cm ± 3.0, and the median IQR of the number of fibroids was 3 (1–5) (Table 1).

Figure 1 
                  Flowchart of the study population selection.
Figure 1

Flowchart of the study population selection.

Table 1

Baseline characteristics of the analyzed population UAE (N = 33)

Characteristic UAE (N = 33)
Age, year 47 ± 14 (SD 6)
Parity median (mean) 0.0
Gravidity median (mean) 0.0
Fertility Status
Pre-menopause 28
Post-menopause 5
Location of largest fibroid with MRI – no. (%)
Submucosa 1 (3.0%)
Subserosa 10 (30.3%)
Muscle wall 22 (66.7%)
Data missing 0 (0%)
Largest dimension of largest fibroid – no. (%)
≤7 cm 13 (39.4%)
>7 cm 20 (60.6%)
Mean, cm 8 ± 3.0
No. of fibroids, no. (%)
1–3 13 (39.4%)
4–10 9 (27.3%)
>10 11 (33.3%)
Median (IQR) 4 (1–5)

3.2 Primary outcome results

The raw domain-specific scores assessed by the UFS-QoL questionnaire are presented in Table 2. UFS-QoL scores are provided in percentages for each domain and the HRQL TOTAL score. Higher scores in “Symptom Severity” indicate greater symptom intensity, while higher scores in HRQL domains indicate better health-related quality of life.

Table 2

Raw pre- and post-treatment scores by the UFS-QoL questionnaire

Domain Score
Symptom severity before 66
Symptom severity after 26
Concern before 81
Concern after 33
Activities before 40
Activities after 82
Energy before 38
Energy after 79
Control before 43
Control after 87
Self-conscious before 61
Self-conscious after 86
Sexual function before 40
Sexual function after 75
HRQL-total before 40
HRQL-total after 81

Using the Wilcoxon signed-rank test, pre- and post-treatment questionnaire scores for each domain were compared, and all domains showed significant improvements (Table 3):

  1. Negative ranks indicate higher pre-treatment scores, compared to post-treatment scores, suggesting symptom reduction.

  2. Positive ranks indicate higher post-treatment scores, compared to pre-treatment scores, suggesting improved quality of life.

  3. Even indicate unchanged scores.

Table 3

UFS-QoL outcomes presented according to positive rank and negative rank scores

N Average rank Sum of the ranks
Symptom severity after – symptom severity before Negative rank 31 17.70 550
Positive rank 2 5.50 11
Even 0
Total 33
Concern after – concern before Negative rank 2 1.75 3.50
Positive rank 26 15.48 402.50
Even 5
Total 33
Activities after – activities before Negative rank 0 0 0
Positive rank 28 14.5 406
Even 5
Total 33
Energy after – energy before Negative rank 0 0 0
Positive rank 30 15.5 465
Even 3
Total 33
Control after – control before Negative rank 2 1.75 3,5
Positive rank 29 16.98 492.5
Even 2
Total 33
Self-conscious after – self-conscious before Negative rank 2 3.75 7.50
Positive rank 25 14.8 370.5
Even 6
Total 33
Sexual function after – sexual function before Negative rank 3 7 21
Positive rank 24 14.88 357
Even 6
Total 33
HRQL total after – HRQL total before Negative rank 0 0 0
Positive rank 33 17 561
Even 0
Total 33

The statistical analysis showed significant frequency variations in scores between pre- and post-treatment, with p < 0.001 for all comparisons (Table 4).

Table 4

Pre- and post-treatment UFS-QoL scores comparison

Sy. after – Sy. before Conc. after – Conc. before A. after – A. before E. after – E. before Cont. after – Cont. before Self. after – Self. before Sex. after – Sex. before HRQL after – HRQL before
Z −4,815 −4,546 −4,623 −4,784 −4,794 −4,369 −4,050 −5,012
Sign. asint. <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001

3.3 Secondary outcome results

Major complications were not observed. Adverse effects were managed conservatively with simple analgesia medications and eventually resolved in all cases.

Fifteen patients (45.5%) had adverse effects related to the UAE procedure: the most frequent were intense pain (11 patients), prolonged menstrual bleeding (2 patients), and fever (2 patients). Post-embolization syndrome (PES) was present in 39% of patients.

The NPRS was performed during hospitalization to assess short-term post-procedural pain intensity. A majority of patients reported high pain scores during the initial hours following the procedure, with score 10 being the most common, affecting 12 patients (Figure 2). Moderate-high pain scores (7–9) were also frequently reported (13 patients). Lower-moderate pain scores (0–6) were less frequent (8 patients), with a small number of patients experiencing minimal or no pain.

