Frontiers in Medicine最新文献

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New medicines for childhood-onset systemic lupus erythematosus: an EU perspective on paediatric drug development. 治疗儿童期系统性红斑狼疮的新药:欧盟对儿科药物开发的看法。
IF 3.1 3区 医学
Frontiers in Medicine Pub Date : 2025-07-10 eCollection Date: 2025-01-01 DOI: 10.3389/fmed.2025.1583140
Roberto De Lisa, Fernando de Andres-Trelles, Ralph Bax, Sara Galluzzo, Brian Alward, Andrew Thomson, Dominik Karres, Hermine I Brunner, Nicolino Ruperto, Gunter F Egger
{"title":"New medicines for childhood-onset systemic lupus erythematosus: an EU perspective on paediatric drug development.","authors":"Roberto De Lisa, Fernando de Andres-Trelles, Ralph Bax, Sara Galluzzo, Brian Alward, Andrew Thomson, Dominik Karres, Hermine I Brunner, Nicolino Ruperto, Gunter F Egger","doi":"10.3389/fmed.2025.1583140","DOIUrl":"https://doi.org/10.3389/fmed.2025.1583140","url":null,"abstract":"<p><p>Childhood-onset systemic lupus erythematosus (cSLE, also known as juvenile or paediatric SLE) is a severe autoimmune disease affecting multiple organs and systems, with higher morbidity and severity compared to adult SLE (aSLE). The European Union's Paediatric Regulation No. 1901/2006 mandates the agreement of a paediatric investigation plan (PIP) for new investigational medicinal products (IMPs) to ensure reliable efficacy and safety data for paediatric indications. This study examined the experience of the Paediatric Committee (PDCO) at the European Medicines Agency (EMA) in assessing PIPs for cSLE, highlighting the challenges and potential solutions in the planning of development of novel agents in this disease and providing the academia point of view on key points of cSLE medicines development. Regulatory requirements so far have been rather consistent when a PIP is agreed, and recommend randomised controlled trials to enable a full benefit-risk assessment. However, PIPs are agreed when adult efficacy data are not yet available and as soon as the product lifecycle progresses, new methods and approaches can offer some advantages over randomised controlled trials in this setting and might provide a comparable level of evidence of efficacy in an alternative way. Extrapolation of adult efficacy data to paediatrics is one possible approach, provided that adult trials produce data that can be used for this purpose and that the degree of residual uncertainty is appropriately quantified for the medicinal product in question. The study also highlights the value of enhanced international cooperation among regulatory authorities, developers, and academic institutions in this field to support collaborative efforts among various stakeholders.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1583140"},"PeriodicalIF":3.1,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12286927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707035","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}
引用次数: 0
Pancreatic stone protein inhibits pyroptosis of pancreatic acinar cells in sepsis-associated pancreatic injury. 胰石蛋白抑制脓毒症相关胰腺损伤中胰腺腺泡细胞的焦亡。
IF 3.1 3区 医学
Frontiers in Medicine Pub Date : 2025-07-10 eCollection Date: 2025-01-01 DOI: 10.3389/fmed.2025.1566728
Pingping Liu, Zhenghui Xiao, Xiulan Lu, Xinping Zhang, Jiaotian Huang
{"title":"Pancreatic stone protein inhibits pyroptosis of pancreatic acinar cells in sepsis-associated pancreatic injury.","authors":"Pingping Liu, Zhenghui Xiao, Xiulan Lu, Xinping Zhang, Jiaotian Huang","doi":"10.3389/fmed.2025.1566728","DOIUrl":"https://doi.org/10.3389/fmed.2025.1566728","url":null,"abstract":"<p><strong>Introduction: </strong>Sepsis-associated pancreatic injury (SPI) is characterized by an increased incidence and significantly higher mortality rates. However, its underlying pathogenesis remains inadequately understood. As an acute-phase protein secreted by the pancreas, the role of pancreatic stone protein/regenerating protein (PSP/reg) in SPI remains unclear.