Frontiers in Medicine最新文献

{"title":"Personalized medicine: when the common becomes the rare.","authors":"Daniel J O'Connor","doi":"10.3389/fmed.2024.1523594","DOIUrl":"10.3389/fmed.2024.1523594","url":null,"abstract":"","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1523594"},"PeriodicalIF":3.1,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11688481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914224","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":"<i>ACE2</i> and <i>TMPRSS2</i> genetic polymorphisms as potential predictors of COVID-19 severity and outcome in females.","authors":"Sanja Matic, Dragan Milovanovic, Zeljko Mijailovic, Predrag Djurdjevic, Srdjan Stefanovic, Danijela Todorovic, Katarina Vitosevic, Vanja Canovic, Suzana Popovic, Nevena Milivojevic Dimitrijevic, Marko Zivanovic, Dragana Seklic, Sanja Aleksic, Nemanja Djordjevic, Milena Vukic, Nenad Vukovic, Nenad Filipovic, Dejan Baskic, Natasa Djordjevic","doi":"10.3389/fmed.2024.1493815","DOIUrl":"10.3389/fmed.2024.1493815","url":null,"abstract":"<p><strong>Introduction: </strong>ACE2 and TMPRSS2 represent the major gateways for SARS-CoV-2 cell entry. The presence of functional ACE2 and TMPRSS2 genetic polymorphisms that affect gene expression may affect the risk of severe form of COVID-19 and its fatal outcome.</p><p><strong>Material and patients: </strong>This observational study enrolled 178 hospitalized patients diagnosed with SARS-CoV-2 infection at the University Clinical Centre of Kragujevac, Serbia. Demographic, clinical, and laboratory data were gathered at admission. Genotyping for single nucleotide polymorphisms of <i>ACE2</i> (rs2106809 and rs2074192) and <i>TMPRSS2</i> (rs2070788 and rs4818239) was performed using the Real-Time PCR method with TaqMan assays.</p><p><strong>Results: </strong>Controlling for other factors of influence, such as CCI, N/L ratio, LDH level, and pO₂, we showed that females with <i>TMPRSS2</i> rs2070788 A/A genotype were less likely to develop severe COVID-19 (odds ratio [OR] [95% confidence interval (95% CI)]: 0.030 [0.001; 0.862]). Additionally, the likelihood of dying of SARS-CoV-2 infection was lower in female carriers of at least one <i>ACE2</i> rs2106809 C allele (OR [95% CI]: 0.004 [0.000; 0.981]).</p><p><strong>Conclusion: </strong>Our findings indicate <i>TMPRSS2</i> rs2070788 and <i>ACE2</i> rs2106809 polymorphisms as independent predictors of severity and outcome of COVID-19 in females.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1493815"},"PeriodicalIF":3.1,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11688283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914179","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":"Corrigendum: Tracheobronchomegaly associated with tracheobronchopathia osteochondroplastica: a case report.","authors":"Zhen Hua Li, Lu-Xia Kong, Shan Zhu, Yi Hu, Shan Gao","doi":"10.3389/fmed.2024.1540232","DOIUrl":"https://doi.org/10.3389/fmed.2024.1540232","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.3389/fmed.2024.1444995.].</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1540232"},"PeriodicalIF":3.1,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11685226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914268","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":"Association between diabetes mellitus and trochanteric bone mineral density in individuals with osteoporotic fractures: a retrospective study.","authors":"Shao-Han Guo, Jian Xu, Min-Zhe Xu, Chong Li, Ya-Qin Gong, Ke Lu","doi":"10.3389/fmed.2024.1492603","DOIUrl":"10.3389/fmed.2024.1492603","url":null,"abstract":"<p><strong>Background: </strong>The relationship between diabetes mellitus (DM) and bone mineral density (BMD) in patients with osteoporotic fractures (OPFs) remains complex and heterogeneous, specifically between the genders. This study aimed to explore the association between diabetes status and trochanteric BMD in a cohort of patients with OPFs and elucidate the differences between male and female patients.</p><p><strong>Methods: </strong>This retrospective analysis was performed on 710 admitted patients aged 50 years or older with OPFs. In this study, the exposure variable was diabetes status. Trochanteric BMD comprised the dependent variable. While controlling for covariance influences, generalized estimating equations (GEE) were applied to examine the independent link between diabetes status and trochanteric BMD in OPFs patients. Moreover, a subgroup analysis was also conducted to validate the result's stability.