Frontiers in MedicinePub Date : 2025-07-02eCollection Date: 2025-01-01DOI: 10.3389/fmed.2025.1607223
Ya Shen, Xiao-Yu Cao, Jing-Feng Shi, Zi-Xiao Cao, Xiao-Bao Teng, Ming-Feng Han
{"title":"Multimodal diagnostic approach for identifying <i>Actinomyces odontolyticus</i> pneumonia: a case report and literature review.","authors":"Ya Shen, Xiao-Yu Cao, Jing-Feng Shi, Zi-Xiao Cao, Xiao-Bao Teng, Ming-Feng Han","doi":"10.3389/fmed.2025.1607223","DOIUrl":"10.3389/fmed.2025.1607223","url":null,"abstract":"<p><p>The emergence of next-generation sequencing (NGS) has significantly improved the detection rate of Actinomyces species in pulmonary actinomycosis (PA), a rare and diagnostically challenging infectious disease. Here, we report a case of an elderly patient with a history of pyoderma gangrenosum who presented with pulmonary infiltrates and was subsequently hospitalized. Both histopathological examination of tracheoscopic biopsy specimens and NGS analysis of bronchoalveolar lavage fluid (BALF) confirmed infection with <i>Actinomyces odontolyticus</i> (<i>A. odontolyticus</i>). The patient exhibited marked clinical and radiological improvement following a period of amoxicillin/clavulanic acid therapy. Additionally, we performed a retrospective analysis of 11 documented cases of <i>A. odontolyticus</i>-associated pneumonia reported between 1978 and 2025. These cases were primarily diagnosed through pathogen culture and histopathology, with most patients demonstrating favorable outcomes following timely intervention. The age distribution of the cohort ranged from 11 to 64 years, with cough, sputum production, and dyspnea being the predominant symptoms. Notably, chest imaging findings varied widely. We anticipate that these findings will enhance clinical awareness of PA, facilitating early detection, accurate diagnosis, and improved patient management. To our knowledge, this represents the first reported case of <i>A. odontolyticus</i> pneumonia diagnosed using a combined NGS and histopathology approach, as well as the largest case series published for this condition.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1607223"},"PeriodicalIF":3.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649015","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}
Frontiers in MedicinePub Date : 2025-07-02eCollection Date: 2025-01-01DOI: 10.3389/fmed.2025.1549791
Yinong Feng, Zehong Wang, Shaoyuan Shi, Li Zhou, Yongli Hua, Xuanxuan Wang, Jianzhong Ma
{"title":"48-week prognostic analysis of very low-level viremia in patients with hepatitis B cirrhosis: a single-center retrospective study.","authors":"Yinong Feng, Zehong Wang, Shaoyuan Shi, Li Zhou, Yongli Hua, Xuanxuan Wang, Jianzhong Ma","doi":"10.3389/fmed.2025.1549791","DOIUrl":"10.3389/fmed.2025.1549791","url":null,"abstract":"<p><strong>Objective: </strong>Despite improvements in the accuracy of hepatitis B virus (HBV) DNA detection, some patients with chronic hepatitis B (CHB) still have very low-level viremia (VLLV; HBV DNA is detectable but less than 20 IU/mL) after achieving a complete virologic response (CVR). This study aimed to investigate the prognosis of patients with cirrhotic hepatitis B and VLLV.</p><p><strong>Methods: </strong>A total of 267 patients with hepatitis B cirrhosis from the Third People's Hospital of Taiyuan were retrospectively enrolled. All patients took oral antiviral drugs for more than 96 weeks and were divided into the target not-detected group (TND; HBV DNA undetectable) and the VLLV group (limits of detection < HBV DNA < 20 IU/mL) by high-sensitivity testing of HBV. The incidence of cirrhosis-related complications was observed.</p><p><strong>Results: </strong>Compared to the TND group, the baseline levels of alanine aminotransferase (ALT; 20.0 vs. 26.0 U/L, <i>p</i> < 0.001), aspartate aminotransferase (AST; 24.0 vs. 27.5 U/L, <i>p</i> < 0.001), and gamma-glutamyl transferase (GGT; 21.0 vs. 30.5 U/L, <i>p</i> = 0.001) were significantly higher in the VLLV group, and so were liver stiffness values (9.4 vs. 10.8 kPa, <i>p</i> = 0.006). No significant difference was observed in the rate of new cirrhosis-related complications between the two groups. The HCC rate was 5.4% in TND and 4.7% in the VLLV (<i>p</i> > 0.05). Multifactorial logistic regression showed that the main factors affecting complications at baseline were age (OR:1.063; <i>p</i> = 0.034), hemoglobin level (OR:0.965; <i>p</i> = 0.036), and platelet count (OR:0.987; <i>p</i> = 0.029).</p><p><strong>Conclusion: </strong>For cirrhotic patients with VLLV, the lower the level of HBV DNA, the less severe the liver injury. There was no difference in the 48-week complication rates between the TND group. Even in the TND group, which can develop new complications, regular follow-up should be performed.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1549791"},"PeriodicalIF":3.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649058","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}