</p><p><strong>Materials and methods: </strong>A total of 137 patients were consecutively admitted to the pediatric intensive care unit (PICU) of Hunan Children's Hospital with sepsis were included. A sepsis-associated pancreatic injury mice model was established using cecal ligation and puncture. Pancreatic injury was assessed using HE staining. Pyroptotic pancreatic cells were evaluated via Hoechst 33342/PI staining. The expression levels of caspase-1 in the pancreatic tissues and acinar cells were determined by immunohistochemistry and immunofluorescence. Protein levels of NLRP3, caspase-1 p20, and GSDMD-N were analyzed using Western blot. The concentrations of TNF-α, IL-6, IL-1β, and IL-18 were measured by ELISA.</p><p><strong>Results and discussion: </strong>Children in dead group exhibited higher circulating PSP/reg levels compared with children in survival group. The circulating PSP/reg level in the septic shock group was significantly higher than that in the sepsis group and the severe sepsis group. The circulating PSP/reg level in the severe elevation of pancreatic amylase group was significantly higher than that in the normal pancreatic amylase group and the mild elevation of pancreatic amylase group. Administration of PSP/reg significantly mitigated pancreatic injury, as evidenced by reduced histological scores and necrotic areas. The amylase activity, the serum levels of LDH, TNF-α, and IL-6 were remarkably downregulated in PSP/reg-treated mice compared to the SPI mice. PSP/reg administration significantly alleviated the LPS-induced pyroptosis. Pyroptosis activation-associated proteins, NLRP3, Caspase-1 p20 and GSDMD-N in pancreatic acinar cells were greatly elevated following LPS stimulation, which decreased with PSP/reg treatment.</p><p><strong>Conclusion: </strong>PSP/reg may exhibit protective effects by inhibiting pancreatic pyroptosis in sepsis-associated pancreatic injury model and LPS-stimulated pancreatic acinar cells.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1566728"},"PeriodicalIF":3.1,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12288849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707036","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}
引用次数: 0
Bibliometric analysis and visualization mapping of herpes zoster vaccine publications from 1999 to 2024. 1999 - 2024年带状疱疹疫苗出版物的文献计量分析和可视化制图。
IF 3.1 3区 医学
Frontiers in Medicine Pub Date : 2025-07-10 eCollection Date: 2025-01-01 DOI: 10.3389/fmed.2025.1516450
Wenli Gao, Dongyang Gao, Lin Li, Juan Li, Xinyi Yao, Junling Zhang
{"title":"Bibliometric analysis and visualization mapping of herpes zoster vaccine publications from 1999 to 2024.","authors":"Wenli Gao, Dongyang Gao, Lin Li, Juan Li, Xinyi Yao, Junling Zhang","doi":"10.3389/fmed.2025.1516450","DOIUrl":"https://doi.org/10.3389/fmed.2025.1516450","url":null,"abstract":"<p><strong>Background: </strong>Herpes Zoster (HZ) is a viral skin disease caused by reactivation of latent Varicella Zoster Virus (VZV) in human ganglia, presenting with unilateral neuropathic pain and vesicular rash. HZ imposes significant burden on patients and healthcare systems, often complicated by postherpetic neuralgia (PHN). The live attenuated zoster vaccine (ZVL, Zostavax) reduces HZ risk by 51% and PHN by 65% in adults ≥60 years. The recombinant zoster vaccine (RZV, Shingrix) shows approximately 90% efficacy in adults ≥50 years. Despite withdrawal of Zostavax from the U.S. market, RZV uptake remains suboptimal due to vaccine hesitancy and provider knowledge gaps. This study aims to analyze global research trends on HZ vaccines using bibliometric methods.</p><p><strong>Methods: </strong>Publications on \"herpes zoster\" and \"zoster vaccine\" were retrieved from the Web of Science Core Collection (WoSCC) database (1999-2024). Bibliometric and visualization tools including CiteSpace, VOSviewer, and R-bibliometrix were applied to analyze contributions by countries, institutions, journals, authors, references, and keywords.