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{"title":"Performance of contrast-enhanced ultrasound liver imaging reporting and data system for differentiation of patients at risk of hepatocellular carcinoma and liver metastasis.","authors":"Weiqin Huang, Ruoxuan Lin, Zhongshi Du, Zhougui Wu, Xiaohui Ke, Lina Tang","doi":"10.1080/07853890.2024.2442072","DOIUrl":"https://doi.org/10.1080/07853890.2024.2442072","url":null,"abstract":"<p><strong>Background: </strong>Hepatocellular carcinoma (HCC) and metastatic liver tumors (MLT) are the most common malignant liver lesions, each requiring distinct therapeutic approaches. Accurate differentiation between these malignancies is critical for appropriate treatment planning and prognostication. However, there is limited data on the performance of contrast-enhanced ultrasound liver imaging reporting and data system (CEUS-LI-RADS) in this differentiation.</p><p><strong>Objective: </strong>To evaluate the diagnostic efficacy of the CEUS-LI-RADS in distinguishing between HCC and MLT in an expanded population at risk for both tumors.</p><p><strong>Methods: </strong>Between June 2017 and January 2022, 108 patients with HCC and 138 patients with MLT who were pathologically diagnosed, where included in this retrospective study. Two radiologists independently reviewed the CEUS features and liver imaging reporting and data system (LI-RADS) categories of the lesions, and based on their consensus, we calculated the diagnostic performance, including the area under the receiver operating characteristic curve, sensitivity, specificity, and accuracy of the CEUS-LI-RADS criteria.</p><p><strong>Results: </strong>The sensitivity, specificity, and accuracy of CEUS LI-RADS category 5 (CEUS-LR-5) for predicting HCC were 49.1% [95% confidence interval (CI)) 39.3-58.9], 97.1% (95% CI 92.7-99.2), and 76%, respectively, whereas the corresponding values for LI-RADS category M (LR-M) for diagnosing MLT were 89.1% (95%CI 82.7-93.8), 72.2% (95%CI 62.8-80.4), and 81.7%, respectively. Based on current LR-M criteria, a small proportion of HCCs were classified as LR-M due to the presence of early cessation (45-60s). In the analysis of the MLT subgroup, we found that the tumor size affects the distribution of LI-RADS (LR) classification in the subgroup (<i>p</i> = 0.037), and LI-RADS category 3 (LR-3) classification was observed more frequently in tumors of small size (≤3cm) than those of larger size. In addition, LR-3 metastases were more frequently characterized by hypovascular supply.</p><p><strong>Conclusions: </strong>CEUS-LI-RADS demonstrates high specificity in distinguishing HCC from MLT, providing a reliable noninvasive diagnostic tool that can enhance clinical decision-making. These findings are clinically significant as they can improve patient management and treatment outcomes, and they underscore the need for future research to refine and expand the use of CEUS-LI-RADS in diverse clinical settings.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2442072"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for severe postpartum hemorrhage in placenta accreta spectrum patients undergoing prophylactic resuscitative endovascular balloon occlusion of the aorta during cesarean delivery.","authors":"Xiafei Wu, Jie He, Yuxiang Bai, Yanqiong Gan, Hongbing Xu, Hongbo Qi, Xinyang Yu","doi":"10.1080/07853890.2024.2442065","DOIUrl":"https://doi.org/10.1080/07853890.2024.2442065","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to investigate the risk factors for severe postpartum hemorrhage (SPPH) in patients with placenta accreta spectrum (PAS) undergoing cesarean delivery, despite the prophylactic use of resuscitative endovascular balloon occlusion of the aorta (REBOA).</p><p><strong>Materials and methods: </strong>We conducted a retrospective case-control study on PAS patients who underwent cesarean delivery with prophylactic REBOA at the First Affiliated Hospital of Chongqing Medical University from January 2017 to December 2021. Prophylactic REBOA placement was determined by a prenatal ultrasound scoring system. Patients were divided into those who experienced SPPH (case group) and those who did not (control group), with SPPH defined by one or a combination of the following criteria: intraoperative blood loss ≥1500 mL, transfusion of ≥4 units of packed red blood cells, intraoperative hysterectomy, or sequential uterine artery embolization. Propensity score matching (PSM) was employed to minimize biases, and multivariate logistic regression was used to calculate adjusted odds ratios (aOR) for risk factors.