其他最新文献

{"title":"Digital learning strategies in residency education.","authors":"Helena Vallo Hult, Adam Abovarda, Christian Master Östlund, Paul Pålsson","doi":"10.1080/07853890.2024.2440630","DOIUrl":"10.1080/07853890.2024.2440630","url":null,"abstract":"<p><strong>Background: </strong>New digital learning environments have transformed medical education and training, allowing students and teachers to engage in synchronous, real-time interactions and asynchronous learning activities online. Despite extensive research on the role of digital technologies in education, understanding the interplay between digital technology, work, and learning, especially in complex fields like healthcare, remains a challenge.</p><p><strong>Objective: </strong>The objective of this study is to examine resident physicians' perceptions and experiences of using a digital learning environment as part of their specialist medical training. The paper focuses on digital learning through video conferencing (virtual lectures and seminars) and related learning technologies. It aims to understand how resident physicians perceive pedagogical opportunities and challenges in digital learning environments during their medical training and what strategies they use to address these.</p><p><strong>Materials and methods: </strong>The methodological approach is qualitative, aiming to capture and understand participants' experiences and views of digital learning. The empirical data gathered from open-ended responses to four course evaluation surveys and semi-structured interviews with nine physicians from a cohort of participants enrolled in two or more digital courses were analyzed through thematic analysis. The analysis revealed three main themes related to digital transformation of learning: sociotechnical, educational and administrative.</p><p><strong>Results: </strong>The results suggest that (i) sociotechnical aspects and understanding of the context in which the learning takes place contribute to enhancing digital learning for resident physicians; (ii) insights into participants' perceptions of digital learning emphasize that interactive communication and group discussions are significant for their learning, and (iii) administrative aspects related to course design, lecture management, and instructional support are more important in digital learning environments compared to traditional teaching and learning.</p><p><strong>Conclusion: </strong>Findings from this study confirm and extend prior studies on digital learning in healthcare, contributing to a better understanding of how digital learning environments, especially virtual lectures and seminars, can be developed and integrated into residency programs and health professions education to increase their usefulness.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2440630"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11656749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848608","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":"Tumour necrosis factor inhibitors in Ulcerative colitis: real-world data on Therapeutic drug monitoring and evaluation of current treatment targets (STRIDE II).","authors":"Jonas Andre Lundekvam, Marte Lie Høivik, Karoline Anisdahl, Milada Cvancarova Småstuen, David J Warren, Nils Bolstad, Asle Wilhelm Medhus","doi":"10.1080/07853890.2024.2424447","DOIUrl":"10.1080/07853890.2024.2424447","url":null,"abstract":"<p><strong>Background: </strong>The benefit of therapeutic drug monitoring (TDM) and implementation of recommendations from the Selection of Therapeutic Targets in Inflammatory Bowel Disease (IBD, STRIDE) are discussed in the IBD community. We report real-world data in ulcerative colitis patients receiving first-line tumour necrosis factor inhibitor (TNFi) treatment followed by TDM, and assess how implementation of the STRIDE II recommendations might affect clinical practice.</p><p><strong>Methods: </strong>Adult, biologically naïve UC patients starting TNFi between 2014 and 2021 at Oslo University Hospital were included in a medical chart review study, and data were collected at three and twelve months after the start of treatment. Target serum drug levels were defined as ≥7.5 mg/L for adalimumab and ≥5 mg/L for infliximab.</p><p><strong>Results: </strong>Of 141 included patients, 36% were in clinical and biochemical (combined) remission after twelve months. Among 102 treatment persistent patients, 54% were in combined remission after twelve months. Target drug level at three months was associated with clinical remission at twelve months (OR = 2.97, 95% CI [1.24-7.12]) and biochemical remission at twelve months (OR = 2.64, 95% CI [1.03-6.77]). In total, 56% of recorded dosage adjustments were related only to serum drug levels.