Figure 2 
                  Pain score in the hours following the operation, measured on an NPRS scale.
Figure 2

Pain score in the hours following the operation, measured on an NPRS scale.

According to VAS (0 = much better; 5 = no change; 10 = worse), patients reported an average pelvic pain improvement after treatment of 2.1 (Figure 3).

Figure 3 
                  VAS Response scores after UAE.
Figure 3

VAS Response scores after UAE.

The duration of reported symptoms after hospital discharge varied among patients: 2 patients (6.1%) experienced no symptoms, 10 patients (30.3%) reported symptoms resolution within 1–2 days post-discharge, 13 patients (39.4%) reported symptoms resolution within 5 days, 4 patients (12.1%) reported symptom persistence for up to 2 weeks, and 4 patients (12.1%) experienced symptoms lasting longer than 2 weeks (Figure 4).

Figure 4 
                  Duration of symptoms after UAE.
Figure 4

Duration of symptoms after UAE.

After the treatment, 22 patients (66.7%) reported feeling well and did not feel the need for further treatments; 2 patients (6.1%) reported having undergone hysterectomy; 5 patients (15.2%) reported having undergone a second UAE procedure; 4 patients (12.1%) believed they needed further treatments (Figure 5). 88% of patients (29 out of 33) would recommend this treatment to other women.

Figure 5 
                  Number of patients who underwent re-treatment (UAE) or different therapies.
Figure 5

Number of patients who underwent re-treatment (UAE) or different therapies.

The most prevalent motivations for patients to undergo this type of treatment include word-of-mouth (24.2%), recommendation of their gynecologist (18.2%), and through Social Networks (15.2%).

4 Discussion

This study demonstrates the significant positive impact of UAE on symptom relief and health-related quality of life in patients with symptomatic UF, in alignment with existing literature [9,10,14,15]. Over the follow-up interval of 10 months, improvement in symptom severity and HRQL was observed in 94% and 73–91%, respectively; p < 0.001 for each comparison, according to the standardized UFS-QoL questionnaire. As previously reported, improvements in HRQL occur rapidly in the early stages and reach their maximum in the long term (>7 months) [16]. “Sexual function” showed the least improvement (73%), likely due to the limited assessment of psychological features, although studies focusing on longer follow-up have shown enhancements after 12 months [17,18]. In this study, the pelvic pain score improved substantially, ultimately resulting in a 2.1 VAS.

Pain is the most commonly reported symptom following UAE, with approximately 90% of patients experiencing postoperative pain, compared to 30% during the procedure [19]. Pain peaks within 6–8 h, gradually declines over 24 h, remains mild for 2–3 days, and typically resolves within 7–10 days [20]. Pain, often due to ischemic necrosis, was common, with 75.7% of patients reporting pain ≥7 on an NPRS scale, peaking at a score of 10 in 36.4% of cases. Despite these challenges, 70% of patients experienced symptom resolution within 5 days, and 88% recovered within 1–2 weeks, reinforcing the transitory nature of these complications [21]. When pain is accompanied by fever, nausea, headache, and fatigue, it is termed PES and can be present in 30–40% of the population [19,22]. In our study, transient complications were reported in 45.5% of cases, the most frequent being PES, present in 39% of cases.

UAE is a key treatment option for symptomatic fibroids in current clinical practice. These results confirm UAE’s validity as a minimally invasive alternative to surgical treatments, particularly for fibroids <15 cm, where considerable symptom relief can be achieved without residual compressive effects. There is a common perception that large fibroids (>10 cm) are associated with an increased risk of complications after UAE, such as infection and ischemic uterine injury; however, this was ultimately disproven [23,24]. However, other authors have reported better clinical response rates in patients with smaller fibroids [16].

Moreover, patients undergoing UAE typically recommence work and daily activities within two weeks, compared to six weeks for surgery [15]. Although 88% of patients expressed satisfaction with the procedure, 27% required additional treatment (12% repeat UAE and 15% hysterectomy), which is slightly higher than the rates reported in the literature (7–14% at 12 months and 24–27% at 5 years), likely due to our shorter follow-up interval, differences in procedural techniques and possibly different patient population baseline characteristics, such as larger (mean: 9 cm ± 3.0) and numerous fibroids (median IQR: 3 (1–5)) compared to the FEMME trial (mean: 7.6 cm ± 3.2; Median IQR: 2 (1–5), respectively) which documented a re-intervention rate of 16% [25,26,27,28]. This underscores the importance of thorough pre-procedural counseling regarding the risks of reintervention [29]. Despite these challenges, the lower complication rates and shorter hospital stays, compared to surgery, make the UAE a cost-effective option in most cases [11,12].