</p><p><strong>Results: </strong>Of the 424 enrolled patients, 102 experienced SPPH (case group), while 322 did not (control group). After PSM, the case group comprised 79 patients, and the control group included 130. After adjusting for confounders, patients with placenta increta (aOR 3, 95% CI 1.49-6.03, <i>p</i> = 0.002), percreta (aOR 21.77, 95% CI 6.57-72.09, <i>p</i> < 0.001), lower hemoglobin levels (aOR 0.98, 95% CI 0.95-1, <i>p</i> = 0.050), and higher D-dimer levels (aOR 1.36, 95% CI 1.12-1.65, <i>p</i> = 0.002) had an elevated risk of SPPH. Threshold effect analysis indicated no significant nonlinear relationship between hemoglobin, D-dimer, and outcomes.</p><p><strong>Conclusions: </strong>PAS patients, particularly those with placenta increta and percreta, lower hemoglobin levels, and elevated D-dimer levels, are at an increased risk of SPPH during cesarean delivery, even with REBOA intervention.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2442065"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic ability for common skin diseases among general practitioners working in community health service centers in Shanghai, China: a cross-sectional study.","authors":"Lei Zhang, Guanghui Wang, Haiying Chen, Xiaoqing Gu, Minjie Jia, Ying Yu, Xiaoxiao Cao, Ruiping Wang","doi":"10.1080/07853890.2024.2442066","DOIUrl":"https://doi.org/10.1080/07853890.2024.2442066","url":null,"abstract":"<p><strong>Objective: </strong>Primary care general practitioners (GPs) play a crucial role in common skin diseases (CSDs) diagnosis and treatment for community residents. This study investigates their clinical diagnostic ability for CSDs and influencing factors among GPs in Shanghai.</p><p><strong>Methods: </strong>In 2023, we recruited 5745 GPs in Shanghai, and online survey was conducted among 5745 GPs with written informed consents. Images of ten CSDs was used to evaluate the diagnostic ability among GPs, logistic regression (LR) analysis was applied to explore influencing factors in GPs with a good skin diseases diagnostic ability.</p><p><strong>Results: </strong>The 5745 GPs included 1740 male (30.3%), the age ranged from 25 to 60 years with an average of age of 40.8 years. The total score for GSDs diagnostic ability ranged from 2 to 10, with a median of 7.5. In this study, GPs who have achieved ≥ 9 scores were identified as GPs with good diagnostic ability, with a prevalence of 26.7%. LR analysis indicated that GPs with 11 to 15 and over 15 years of work experience had a higher prevalence of good diagnostic ability compared with those with <5 years, the OR was 1.23 (95% CI: 1.02-1.48) and 1.25 (95% CI: 1.05-1.49) respectively. GPs with advanced studies [OR = 1.61, 95% CI:1.33-1.95] and work experience [OR = 1.39, 95% CI:1.20-1.61] in dermatology had a higher prevalence of good diagnostic ability.</p><p><strong>Conclusion: </strong>The diagnostic ability for CSDs was good among GPs in Shanghai. GPs with more years of work, advanced studies and work experience in dermatology have better diagnostic abilities CSDs.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2442066"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Digital Revolution in Medicine: Applications in Cardio-Oncology.","authors":"Gift Echefu, Ladislav Batalik, Abdulkareem Lukan, Rushabh Shah, Priyanshu Nain, Avirup Guha, Sherry-Ann Brown","doi":"10.1007/s11936-024-01059-x","DOIUrl":"10.1007/s11936-024-01059-x","url":null,"abstract":"<p><strong>Purpose of review: </strong>A critical evaluation of contemporary literature regarding the role of big data, artificial intelligence, and digital technologies in precision cardio-oncology care and survivorship, emphasizing innovative and groundbreaking endeavors.