</p><p><strong>Results: </strong>A total of 719 articles from 261 journals across 56 countries were included. The United States led publications, with GlaxoSmithKline (GSK) as the most prolific institution. <i>Vaccine</i> was the most prolific journal; Levin et al. was the most productive author. The most cited article, \"Efficacy of the Herpes Zoster Subunit Vaccine in Adults Aged 70 Years or Older,\" by Cunningham AL, appeared in the <i>New England Journal of Medicine</i>. Frequently used keywords included \"herpes zoster,\" \"vaccination,\" \"postherpetic neuralgia,\" \"efficacy,\" \"subunit vaccine,\" and \"safety\".</p><p><strong>Conclusion: </strong>This bibliometric study comprehensively summarizes HZ vaccine research over 25 years, offering insights to guide future research and clinical practice.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1516450"},"PeriodicalIF":3.1,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12287100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707011","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}
引用次数: 0
Efficacy of acupuncture on upper limb dysfunction after stroke: a randomized controlled trial protocol with surface electromyography evaluation. 针刺对中风后上肢功能障碍的疗效:一项随机对照试验方案与表面肌电图评估。
IF 3.1 3区 医学
Frontiers in Medicine Pub Date : 2025-07-10 eCollection Date: 2025-01-01 DOI: 10.3389/fmed.2025.1615762
Liying Wang, Zining Guo, Jiewen Zhang, Run Lin, Xiaorong Tang, Cui Gao, Shaoyang Cui, Nenggui Xu
{"title":"Efficacy of acupuncture on upper limb dysfunction after stroke: a randomized controlled trial protocol with surface electromyography evaluation.","authors":"Liying Wang, Zining Guo, Jiewen Zhang, Run Lin, Xiaorong Tang, Cui Gao, Shaoyang Cui, Nenggui Xu","doi":"10.3389/fmed.2025.1615762","DOIUrl":"https://doi.org/10.3389/fmed.2025.1615762","url":null,"abstract":"<p><strong>Background: </strong>Upper extremity functional reconstruction remains a major clinical challenge in post-stroke neurorehabilitation. Acupuncture has unique advantages as a complementary alternative therapy. Thus, in this study, we aim to compare sham acupuncture to reveal the efficacy and safety of acupuncture in the treatment of upper limb dysfunction post-stroke with surface electromyography (sEMG), a validated objective assessment tool, and a subjective index.</p><p><strong>Methods: </strong>In this prospective, principal-investigator-blinded randomized controlled trial, 74 patients who meet the inclusion criteria are randomly assigned to the acupuncture and sham acupuncture groups in a 1:1 ratio using a central randomization system. The patients receive the same routine basic treatment. The core acupoints selected in the acupuncture group are GV20 (Bai hui), DU14 (Da zhui), and LI11 (Qu chi). Six non-meridian acupuncture points are selected for the sham acupuncture group. The treatment cycle lasts for 4 weeks, five times per week, for 20 treatments. The Fugl-Meyer Upper Limb Assessment scale score is used as the main outcome. Secondary outcomes include the Motor Status Scale, Action Research Arm Test, Motor Assessment Scale, Self-rating Anxiety Scale, and Self-rating Depression Scale scores. Simultaneously using sEMG as an auxiliary efficacy indicator.</p><p><strong>Conclusion: </strong>This study assesses the effectiveness and safety of acupuncture for post-stroke upper limb impairment in multiple aspects and elucidates the underlying neuromuscular effect mechanism of acupuncture to provide clinical evidence.</p><p><strong>Registration: </strong>International Traditional Medicine Clinical Trials Registry. Registration No. ITMCTR2025000228. November 27, 2024. The study was approved by the Ethics Committee of Guangzhou University of Traditional Chinese Medicine, Shenzhen Hospital (Futian), Ethics. No. GZYLL (KY)-2024-045-01. November 13, 2024.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1615762"},"PeriodicalIF":3.1,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12287058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707026","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}
引用次数: 0
Current status of medical research among undergraduate medical students in China: a nationwide questionnaire survey. 中国医科大学生医学研究现状:一项全国性的问卷调查。