One of the main strengths of this study is its prospective design, which provides robust data on the clinical outcomes and patient satisfaction associated with UAE. The use of internationally validated tools, such as the UFS-QoL questionnaire, adds reliability to the findings. Furthermore, the focus on patient-reported outcomes highlights the procedure’s impact on quality of life, an essential consideration in treatment planning.

4.1 Limitations

The single-center design may limit the generalizability of the findings to other settings. The relatively small sample size (33 patients completing follow-up) and the high dropout rate (17.5%) may have introduced selection bias, as patients who did not complete post-procedural assessments might differ systematically from those who did. Fertility-focused research, including ovarian reserve assessment and pregnancy outcomes post-UAE, is essential to guide clinical decision-making for younger patients; however, in this study, no fertility markers were collected for analysis. This study did not carry out further subgroup analysis, which might have provided valuable comparisons with previous research. Additionally, investigations should explore systematically the impact of radial access on post-procedural recovery and patient mobility. Lastly, efforts to develop evidence-based pain management protocols and accepted international guidelines will be critical in improving patient experiences and outcomes following UAE.

5 Conclusions

UAE has statistically significantly improved symptom severity and health-related quality of life in patients with symptomatic fibroids. PES occurred in 39% of patients, and in the majority of them, it resolved within 2 weeks. Pelvic pain scores improved drastically. 88% of the population was satisfied with UAE results, and 66.7% of patients did not feel the need for further treatments in the follow-up. Future research should prioritize randomized controlled trials to confirm these findings, explore fertility-related outcomes, analyze the effectiveness of radial puncture access in the post-procedural management, and assess peri-procedural pain care, to maximize patient satisfaction and clinical efficacy.

  1. Funding information: There are no funding sources for this study.

  2. Author contributions: N.U. and M.A.T. contributed to the initial manuscript draft, extracted, analyzed the data, and organized the study as an overall supervisor. A.G., T.G.D., and G.G. contributed to data acquisition, interpreted the results and revised the first draft of the manuscript. A.Z. and E.R. study the design of the research. D.C., A.S.L., and M.R. contributed to the study conception and design. N.U.: Experimental work and manuscript drafting. M.A.T. and M.R.: Study design and literature review. A.G. and T.G.D.: Manuscript revision and data analysis. All authors participated in the critical revision of the manuscript and approved the final version.

  3. Conflict of interest: Tullio Golia D’Augè and Antonio Simone Laganà serve as an editors for the journal; however, this role did not influence the editorial processing or the peer review of this article. The authors declare that they have no conflict of interest.

  4. Data availability statement: The data supporting the findings of this study are available within the article. Additional data related to the study can be requested from the corresponding author upon reasonable request.

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Received: 2025-03-14
Revised: 2025-06-04
Accepted: 2025-06-05
Published Online: 2025-08-07

© 2025 the author(s), published by De Gruyter

This work is licensed under the Creative Commons Attribution 4.0 International License.

