Frontiers in Medicine最新文献

{"title":"Association and risk factors analysis of FeNO and CRP in bronchial asthma combined with obstructive sleep apnea.","authors":"Zhao Yan, Wang Peng Fei, Wang Nai Zhu","doi":"10.3389/fmed.2025.1546389","DOIUrl":"https://doi.org/10.3389/fmed.2025.1546389","url":null,"abstract":"<p><p>Bronchial asthma (BA) and obstructive sleep apnea (OSA) are chronic disorders of the respiratory system; both diseases are widespread and can cause a decrease in the quality of life. The latter contrasts the airway inflammation and excessive reactivity that define BA, and the intermittent airway obstruction during sleep that defines OSA results in periods of hypoxemia and disruptive breathing. BA appears when children have OSA in addition to other disorders, including night ventilation, breathlessness, and sleep conflicts. Current studies have focused on inflammatory indicators such as the FeNO and CRP in these diseases. FeNO is a measure of eosinophilic airway inflammation, which is usually high in asthma. In, contrast, CRP is a measure of systemic inflammation that is usually high in both forms of asthma. This review paper will focus on FeNO and CRP in connection to the pathophysiology of BA and OSA with further descriptions of how these markers relate to inflammation in both disorders. The review also focuses on how these markers interlink in patients with both diseases and how FeNO and CRP can also reflect the severity of the disease and the effectiveness of the treatments being used. Finally, identifying the interaction between these markers might advance the identification and management of patients with both BA and OSA.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1546389"},"PeriodicalIF":3.1,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12256523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of problem-based learning combined with seminar versus traditional teaching method in medical education in China: a systematic evaluation and meta-analysis.","authors":"Haozhong Wang, Qiang Yuan, Yinling Guo, Xiuli Zheng, Jian Luo, Junhui Qian","doi":"10.3389/fmed.2025.1592199","DOIUrl":"https://doi.org/10.3389/fmed.2025.1592199","url":null,"abstract":"<p><strong>Objectives: </strong>This study systematically evaluates the effectiveness of combining problem-based learning with the seminar teaching method and the traditional lecture-based learning model in medical education by meta-analysis.</p><p><strong>Methods: </strong>A computer-based search of major domestic and international literature databases was conducted, including PubMed, EMBASE, Web of Science Core Collection, Cochrane Library, China National Knowledge Infrastructure(CNKI), Wanfang Database, VIP Chinese Science and Technology Periodicals Database, and China Biology Medicine disk (CBMdisc). The search period spanned from the inception of the databases to 30 August 2024. Quantitative synthesis was performed using the RevMan V.5.4 software, following the Cochrane Reviewer's Handbook guidelines and the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement.</p><p><strong>Results: </strong>A total of 13 articles involving 857 medical students were included. The meta-analysis results revealed statistically significant differences between the experimental and control groups in the following areas: theoretical knowledge scores (MD = 4.99, 95% CI: 4.29-5.69, <i>p</i> < 0.00001); clinical skill scores (MD = 4.98,95% CI: 4.21-5.75, <i>p</i> < 0.00001); case analysis ability (SMD = 3.07, 95% CI: 2.66-3.47, <i>p</i> < 0.00001); Learning interest (SMD = 2.46, 95% CI: 1.89-3.03, <i>p</i> < 0.00001); Active learning (SMD = 3.26, 95% CI: 2.66-3.85, <i>p</i> < 0.00001); teamwork abilities (SMD = 1.66, 95% CI: 1.27-2.05, <i>p</i> < 0.00001); students' research and academic ability (MD = 26.85, 95% CI: 24.79-28.91, <i>p</i> < 0.00001). The experimental group demonstrated superior outcomes in all areas compared to the control group.</p><p><strong>Conclusion: </strong>This meta-analysis showed that the integration of problem-based learning and seminar teaching methods is an effective method for improving theoretical knowledge scores, clinical skill scores, case analysis ability, learning interest, active learning, teamwork abilities and research and academic ability.