IF 3.1 3区 医学
Frontiers in Medicine Pub Date : 2025-07-10 eCollection Date: 2025-01-01 DOI: 10.3389/fmed.2025.1593233
Liuyan Xu, Jian Zhou, Chengxi Fan, Kailin Huang, Abudukerimu Muyesha, Rurong Wang, Xuehan Li
{"title":"Current status of medical research among undergraduate medical students in China: a nationwide questionnaire survey.","authors":"Liuyan Xu, Jian Zhou, Chengxi Fan, Kailin Huang, Abudukerimu Muyesha, Rurong Wang, Xuehan Li","doi":"10.3389/fmed.2025.1593233","DOIUrl":"https://doi.org/10.3389/fmed.2025.1593233","url":null,"abstract":"<p><p>The increasing demand for physician-scientists highlights the essential role of medical schools in fostering the development of these professionals. This study aims to assess the current status of research engagement, attitudes toward research, and barriers to participation among Chinese undergraduate medical students. A cross-sectional, nationwide questionnaire survey was conducted in February 2024 using an online platform, with responses from 3,423 students (effective rate: 87.79%). Furthermore, we have designed a questionnaire among physician-scientists with experience in teaching undergraduates about research at West China Hospital of Sichuan University, resulting in 51 responses being collected. The questionnaires were developed based on existing literature and expert input and underwent pilot testing. Reliability and validity were confirmed via Cronbach's alpha and KMO-Bartlett tests. Statistical analyses included chi-square, ANOVA, and multivariate regression. Results showed that 70.6% of students had engaged in research at least once, but reported limited exposure and a lack of knowledge as major barriers. Males and preventive and basic medicine students demonstrated higher research interest and participation. Factors such as gender, major, academic year, and prior research involvement significantly influenced students' attitudes and perceptions of scientific research. The faculty considered the presence of undergraduate research engagements to be a significant assessment criterion. They opined that the prevailing undergraduate research climate was inadequate. The findings underscore the need for structured, competency-based research training and institutional support.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1593233"},"PeriodicalIF":3.1,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12286971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707022","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}
引用次数: 0
Unraveling the role of cumulative triglyceride-total cholesterol-body weight index in stroke development: evidence from the CHARLS cohort. 揭示累积甘油三酯-总胆固醇-体重指数在卒中发展中的作用:来自CHARLS队列的证据。
IF 3.1 3区 医学
Frontiers in Medicine Pub Date : 2025-07-10 eCollection Date: 2025-01-01 DOI: 10.3389/fmed.2025.1616520
Huang Luwen, Zhang Yunwei, Xu Lei, Li Linlin, Yu Ming
{"title":"Unraveling the role of cumulative triglyceride-total cholesterol-body weight index in stroke development: evidence from the CHARLS cohort.","authors":"Huang Luwen, Zhang Yunwei, Xu Lei, Li Linlin, Yu Ming","doi":"10.3389/fmed.2025.1616520","DOIUrl":"https://doi.org/10.3389/fmed.2025.1616520","url":null,"abstract":"<p><strong>Background: </strong>This study investigated the association between the cumulative triglyceride-total cholesterol-body weight index (TCBI) and the risk of stroke among middle-aged and older adults, focusing on hypertension as a potential mediator.</p><p><strong>Methods: </strong>Data from 5,598 participants aged ≥ 45 years in the China Health and Retirement Longitudinal Study were analyzed over a median follow-up of 57.2 months. CumTCBI was calculated as ((TCBI<sub>(2011)</sub> + TCBI<sub>(2015)</sub>)/2) × (2015-2011). The risk of stroke was the primary outcome. Cox proportional hazards models and restricted cubic splines were used to examine the association between CumTCBI and stroke risk. Mediation analysis investigated the role of hypertension as a potential mediator of the association between CumTCBI and stroke risk.