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  17. Lysophosphatidic acid 2 alleviates deep vein thrombosis via protective endothelial barrier function
  18. Transcription factor A, mitochondrial promotes lymph node metastasis and lymphangiogenesis in epithelial ovarian carcinoma
  19. Serum PM20D1 levels are associated with nutritional status and inflammatory factors in gastric cancer patients undergoing early enteral nutrition
  20. Hydromorphone reduced the incidence of emergence agitation after adenotonsillectomy in children with obstructive sleep apnea: A randomized, double-blind study
  21. Vitamin D replacement therapy may regulate sleep habits in patients with restless leg syndrome
  22. The first-line antihypertensive nitrendipine potentiated the therapeutic effect of oxaliplatin by downregulating CACNA1D in colorectal cancer
  23. Health literacy and health-related quality of life: The mediating role of irrational happiness
  24. Modulatory effects of Lycium barbarum polysaccharide on bone cell dynamics in osteoporosis
  25. Mechanism research on inhibition of gastric cancer in vitro by the extract of Pinellia ternata based on network pharmacology and cellular metabolomics
  26. Examination of the causal role of immune cells in non-alcoholic fatty liver disease by a bidirectional Mendelian randomization study
  27. Clinical analysis of ten cases of HIV infection combined with acute leukemia
  28. Investigating the cardioprotective potential of quercetin against tacrolimus-induced cardiotoxicity in Wistar rats: A mechanistic insights
  29. Clinical observation of probiotics combined with mesalazine and Yiyi Baitouweng Decoction retention enema in treating mild-to-moderate ulcerative colitis
  30. Diagnostic value of ratio of blood inflammation to coagulation markers in periprosthetic joint infection
  31. Sex-specific associations of sex hormone binding globulin and risk of bladder cancer
  32. Core muscle strength and stability-oriented breathing training reduces inter-recti distance in postpartum women
  33. The ERAS nursing care strategy for patients undergoing transsphenoidal endoscopic pituitary tumor resection: A randomized blinded controlled trial
  34. The serum IL-17A levels in patients with traumatic bowel rupture post-surgery and its predictive value for patient prognosis
  35. Impact of Kolb’s experiential learning theory-based nursing on caregiver burden and psychological state of caregivers of dementia patients
  36. Analysis of serum NLR combined with intraoperative margin condition to predict the prognosis of cervical HSIL patients undergoing LEEP surgery
  37. Commiphora gileadensis ameliorate infertility and erectile dysfunction in diabetic male mice
  38. The correlation between epithelial–mesenchymal transition classification and MMP2 expression of circulating tumor cells and prognosis of advanced or metastatic nasopharyngeal carcinoma
  39. Tetrahydropalmatine improves mitochondrial function in vascular smooth muscle cells of atherosclerosis in vitro by inhibiting Ras homolog gene family A/Rho-associated protein kinase-1 signaling pathway
  40. A cross-sectional study: Relationship between serum oxidative stress levels and arteriovenous fistula maturation in maintenance dialysis patients
  41. A comparative analysis of the impact of repeated administration of flavan 3-ol on brown, subcutaneous, and visceral adipose tissue
  42. Identifying early screening factors for depression in middle-aged and older adults: A cohort study
  43. Perform tumor-specific survival analysis for Merkel cell carcinoma patients undergoing surgical resection based on the SEER database by constructing a nomogram chart
  44. Unveiling the role of CXCL10 in pancreatic cancer progression: A novel prognostic indicator
  45. High-dose preoperative intraperitoneal erythropoietin and intravenous methylprednisolone in acute traumatic spinal cord injuries following decompression surgeries
  46. RAB39B: A novel biomarker for acute myeloid leukemia identified via multi-omics and functional validation
  47. Impact of peripheral conditioning on reperfusion injury following primary percutaneous coronary intervention in diabetic and non-diabetic STEMI patients
  48. Clinical efficacy of azacitidine in the treatment of middle- and high-risk myelodysplastic syndrome in middle-aged and elderly patients: A retrospective study
  49. The effect of ambulatory blood pressure load on mitral regurgitation in continuous ambulatory peritoneal dialysis patients
  50. Expression and clinical significance of ITGA3 in breast cancer
  51. Single-nucleus RNA sequencing reveals ARHGAP28 expression of podocytes as a biomarker in human diabetic nephropathy
  52. rSIG combined with NLR in the prognostic assessment of patients with multiple injuries
  53. Toxic metals and metalloids in collagen supplements of fish and jellyfish origin: Risk assessment for daily intake
  54. Exploring causal relationship between 41 inflammatory cytokines and marginal zone lymphoma: A bidirectional Mendelian randomization study