Frontiers in MedicinePub Date : 2025-07-02eCollection Date: 2025-01-01DOI: 10.3389/fmed.2025.1581544
Jinguo Liu, Jing Xu, Li Wang, Xiaojiang Gu, Xuesong Zhang, Zhou Zhang, Chi Zhang, Liangliang Yu
{"title":"Case Report: A novel strategy of endoscopic full-thickness resection: single traction combined with pre-clamping.","authors":"Jinguo Liu, Jing Xu, Li Wang, Xiaojiang Gu, Xuesong Zhang, Zhou Zhang, Chi Zhang, Liangliang Yu","doi":"10.3389/fmed.2025.1581544","DOIUrl":"10.3389/fmed.2025.1581544","url":null,"abstract":"<p><p>Endoscopic full-thickness resection (EFTR) is an effective, economical, and minimally invasive technique for submucosal tumors (SMTs). However, technical complexity and prolonged operative time remain significant limitations. This study introduces a refined EFTR strategy termed \"single traction combined with pre-clamping\" in a cohort of 10 patients. The proposed technique demonstrates reduced procedural duration, technical difficulty, and intraoperative risks compared to the conventional approach.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1581544"},"PeriodicalIF":3.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649064","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":"Case Report: Immune checkpoint inhibitor exhibits dual benefits for a refractory lymphoma patient with disseminated mucormycosis.","authors":"Qibei Teng, Qianqian Yang, Zhizhi Tao, Jinwen Huang, Cheng Zhang, Fangfei Shao, Wenjue Pan, Xiujie Zhao, Haowen Xiao","doi":"10.3389/fmed.2025.1608828","DOIUrl":"10.3389/fmed.2025.1608828","url":null,"abstract":"<p><p>Invasive mucormycosis contributes to a high mortality rate in patients with hematological malignancies. When it disseminates to multiple organs, especially to the brain, the prognosis is extremely poor. The traditional antifungal strategies including surgery have less efficacy in patients with hematological malignancies. Here, we describe a case report of a 62-year-old man with refractory lymphoma who developed mucormycosis caused by <i>Rhizomucor pusillus</i> after chemotherapy, which disseminated extensively to the lungs, diaphragm, brain and spleen. He was successfully treated with antifungal agents combined with PD-1 inhibitor, which may simultaneously exhibit efficacy in treatment of lymphoma and mucormycosis. The patient's lymphoma and mucormycosis were well controlled; ultimately, autologous hematopoietic stem cell transplantation was successfully performed, and the patient achieved long-term survival.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1608828"},"PeriodicalIF":3.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649065","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}
Frontiers in MedicinePub Date : 2025-07-02eCollection Date: 2025-01-01DOI: 10.3389/fmed.2025.1569949
Hongxia Mei, Pengchen Bao, Yongxu Wang, Zhijing Wei, Qin Yang, Chen Chen, Yakai Sun, Xinming Su, Jian Kang, WenYang Li
{"title":"Pulmonary cryptococcosis in the setting of immunosuppression by methylprednisolone monotherapy for oral pemphigus: a case report and literature review.","authors":"Hongxia Mei, Pengchen Bao, Yongxu Wang, Zhijing Wei, Qin Yang, Chen Chen, Yakai Sun, Xinming Su, Jian Kang, WenYang Li","doi":"10.3389/fmed.2025.1569949","DOIUrl":"10.3389/fmed.2025.1569949","url":null,"abstract":"<p><p><i>Cryptococcosis</i> is an opportunistic and potentially fatal fungal infectious disease. Pemphigus diseases are characterized by blistering of the cutaneous and mucous membranes. We report a case of pulmonary <i>cryptococcosis</i> (PC) following methylprednisolone treatment for pemphigus vulgaris. Additionally, we analyzed a case series of PC infections recorded in PUBMED from 2013 to 2023. A total of 229 cases