</p><p><strong>Conclusions: </strong>Combined remission rates at twelve months for treatment persistent patients suggest that 46% should have been considered for a change of treatment according to the STRIDE II recommendations. A majority of dosage adjustments were made proactively. Target drug level at three months was associated with remission at twelve months and supports the use of proactive TDM.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2424447"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11721610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142934012","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":"Using network pharmacology and molecular docking technology, proteomics and experiments were used to verify the effect of Yigu decoction (YGD) on the expression of key genes in osteoporotic mice.","authors":"Kun Yan, Rui-Kun Zhang, Jia-Xin Wang, Hai-Feng Chen, Yang Zhang, Feng Cheng, Yi Jiang, Min Wang, Ziqi Wu, Xiao-Gang Chen, Zhi-Neng Chen, Gui-Jin Li, Xin-Miao Yao","doi":"10.1080/07853890.2024.2449225","DOIUrl":"https://doi.org/10.1080/07853890.2024.2449225","url":null,"abstract":"<p><strong>Background: </strong>Yigu decoction (YGD) is a traditional Chinese medicine prescription for the treatment of osteoporosis, although many clinical studies have confirmed its anti-OP effect, but the specific mechanism is still not completely clear.</p><p><strong>Methods: </strong>In this study, through the methods of network pharmacology and molecular docking, the material basis and action target of YGD in preventing and treating OP were analyzed, and the potential target and mechanism of YGD in preventing and treating OP were clarified by TMT quantitative protein and experiment.</p><p><strong>Results: </strong>Network pharmacology and molecular docking revealed that the active components of YGD were mainly stigmasterol and flavonoids. Molecular docking mainly studied the strong binding ability of stigmasterol to the target. Animal proteomics verified the related mechanism of YGD in preventing and treating OP. Based on the KEGG enrichment of network pharmacology and histology, our animal experiments <i>in vivo</i> verified that YGD may play a role in the treatment of OP by mediating hif1- α/vegf/glut1 signal pathway.</p><p><strong>Conclusions: </strong>YGD prevention and treatment of OP may be achieved by interfering with multiple targets. This study confirmed that it may promote osteoblast proliferation and protect osteoblast function by up-regulating the expression of proteins related to HIF signal pathway.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2449225"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142924158","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":"Network characteristics of comorbid symptoms in alcohol use disorder.","authors":"Xin Yu, Wen Zhang, Can Wang, Guolin Mi, Xiuzhe Chen, Yanhu Wang, Xu Chen","doi":"10.1080/07853890.2024.2446691","DOIUrl":"10.1080/07853890.2024.2446691","url":null,"abstract":"<p><strong>Background: </strong>Individuals with alcohol use disorder (AUD) often experience symptoms such as anxiety, depression, and decreased sleep quality. Although these are not diagnostic criteria, they may increase dependence risk and complicate treatment. This study aims to analyze comorbidities and their complex relationships in AUD patients through epidemiological surveys and network analysis.</p><p><strong>Materials and methods: </strong>Using multi-stage stratified cluster random sampling, we selected 27,913 individuals and identified those with AUD for the study. All screened subjects were assessed with the General Health Questionnaire, Pittsburgh Sleep Quality Index, and Simple Coping Style Questionnaire, and diagnosed according to DSM-IV criteria. Network analysis and visualization were performed in R 4.4.0. The <i>qgraph</i> and <i>bootnet</i> packages in R were used to obtain partial correlation network analysis and node centrality of mental health, sleep quality, and coping styles in individuals with AUD through the <i>estimateNetwork</i> function. The <i>bootnet</i> package was used to assess the accuracy and stability of the network. The <i>bnlearn</i> package in R was used to construct directed acyclic graph (DAG) for individuals with AUD using the Bayesian hill-climbing algorithm.</p><p><strong>Results: </strong>In the partial correlation network, among the three major comorbidity categories, 'anxiety/depression' was most strongly associated with 'sleep quality'. 'Anxiety/depression' and 'sleep quality' had the highest node centrality, with 'sleep latency' also showing notable centrality. The DAG results indicated that 'sleep latency' had the highest probability priority, directly affecting 'anxiety/depression' and key sleep quality symptoms such as 'subjective sleep quality', 'sleep disturbances', 'sleep duration', and 'sleep efficiency', while also indirectly influencing other symptoms.