</p><p><strong>Results: </strong>A substantial positive association was noted between diabetes status and trochanteric BMD in diabetic patients, as determined by the fully adjusted model (<i>β</i> = 0.017, 95% CI 0.001 to 0.033, <i>p</i> = 0.035). Furthermore, the sex-specific analysis showed a significant positive relationship between diabetes status and trochanteric BMD in male patients (<i>β</i> = 0.040, 95% CI 0.006 to 0.075, <i>p</i> = 0.022), whereas no significant relationship was observed in female patients (<i>β</i> = 0.010, 95% CI -0.008 to 0.028, <i>p</i> = 0.256).</p><p><strong>Conclusion: </strong>This study highlighted the significant sex differences in the impact of diabetes on trochanteric BMD among patients with OPFs. The male diabetic patients had higher trochanteric BMD than their non-diabetic counterparts; however, this association was not evident in female patients. Further research is necessary to understand the underlying mechanisms that contribute to these sex-specific differences and to evaluate the clinical implications of managing fracture risk in diabetic patients.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1492603"},"PeriodicalIF":3.1,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11685145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914258","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 gender and age perspectives of allostatic load.","authors":"Nikola Volarić, Dunja Šojat, Mile Volarić, Ivan Včev, Tanja Keškić, Ljiljana Trtica Majnarić","doi":"10.3389/fmed.2024.1502940","DOIUrl":"10.3389/fmed.2024.1502940","url":null,"abstract":"<p><p>The role of chronic stress in the development of chronic diseases, especially multimorbidity, through the pathways of increasing allostatic load, and finally, allostatic overload (the state when a compensatory mechanism is likely to fail) is being emphasized. However, allostatic load is a dynamic measure that changes depending on sex, gender, age, level and type of stress, experience of a stressful situation, and coping behaviors. Many other factors such as race, ethnicity, working environment, lifestyle, and circadian rhythm of sleep are also important. The aim of this paper was to synthesize the available information on allostatic load differences, especially those connected to sex/gender and age, and to provide a model for the future study of allostatic load, with a focus on these differences. By carefully studying allostatic load factors, we realized that many studies do not take this allostatic load difference into account in the analysis methods. In this paper, we also support the idea of further research to develop new allostatic load analysis strategies that will include all knowledge about sex/gender differences and that will, in more detail, explain numerous changeable social and educational factors that are currently accepted as biological ones. Furthermore, specific allostatic load biomarkers are expressed differently in different age groups, indicating that the discrepancies cannot be attributed solely to sex/gender disparities. This kind of approach can be valuable, not only for better explaining the differences in the frequency and age of onset of chronic diseases and multimorbidity, but also for the potential planning and development of preventive actions based on the aforementioned sex/gender and age disaparities, in order to prevent the most frequent diseases and to establish specific biomarker cut-off values for each sex/gender and age group.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1502940"},"PeriodicalIF":3.1,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11685202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913977","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 role of blended learning in improving medical students' academic performance: evidence from Pakistan.","authors":"Muhammad Azeem Ashraf, Samson Maekele Tsegay, Nida Gull, Muneeba Saeed, Hussain Dawood","doi":"10.3389/fmed.2024.1425659","DOIUrl":"10.3389/fmed.2024.1425659","url":null,"abstract":"<p><strong>Objective: </strong>The study examines the role of blended learning in improving medical students' academic performance through self-regulatory learning and technological competence and identifies the moderating role of perceived institutional support in the relationships between self-regulatory learning, perceived teacher credibility, technological competencies, and academic performance.</p><p><strong>Methods: </strong>The study was based on behavioral learning theory as a theoretical framework, and an adapted questionnaire was used to collect the data. In total, 275 medical students participated in the study, and the data was analyzed using structural equation modeling techniques with SmartPLS.