of PC were included. The median age was 54 years, with 66.4% of patients being male. Those with previous use of corticosteroids or immunosuppressives accounted for 38.4% of cases. Underlying conditions included solid organ transplantations (25.7%), respiratory diseases (6.6%), malignant tumors (6.1%), rheumatoid arthritis (5.7%), hematological malignancies (4.4%), among others. The main source of infection was exposure to birds, poultry, and their feces (12.7%). <i>Cryptococcus neoformans</i> was most frequently isolated (76.4%). Overall mortality was 14.8%. Previous use of corticosteroids or immunosuppressants was a risk factor for disseminated <i>cryptococcus</i> (<i>p</i> < 0.05). Age, underlying disease, dissemination, and no antifungal therapy were independently associated with increased mortality (<i>p</i> < 0.05). Co-occurrence of pemphigus and PC is rare. Prompt diagnosis and appropriate treatment of PC are essential to prevent fatal consequences. Corticosteroids or immunosuppressive therapy are associated with the development of disseminated cryptococcal infection. Age, underlying disease, and dissemination are related to increased mortality. Timely antifungal therapy can improve prognosis.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1569949"},"PeriodicalIF":3.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12264761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649092","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}
Frontiers in MedicinePub Date : 2025-07-02eCollection Date: 2025-01-01DOI: 10.3389/fmed.2025.1581904
Riken Chen, Yuan Zhang, Weilong Ye, Zhaojun Chen, Weifeng Liao, Huizhao Liao, Tingting Sun, Huan Li, Junfen Cheng, Wang Liu, Weimin Yao, Yitian Yang
{"title":"Improving OSA screening efficiency with subjective questionnaires: integrating STOP-Bang, ESS, and Berlin.","authors":"Riken Chen, Yuan Zhang, Weilong Ye, Zhaojun Chen, Weifeng Liao, Huizhao Liao, Tingting Sun, Huan Li, Junfen Cheng, Wang Liu, Weimin Yao, Yitian Yang","doi":"10.3389/fmed.2025.1581904","DOIUrl":"10.3389/fmed.2025.1581904","url":null,"abstract":"<p><strong>Objective: </strong>To compare the predictive value of the STOP-Bang questionnaire, the Epworth Sleepiness Scale (ESS), and the Berlin questionnaire, while evaluating the combined application of these tools in a three-step screening strategy for obstructive sleep apnea (OSA).</p><p><strong>Methods: </strong>From September 1, 2016, to October 31, 2020, at the Sleep Medicine Center of the First Affiliated Hospital of Guangzhou Medical University, 2,208 suspected OSA patients completed the ESS, STOP-Bang, and Berlin questionnaires and underwent polysomnography (PSG). The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and receiver operating characteristic (ROC) curves were calculated for each questionnaire, and the accuracy and predictive value of combining the STOP-Bang, ESS, and Berlin questionnaires for OSA screening were analyzed.</p><p><strong>Results: </strong>Among the individual scales, the Berlin questionnaire had the highest area under the curve (AUC), demonstrating the best diagnostic performance and the highest PPV. The ESS had the smallest AUC and the highest specificity, but the lowest sensitivity and NPV. The STOP-Bang had the highest sensitivity and NPV but the lowest specificity and PPV. When the scales were combined, the AUCs of all combinations were less than 0.7, indicating that the diagnostic performance of the combined scales slightly decreased compared to the individual scales. However, among the combined scales, the AUC of the three-scale combination was higher than that of the two-scale combinations. After combining the questionnaires, specificity and PPV increased, but sensitivity and NPV decreased. Among the two-questionnaire combinations, the sensitivity and NPV of the ESS and STOP-Bang combination were higher than those of the ESS and Berlin questionnaire combination, while specificity and PPV were lower. The combination of all three questionnaires resulted in the highest specificity and PPV, but the lowest sensitivity and NPV.</p><p><strong>Conclusion: </strong>As the number of scales increases, sensitivity and NPV decrease, while specificity and PPV increase. Therefore, we recommend a three-step strategy, combining a STOP-Bang score of 3, an ESS score of 9, and the Berlin questionnaire to improve the specificity and PPV in screening for OSA.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1581904"},"PeriodicalIF":3.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649012","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}