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1592199"},"PeriodicalIF":3.1,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12256451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systemic immune-inflammatory complex index as a novel predictor of sepsis prognosis: a retrospective cohort study using MIMIC-IV.","authors":"Xueqing Wang, Yingxin Lin, Sheng Zhang, Junshi Wang, Bin Huang, Hua Luo, Lei Huang","doi":"10.3389/fmed.2025.1608619","DOIUrl":"https://doi.org/10.3389/fmed.2025.1608619","url":null,"abstract":"<p><strong>Purpose: </strong>Sepsis is a life-threatening condition with high mortality and morbidity, making its early detection is critical. Current diagnosis relies on the Sequential [sepsis-related] Organ Failure Assessment score, which is complex and time-consuming to determine. Herein, we proposed a novel index, the systemic immune-inflammatory complex index (SIICI), defined as (neutrophil × monocyte count) × 10³/(platelet × lymphocyte count), to predict illness severity, and we verified its prognostic value.</p><p><strong>Methods: </strong>All data were extracted from the Medical Information Mart for Intensive Care database IV (MIMIC-IV). Cox proportional hazards and Kaplan-Meier survival analyses were used to determine the association between target indices and 30- and 90-days mortality. Restricted cubic splines were used to reveal the linear relationship between indices and mortality. To assess the prognostic value of the SIICI, the systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI), the area under the receiver operating characteristic curve (AUC), and the Youden index were measured and compared. Propensity score matching was used to reveal the association between the SIICI and secondary outcomes. Finally, subgroup analysis was performed to confirm the predictive ability of the SIICI.</p><p><strong>Results: </strong>We included 3,944 patients; among these, 609 (15.4%) and 663 (16.8%) patients had 30- and 90-days mortality, respectively. Our findings showed a strong association between the SIICI and mortality at 30 and 90 days in all models, which was more pronounced and better stratified than for the SIRI and SII. The <i>p</i>-value was < 0.05 in all cases; however, the SIICI was closer to a linear relationship with mortality than the SIRI or SII. Additionally, the SIICI had a higher AUC and Youden value than the other two indices. Moreover, a higher SIICI was positively associated with a longer stay in the intensive care unit or the hospital, an increased incidence of acute kidney injury, and greater use of renal replacement therapy and mechanical ventilation.</p><p><strong>Conclusion: </strong>The SIICI was positively associated with sepsis mortality and showed a better prognostic value than the SIRI and SII. The SIICI may be a promising complementary index to classical scoring systems for early assessment of patients with sepsis.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1608619"},"PeriodicalIF":3.1,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12258050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tranexamic acid impairs plasmin generation on human mesenchymal stem cells and derived membrane microvesicles, halting pericellular proteolysis.","authors":"Ramy Abou Rjeily, Christina Mrad, Fatiha Z El-Ghazouani, Florence Toti, Audrey Cras, Eduardo Angles-Cano","doi":"10.3389/fmed.2025.1570395","DOIUrl":"https://doi.org/10.3389/fmed.2025.1570395","url":null,"abstract":"<p><strong>Introduction: </strong>Mesenchymal stem cells (MSCs) participate in the dynamic remodeling of the extracellular matrix during wound healing, natural bleeding processes or cancer progression. Pericellular proteolysis is a key mechanism mediating the aforementioned processes.</p><p><strong>Aim: </strong>This study primarily aimed to define mechanistic pathways of plasmin formation and its consequences on MSC phenotype and functioning. We have also investigated the regulatory mechanisms mediated by PAI-1 and the ability of MSCs to shed microvesicles bearing the proteolytic machinery.</p><p><strong>Methods: </strong>Human MSCs were derived from bone marrow or umbilical cord donors. Cells thus obtained were seeded in multi-well plates and treated with different concentrations of plasminogen and pro-urokinase in the presence or absence of variable amounts of tranexamic acid. We measured MVs formation and phenotypical changes occurring on MSCs. The amount of plasmin formed was quantified by western blot along with the plasmin activity detected by photometry.</p><p><strong>Results: </strong>We demonstrate that vesiculation is the early response of plasmin formation at the membrane of MSCs followed by cell retraction and detachment. We measured the effect of TXA on plasmin formation and its consequences on cell behavior. Our findings provide the first demonstration that TXA efficiently inhibits MSC-driven plasmin generation by competitively blocking plasminogen binding to the uPA•uPAR complex at the cell plasma membrane.