</p><p><strong>Results: </strong>The results indicate that self-regulatory learning significantly affects student academic performance and mediates the role of teachers' credibility and technological competencies. Furthermore, perceived institutional support is a significant moderator in the relationship between self-regulated learning, technological competencies, and teacher credibility.</p><p><strong>Conclusion: </strong>The study highlights the importance of self-regulated learning in students' academic achievement. Moreover, it suggests that educational institutions should advance teachers' competence and encourage collaborative learning to enhance students' learning, motivation, and academic performance.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1425659"},"PeriodicalIF":3.1,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11685129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914178","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":"Electrolyte imbalance and liver function test abnormalities among pregnant women with hyperemesis gravidarum at Wag-himra zone public hospitals, Northeast Ethiopia, 2023: a comparative cross-sectional study.","authors":"Abebaw Worede, Teshiwal Deress, Habtamu Wondifraw, Getnet Fetene, Alemseged Berie","doi":"10.3389/fmed.2024.1451036","DOIUrl":"10.3389/fmed.2024.1451036","url":null,"abstract":"<p><strong>Background: </strong>Hyperemesis gravidarum affects about 4.8% of pregnant women. It can lead to electrolyte imbalances and liver function disturbances, which may result in pregnancy complications. Despite its prevalence, data on these abnormalities in the study area is scarce. Therefore, the current study investigated these health concerns among HG-affected pregnant women in this region from June to October 2023.</p><p><strong>Method: </strong>A comparative cross-sectional study was conducted on 123 study participants. Socio-demographic, clinical, and anthropometric data were collected using structured questionnaires. Blood samples were taken to determine liver function tests and electrolyte levels. Statistical analysis was performed using a one-way ANOVA with a Tuckey <i>post hoc</i> test, Kruskal-Wallis with a Mann-Whitney <i>U</i> test, and binary logistic regression analysis. A <i>p</i>-value of <0.05 with 95% confidence intervals was considered statistically significant.</p><p><strong>Results: </strong>The results showed that pregnant women with hyperemesis gravidarum had significantly higher levels of AST and ALT and lower levels of Na+ and K+ compared to normal pregnant women and non-pregnant women. The abnormalities observed were elevated AST (48.8%), ALT (46.3%), and decreased Na+ (51.2%) and K+ (41.5%). Hyperemesis gravidarum was associated with both electrolyte imbalances and liver function test abnormalities.</p><p><strong>Conclusion: </strong>Pregnant women with hyperemesis gravidarum experience electrolyte imbalances and liver function test abnormalities. Given the marked increase in liver enzymes and decrease in electrolyte levels, the authors recommend routine laboratory testing of liver function and electrolyte parameters for pregnant women with hyperemesis gravidarum is recommended.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1451036"},"PeriodicalIF":3.1,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11685153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914279","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":"Primary perianal alveolar rhabdomyosarcoma with uncommon metastatic sites: a case report and follow-up using ¹⁸F-FDG PET/CT.","authors":"Yihan Yang, Zhao Chen, Yongkang Qiu, Jia Cheng, Ritai Na, Min Liu, Lei Kang","doi":"10.3389/fmed.2024.1474698","DOIUrl":"10.3389/fmed.2024.1474698","url":null,"abstract":"<p><strong>Background: </strong>Rhabdomyosarcoma (RMS), a rare pediatric soft tissue neoplasm, predominantly develops in late childhood and adolescence with no discernible gender bias. Alveolar rhabdomyosarcoma (ARMS) stems from mesenchymal cells and may develop most frequently in the trunk, extremities, and head/neck areas, while occurrences in the pelvic cavity are less frequent. The manifestation is typically characterized by a high rate of aggressive metastasis and a poor overall survival prognosis.</p><p><strong>Case report: </strong>We present the case of an 11-year-old girl with ARMS initially presenting with a perianal mass. The diagnostic workup included MRI and PET/CT, which highlighted the tumor's aggressive nature and metastatic potential. Subsequent metastases to the pleura, lymph nodes, and, less frequently, to the bone were detected using 2-deoxy-2-[fluorine-18]-fluoro-D-glucose positron emission tomography combined with computed tomography (¹⁸F-FDG PET/CT) imaging. The patient underwent a multi-regimen chemotherapy protocol but showed an incomplete response, indicating a poor prognosis.