</p><p><strong>Results: </strong>During the follow-up period, 480 (8.93%) participants experienced stroke. The fully adjusted CumTCBI was significantly associated with stroke (HR per 1 SD = 1.166). A non-linearly association was observed, with stroke risk increasing when CumTCBI was below 12.639 (HR per 100 units = 1.166, <i>P</i> = 0.002) and remaining stable beyond this threshold (<i>P</i> = 0.356). Additionally, hypertension mediated 27.4% of the association.</p><p><strong>Conclusion: </strong>CumTCBI is non-linearly associated with stroke risk, partially mediated by hypertension. Managing both metabolic status and hyperternsion may reduce stroke risk in aging populations.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1616520"},"PeriodicalIF":3.1,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12287075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707041","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}
引用次数: 0
Diabetic foot ulcer healing with polylactic acid membrane assessed by thermographic imaging: a case report. 热成像评价聚乳酸膜治疗糖尿病足溃疡1例。
IF 3.1 3区 医学
Frontiers in Medicine Pub Date : 2025-07-09 eCollection Date: 2025-01-01 DOI: 10.3389/fmed.2025.1568144
Víctor Manuel Loza-González, Mario Aurelio Martínez-Jiménez, Ana Lorena Novoa-Moreno, José Luis Ramírez-GarcíaLuna, Alejandra Ortiz-Dosal, Eleazar Samuel Kolosovas-Machuca
{"title":"Diabetic foot ulcer healing with polylactic acid membrane assessed by thermographic imaging: a case report.","authors":"Víctor Manuel Loza-González, Mario Aurelio Martínez-Jiménez, Ana Lorena Novoa-Moreno, José Luis Ramírez-GarcíaLuna, Alejandra Ortiz-Dosal, Eleazar Samuel Kolosovas-Machuca","doi":"10.3389/fmed.2025.1568144","DOIUrl":"https://doi.org/10.3389/fmed.2025.1568144","url":null,"abstract":"<p><p>Diabetic foot ulcers reduce patient's quality of life and increase treatment costs, evaluating this condition is promising. We report the clinical progression of an elderly patient who developed a diabetic foot ulcer following minor trauma. She was treated for over 2 months until her condition progressed to Grade 4 on the Wagner Classification of Diabetic Foot. A Serial infrared thermography was performed. The treatment plan included antibiotics and a polylactic acid membrane until complete ulcer remission. Thermographic imaging showed a quantitative reduction of the temperature differences between the affected and contralateral foot from an initial ΔT: -4.6°C ± 2.4, progressing to ΔT: -1.7°C ± 1.6 at 12 weeks, and a temperature reduction from the proximal third tibial area with ΔT: -1.7°C ± 0.6, with a change to ΔT 0.8°C ± 0.4 at 12 weeks near the metatarsal bone region. This article underscores the use of infrared thermography to give physicians feedback on ulcer healing progression phases and treatment effectiveness.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1568144"},"PeriodicalIF":3.1,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12283997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698089","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}
引用次数: 0
Efficacy and safety of sofosbuvir plus daclatasvir in hemodialysis patients with genotype 1b or 2a hepatitis C virus infection: a single-arm, prospective real-world study. 索非布韦联合daclatasvir治疗基因型1b或2a型丙型肝炎病毒感染血液透析患者的疗效和安全性:一项单臂、前瞻性现实世界研究
IF 3.1 3区 医学
Frontiers in Medicine Pub Date : 2025-07-09 eCollection Date: 2025-01-01 DOI: 10.3389/fmed.2025.1576654
Kaili Wang, Hongyu Yao, Xia Zhou, Hongling Liu, Jun Zhao