</p><p><strong>Discussion: </strong>We propose that plasmin formation on MSCs may be involved in pathological processes such as endometrial hemorrhage (metrorrhagia and Post-Partum Hemorrhage), autoimmune and ischaemic diseases, as well as cancer. By advancing our understanding of these mechanisms, we open new avenues for the development of biomarkers and targeted treatments.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1570395"},"PeriodicalIF":3.1,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12256440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shame and disgust in patients with inflammatory skin diseases: a systematic review of psychological correlates and psychotherapeutic approaches.","authors":"Jakob Fink-Lamotte, Sebastian Wehle, Frederica Brinkmann, Marie Pelzer, Cornelia Exner, Christian Stierle","doi":"10.3389/fmed.2025.1620940","DOIUrl":"https://doi.org/10.3389/fmed.2025.1620940","url":null,"abstract":"<p><strong>Introduction: </strong>Skin diseases are among the most common diseases worldwide and can cause severe psychological and social impairments. Negative self-directed emotions like shame and disgust may be important in the development and progression of these diseases, and thus, patients may benefit from psychotherapeutic approaches targeting shame and self-disgust. The first aim of this systematic review is to investigate the existing literature regarding shame and disgust as psychological correlates of inflammatory skin diseases. The second aim is to review the existing literature concerning the evidence of the efficacy of mindfulness-based and compassion-based therapy for alleviating shame and self-disgust in the context of skin diseases.</p><p><strong>Methods: </strong>Therefore, we carried out a systematic literature review via the databases PubMed, Web of Science and PSYINDEX.</p><p><strong>Results: </strong>46 manuscripts were included in this review. Research shows that acne vulgaris, psoriasis, and atopic eczema are accompanied by a severe psychosocial burden, shame, and self-disgust, often due to highly visible skin lesions in affected patients. The use of mindfulness-based and compassion-based approaches is already being studied to address the experiences of shame and disgust due to these diseases, and initial promising results indicate that they can be considered beneficial in the holistic therapy of skin diseases.</p><p><strong>Discussion: </strong>This systematic review shows that skin disorders have a significant psychosocial impact, leading to shame and self-disgust, especially due to the manifestation of visible skin lesions in affected patients. Mindfulness- and compassion-based approaches are currently being studied as potential treatments for the psychosocial impacts of skin diseases, and show promising results in addressing affected patients' psychological burden.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1620940"},"PeriodicalIF":3.1,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12256482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The influence of high myopia-related exotropia on surgical dose-response in unilateral recession and resection surgery: a retrospective study.","authors":"Chao Li, ZhiYin Lou, Fan Yang","doi":"10.3389/fmed.2025.1588698","DOIUrl":"https://doi.org/10.3389/fmed.2025.1588698","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the impact of high myopia on the surgical dose-response in unilateral recession and resection (R&R) surgery for exotropia.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 101 Chinese patients who underwent unilateral R&R surgery for concomitant exotropia between June 2021 and June 2024. Patients were divided into two groups based on axial length: those with high myopia (<i>n</i> = 38) and those without high myopia (<i>n</i> = 63). Surgical doses for lateral rectus (LR) recession and medial rectus (MR) resection were compared between the groups. Preoperative and postoperative deviations were measured, and statistical analyses were performed to assess the relationship between surgical dose, axial length (AL), and other clinical variables.</p><p><strong>Results: </strong>Age, duration of exotropia, and AL differed significantly between the groups, but other baseline characteristics were comparable. The LR recession dose did not differ significantly between the high myopia group (6.40 ± 1.11 mm) and the non-high myopia group (6.74 ± 1.00 mm, <i>p</i> > 0.05). However, the MR resection dose was significantly lower in the high myopia group (5.77 ± 1.02 mm) compared to the non-high myopia group (6.32 ± 0.92 mm, <i>p</i> < 0.05). The MR resection and LR recession dose was positively correlated with the horizontal deviation (<i>p</i> < 0.001), but showed no significant correlation with AL (<i>p</i> > 0.05).