</p><p><strong>Conclusions: </strong>Among the comorbid symptoms of AUD, sleep latency appears to be a key factor in triggering other comorbid symptoms. This study provides a basis for interventions aimed at reducing the comorbid symptoms of AUD and promoting recovery.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2446691"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973762","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":"Access to healthcare: waiting time until the surgical procedure.","authors":"Cassiane de Santana Lemos, Ana Maria Muller Magalhães, Danielle Saraiva Tuma Dos Reis, Alessandra Yuri Takehana de Andrade, Karla Cristina de Almeida, Fabiana Zerbieri Martins, Nancy Reynolds, Vanessa de Brito Poveda","doi":"10.1080/07853890.2025.2452358","DOIUrl":"10.1080/07853890.2025.2452358","url":null,"abstract":"<p><strong>Background: </strong>Understanding the determinants that limit the population's access to surgical care in health services is highly relevant in order to provide data to support political interventions.</p><p><strong>Objective: </strong>This study aimed to evaluate the time between diagnosis and elective surgery in adult patients with the longest waiting lists in Brazil; identify the determinants that interfere with access to the health service to perform surgery; and analyze the quality of life after the indicative diagnosis of surgical intervention.</p><p><strong>Methods: </strong>A cross-sectional study was conducted with adult patients treated at three hospitals in the Southeast, North and South regions of Brazil, from October 2020 to October 2022. Data collection included socio-demographic data and assessment of quality of life using the WHOQOL-Bref instrument in the immediate postoperative period and one month after surgery.</p><p><strong>Results: </strong>A total of 250 patients participated in the study, 55.6% patients from the Southeast, 20.4% patients from the North and 24% patients from the South, with a mean age of 51.86 (SD = 14.27) years and clinical history such as arterial hypertension (<i>p</i> < 0.001). The longest mean waiting time for surgery identified was 26.23 (SD = 17.62) months in the South region, with a significant difference between the evaluated institutions (<i>p</i> = 0.02). Differences were observed between the first place of care of the evaluated patients (<i>p</i> < 0.001). There was a difference in the perception of quality of life between the immediate and late postoperative periods (<i>p</i> = 0.007) and in the physical domain, with an increase in scores among older patients (<i>p</i> = 0.004) and previous clinical history (<i>p</i> = 0.03).</p><p><strong>Conclusion: </strong>Access to the health system varies by region and does not meet the standards proposed by the Brazilian health system. In addition, it seems that longer waiting times for surgery more perceptibly affect the quality of life of older adults and those with other associated diseases.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2452358"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018241","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":"Gut microbiota and endometrial cancer: research progress on the pathogenesis and application.","authors":"Weiqin Zheng, Xiaowen Lin, Huixin Chen, Ziling Yang, Han Zhao, Shibo Li, Tao Song, Yuhui Sun","doi":"10.1080/07853890.2025.2451766","DOIUrl":"10.1080/07853890.2025.2451766","url":null,"abstract":"<p><p>As one of the three major malignant tumors in women, the morbidity of endometrial cancer is second only to that of cervical cancer and is increasing yearly. Its etiological mechanism is not clear, and the risk factors are numerous and common and are closely related to obesity, hypertension, diabetes, etc. The gut microbiota has many strains, which play a considerable part in normal digestion and absorption in the human body and the regulation of the immune response. In the last few years, research on the gut microbiota has been unprecedentedly popular, and it has been confirmed that the gut microbiota closely correlates with the occurrence and development of all kinds of benign and malignant diseases. In this article, the effects of the gut microbiota and its metabolites on the occurrence and development of endometrial cancer is reviewed, and its application in the prevention, diagnosis and treatment of endometrial cancer is explored.