Heart failure (HF) and sarcopenia are prevalent, interrelated conditions that significantly impact older adults. Sarcopenia, characterized by progressive decline in muscle mass, strength, and function, is common in HF and linked to higher mortality, hospitalization, and functional decline. Early recognition is hindered by overlap with frailty, variability in assessment methods, and diagnostic challenges in fluid-overloaded patients. These challenges underscore the importance of clarifying the prognostic role of specific sarcopenia-related components in HF. This study aimed to assess which components related to sarcopenia are the strongest predictors of adverse outcomes in HF patients.

The global rise in overweight and obesity has become a critical public health issue, recognized by the World Health Organization as a leading cause of morbidity and mortality. In Saudi Arabia, alarming rates of obesity necessitate a closer examination of the baseline characteristics and clinical features associated with these conditions. This study aims to analyze the prevalence of overweight and obesity in an adult population in Abha, Saudi Arabia, and identify the contributing clinical factors. A retrospective review of health records from a specialized healthcare facility in Abha was conducted for the year 2024. Participants included adults aged 18 and older, with data on anthropometric measurements and relevant laboratory results analyzed to determine the prevalence of overweight and obesity. The body mass index (BMI) was calculated, and its association with clinical parameters was explored using logistic regression analysis. The study included 202 participants, revealing a mean age of 54.75 years and a mean BMI of 32.23 kg/m2, indicating a significant prevalence of obesity. Females represented a higher proportion of the obese population (77.6%), while obesity was prevalent across all age groups. Notably, higher rates of hypertension were observed in the obese cohort. Correlations between BMI and clinical parameters demonstrated significant associations between higher BMI, poorer glycemic control (haemoglobin A1c), and elevated fasting glucose levels. The analysis indicated significant predictors of obesity, including age, gender, glycemic control, and lipid profile abnormalities. The findings underscore the pressing need for targeted public health interventions aimed at addressing obesity and its associated health risks, particularly among females and older adults. This study contributes valuable insights into the clinical characteristics of individuals with obesity, emphasizing the importance of comprehensive approaches to managing obesity-related comorbidities in the Kingdom of Saudi Arabia.

Previous studies have suggested an association between periodontitis and intracranial aneurysms (IAs). However, it remains unclear whether the association is causal. This study systematically investigated the potential genetic link between periodontitis and IAs, including the formation and rupture of IAs. This study utilized publicly available genome-wide association study summary statistics data for a 2-sample bidirectional Mendelian randomization (MR) analysis. The main statistical analysis method used was inverse variance weighting. The reliability of the results was verified through sensitivity analysis and assessment of the strength of genetic instrumental variables. There was no causal relationship between genetically determined periodontitis and uIAs (odds ratio [OR] = 1.02, 95% confidence interval [CI]: 0.89-1.17, P = .76) or aneurysmal subarachnoid hemorrhage (OR = 0.96, 95% CI: 0.85-1.08, P = .50). In the reverse MR analysis, the increased risk of uIAs or SAH was not statistically significant for an increased risk of periodontitis (uIAs: OR = 0.99, 95% CI: 0.94-1.05, P = .78; aneurysmal subarachnoid hemorrhage: OR = 1.02, 95% CI: 0.96-1.09, P = .51). The results from MR-Egger regression and weighted median method were consistent with the inverse variance weighted method. Sensitivity analysis indicated that horizontal pleiotropy was unlikely to distort the causal estimates. Our study does not support a causal relationship between periodontitis and the formation or rupture of IAs, and vice versa.

This study aimed to evaluate the correlation between the %LAV-950 threshold method and a deep learning-based algorithm for emphysema quantification in chest computed tomography (CT) scans with pulmonary function test (PFT) parameters. This retrospective study included 101 chronic obstructive pulmonary disease patients who underwent chest CT and PFTs to assess FEV₁ and carbon monoxide transfer coefficient (KCO). Emphysema was quantified using the %LAV-950 method and a deep learning-based algorithm. Quantitative results were obtained from lung and soft tissue reconstruction kernels. Pearson correlation coefficients were calculated to assess associations between CT metrics and PFT parameters. Permutation testing was used to compare correlation coefficients. The %LAV-950 method showed a weak but significant correlation with FEV₁ using soft tissue kernel (r = -0.281; P = .005), while no significant association was observed with KCO. The deep learning-based method demonstrated stronger and more consistent correlations: a moderate correlation with FEV₁ using lung kernel (r = -0.303; P = .005), a weak correlation with FEV₁ using soft tissue kernel (r = -0.289; P = .006), and a moderate correlation with KCO using soft tissue kernel (r = -0.404; P = .014). Permutation testing confirmed a significant difference in the correlation with KCO between both methods using soft tissue kernel (r = -0.264; P = .025). The deep learning-based approach demonstrated stronger and more consistent correlations with pulmonary function parameters than the traditional %LAV-950 method, especially for soft tissue kernel reconstructions. These findings highlight its potential to provide a more accurate quantification of emphysema and support its integration into routine CT analysis and artificial intelligence-assisted diagnostic workflows.