  55. Gender beliefs and legitimization of dating violence in adolescents
  56. Effect of serum IL-6, CRP, and MMP-9 levels on the efficacy of modified preperitoneal Kugel repair in patients with inguinal hernia
  57. Effect of smoking and smoking cessation on hematological parameters in polycythemic patients
  58. Pathogen surveillance and risk factors for pulmonary infection in patients with lung cancer: A retrospective single-center study
  59. Necroptosis of hippocampal neurons in paclitaxel chemotherapy-induced cognitive impairment mediates microglial activation via TLR4/MyD88 signaling pathway
  60. Celastrol suppresses neovascularization in rat aortic vascular endothelial cells stimulated by inflammatory tenocytes via modulating the NLRP3 pathway
  61. Cord-lamina angle and foraminal diameter as key predictors of C5 palsy after anterior cervical decompression and fusion surgery
  62. GATA1: A key biomarker for predicting the prognosis of patients with diffuse large B-cell lymphoma
  63. Influencing factors of false lumen thrombosis in type B aortic dissection: A single-center retrospective study
  64. MZB1 regulates the immune microenvironment and inhibits ovarian cancer cell migration
  65. Integrating experimental and network pharmacology to explore the pharmacological mechanisms of Dioscin against glioblastoma
  66. Trends in research on preterm birth in twin pregnancy based on bibliometrics
  67. Four-week IgE/baseline IgE ratio combined with tryptase predicts clinical outcome in omalizumab-treated children with moderate-to-severe asthma
  68. Single-cell transcriptomic analysis identifies a stress response Schwann cell subtype
  69. Acute pancreatitis risk in the diagnosis and management of inflammatory bowel disease: A critical focus
  70. Effect of subclinical esketamine on NLRP3 and cognitive dysfunction in elderly ischemic stroke patients
  71. Interleukin-37 mediates the anti-oral tumor activity in oral cancer through STAT3
  72. CA199 and CEA expression levels, and minimally invasive postoperative prognosis analysis in esophageal squamous carcinoma patients
  73. Efficacy of a novel drainage catheter in the treatment of CSF leak after posterior spine surgery: A retrospective cohort study
  74. Comprehensive biomedicine assessment of Apteranthes tuberculata extracts: Phytochemical analysis and multifaceted pharmacological evaluation in animal models
  75. Relation of time in range to severity of coronary artery disease in patients with type 2 diabetes: A cross-sectional study
  76. Dopamine attenuates ethanol-induced neuronal apoptosis by stimulating electrical activity in the developing rat retina
  77. Correlation between albumin levels during the third trimester and the risk of postpartum levator ani muscle rupture
  78. Factors associated with maternal attention and distraction during breastfeeding and childcare: A cross-sectional study in the west of Iran
  79. Mechanisms of hesperetin in treating metabolic dysfunction-associated steatosis liver disease via network pharmacology and in vitro experiments
  80. The law on oncological oblivion in the Italian and European context: How to best uphold the cancer patients’ rights to privacy and self-determination?
  81. The prognostic value of the neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and prognostic nutritional index for survival in patients with colorectal cancer
  82. Factors affecting the measurements of peripheral oxygen saturation values in healthy young adults
  83. Comparison and correlations between findings of hysteroscopy and vaginal color Doppler ultrasonography for detection of uterine abnormalities in patients with recurrent implantation failure
  84. The effects of different types of RAGT on balance function in stroke patients with low levels of independent walking in a convalescent rehabilitation hospital
  85. Causal relationship between asthma and ankylosing spondylitis: A bidirectional two-sample univariable and multivariable Mendelian randomization study
  86. Correlations of health literacy with individuals’ understanding and use of medications in Southern Taiwan
  87. Correlation of serum calprotectin with outcome of acute cerebral infarction
  88. Comparison of computed tomography and guided bronchoscopy in the diagnosis of pulmonary nodules: A systematic review and meta-analysis
  89. Curdione protects vascular endothelial cells and atherosclerosis via the regulation of DNMT1-mediated ERBB4 promoter methylation
  90. The identification of novel missense variant in ChAT gene in a patient with gestational diabetes denotes plausible genetic association
  91. Molecular genotyping of multi-system rare blood types in foreign blood donors based on DNA sequencing and its clinical significance
  92. Exploring the role of succinyl carnitine in the association between CD39⁺ CD4⁺ T cell and ulcerative colitis: A Mendelian randomization study
  93. Dexmedetomidine suppresses microglial activation in postoperative cognitive dysfunction via the mmu-miRNA-125/TRAF6 signaling axis