</p><p><strong>Recent findings: </strong>Artificial intelligence (AI) algorithm models can automate the risk assessment process and augment current subjective clinical decision tools. AI, particularly machine learning (ML), can identify medically significant patterns in large data sets. Machine learning in cardio-oncology care has great potential in screening, diagnosis, monitoring, and managing cancer therapy-related cardiovascular complications. To this end, large-scale imaging data and clinical information are being leveraged in training efficient AI algorithms that may lead to effective clinical tools for caring for this vulnerable population. Telemedicine may benefit cardio-oncology patients by enhancing healthcare delivery through lowering costs, improving quality, and personalizing care. Similarly, the utilization of wearable biosensors and mobile health technology for remote monitoring holds the potential to improve cardio-oncology outcomes through early intervention and deeper clinical insight. Investigations are ongoing regarding the application of digital health tools such as telemedicine and remote monitoring devices in enhancing the functional status and recovery of cancer patients, particularly those with limited access to centralized services, by increasing physical activity levels and providing access to rehabilitation services.</p><p><strong>Summary: </strong>In recent years, advances in cancer survival have increased the prevalence of patients experiencing cancer therapy-related cardiovascular complications. Traditional cardio-oncology risk categorization largely relies on basic clinical features and physician assessment, necessitating advancements in machine learning to create objective prediction models using diverse data sources. Healthcare disparities may be perpetuated through AI algorithms in digital health technologies. In turn, this may have a detrimental effect on minority populations by limiting resource allocation. Several AI-powered innovative health tools could be leveraged to bridge the digital divide and improve access to equitable care.</p>","PeriodicalId":35912,"journal":{"name":"Current Treatment Options in Cardiovascular Medicine","volume":"27 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11600984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic indicators and outcome in patients with acute liver failure, sepsis and with and without shock: a retrospective cohort study.","authors":"Dan Wang, Xin Wang, Jinsong Mu, Zhidan Kuang, Junchang Zhang, Xianghong Lu, Xuemei Wang, Fang Lin","doi":"10.1080/07853890.2024.2438833","DOIUrl":"10.1080/07853890.2024.2438833","url":null,"abstract":"<p><strong>Background: </strong>Sepsis or septic shock is associated with severe morbidity and mortality in patients with acute liver failure (ALF). This study aimed to explore the potential prognostic value of common clinical indicators in patients with ALF, sepsis and with and without shock.</p><p><strong>Patients and methods: </strong>The clinical, laboratory, and microbiological data of patients with ALF and sepsis or septic shock who were admitted to the intensive care unit from January 2014 to December 2019 were collected retrospectively. Clinical indicators, outcomes and the associations among them were analyzed and defined.</p><p><strong>Results: </strong>Of 150 patients, 64 (42.7%) and 86 (57.3%) were divided into the shock and non-shock groups, respectively. Plasma procalcitonin (PCT), C-reactive protein (CRP), and creatinine (Cre) levels, aspartate aminotransferase to alanine aminotransferase (AST/ALT) ratio, and prothrombin time (PT) in the shock group and plasma PCT and Cre levels in the non-shock group were positively correlated with 30-day, 60-day, and 90-day mortality. Furthermore, plasma ALT levels were positively correlated with 60-day and 90-day mortality, and PTA showed negative correlations with 30-day, 60-day, and 90-day mortality in both groups. Multivariate logistic regression analysis revealed that the combination of plasma PCT and CRP levels, the combination of plasma PCT and ALT levels, and the combination of plasma ALT levels and PTA were found to be associated with 90-day mortality.</p><p><strong>Conclusions: </strong>Clinical indicators, especially plasma PCT, CRP, and ALT levels, PTA, and their combinations were associated with poor outcomes in patients with ALF, sepsis and with and without shock.