</p><p><strong>Conclusion: </strong>Exotropia with high myopia had a greater surgical dose response than those without high myopia. No significant difference was found in LR recession dose, but the MR resection dose was significantly lower in the high myopia group.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1588698"},"PeriodicalIF":3.1,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12256437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transforming individuals and institutions through competency-based faculty development.","authors":"Mariah L Robertson, Joseph Cofrancesco, Rachel B Levine","doi":"10.3389/fmed.2025.1621376","DOIUrl":"https://doi.org/10.3389/fmed.2025.1621376","url":null,"abstract":"<p><p>Faculty development (FD) is foundational to advancing the quality of health professions education and, by extension, the healthcare system. While FD has traditionally emphasized teaching, its scope now includes educational leadership, scholarship, and systems-level change. This Perspective argues for the adoption of competency-based FD frameworks to not only support individual educator growth but also catalyze institutional transformation. Aligning FD programming with established educator competencies fosters professional identity, enables targeted skill development, and legitimizes educational contributions in academic medicine. Drawing from global models-including frameworks from the United States, United Kingdom, the Netherlands, and Lebanon-we illustrate how institutions can adapt existing structures to their specific needs. We describe our experience at Johns Hopkins School of Medicine, where a locally tailored competency framework was developed to define six core educator domains and associated metrics. This initiative has driven significant changes in FD offerings, educator recognition, and promotion processes. Key lessons include the importance of making educator work visible, aligning FD with promotion pathways, delivering flexible programming, and engaging stakeholders early. Adapting frameworks to local contexts clarifies institutional values, supports customized faculty programming, and strengthens advocacy for educational excellence. Ultimately, competency-based FD serves as a strategic tool to enhance faculty satisfaction, retention, and institutional impact. We encourage institutions to adopt a systems-oriented approach that integrates shared standards with local relevance to elevate educational practice and culture.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1621376"},"PeriodicalIF":3.1,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12256433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating clinical features, inflammatory markers, and immune profiles: a Yunke-based nomogram model for rheumatoid arthritis prognosis.","authors":"Zhen Wang, Yihao Li, Jingjing Zhao, Lin Wang, Zengyu Cheng, Fuzeng Zheng","doi":"10.3389/fmed.2025.1617957","DOIUrl":"https://doi.org/10.3389/fmed.2025.1617957","url":null,"abstract":"<p><strong>Objective: </strong>To develop a prognostic nomogram integrating clinical, inflammatory, and immune parameters for rheumatoid arthritis (RA) patients receiving Yunke-drug combination therapy, facilitating personalized treatment decisions.</p><p><strong>Methods: </strong>We retrospectively analyzed 304 RA patients (2010-2024) divided into training (<i>n</i> = 213) and validation (<i>n</i> = 91) cohorts. Predictor selection through univariate/multivariate logistic regression informed nomogram construction. Model performance was assessed via ROC curves, calibration plots, and decision curve analysis (DCA).</p><p><strong>Results: </strong>Six independent predictors emerged: elevated rheumatoid factor (OR = 1.32, 1.08-1.62), CRP > 10 mg/L (OR = 2.14, 1.45-3.16), ≥4 swollen joints (OR = 1.87, 1.22-2.88), TNF-<i>α</i> > 8.1 pg./mL (OR = 2.05, 1.33-3.17), IL-6 > 15 pg./mL (OR = 1.94, 1.25-3.01), and CD3 + T cells <650/μL (OR = 1.76, 1.15-2.70) (all <i>p</i> < 0.05). The nomogram showed strong discrimination (C-index: 0.883 training; 0.823 validation) with AUCs of 0.881 (0.804-0.958) and 0.823 (0.679-0.966). Sensitivity/specificity reached 94.3%/90.7% (training) versus 78.3%/81.2% (validation). DCA confirmed clinical utility across probability thresholds (15-85%).</p><p><strong>Conclusion: </strong>This first multifactorial nomogram for Yunke-combined therapy integrates joint assessments, serum biomarkers, cytokine profiles, and cellular immunity indicators. Demonstrated predictive accuracy (30.5% training; 29.7% validation response rates) supports its potential for therapeutic monitoring. While internally validated, multicenter studies are required to confirm generalizability. The model establishes a framework for precision RA management, with implications for dose optimization and resistance mechanism research.