  94. Analysis of serum metabolomics in patients with different types of chronic heart failure
  95. Diagnostic value of hematological parameters in the early diagnosis of acute cholecystitis
  96. Pachymaran alleviates fat accumulation, hepatocyte degeneration, and injury in mice with nonalcoholic fatty liver disease
  97. Decrease in CD4 and CD8 lymphocytes are predictors of severe clinical picture and unfavorable outcome of the disease in patients with COVID-19
  98. METTL3 blocked the progression of diabetic retinopathy through m6A-modified SOX2
  99. The predictive significance of anti-RO-52 antibody in patients with interstitial pneumonia after treatment of malignant tumors
  100. Exploring cerebrospinal fluid metabolites, cognitive function, and brain atrophy: Insights from Mendelian randomization
  101. Development and validation of potential molecular subtypes and signatures of ocular sarcoidosis based on autophagy-related gene analysis
  102. Widespread venous thrombosis: Unveiling a complex case of Behçet’s disease with a literature perspective
  103. Uterine fibroid embolization: An analysis of clinical outcomes and impact on patients’ quality of life
  104. Discovery of lipid metabolism-related diagnostic biomarkers and construction of diagnostic model in steroid-induced osteonecrosis of femoral head
  105. Serum-derived exomiR-188-3p is a promising novel biomarker for early-stage ovarian cancer
  106. Enhancing chronic back pain management: A comparative study of ultrasound–MRI fusion guidance for paravertebral nerve block
  107. Peptide CCAT1-70aa promotes hepatocellular carcinoma proliferation and invasion via the MAPK/ERK pathway
  108. Electroacupuncture-induced reduction of myocardial ischemia–reperfusion injury via FTO-dependent m6A methylation modulation
  109. Hemorrhoids and cardiovascular disease: A bidirectional Mendelian randomization study
  110. Cell-free adipose extract inhibits hypertrophic scar formation through collagen remodeling and antiangiogenesis
  111. HALP score in Demodex blepharitis: A case–control study
  112. Assessment of SOX2 performance as a marker for circulating cancer stem-like cells (CCSCs) identification in advanced breast cancer patients using CytoTrack system
  113. Risk and prognosis for brain metastasis in primary metastatic cervical cancer patients: A population-based study
  114. Comparison of the two intestinal anastomosis methods in pediatric patients
  115. Factors influencing hematological toxicity and adverse effects of perioperative hyperthermic intraperitoneal vs intraperitoneal chemotherapy in gastrointestinal cancer
  116. Endotoxin tolerance inhibits NLRP3 inflammasome activation in macrophages of septic mice by restoring autophagic flux through TRIM26
  117. Lateral transperitoneal laparoscopic adrenalectomy: A single-centre experience of 21 procedures
  118. Petunidin attenuates lipopolysaccharide-induced retinal microglia inflammatory response in diabetic retinopathy by targeting OGT/NF-κB/LCN2 axis
  119. Procalcitonin and C-reactive protein as biomarkers for diagnosing and assessing the severity of acute cholecystitis
  120. Factors determining the number of sessions in successful extracorporeal shock wave lithotripsy patients
  121. Development of a nomogram for predicting cancer-specific survival in patients with renal pelvic cancer following surgery
  122. Inhibition of ATG7 promotes orthodontic tooth movement by regulating the RANKL/OPG ratio under compression force
  123. A machine learning-based prognostic model integrating mRNA stemness index, hypoxia, and glycolysis‑related biomarkers for colorectal cancer
  124. Glutathione attenuates sepsis-associated encephalopathy via dual modulation of NF-κB and PKA/CREB pathways
  125. FAHD1 prevents neuronal ferroptosis by modulating R-loop and the cGAS–STING pathway
  126. Association of placenta weight and morphology with term low birth weight: A case–control study
  127. Investigation of the pathogenic variants induced Sjogren’s syndrome in Turkish population
  128. Nucleotide metabolic abnormalities in post-COVID-19 condition and type 2 diabetes mellitus patients and their association with endocrine dysfunction
  129. TGF-β–Smad2/3 signaling in high-altitude pulmonary hypertension in rats: Role and mechanisms via macrophage M2 polarization
  130. Ultrasound-guided unilateral versus bilateral erector spinae plane block for postoperative analgesia of patients undergoing laparoscopic cholecystectomy
  131. Profiling gut microbiome dynamics in subacute thyroiditis: Implications for pathogenesis, diagnosis, and treatment
  132. Delta neutrophil index, CRP/albumin ratio, procalcitonin, immature granulocytes, and HALP score in acute appendicitis: Best performing biomarker?
  133. Anticancer activity mechanism of novelly synthesized and characterized benzofuran ring-linked 3-nitrophenyl chalcone derivative on colon cancer cells
  134. H2valdien3 arrests the cell cycle and induces apoptosis of gastric cancer