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2438833"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11636143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and application of an uncapped mRNA platform.","authors":"Xiaodi Zheng, Biao Liu, Peng Ni, Linkang Cai, Xiaotai Shi, Zonghuang Ke, Siqi Zhang, Bing Hu, Binfeng Yang, Yiyan Xu, Wei Long, Zhizheng Fang, Yang Wang, Wen Zhang, Yan Xu, Zhong Wang, Kai Pan, Kangping Zhou, Hanming Wang, Hui Geng, Han Hu, Binlei Liu","doi":"10.1080/07853890.2024.2437046","DOIUrl":"10.1080/07853890.2024.2437046","url":null,"abstract":"<p><strong>Background: </strong>A novel uncapped mRNA platform was developed.</p><p><strong>Methods: </strong>Five lipid nanoparticle (LNP)-encapsulated mRNA constructs were made to evaluate several aspects of our platform, including transfection efficiency and durability <i>in vitro</i> and <i>in vivo</i> and the activation of humoral and cellular immunity in several animal models. The constructs were eGFP-mRNA-LNP (for enhanced green fluorescence mRNA), Fluc-mRNA-LNP (for firefly luciferase mRNA), S^δT-mRNA-LNP (for Delta strain SARS-CoV-2 spike protein trimer mRNA), gD^ED-mRNA-LNP (for truncated glycoprotein D mRNA coding ectodomain from herpes simplex virus type 2 (HSV2)) and gD^FR-mRNA-LNP (for truncated HSV2 glycoprotein D mRNA coding amino acids 1-400).</p><p><strong>Results: </strong>Quantifiable target protein expression was achieved <i>in vitro</i> and <i>in vivo</i> with eGFP- and Fluc-mRNA-LNP. S^δT-mRNA-LNP, gD^ED-mRNA-LNP and gD^FR-mRNA-LNP induced both humoral and cellular immune responses comparable to those obtained by previously reported capped mRNA-LNP constructs. Notably, S^δT-mRNA-LNP elicited neutralizing antibodies in hamsters against the Omicron and Delta strains. Additionally, gD^ED-mRNA-LNP and gD^FR-mRNA-LNP induced potent neutralizing antibodies in rabbits and mice. The mRNA constructs with uridine triphosphate (UTP) outperformed those with N1-methylpseudouridine triphosphate (N1mψTP) in the induction of antibodies via S^δT-mRNA-LNP.</p><p><strong>Conclusions: </strong>Our uncapped, process-simplified and economical mRNA platform may have broad utility in vaccines and protein replacement drugs.KEY MESSAGESThe mRNA platform described in our paper uses internal ribosome entry site (IRES) (Rapid, Amplified, Capless and Economical, RACE; Register as BH-RACE platform) instead of caps and uridine triphosphate (UTP) instead of N1-methylpseudouridine triphosphate (N1mψTP) to synthesize mRNA.Through the self-developed packaging instrument and lipid nanoparticle (LNP) delivery system, mRNA can be expressed in cells more efficiently, quickly and economically.Particularly exciting is that potent neutralizing antibodies against Delta and Omicron real viruses were induced with the new coronavirus S protein mRNA vaccine from the BH-RACE platform.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2437046"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optic disc changes in Chinese patients with <i>NLRP3</i>-associated autoinflammatory disease.","authors":"Yuezhu Lu, Min Shen, Zhikun Yang, Xiao Zhang, Donghui Li, Zhangwanyu Wei, Bing Li, Xufeng Zhao, Na Wu, Bingxuan Wu, Weihong Yu, Yong Zhong","doi":"10.1080/07853890.2024.2438842","DOIUrl":"https://doi.org/10.1080/07853890.2024.2438842","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the optic disc changes (ODC) in Chinese patients with <i>NLRP3</i>-associated autoinflammatory disease (<i>NLRP3</i>-AID).</p><p><strong>Methods: </strong>Patients who were diagnosed with <i>NLRP3</i>-AID at the Department of Rheumatology, Peking Union Medical College Hospital between April 2015 and December 2022 were retrospectively reviewed and analyzed.</p><p><strong>Results: </strong>A total of 20 patients were enrolled in this retrospective study. All 20 patients had a moderate MWS <i>NLRP3</i>-AID phenotype. Thirteen patients (65%) had ocular involvements. The interval between symptoms onset and diagnosis was significantly longer in patients with ocular involvement than in patients without (<i>p</i> = 0.044). The incidence of hearing loss was significantly higher in patients with ocular involvement (<i>p</i> = 0.017), while the incidence of abdominal pain was significantly lower when compared to patients without ocular involvement (<i>p</i> = 0.007). Optic disc swelling (ODS) (50%) was the most common ODC. All of the four