Frontiers in MedicinePub Date : 2025-07-02eCollection Date: 2025-01-01DOI: 10.3389/fmed.2025.1589245
Yan Li, Xi Ye, Xiaoyu Chen
{"title":"Association of estimated glucose disposal rate with risk of future metabolic dysfunction-associated steatotic liver disease and other chronic liver diseases: a prospective cohort study.","authors":"Yan Li, Xi Ye, Xiaoyu Chen","doi":"10.3389/fmed.2025.1589245","DOIUrl":"10.3389/fmed.2025.1589245","url":null,"abstract":"<p><strong>Background: </strong>The incidence of insulin resistance, as determined by estimated glucose disposal rate (eGDR), is associated with various morbidities. The relationship between eGDR and chronic liver diseases remains to be explored. This study examined the association between eGDR and the risk of future metabolic dysfunction-associated steatotic liver disease (MASLD), cirrhosis, liver cancer, and liver-related mortality.</p><p><strong>Method: </strong>We analyzed data from UK Biobank participants with no history of liver diseases. We calculated the eGDR values for each participant and divided them into four quartile groups based on these values. The primary outcome was MASLD, whereas the secondary outcomes included cirrhosis, liver cancer, and liver-related mortality. We estimated hazard ratios (HRs) and 95% confidence intervals (CIs) using Cox proportional hazard regression models. We used restricted cubic splines models to detect potential non-linear relationships.</p><p><strong>Results: </strong>This study included data from 290,397 UK Biobank participants who had no history of liver diseases, and the magnetic resonance imaging (MRI)-derived liver proton density fat fraction (PDFF) analysis included 25,810 individuals. Over a median follow-up period of 15.69 years, we identified 3,926 cases of MASLD, 1,553 cases of cirrhosis, 167 cases of liver cancer, and 120 cases of liver-related mortality. After adjusting for multiple variables, higher eGDR levels were significantly associated with a lower risk of MASLD (HR: 0.91, 95% CI: 0.90-0.93), cirrhosis (HR: 0.89, 95% CI: 0.86-0.92), and liver cancer (HR: 0.91, 95% CI: 0.83-1.00). Comparing participants between the lowest and highest quartiles (Q1 and Q4) of eGDR, Q4 had a 47% lower risk of MASLD (HR: 0.53; 95% CI: 0.45-0.63), with similar results for cirrhosis. Moreover, high eGDR levels were associated with a low risk of MASLD based on MRI-derived liver PDFF > 5% (odds ratio: 0.98, 95% CI: 0.97-0.98).</p><p><strong>Conclusion: </strong>We found a significant inverse correlation between eGDR and MASLD, cirrhosis, and liver cancer. Incorporating eGDR into clinical decision-making can improve the long term follow-up of patients with MASLD.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1589245"},"PeriodicalIF":3.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649061","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}
Frontiers in MedicinePub Date : 2025-07-02eCollection Date: 2025-01-01DOI: 10.3389/fmed.2025.1563299
Ying Xie, Sha Luo, Yumei Yang, Xin Zou, Shuying Lv, Meijiao Du, Yonglong Xu, Xiaojuan Song, Changjie Qi, Nuo Li, Dingquan Yang
{"title":"Autosomal recessive woolly hair/hypotrichosis caused by LIPH mutations: a case report.","authors":"Ying Xie, Sha Luo, Yumei Yang, Xin Zou, Shuying Lv, Meijiao Du, Yonglong Xu, Xiaojuan Song, Changjie Qi, Nuo Li, Dingquan Yang","doi":"10.3389/fmed.2025.1563299","DOIUrl":"10.3389/fmed.2025.1563299","url":null,"abstract":"<p><strong>Objective: </strong>To report the clinical characteristics of a case of Autosomal recessive woolly hair/ hypotrichosis(ARWH/HT, OMIM:278150/604379) in a child, analyze and identify the causative gene and mutation site. A review of related research at home and abroad was conducted to summarize the current progress in the diagnosis and treatment of ARWH.</p><p><strong>Methods: </strong>Clinical data were collected, and exome sequencing was performed on blood samples from the patient and parents to screen for mutations. Sanger sequencing validated suspected pathogenic variants. A summary analysis of previously published woolly hair cases was also conducted.