  135. Prognostic relevance of PRSS2 and its immune correlates in papillary thyroid carcinoma
  136. Association of SGLT2 inhibition with psychiatric disorders: A Mendelian randomization study
  137. Motivational interviewing for alcohol use reduction in Thai patients
  138. Luteolin alleviates oxygen-glucose deprivation/reoxygenation-induced neuron injury by regulating NLRP3/IL-1β signaling
  139. Polyphyllin II inhibits thyroid cancer cell growth by simultaneously inhibiting glycolysis and oxidative phosphorylation
  140. Relationship between the expression of copper death promoting factor SLC31A1 in papillary thyroid carcinoma and clinicopathological indicators and prognosis
  141. CSF2 polarized neutrophils and invaded renal cancer cells in vitro influence
  142. Proton pump inhibitors-induced thrombocytopenia: A systematic literature analysis of case reports
  143. The current status and influence factors of research ability among community nurses: A sequential qualitative–quantitative study
  144. OKAIN: A comprehensive oncology knowledge base for the interpretation of clinically actionable alterations
  145. The relationship between serum CA50, CA242, and SAA levels and clinical pathological characteristics and prognosis in patients with pancreatic cancer
  146. Identification and external validation of a prognostic signature based on hypoxia–glycolysis-related genes for kidney renal clear cell carcinoma
  147. Engineered RBC-derived nanovesicles functionalized with tumor-targeting ligands: A comparative study on breast cancer targeting efficiency and biocompatibility
  148. Relationship of resting echocardiography combined with serum micronutrients to the severity of low-gradient severe aortic stenosis
  149. Effect of vibration on pain during subcutaneous heparin injection: A randomized, single-blind, placebo-controlled trial
  150. The diagnostic performance of machine learning-based FFRCT for coronary artery disease: A meta-analysis
  151. Comparing biofeedback device vs diaphragmatic breathing for bloating relief: A randomized controlled trial
  152. Serum uric acid to albumin ratio and C-reactive protein as predictive biomarkers for chronic total occlusion and coronary collateral circulation quality
  153. Multiple organ scoring systems for predicting in-hospital mortality of sepsis patients in the intensive care unit
  154. Single-cell RNA sequencing data analysis of the inner ear in gentamicin-treated mice via intraperitoneal injection
  155. Review Articles
  156. The effects of enhanced external counter-pulsation on post-acute sequelae of COVID-19: A narrative review
  157. Diabetes-related cognitive impairment: Mechanisms, symptoms, and treatments
  158. Microscopic changes and gross morphology of placenta in women affected by gestational diabetes mellitus in dietary treatment: A systematic review
  159. Review of mechanisms and frontier applications in IL-17A-induced hypertension
  160. Research progress on the correlation between islet amyloid peptides and type 2 diabetes mellitus
  161. The safety and efficacy of BCG combined with mitomycin C compared with BCG monotherapy in patients with non-muscle-invasive bladder cancer: A systematic review and meta-analysis
  162. The application of augmented reality in robotic general surgery: A mini-review
  163. The effect of Greek mountain tea extract and wheat germ extract on peripheral blood flow and eicosanoid metabolism in mammals
  164. Neurogasobiology of migraine: Carbon monoxide, hydrogen sulfide, and nitric oxide as emerging pathophysiological trinacrium relevant to nociception regulation
  165. Plant polyphenols, terpenes, and terpenoids in oral health
  166. Laboratory medicine between technological innovation, rights safeguarding, and patient safety: A bioethical perspective
  167. End-of-life in cancer patients: Medicolegal implications and ethical challenges in Europe
  168. The maternal factors during pregnancy for intrauterine growth retardation: An umbrella review
  169. Intra-abdominal hypertension/abdominal compartment syndrome of pediatric patients in critical care settings
  170. PI3K/Akt pathway and neuroinflammation in sepsis-associated encephalopathy
  171. Screening of Group B Streptococcus in pregnancy: A systematic review for the laboratory detection
  172. Giant borderline ovarian tumours – review of the literature
  173. Leveraging artificial intelligence for collaborative care planning: Innovations and impacts in shared decision-making – A systematic review
  174. Cholera epidemiology analysis through the experience of the 1973 Naples epidemic
  175. Risk factors of frailty/sarcopenia in community older adults: Meta-analysis
  176. Supplement strategies for infertility in overweight women: Evidence and legal insights
  177. Scurvy, a not obsolete disorder: Clinical report in eight young children and literature review
  178. A meta-analysis of the effects of DBS on cognitive function in patients with advanced PD
  179. Protective role of selenium in sepsis: Mechanisms and potential therapeutic strategies