T348M mutation carriers within our cohort exhibited ODS with visual-field defects. There was a significant difference between patients with/without ODS regarding the number of patients carrying T348M mutation (<i>p</i> = 0.014). The occurrence of hearing loss and CNS involvement was significantly higher in the group with ODS compared to the group without (<i>p</i> = 0.0014, <i>p</i> = 0.0198). Of the eight patients who underwent lumbar puncture, five presented with intracranial hypertension (IH). ODS was observed in all patients with IH. The serum inflammatory markers were significantly higher in patients with ODS than in those without. Two patients receiving regular subcutaneous IL-1 inhibitor treatment showed improvements in ODC.</p><p><strong>Conclusions: </strong>ODC is common among Chinese patients with NLRP3-AID, with ODS being the most common manifestation. Hearing loss and CNS involvement often accompany the occurrence of ODS. The serum inflammatory markers are associated with ODS. The T348M mutation is more likely to lead to ODC with visual-field defects.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2438842"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical features and endovascular treatment of ruptured peripheral cerebral aneurysms associated with moyamoya disease: an 8-year single-center experience.","authors":"Zheng Feng, Yongquan Chang, Xingyi Jin, Weidong Yu, Chao Fu","doi":"10.1080/07853890.2024.2441517","DOIUrl":"https://doi.org/10.1080/07853890.2024.2441517","url":null,"abstract":"<p><strong>Objective: </strong>Ruptured peripheral cerebral aneurysm (PPCA) associated with moyamoya disease (MMD) is rarely reported, and its optimal treatment remains controversial. This study aims to present the clinical characteristics, treatment strategies, and outcome predictors of this rare clinical entity.</p><p><strong>Methods: </strong>A retrospective review of patients with hemorrhagic MMD from January 2013 to December 2020 was performed. All medical records were independently compiled and reviewed.</p><p><strong>Results: </strong>Twenty-three patients were identified, 56.5% of whom were female. The mean age was 45.9 years with a peak age of onset of 51-60 years. Most patients (65.2%) developed intraventricular hemorrhage with or without intracerebral hemorrhage. These aneurysms were frequently located on the anterior (26.1%) and posterior (43.5%) choroidal arteries. Sixteen (69.6%) aneurysms were embolized and the remaining 7 (30.4%) were managed conservatively due to approach inaccessibility. Good outcomes were achieved in 82.6% of all cases, with 81.3% for embolization and 85.7% for observation. Complete occlusion was observed in all 16 aneurysms embolized. Of the conservatively treated aneurysms, 1 (14.3%) re-ruptured, 1 (14.3%) decreased in size, 2 (28.6%) disappeared, and 3 (42.8%) remained stable in size. Aneurysm rebleeding was associated with an unfavorable outcome (<i>P</i> = 0.026).</p><p><strong>Conclusions: </strong>PPCA should be considered in the differential diagnosis of hemorrhagic MMD. Aneurysm rebleeding appears to be a potential predictor of poor outcome and therefore aggressive intervention should be advocated. Endovascular embolization may be safe and feasible, and conservative observation should be carefully chosen given the high risk of aneurysm re-rupture.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2441517"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low-dose heparin sodium as a protective factor against bronchiolitis obliterans formation after adenovirus infection.","authors":"Li Peng, Lili Zhong, Rong Hu, Lei Cui, Silan Liu, Han Huang, Xiaofang Ding, Min Chen, Lin Lin","doi":"10.1080/07853890.2024.2440130","DOIUrl":"https://doi.org/10.1080/07853890.2024.2440130","url":null,"abstract":"<p><strong>Background: </strong>Adenovirus (ADV) pneumonia in children is a significant contributor to the occurrence of post-infectious bronchiolitis obliterans (BO). Heparin sodium has known anti-inflammatory, immunomodulatory, and tissue repair properties. However, its role in treating BO after ADV infection remains unclear.