Summarize the clinical experience of interventional thrombolysis treatment for a variant central retinal artery occlusion(CRAO).

High-frequency oscillation ventilation (HFOV) is a commonly used therapeutic modality in the pediatric intensive care unit, and this study aims to investigate the clinical characteristics of children treated with HFOV. The clinical data of children admitted to the PICU of Guangzhou Women and Children's Medical Center from January 1, 2017 to December 31, 2022, who were treated with HFOV, were retrospectively collected and the clinical features data were analyzed. A total of 52 children treated with HFOV were included in this study, with a higher number of infants compared to older children (43 infants vs 9 older children, P <.05). The clinical manifestations of the children were multi-systemic diseases. 73.1% of the children were diagnosed with severe pneumonia, 23.1% had pulmonary hypertension, 25.0% were diagnosed with septicemia, and more than half of the children had underlying diseases in different systems, which required additional advanced support during treatment. In terms of pathogenesis, adenovirus (13.5%), Staphylococcus aureus and Mycoplasma pneumoniae (11.5%), and fungal infections (23.1%) were frequently identified, with many children suffering from mixed infections. Complications were notable; 19.2% of the children experienced air leakage, while 63.5% had mucus plugging. Finally, 46.2% of the children improved and were discharged, while 36.5% unfortunately did not survive. Surviving infants had a lower average peak airway pressure with HFOV than the fatal group (P <.05), Additionally, the oxygenation index values were lower, and the P/F values (PaO2/FiO2 ratio) were higher in the survivors than in the fatal group (P <.05). Children treated with HFOV were predominantly infants and young children under 36 months old. These patients exhibited high mortality rates and impacted on multiple systems throughout the body, often with mixed infections. These children required more significant medical support and longer treatment times.

The high morbidity and mortality associated with cardiovascular disease (CVD) are well known; however, the health impact of its financial toxicity (FT) is only beginning to be recognized. This study aims to identify and describe the potential categories of FT among patients with cardiovascular disease and to examine the association between FT profiles and individual characteristics. A cross-sectional study was conducted using 4 data collection tools: a self-designed general information questionnaire, the comprehensive score for FT (COST) scale, the perceived social support scale, and the medical coping modes questionnaire. Data from 204 patients at a tertiary hospital in Shandong Province, China, were analyzed using latent profile analysis, descriptive statistics, and multinomial logistic regression. This study included 204 patients undergoing cardiac surgery, predominantly male and over 60 years old, with 62.3% residing in rural areas. The mean COST of participation was 18.55 ± 8.44. latent profile analysis results indicated that a 3-profile model was most appropriate: high FT (32.4%), moderate FT (55.4%), and low FT (12.2%), with a high relative entropy value of 0.923. Multivariate logistic regression analysis identified monthly income, employment status, education level, length of hospitalization, and insurance type as significant predictors of FT among patients undergoing cardiac surgery (P < .05). This study may provide a theoretical basis for developing intervention measures targeting FT in patients undergoing cardiac surgery. Furthermore, it identifies risk factors associated with higher FT levels. Tailored interventions addressing modifiable factors should be implemented across different FT profiles to help healthcare providers deliver more person-centered care and support.

Amyloid A (AA) amyloidosis involving the gastrointestinal (GI) tract is a rare but potentially life-threatening complication of chronic inflammatory rheumatic diseases. Although typically associated with long-standing rheumatoid arthritis (RA), it is rarely reported in the context of RA-peripheral spondyloarthritis (pSpA) overlap syndrome. We report a rare case of early-onset GI-predominant AA amyloidosis without renal involvement in a patient with overlapping RA and HLA-B27-positive pSpA.