</p><p><strong>Conclusion: </strong>This report presents a rare case of ARMS primarily located in the perianal region with multiple metastases, including the uncommon occurrence of bone metastasis, which illustrates the challenges in diagnosing and treating ARMS, emphasizing the need for accurate and early diagnosis, advanced imaging for disease assessment, and more effective treatment strategies. ¹⁸F-FDG PET/CT imaging highlights its preeminence in detecting multiple rare metastatic lesions. However, the persistent disease activity despite treatment highlights the need for further research into the biology of ARMS and the development of novel therapeutics to improve patient outcomes.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1474698"},"PeriodicalIF":3.1,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11688604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914228","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":"Efficacy of preoperative prophylactic application of betamethasone on postoperative nausea and vomiting in patients undergoing total knee arthroplasty: a prospective randomized controlled trial.","authors":"Xiaobo Sun, Qunli Dou, Bowei Li, Guoyang Bai, Kai Qin, Jianbing Ma, Fudong Yao, Yuanchi Huang","doi":"10.3389/fmed.2024.1487818","DOIUrl":"10.3389/fmed.2024.1487818","url":null,"abstract":"<p><strong>Background: </strong>The demand for total knee arthroplasty (TKA) is increasing, yet postoperative nausea and vomiting (PONV) significantly hinder patient recovery. Preoperative prophylactic administration of glucocorticoids can alleviate PONV, with betamethasone showing promising results in breast and cardiac surgeries. However, its efficacy in TKA patients remains unclear. This study evaluates the efficacy and safety of preoperative betamethasone for PONV in TKA patients through a prospective randomized controlled trial (RCT).</p><p><strong>Materials and methods: </strong>In this trial, 124 patients were randomly assigned to receive either 2 mL of normal saline (control group) or 2 mL of betamethasone sodium phosphate (10.52 mg total dose; experimental group) 10 min before anesthesia induction. Primary outcomes included nausea severity, vomiting frequency, and antiemetic use, while secondary outcomes were pain scores, knee range of motion, blood glucose, IL-6, CRP, ESR, and adverse reactions.</p><p><strong>Results: </strong>Results showed the experimental group had significantly lower nausea severity at 2, 4, 6, 12, and 24 h post-surgery compared to controls. The average frequency of vomiting in the experimental group (0.060 ± 0.307) was lower than that in the control group (0.390 ± 0.662), with a statistical difference (<i>P</i> < 0.001). The postoperative use of metoclopramide in the experimental group (0.480 ± 2.163) was lower than that in the control group (4.520 ± 6.447), and there was a statistical difference between the two groups (<i>P</i> < 0.001). CRP in the experimental group on the second day after surgery (45.741 ± 47.044) was lower than that in the control group (65.235 ± 50.970), with a statistical difference (<i>P</i> = 0.014). IL-6 in the experimental group was lower on the first (51.853 ± 67.202) and second postoperative days (25.143 ± 31.912) than that in the control group on the first (79.477 ± 97.441) and second postoperative days (38.618 ± 36.282), with statistical differences (<i>P</i> = 0.039, <i>P</i> = 0.006). There was no significant difference in postoperative knee pain, knee range of motion, blood glucose, ESR, and adverse reactions between the two groups.</p><p><strong>Conclusion: </strong>Our prospective RCT demonstrates that preoperative betamethasone is effective and safe for reducing PONV in TKA patients, suggesting a new clinical approach for prophylactic treatment of PONV post-TKA.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1487818"},"PeriodicalIF":3.1,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11687124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914278","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":"Editorial: Efficient artificial intelligence (AI) in ophthalmic imaging.","authors":"Yanda Meng, Meng Wang, Haoyu Chen, Yalin Zheng","doi":"10.3389/fmed.2024.1523647","DOIUrl":"https://doi.org/10.3389/fmed.2024.1523647","url":null,"abstract":"","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1523647"},"PeriodicalIF":3.1,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11685151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914270","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}