  180. Strategies for hyperkalemia management in dialysis patients: A systematic review
  181. C-reactive protein-to-albumin ratio in peripheral artery disease
  182. Case Reports
  183. Delayed graft function after renal transplantation
  184. Semaglutide treatment for type 2 diabetes in a patient with chronic myeloid leukemia: A case report and review of the literature
  185. Diverse electrophysiological demyelinating features in a late-onset glycogen storage disease type IIIa case
  186. Giant right atrial hemangioma presenting with ascites: A case report
  187. Laser excision of a large granular cell tumor of the vocal cord with subglottic extension: A case report
  188. EsoFLIP-assisted dilation for dysphagia in systemic sclerosis: Highlighting the role of multimodal esophageal evaluation
  189. Molecular hydrogen-rhodiola as an adjuvant therapy for ischemic stroke in internal carotid artery occlusion: A case report
  190. Coronary artery anomalies: A case of the “malignant” left coronary artery and its surgical management
  191. Rapid Communication
  192. Biological properties of valve materials using RGD and EC
  193. A single oral administration of flavanols enhances short-term memory in mice along with increased brain-derived neurotrophic factor
  194. Letter to the Editor
  195. Role of enhanced external counterpulsation in long COVID
  196. Expression of Concern
  197. Expression of concern “A ceRNA network mediated by LINC00475 in papillary thyroid carcinoma”
  198. Expression of concern “Notoginsenoside R1 alleviates spinal cord injury through the miR-301a/KLF7 axis to activate Wnt/β-catenin pathway”
  199. Expression of concern “circ_0020123 promotes cell proliferation and migration in lung adenocarcinoma via PDZD8”
  200. Corrigendum
  201. Corrigendum to “Empagliflozin improves aortic injury in obese mice by regulating fatty acid metabolism”
  202. Corrigendum to “Comparing the therapeutic efficacy of endoscopic minimally invasive surgery and traditional surgery for early-stage breast cancer: A meta-analysis”
  203. Corrigendum to “The progress of autoimmune hepatitis research and future challenges”
  204. Retraction
  205. Retraction of “miR-654-5p promotes gastric cancer progression via the GPRIN1/NF-κB pathway”
  206. Retraction of: “LncRNA CASC15 inhibition relieves renal fibrosis in diabetic nephropathy through downregulating SP-A by sponging to miR-424”
  207. Retraction of: “SCARA5 inhibits oral squamous cell carcinoma via inactivating the STAT3 and PI3K/AKT signaling pathways”
  208. Special Issue Advancements in oncology: bridging clinical and experimental research - Part II
  209. Unveiling novel biomarkers for platinum chemoresistance in ovarian cancer
  210. Lathyrol affects the expression of AR and PSA and inhibits the malignant behavior of RCC cells
  211. The era of increasing cancer survivorship: Trends in fertility preservation, medico-legal implications, and ethical challenges
  212. Bone scintigraphy and positron emission tomography in the early diagnosis of MRONJ
  213. Meta-analysis of clinical efficacy and safety of immunotherapy combined with chemotherapy in non-small cell lung cancer
  214. Special Issue Computational Intelligence Methodologies Meets Recurrent Cancers - Part IV
  215. Exploration of mRNA-modifying METTL3 oncogene as momentous prognostic biomarker responsible for colorectal cancer development
  216. Special Issue The evolving saga of RNAs from bench to bedside - Part III
  217. Interaction and verification of ferroptosis-related RNAs Rela and Stat3 in promoting sepsis-associated acute kidney injury
  218. The mRNA MOXD1: Link to oxidative stress and prognostic significance in gastric cancer
  219. Special Issue Exploring the biological mechanism of human diseases based on MultiOmics Technology - Part II
  220. Dynamic changes in lactate-related genes in microglia and their role in immune cell interactions after ischemic stroke
  221. A prognostic model correlated with fatty acid metabolism in Ewing’s sarcoma based on bioinformatics analysis
  222. Red cell distribution width predicts early kidney injury: A NHANES cross-sectional study
  223. Special Issue Diabetes mellitus: pathophysiology, complications & treatment
  224. Nutritional risk assessment and nutritional support in children with congenital diabetes during surgery
  225. Correlation of the differential expressions of RANK, RANKL, and OPG with obesity in the elderly population in Xinjiang
  226. A discussion on the application of fluorescence micro-optical sectioning tomography in the research of cognitive dysfunction in diabetes
  227. A review of brain research on T2DM-related cognitive dysfunction
  228. Metformin and estrogen modulation in LABC with T2DM: A 36-month randomized trial
  229. Special Issue Innovative Biomarker Discovery and Precision Medicine in Cancer Diagnostics
  230. CircASH1L-mediated tumor progression in triple-negative breast cancer: PI3K/AKT pathway mechanisms
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