According to the perspective of psychosomatic medicine, infertility is the consequence of the interaction of individual psychological and physiological factors. Specifically, depression and ovarian cysts are strongly associated with infertility in women. However, the causality and mechanisms are still unclear. This study was conducted to investigate the causal relationships between depression, ovarian cysts and infertility based on large-scale genome-wide association studies pooled statistical Mendelian randomization (MR) analysis. In the primary inverse-variance weighted analysis, there was a genetically predicted causal effect of depression on both female infertility and ovarian cysts, as well as a direct causal association observed between ovarian cysts and female infertility. Multivariable MR (MVMR) analysis revealed that ovarian cysts mediate the causal relationship between depression and infertility. The findings demonstrate from a genetic perspective that depression confers susceptibility to infertility via increasing the risk of ovarian cysts in females. It provides robust evidence for the potential biological link between psychological factors and reproductive health.

As the 2nd-leading cause of death, cancer poses a serious danger to human life and health. The pathogenesis and progression of various cancer types are exceedingly intricate. Attention has been drawn to cuproptosis, a recently identified cell death mechanism. Dihydrolipoamide S-acetyltransferase (DLAT), functioning as a target during copper-induced cell death, assumes a crucial role. Hence, investigating the impact of the DLAT gene on the occurrence and development of diverse cancers becomes highly imperative. Employing a pan-cancer analysis approach, we conducted a comprehensive examination of DLAT expression and prognosis across 33 cancers. To accomplish this, we accessed datasets from the University of California Santa Cruz xene database, CellMiner database, and Gene Set Enrichment Analysis official website. The gene expression data and survival data of 10991 samples were analyzed. By utilizing Gene Set Enrichment Analysis, we explored potential pathways involving DLAT. Additionally, the relationship between DLAT expression and the tumor microenvironment, immune infiltration, tumor mutational burden, microsatellite instability, co-expression of immune marker genes, and the sensitivity of common chemotherapy drugs in the 33 cancers was also examined using the Spearman correlation test. In the majority of cancers, the DLAT gene has differential expression that is statistically significant, and this variation in expression is associated with varied prognoses for survival. We observed that DLAT was related with an unfavorable prognosis in pancreatic adenocarcinoma, liver hepatocellular carcinoma, head and neck squamous cell carcinoma, and uveal melanoma, whereas it exhibited a favorable survival trend in colon adenocarcinoma, kidney renal clear cell carcinoma, and rectal adenocarcinoma. Notably, in these tumors, immune-related analyses revealed significant correlations between DLAT and immune markers, such as immune infiltration, tumor mutational burden, and microsatellite instability. Considering the prognostic implications of DLAT in tumors and its correlations with immune indicators, it is plausible to regard DLAT as both a prognosis feature for certain malignancies and an evaluative metric for immunotherapy efficacy. The findings suggest that DLAT could be a potential therapeutic target and serve as a biomarker for predicting patient outcomes and guiding treatment strategies in various cancers, with its prognostic and immunological implications likely to be context-dependent across different tumor types.

Obstructive sleep apnea (OSA) is a prevalent sleep-related breathing disorder. There has been some evidence that patients with OSA may benefit from high-flow nasal cannula (HFNC). This meta-analysis aims to assess the effect of HFNC on adults with OSA.

The role of ferroptosis in the pathogenesis of aortic dissection (AD) has not been fully clarified. Data from the gene expression omnibus database were analyzed to identify differentially expressed ferroptosis-related genes (FRGs) in AD. Key FRGs were selected using Least Absolute Shrinkage and Selection Operator regression and validated with receiver operating characteristic analysis. Single-cell RNA sequencing was applied to assess expression patterns in specific cell types. Mendelian randomization was further performed using genome-wide association study summary statistics for 211 gut microbial taxa and 1400 serum metabolites to explore causal associations with AD. A total of 14 differentially expressed FRGs were identified. Among them, 7 genes (CHAC1, CDO1, HILPDA, GSK3B, DPEP1, BRD4, and NUPR1) were recognized as key candidates. GSK3B and BRD4 were significantly downregulated in endothelial cells, while DPEP1 showed reduced expression in fibroblasts. Immune cell analysis indicated an increase in neutrophils and a decrease in NK and dendritic cells in AD tissues. Regulatory network prediction identified 194 microRNAs, 218 long noncoding RNAs, and 61 potential therapeutic drugs targeting the key FRGs. Mendelian randomization analysis suggested causal associations between AD risk and 8 gut microbial taxa as well as 64 serum metabolites. This study identified critical FRGs and their regulatory networks in AD. Potential causal links with microbial and metabolic factors were also uncovered. These findings provide new insights into ferroptosis-mediated mechanisms of AD and suggest promising targets for therapeutic intervention.