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2451766"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11737052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985821","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":"Workload-capacity imbalances and their impact on self-management complexity in patients with multimorbidity: a multicenter cross-sectional study.","authors":"Binyu Zhao, Yujia Fu, Jingjie Wu, Erxu Xue, Chuyang Lai, Dandan Chen, Qiwei Wu, Jianing Yu, Qiaoyu Wu, Zhihong Ye, Jing Shao","doi":"10.1080/07853890.2025.2451195","DOIUrl":"10.1080/07853890.2025.2451195","url":null,"abstract":"<p><strong>Introduction: </strong>Multimorbidity is increasing globally, emphasizing the need for effective self-management strategies. The Cumulative Complexity Model (CuCoM) offers a unique perspective on understanding self-management based on workload and capacity. This study aims to validate the CuCoM in multimorbid patients and identify tailored predictors of self-management.</p><p><strong>Methods: </strong>This multicenter cross-sectional survey recruited 1920 multimorbid patients in five primary health centres and four hospitals in China. The questionnaire assessed workload (drug intake, doctor visits and follow-up, disruption in life, and health problems), capacity (social, environmental, financial, physical, and psychological), and self-management. Data were analyzed using latent profile analysis, chi-square, multivariate linear regression, and network analysis.</p><p><strong>Results: </strong>d Patients were classified into four profiles: low workload-low capacity (10.2%), high workload-low capacity (7.5%), low workload-high capacity (64.6%), and high workload-high capacity (17.7%). Patients with low workload and high capacity exhibited better self-management (β = 0.271, <i>p</i> < 0.001), while those with high workload and low capacity exhibited poorer self-management (β=-0.187, <i>p</i> < 0.001). Social capacity was the strongest predictor for all profiles. Environmental capacity ranked second for 'high workload-high capacity' (R² = 3.26) and 'low workload-low capacity' (R² = 5.32) profiles. Financial capacity followed for the 'low workload-high capacity' profile (R² = 5.40), while psychological capacity was key in the 'high workload-low capacity' profile (R² = 6.40). In the network analysis, socioeconomic factors exhibited the central nodes (<i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>Personalized interventions designed to increase capacity and reduce workload are essential for improving self-management in multimorbid patients. Upstream policies promoting health equity are also crucial for better self-management outcomes.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2451195"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018085","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":"Facilitators and barriers of alcohol goals for Latinx men hospitalized with alcohol use disorder seen by an Addiction Consult Team.","authors":"Mariam S Carson, Alein Y Haro-Ramos, Naomi López-Solano, Carla Fernandez, Marcus Cummins, Alicia Fernandez, Triveni DeFries, Marlene Martin","doi":"10.1080/07853890.2025.2453634","DOIUrl":"10.1080/07853890.2025.2453634","url":null,"abstract":"<p><strong>Introduction: </strong>Latinx individuals are disproportionately affected by alcohol use disorder (AUD). Understanding Latinx individuals' barriers and facilitators to reach AUD-related goals can help implement culturally and linguistically concordant interventions to improve alcohol-related outcomes.</p><p><strong>Methods: </strong>We conducted semi-structured qualitative interviews with Latinx, Spanish-speaking men with AUD within 20 weeks of hospital discharge who were seen by an addiction consult team during hospitalization in an urban, safety-net hospital in San Francisco. Interviews focused on the facilitators and barriers to participants' AUD-related goals pre-, during, and post-hospitalization. We recorded and transcribed interviews and used a mixed deductive and inductive analytic approach until we reached thematic saturation (<i>n</i> = 10).</p><p><strong>Results: </strong>We identified three major themes: 1. Hospitalization was an actionable moment for change; 2. Social factors were closely intertwined with AUD goals; and 3. Accessible addiction, physical health, and mental health services can help achieve AUD goals.</p><p><strong>Conclusions: </strong>Hospitalization may serve as a facilitator for Latinx individuals with AUD to achieve AUD goals. Addressing social determinants of health including housing, immigration status, and social support networks before, during, and after hospitalization, may help facilitate AUD goals. Providing language-concordant and accessible services may decrease barriers to achieving AUD goals.