</p><p><strong>Results: </strong>The family was found to have mutations in the LIPH gene, with the patient's sample showing two heterozygous mutations: <i>c.1101del</i> (maternal) and <i>c.736 T > A</i> (paternal). These compound heterozygous mutations are responsible for the ARWH phenotype.</p><p><strong>Conclusion: </strong>The compound heterozygous mutations <i>c.1101del</i> and <i>c.736 T > A</i> in the LIPH gene are the pathogenic mutations causing the clinical phenotype of autosomal recessive woolly hair in the child. The <i>c.1101del</i> mutation is a newly discovered frameshift mutation, enriching the mutation spectrum of LIPH-associated autosomal recessive woolly hair with hypotrichosis.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1563299"},"PeriodicalIF":3.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649062","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}
Frontiers in MedicinePub Date : 2025-07-02eCollection Date: 2025-01-01DOI: 10.3389/fmed.2025.1481209
Richard Hobday, Mariëlle Aarts, Christian Cajochen, Lenka Maierova, Mirjam Münch, Werner Osterhaus, Oliver Stefani, Katharina Wulff
{"title":"Myopia and daylight-A combination of factors.","authors":"Richard Hobday, Mariëlle Aarts, Christian Cajochen, Lenka Maierova, Mirjam Münch, Werner Osterhaus, Oliver Stefani, Katharina Wulff","doi":"10.3389/fmed.2025.1481209","DOIUrl":"10.3389/fmed.2025.1481209","url":null,"abstract":"<p><p>The incidence of myopia among school children has risen markedly over the last three decades. In urban areas of South and East Asia, as many as 80-90% of young adults are now myopic. This trend is occurring elsewhere around the world. During the COVID-19 lockdowns, children in many countries were confined indoors and spent an undue amount of time exposed to television screens, computers, and mobile devices. This resulted in an acceleration in the incidence and progression of the condition. Myopia is a significant public health issue as it is a leading cause of blindness and other vision problems. Yet the underlying mechanisms that produce the condition remain elusive. Pseudomyopia has recently been proposed as an independent risk factor for myopia. We hypothesize that pseudomyopia induced by prolonged close work, stress, and anxiety combines and is further amplified by chronically low ambient light levels. If time spent outdoors in daylight is restricted, the effects worsen and together may play a significant part in myopia epidemics.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1481209"},"PeriodicalIF":3.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649016","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}
Frontiers in MedicinePub Date : 2025-07-02eCollection Date: 2025-01-01DOI: 10.3389/fmed.2025.1540103
Junjun Yan, Qiangming Liao, Bin Ding
{"title":"Case Report: Successful application of endoscopic biliary accessories in a patient with complete esophageal stricture.","authors":"Junjun Yan, Qiangming Liao, Bin Ding","doi":"10.3389/fmed.2025.1540103","DOIUrl":"10.3389/fmed.2025.1540103","url":null,"abstract":"<p><p>The endoscopic treatment of complete esophageal stricture presents a huge challenge. In instances where the esophageal lumen is nearly obliterated, preventing the passage of a dilating guide wire, conventional endoscopic bougie dilation is often difficult to perform. We report a case of patients with nearly complete esophageal stricture due to esophageal cancer surgery, leading to severe dysphagia and weight loss. Our strategy began with the achievement of anterograde esophageal access, facilitated by a biliary intubation method and aided by a 0.35-inch guidewire. Subsequently, we sequentially applied biliary dilators and balloon dilators, progressing along the guidewire to incrementally dilate the esophageal lumen up to the site of complete stenosis. The stenosis was successfully penetrated and dilated, and eventually the patient's dysphagia was completely relieved. This case underscores the efficacy of the novel endoscopic treatment for biliary appendices in patients with refractory esophageal anastomotic stricture, offering a new therapeutic approach for clinical management.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1540103"},"PeriodicalIF":3.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649084","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}