The association between the neutrophil percentage-to-albumin ratio (NPAR) and all-cause and cardiovascular disease mortality in individuals with coronary heart disease (CHD) remains unclear. This study aimed to investigate the correlation between NPAR levels and the risks of all-cause and cardiovascular disease mortality within this specific patient population. This research included 935 participants diagnosed with CHD. We conducted survival analyses using the Kaplan-Meier method and employed multivariate Cox proportional hazards regression models to assess the association between NPAR, categorized into tertiles, and the risk of all-cause and cardiovascular mortality. Additionally, we utilized restricted cubic splines to analyze potential nonlinear relationships and performed subgroup analyses based on relevant covariates to identify populations potentially at higher risk. Over the follow-up period, 260 all-cause deaths and 100 cardiovascular deaths were recorded among the participants. Multivariate Cox regression analysis demonstrated that, compared to the lowest NPAR tertile (Q1), participants in the highest tertile (Q3) had significantly elevated risks of all-cause mortality (hazard ratio = 1.76, 95% confidence interval: 1.19-2.61, P = .005) and cardiovascular mortality (hazard ratio = 3.12, 95% confidence interval: 1.67-5.81, P < .001). The restricted cubic splines analysis confirmed a nonlinear association between continuous NPAR levels and both all-cause and cardiovascular mortality. Higher NPAR levels were significantly associated with an increased likelihood of both all-cause and cardiovascular mortality among patients with CHD. These findings suggest that NPAR could serve as a potentially valuable prognostic marker for predicting mortality risk in individuals affected by CHD.

This study investigated the impact of varying the tension of the elastic band in a lower-limb orthosis with a trunk belt (hereinafter, lower-limb orthosis) on muscle activity in the lower limbs during walking in healthy adults. Within-subject repeated-measures pilot study. University motion analysis laboratory. The task involved walking 10 m on flat ground for 18 healthy adult males. Two conditions were assessed: walking without lower-limb orthosis and with the orthosis applied to the right lower limb. For the latter, the elastic-band tension in stationary standing position was set to 3 levels: 1.5, 2.0, and 2.5 kgw. A 3-dimensional motion analysis device and surface electromyograph were used. The parameters analyzed were the joint angle and muscle activity of the right lower limb under the 3 elastic-band tensions while walking without and with a lower limb orthosis. The ankle dorsiflexion angle during the swing phase was significantly increased at a tension of 2.5 compared to 1.5 kgw. In addition, the knee flexion angles during both the stance and swing phases were significantly reduced when walking with the orthosis compared to walking without it. Regarding muscle activity, the tibialis anterior showed a significant decrease in muscle activity during the swing phase when walking with a lower-limb orthosis compared to walking without a orthosis. The vastus lateralis showed a significant decrease in muscle activity during the stance and early stance phases when walking with a lower-limb orthosis compared to walking without a orthosis. Furthermore, muscle activity during the swing phase was significantly reduced when walking with the lower-limb orthosis at tensions of 2.0 and 2.5 kgw compared to walking without the orthosis. Lower-limb orthoses may help prevent excessive knee flexion during the stance phase and avoid initial contact of the affected leg with an extended knee when walking in patients with stroke-induced hemiplegia. These findings can guide optimization of orthoses for clinical populations.

Deep neck infections (DNIs) in children can progress rapidly and lead to life-threatening complications. Early identification of patients at high risk for severe disease is essential for timely intervention and optimal allocation of pediatric intensive care unit (PICU) resources. This study aimed to identify clinical and laboratory predictors associated with PICU admission in children diagnosed with DNIs in the pediatric emergency department. This retrospective, single-center study included pediatric patients diagnosed with DNIs from January 1 to December 31, 2024. Demographic, clinical, laboratory, and radiological data were extracted from electronic medical records. Patients were categorized according to admission to the PICU or pediatric ward. Statistical analyses were performed to identify independent predictors of PICU admission. A total of 107 patients (53.3% male; median age, 95.0 months) were included. The most common abscess types were peritonsillar (52.3%), parapharyngeal (27.1%), and retropharyngeal (20.6%). Dysphagia (P = .013), tonsillar hypertrophy (P = .039), and trismus (P = .015) were significantly more common among PICU patients. Laboratory findings showed higher white blood cell (WBC) counts (P = .048), absolute neutrophil counts (P = .010), and C-reactive protein (CRP) levels (P < .001), and lower absolute lymphocyte counts (P = .001) in the PICU group. Elevated CRP (≥50 mg/L; P = .018) and WBC (≥15.0 × 109/L; P = .040) were independently associated with PICU admission. Dysphagia, tonsillar hypertrophy, restricted mouth opening, and elevated inflammatory markers particularly high WBC and CRP are potential early predictors of severe DNIs requiring intensive care. Recognition of these indicators may support prompt triage, efficient use of critical care resources, and timely interventions to prevent serious complications.