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1617957"},"PeriodicalIF":3.1,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12256532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine learning-enabled prediction of bone metastasis in esophageal cancer.","authors":"Liqiang Liu, Wanshi Duan, Tao She, Shouzheng Ma, Haihui Wang, Jiakuan Chen","doi":"10.3389/fmed.2025.1620687","DOIUrl":"https://doi.org/10.3389/fmed.2025.1620687","url":null,"abstract":"<p><strong>Purpose: </strong>Bone metastasis (BM) is a common manifestation of distant spread in patients with esophageal cancer. This study aimed to develop a machine learning algorithm to predict the risk of bone metastasis in esophageal cancer patients, thereby supporting clinical decision-making support.</p><p><strong>Methods: </strong>Clinical and pathological data of esophageal cancer patients were obtained from the SEER database of the U.S. National Institutes of Health from 2010 to 2020. Six machine learning models were constructed: Support Vector Machine, Logistic Regression, Extreme Gradient Boosting, Neural Network, Random Forest, and k-Nearest Neighbors. Models performance was evaluated using accuracy, precision, recall, F1-score, and the area under the receiver operating characteristic curve. The optimal model was further used to interpret the associations between clinicopathological features and bone metastasis.</p><p><strong>Results: </strong>A total of 9,744 patients were included, with 532 (5.47%) had bone metastasis and 9,212 (94.53%) without. Multivariate logistic regression analysis identified age, T stage, N stage, and histological type as independent risk factors for bone metastasis. The XGBoost model demonstrated the best performance, achieving an accuracy of 0.80, a recall of 0.99, a precision of 0.72, an F1-score of 0.8300, and AUC of 0.92.</p><p><strong>Conclusion: </strong>The XGBoost model showed excellent predictive performance for bone metastasis in esophageal cancer patients, providing valuable insights for guiding clinical treatment decisions.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1620687"},"PeriodicalIF":3.1,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12256537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute abdomen with intraperitoneal free gas: a diagnostic pitfall of pneumatosis cystoides intestinalis-a case report.","authors":"Hao Wang, Yan-Hui Yang","doi":"10.3389/fmed.2025.1588800","DOIUrl":"https://doi.org/10.3389/fmed.2025.1588800","url":null,"abstract":"<p><strong>Background: </strong>Pneumatosis cystoides intestinalis (PCI) is a rare condition characterized by the presence of multiple gas-filled cysts located beneath the intestinal submucosa or plasma membrane. The pathogenesis of PCI remains incompletely understood, and its clinical presentation lacks specificity.</p><p><strong>Case description: </strong>A 69-year-old woman was admitted to the hospital with symptoms of abdominal distension, abdominal pain lasting over 2 weeks, and altered consciousness for 3 days. She had a two-year history of mixed connective tissue disease and was undergoing regular hormone therapy. Upon admission, she demonstrated signs of peritoneal irritation, and computed tomography (CT) revealed the presence of multiple free air pockets within the abdominal cavity, as well as \"bead-like\" translucent areas within the intestinal wall. An emergency abdominal exploration revealed extensive gas accumulation in the wall of the small intestine and multiple gas bubbles in the mesentery. Subsequently, resection and anastomosis of the affected intestinal section were performed. Postoperative pathology identified multiple non-endothelial cystic cavities within the submucosa and muscularis propria of this segment of the small intestine, with <i>Escherichia coli</i> and Phocaeicola vulgatus detected in the affected intestinal wall. The patient was further treated in the Intensive Care Unit (ICU) after surgery, but following a brief period of improvement, she developed a lung infection and unfortunately passed away.</p><p><strong>Conclusion: </strong>This case report demonstrates the diagnostic difficulties in patients with peritonitis with abdominal free gas in intestinal gas cysts, reveals the potential role of abnormal intestinal flora, especially the never reported colonization by Phocaeicola vulgatus, in the development of PCI combined with abdominal free gas.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1588800"},"PeriodicalIF":3.1,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12256438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}