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 793 children diagnosed with ADV pneumonia and hospitalized in the southern region from January 2019 to December 2019. Among them, 307 cases were classified as single ADV pneumonia. We utilized directed acyclic graphs to analyze the causal relationships between various variables, which further helped us identify the independent and confounding variables for constructing our regression model. Propensity score matching (PSM) was also employed to control for confounding variables that could not be intervened in this study, ensuring baseline level equilibrium and correction. We utilized univariate logistic regression analysis to explore the factors influencing BO development after ADV pneumonia.</p><p><strong>Results: </strong>Among the 793 children diagnosed with ADV pneumonia, 86 cases (10.84%) progressed to BO. The proportion of heparin use was higher in the non-BO group than in the BO group after PSM. The univariate regression analysis revealed that acute respiratory failure, neurological involvement and fibrinogen (FIB) were risk factors for the development of BO in ADV pneumonia cases (OR > 1, <i>p</i> < 0.05), but low-dose heparin sodium treatment and hemoglobin (OR < 1, <i>p</i> < 0.05) exhibited protective effects against BO formation. Among the 307 children with single ADV pneumonia (excluding confounding factors), 33 cases (10.75%) developed BO. The univariate regression analysis further indicated that fever duration, acute respiratory failure and FIB were risk factors for the development of BO in single ADV pneumonia (OR > 1, <i>p</i> < 0.05), while low-dose heparin sodium treatment (OR < 1, <i>p</i> < 0.05) was protective against BO formation after a single ADV pneumonia.</p><p><strong>Conclusion: </strong>Low-dose heparin sodium treatment may be a protective factor against the development of BO after ADV pneumonia infection.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2440130"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142831194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of DUOXA2 in the clinical diagnosis of paediatric congenital hypothyroidism.","authors":"Jiani Du, Yanling Yang, Ding Wei, Jiajun Wu, Chunping Tian, Qianqian Hu, Hongyan Bian, Chen Cheng, Xiaoyan Zhai","doi":"10.1080/07853890.2024.2440121","DOIUrl":"https://doi.org/10.1080/07853890.2024.2440121","url":null,"abstract":"<p><p><b>Background</b>: Congenital hypothyroidism (CH) is a common metabolic disorder in children that can impact growth and neurodevelopment, particularly during infancy and early childhood. DUOXA2, a DUOX maturation factor, plays a crucial role in the maturation and activation of dual oxidase DUOX2 (a member of the NADPH oxidase family). DUOX2 can correctly migrate to the plasma membrane from the endoplasmic reticulum (ER) with the help of DUOXA2, and the two proteins together form a stable complex that promotes hydrogen peroxide (H2O2) generation in the synthesis of thyroid hormones. Genetic alterations in <i>DUOXA2</i> lead to defects function of DUOX2 protein causing inherited CH.</p><p><p><b>Objectives</b>: This review discusses the relationship between DUOXA2 and CH, including the pathogenic mechanisms of CH in children caused by <i>DUOXA2</i> mutations and the possibility or promise of <i>DUOXA2</i> gene screening as a diagnostic marker for CH in the clinic.</p><p><p><b>Methods</b>: The review synthesizes current research on the biological role of DUOXA2 and DUOX2 in thyroid hormone synthesis, the molecular impact of DUOXA2 mutations, and the clinical implications of genetic screening for CH.</p><p><p><b>Results</b>: Mutations in <i>DUOXA2</i> disrupt this process of H2O2 generation in the synthesis of thyroid hormones , leading to inherited CH. Early identification through <i>DUOXA2</i> gene screening could improve diagnostic accuracy, which facilitates early intervention and personalized treatment.</p><p><p><b>Conclusions</b>: <i>DUOXA2</i> gene screening holds promise for enhancing diagnostic accuracy in CH. However, it cannot be used as a sole diagnostic indicator, and to optimize diagnostic sensitivity, it should be combined with the screening of other relevant genetic mutations and diagnostic tools. Further research is needed to refine screening protocols and explore therapeutic options.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2440121"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}