To delineate the clinical phenotype, putative mechanisms, and treatment outcomes of adult-onset nocturnal enuresis attributable to obstructive sleep apnea-hypopnea syndrome (OSAHS).

This study evaluates the global burden of gout in young adults across 204 countries, focusing on incidence, prevalence, disability-adjusted life years (DALYs), and risk factors. Data were extracted from the 2019 global burden of disease study. We analyzed gout burden using numbers, rates, and estimated annual percentage change to assess trends over time, stratified by sex, age, geographical region, and the sociodemographic development index (SDI). From 1990 to 2021, the global incidence, prevalence, and DALYs associated with gout exhibited a marked increase. The incidence rate rose from 1.94 million to 3.89 million cases, while the prevalence rate increased from 9.14 million to 19.24 million. Males consistently demonstrated higher incidence, prevalence, and DALYs compared to females, though similar upward trends were observed in both sexes. Age specific analyses showed that the gout burden increased with age, peaking in the 50 to 54 age group. Notably, there is a growing burden among younger individuals. High body mass index emerged as the leading risk factor for gout. This study highlights a growing global burden of gout, with an alarming shift towards younger age groups and a significant rise in females. High body mass index remains the predominant modifiable risk factor. These findings emphasize the need for targeted interventions to mitigate the increasing impact of gout, particularly among younger populations and females.

Congenital heart disease (CHD), the most common birth defect in China with high neonatal mortality, is frequently associated with chromosomal abnormalities including copy number variations (CNVs), yet conventional ultrasound screening has limitations in detecting these genetic underpinnings; noninvasive prenatal testing plus (NIPT Plus) may address this gap, but its clinical efficacy in diagnosing fetal CHD remains unclear. To explore the clinical efficacy of NIPT Plus in the diagnosis of fetal CHD. Pregnant women whose fetuses were identified with congenital structural heart defects or abnormal cardiac soft markers via ultrasound between August 2019 and September 2023 were enrolled. All participants underwent NIPT-Plus and invasive prenatal diagnostic procedures, including chromosome karyotyping and/or chromosomal microarray analysis (CMA). The concordance between CNVs detected by NIPT-Plus and results from invasive prenatal diagnosis was analyzed. Among fetuses with congenital structural cardiac malformations or abnormal cardiac soft markers identified by prenatal ultrasound, 39 cases underwent NIPT-Plus testing, with a positive rate of 30.77% (12/39). Seven cases withdrew from the study for personal reasons after NIPT-Plus showed no abnormalities, and the remaining 32 cases received further confirmation via invasive prenatal diagnosis. Of these 32 cases, 12 were positive for NIPT-Plus, 11 of which were consistent with CMA validation results, yielding a positive predictive value of 91.67%. Additionally, 10 cases had CNVs > 4 Mb, 9 of which matched CMA results, with a positive predictive value of 90%. No significant difference was observed between NIPT-Plus and CMA results. NIPT-Plus exhibits favorable detection performance and clinical utility in the auxiliary diagnosis of fetal cardiovascular developmental abnormalities. However, in clinical practice, its results should be validated in combination with ultrasound findings and invasive tests such as amniocentesis to minimize the risks of false positives and missed diagnoses.