{"title":"Efficacy and safety of sofosbuvir plus daclatasvir in hemodialysis patients with genotype 1b or 2a hepatitis C virus infection: a single-arm, prospective real-world study.","authors":"Kaili Wang, Hongyu Yao, Xia Zhou, Hongling Liu, Jun Zhao","doi":"10.3389/fmed.2025.1576654","DOIUrl":"https://doi.org/10.3389/fmed.2025.1576654","url":null,"abstract":"<p><strong>Background/aims: </strong>This investigation assessed the clinical outcomes and adverse effects of combination therapy using sofosbuvir (SOF) and daclatasvir (DCV) among dialysis-dependent patients infected with hepatitis C virus (HCV) genotypes 1b or 2a in real-world settings.</p><p><strong>Methods: </strong>We conducted a prospective, single-arm interventional trial comprising 16maintenance hemodialysis patients (14 with HCV-1b, 2 with HCV-2a). Participants received SOF-DCV combination therapy over 24 weeks with monitoring at weeks 4, 12, and 24 during treatment, plus a follow-up assessment 12 weeks post-treatment completion. The primary outcome measure was sustained virologic response at 12 weeks post-treatment (SVR12). Secondary endpoints included therapeutic tolerance and safety profiles.</p><p><strong>Results: </strong>All 16 participants completed the prescribed treatment regimen. Demographic characteristics revealed a mean age of 57.0 years, male predominance (75%), average dialysis duration of 7.0 years, and mean body weight of 63.0 kg. Five patients (31.3%) had compensated cirrhosis. Liver function parameters remained stable throughout the study period. Rapid virologic response (RVR) was documented in 87.5% (14/16) of participants, while end-of-treatment response (ETR) and SVR12 were both achieved in 93.8% (15/16) of cases. All cirrhotic patients (5/5) ultimately attained SVR12. The therapeutic regimen demonstrated favorable tolerability, with no treatment discontinuations due to adverse events. One participant was lost to follow-up. APRI scores significantly decreased from baseline (0.56) to week 24 (0.20, <i>p</i> < 0.001). Reported adverse reactions included headache, fatigue, nausea (each 6.3%), and anemia (18.8%).</p><p><strong>Conclusion: </strong>The 12-week SOF-DCV combination demonstrated robust therapeutic efficacy and acceptable safety profiles in hemodialysis patients infected with HCV genotypes 1b or 2a, including those with compensated cirrhosis.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1576654"},"PeriodicalIF":3.1,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12283709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698103","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}
引用次数: 0
Endothelial activation and stress index for prediction of mortality in asthma. 内皮细胞激活和应激指数预测哮喘患者死亡率。
IF 3.1 3区 医学
Frontiers in Medicine Pub Date : 2025-07-09 eCollection Date: 2025-01-01 DOI: 10.3389/fmed.2025.1622944
Yili He, Yang Li, Yuan Xiaojin, Dan Wu, Wenyan Jiang, Xianlong Xie
{"title":"Endothelial activation and stress index for prediction of mortality in asthma.","authors":"Yili He, Yang Li, Yuan Xiaojin, Dan Wu, Wenyan Jiang, Xianlong Xie","doi":"10.3389/fmed.2025.1622944","DOIUrl":"https://doi.org/10.3389/fmed.2025.1622944","url":null,"abstract":"<p><strong>Background: </strong>EASIX (Endothelial Activation and Stress Index) has been shown to be associated with the prognosis of various diseases in numerous studies, but its relationship with short- and medium-term outcomes in asthma patients admitted to the ICU (Intensive Care Unit) remains unclear.</p><p><strong>Methods: </strong>This retrospective cohort study included 3,737 asthma patients from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database (2008-2019). We calculated log2(EASIX) using platelet count, creatinine, and lactate dehydrogenase levels measured on ICU admission day 1. We analyzed the association between log2(EASIX) and 28-day and 60-day in-hospital mortality using multivariable Cox regression and restricted cubic splines. Proportional hazards assumptions were tested to ensure no time-dependent bias. Subgroup analyses and interaction tests were conducted to verify the stability. ROC (Receiver Operating Characteristic) analysis was performed to assess the prognostic performance of log2(EASIX).