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2453634"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018276","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":"The importance of Naples prognostic score in predicting long-term mortality in heart failure patients.","authors":"Sidar Şiyar Aydın, Selim Aydemir, Murat Özmen, Emrah Aksakal, İbrahim Saraç, Faruk Aydınyılmaz, Onur Altınkaya, Oğuzhan Birdal, İbrahim Halil Tanboğa","doi":"10.1080/07853890.2024.2442536","DOIUrl":"10.1080/07853890.2024.2442536","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF) remains a significant health problem despite advances in diagnosis and treatment options. Malnutrition and increased inflammation predict poor disease prognosis. The parameters of the Naples prognostic score (NPS) include albumin, total cholesterol, neutrophil-lymphocyte ratio (NLR), and lymphocyte-monocyte ratio (LMR). We aimed to assess the potential of NPS as a predictor of long-term mortality in patients with HF.</p><p><strong>Methods: </strong>A total of 1728 patients with HF who applied to our center between 2018 and 2022 were included in this study. The NPS was computed and the patients were divided into three groups according to their NPS values as follows: NPS = 0 (Group 1), NPS = 1-2 (Group 2), and NPS = 3-4 (Group 3). We also evaluated the association between NPS value and HF mortality.</p><p><strong>Results: </strong>The patients were followed for a mean follow-up duration of 30 months. The mortality rate was 8.3% (145 patients). We carried out Model-1 and -2 Cox regression analyses to identify long-term mortality determinants. Model-2 was constructed by adding NPS to Model-1. NPS was significantly associated with HF mortality (Hazard Ratio: 2.194, 95% Confidence Interval: 1.176-4.091, <i>p</i> = 0.014). According to the Kaplan-Meier plot and log-rank analyses, there was a statistically significant difference in the long-term mortality of patients with HF and their NPS values for the entire cohort.</p><p><strong>Conclusion: </strong>Based on our findings, NPS showed promise as an independent predictor of long-term mortality in individuals with HF.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2442536"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11648133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824863","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":"Leucine-rich alpha-2 glycoprotein in combination with C-reactive protein for predicting endoscopic activity in Crohn's disease: a single-centre, cross-sectional study.","authors":"Yoshiaki Takada, Hiroki Kiyohara, Yohei Mikami, Masataka Taguri, Ryoya Sakakibara, Yasuhiro Aoki, Kosaku Nanki, Takaaki Kawaguchi, Yusuke Yoshimatsu, Shinya Sugimoto, Tomohisa Sujino, Kaoru Takabayashi, Naoki Hosoe, Haruhiko Ogata, Motohiko Kato, Yasushi Iwao, Nobuhiro Nakamoto, Takanori Kanai","doi":"10.1080/07853890.2025.2453083","DOIUrl":"10.1080/07853890.2025.2453083","url":null,"abstract":"<p><strong>Background and objective: </strong>Leucine-rich alpha-2 glycoprotein (LRG) is a novel biomarker for Crohn's disease (CD). The utility of combination use of LRG and C-reactive protein (CRP) has not been reported. This study aimed to investigate the diagnostic performance of LRG in combination with CRP to predict endoscopic activity.</p><p><strong>Methods: </strong>A single-centre, retrospective, cross-sectional study was conducted. Patients with CD who had serum LRG concentrations measured at least once between June 2020 and May 2021 were enrolled. Clinical activity was evaluated with the Harvey-Bradshaw Index (HBI). Spearman's rank correlation coefficient (<i>r_s</i>) was used to analyse the correlations between the HBI, LRG concentrations and CRP concentrations. In patients undergoing ileocolonoscopy or balloon-assisted enteroscopy within 60 days before or after LRG measurement, endoscopic activity was evaluated with the simple endoscopic score for Crohn's disease (SES-CD). The diagnostic performance of LRG and CRP for endoscopic activity was evaluated using receiver operating characteristic (ROC) analysis.</p><p><strong>Results: </strong>Four hundred and eighty-nine measurements in 343 patients were analysed. Although a strong correlation was found between LRG and CRP concentrations (<i>r_s</i> = 0.75), the HBI did not well correlate with LRG or CRP concentrations. Endoscopic activity was analysed in 56 patients. In diagnosing endoscopically moderate to severe activity (SES-CD > 6), the area under the ROC curve of LRG was greater than that of CRP (0.74 vs. 0.63; <i>p</i> = .037). The optimal cut-off value estimated by Youden's index was 15.5 µg/mL for LRG, and 0.13 mg/dL for CRP. LRG and CRP concentrations were considered positive when they were above these cut-off values, and the sensitivity and specificity for an SES-CD > 6 were 58.3% and 93.8%, respectively. Dual positivity of LRG and CRP showed the highest specificity.</p><p><strong>Conclusions: </strong>Combination use of dual positive LRG and CRP is useful for diagnosing endoscopically moderate to severe disease.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2453083"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017338","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}