Postoperative chyle leak after thyroid cancer surgery is a serious complication that can lead to electrolyte disturbance, malnutrition, and prolonged hospitalization. Although low-fat diet is recommended, the effects of different low-fat dietary approaches remain unclear. We compared a hospital-formulated oral nutritional meal with a self-controlled oral diet in patients with postoperative chyle leak to assess effects on recovery speed, economic burden, and electrolyte balance. This retrospective study included 87 patients diagnosed with thyroid cancer who presented with chyle leak between January and August 2022. Differences between nutritional meals and self-controlled diets were evaluated in terms of hospitalization days, postoperative expenses, drainage volume, and changes in blood sodium concentration. Patients in the nutritional meal group had significantly fewer days of postoperative hospitalization than those in the self-controlled diet group (9, 8-11 vs 11, 9-13 P < .05), with a significantly lower average cost of treatment (1.16, 0.99-1.45 vs 1.37, 1.16-1.81 P < .05). Maximum 24-hour drainage volume shows no significant between-group difference (232.7 ± 91.7 vs 239.0 ± 103.1 mL, P = .76), and the incidence of hyponatremia was similar (9.8% vs 6.5%, P = .12). Oral nutritional meals have clear advantages in promoting recovery and reducing hospitalization costs in patients with postoperative chyle leak after thyroid cancer surgery, suggesting that nutritional support should be strengthened in clinical practice to improve patient outcomes.

Peristomal irritant dermatitis (PIAD) is a common and difficult complication after stoma surgery, which brings both physical and psychological torture and seriously interferes with the normal recovery process and daily life. In-depth analysis of the influencing factors of PIAD and the establishment of a scientific and efficient prediction model have become the most urgent task to improve the quality of stoma care and the outcome of patients. Exploration of risk factors for postoperative development of PIAD in patients with colostomy for colorectal cancer and development of relevant predictive models. A total of 272 patients were collected in the study, of whom 58 had stoma prolapse; the patients enrolled in this study were randomly divided into a training set and a validation set according to a ratio of 7:3, of whom 190 were in the training set and 82 in the validation set. The patients' past medical history, stoma-related information and information related to the hospitalization period were collected separately to study the correlation factors affecting the emergence of PIAD in patients and to establish a prediction model. The potentially relevant factors were included in a 1-way logistic regression, and after analyzing the results: regular stoma clinic review, stoma site, ostomy flange fit, hypoproteinemia, anxiety, and radiotherapy were potential risk factors for PIAD, P < .05; The data obtained were further included in a multifactorial review: regular stoma clinic review, stoma site, ostomy flange fit or not, hypoproteinaemia, and anxiety were independent risk factors for PIAD (P < .05). This model provides a powerful tool for clinicians to identify patients at high risk of postoperative PIAD, which can help to take targeted preventive and interventional measures before the occurrence of dermatitis.

Pelvic inflammatory disease (PID) is a common infectious disease affecting the female reproductive organs and surrounding tissues. Antibiotics remain a cornerstone of current treatment regimens. This work aimed to systematically assess efficacy of fluoroquinolone antibiotics in the treatment of PID through meta-analysis (MA). Randomized controlled trials (RCTs) on fluoroquinolone antibiotics for uncomplicated PID were retrieved from online databases up to July 8, 2024. Statistical analysis was conducted using RevMan5.2, focusing on WBC count, CRP levels, clinical efficacy, and adverse reactions (ARs), with outcomes measured by odds ratios (ORs) and 95% confidence intervals (CIs). Fourteen studies were included, comprising a total of 2483 patients with PID, of whom 1244 received fluoroquinolone antibiotics (experimental group - EG). All patients received treatment for 7 to 14 days. After treatment, the EG showed significantly lower WBC and CRP levels compared to the control group (CG), with both differences statistically significant (P < .00001, 5 studies; I2 = 0% for WBC; I2 = 0% for CRP). The cure rate in EG was 66.43% (663/998), which was higher than the CG cure rate of 62.42% (623/998) (P < .05, 9 studies; I2 = 42%). The incidence rates of abdominal pain (3.89%, 18/463), nausea and vomiting (17.13%, 168/981), and overall adverse reactions (35.22%, 273/775) were all lower in EG compared to CG (P < .05, 7 studies for ARs; I2 = 54%). Fluoroquinolone antibiotics appear to improve inflammatory markers and may increase the cure rate for PID. Additionally, their incidence of adverse reactions seems lower compared to other treatments. While they show promising efficacy, safety concerns - such as tendon damage, cardiovascular issues, and neuropsychiatric effects - should be carefully considered, especially in at-risk populations. Given these risks and the variability in outcomes, further large-scale, long-term studies are needed to confirm their overall safety and efficacy. Future research should also identify the best patient populations for fluoroquinolone use and explore alternative treatments with comparable benefits and fewer risks.