</p><p><strong>Results: </strong>The mean age of patients was 62.5 years, with 289 deaths at 28 days and 432 at 60 days. Higher log2(EASIX) was independently associated with increased mortality at both 28 days [hazard ratio (HR) = 1.14, 95% confidence interval (CI): 1.02-1.27, <i>p</i> = 0.017] and 60 days (HR = 1.13, 95% CI: 1.02-1.24, <i>p</i> = 0.017). The highest tertile had significantly higher mortality than the lowest tertile (28-day: HR = 1.84, 95% CI: 1.16- 2.90, <i>p</i> = 0.009; 60-day: HR = 1.65, 95% CI: 1.08-2.51, <i>p</i> = 0.019). A linear relationship was observed between log2(EASIX) and both 28-day and 60-day mortality (P for non-linearity test = 0.29 and 0.633). Subgroup analyses and interaction tests indicated that the association between log2(EASIX) and mortality was stable. The ROC curve analysis revealed AUC (Area Under the Curve) values for 28- and 60-day mortality of 0.892 and 0.881, respectively, with Youden indices of 0.63 and 0.61, indicating good predictive performance.</p><p><strong>Conclusion: </strong>Elevated log2(EASIX) levels are independently associated with increased in-hospital mortality in patients with asthma. Endothelial Activation and Stress Index show good predictive performance for short- and medium-term mortality in this patient population.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1622944"},"PeriodicalIF":3.1,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12283289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698104","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}
引用次数: 0
Eosinopenia predicts poor outcomes in patients with lung cancer with the omicron variant of COVID-19. 红细胞减少预示着携带新冠病毒组粒变异的肺癌患者预后不良。
IF 3.1 3区 医学
Frontiers in Medicine Pub Date : 2025-07-09 eCollection Date: 2025-01-01 DOI: 10.3389/fmed.2025.1583843
Xiao Hu, Jie Tan, Rumei Luan, Dongyan Ding, Ming Yue, Junling Yang, Qianfei Xue
{"title":"Eosinopenia predicts poor outcomes in patients with lung cancer with the omicron variant of COVID-19.","authors":"Xiao Hu, Jie Tan, Rumei Luan, Dongyan Ding, Ming Yue, Junling Yang, Qianfei Xue","doi":"10.3389/fmed.2025.1583843","DOIUrl":"https://doi.org/10.3389/fmed.2025.1583843","url":null,"abstract":"<p><strong>Background: </strong>Lung cancer is among the malignancies most vulnerable to coronavirus disease 2019 (COVID-19). Eosinophils have anti-tumor and antiviral effects. Since November 2021, the omicron variant of COVID-19 has become a topic of concern; however, the impact of eosinophils on the severity and outcomes of patients with lung cancer with omicron remains uncertain. This study aimed to utilize eosinophils to predict patient outcomes and guide the prevention and monitoring of omicron.</p><p><strong>Methods: </strong>This study performed an analysis of 284 patients with lung cancer who were hospitalized in the second hospital of Jilin University, of whom 83 patients were confirmed to have omicron infection. Depending on the eosinophil counts, patients were divided into two groups: low and high eosinophil counts. The relationship between eosinophil counts and severity and outcomes was then analyzed.</p><p><strong>Results: </strong>We found that omicron, especially severe-to-critical omicron, decreased survival in patients with lung cancer. Patients with omicron had a lower eosinophil count. Patients with eosinopenia (< 0.015 × 10<sup>9</sup>/L) were more likely to have an eastern cooperative oncology group performance status ≥ 2; be undergoing anti-cancer treatment; have comorbidities; and exhibit lower disease control rates, reduced 30-day survival, and shorter overall survival (median 75 days vs. not reached). Multivariate regression analysis revealed that the eosinophil count was an independent predictor of disease severity and survival in patients with lung cancer with omicron.</p><p><strong>Conclusion: </strong>Eosinopenia correlates with poor outcomes in patients with lung cancer with omicron, and the eosinophil count is an independent indicator for predicting the severity and outcomes in these patients.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1583843"},"PeriodicalIF":3.1,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12283595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698106","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}
引用次数: 0
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