International Journal of Clinical Practice最新文献

{"title":"Outcomes of Tamoxifen Treatment Alone in Patients With Ductal Carcinoma In Situ or Atypical Ductal Hyperplasia Who Refused Surgery","authors":"Youngji Kwak,&nbsp;Jai Min Ryu,&nbsp;Byung Joo Chae,&nbsp;Jonghan Yu,&nbsp;Seok Won Kim,&nbsp;Seok Jin Nam,&nbsp;Jeong Eon Lee","doi":"10.1155/2024/1805803","DOIUrl":"https://doi.org/10.1155/2024/1805803","url":null,"abstract":"<div>\u0000 <p><b>Objective:</b> Recent trends involving increased screening have led to broad populations being diagnosed with atypical ductal hyperplasia (ADH) or ductal carcinoma in situ (DCIS); as a result, many patients have had to receive surgery followed by standard treatment for ADH or DCIS. The common interest in reducing the use of superfluous invasive treatment has led us to question the necessity of surgical treatment for ADH or DCIS patients in a retrospective review. This work is expected to be a particularly useful reference as there have yet to be any studies describing the outcomes of initial treatment with tamoxifen without curative surgery in Korea.</p>\u0000 <p><b>Methods:</b> The clinicopathological characteristics and oncologic outcomes of 36 patients with DCIS or ADH diagnosis who received initial treatment with tamoxifen between 2013 and 2019 were investigated.</p>\u0000 <p><b>Results:</b> Among 36 patients enrolled, 30 were diagnosed with DCIS and six were diagnosed with ADH. The median age in the included cohort was 47 years old (range, 26–81 years). There was a change in the follow-up strategy including the need for surgery in 13.9% of cases. The median time to surgery in those patients was 32 months (IQR, 17.5–63.5 months). Only one patient had upgraded to a higher nuclear grade, which was a case of ADH upgrading to intermediate DCIS. Three (8.3%) of 36 patients were upstaged to an invasive disease. Of them, two patients were upstaged to microinvasive ductal carcinoma, whereas one patient was diagnosed with metastatic invasive ductal carcinoma.</p>\u0000 <p><b>Conclusion:</b> The use of endocrine therapy without surgery could be a potential treatment strategy in patients with DCIS or ADH. Further validation in larger cohorts and in the context of clinical trials is needed.</p>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/1805803","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142588197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomarkers of Bacterial Translocation and Intestinal Wall Damage in Patients With Multiple Organ Dysfunction Syndrome","authors":"Yermek Turgunov,&nbsp;Alina Ogizbayeva,&nbsp;Sofiko Asamidanova,&nbsp;Olga Avdiyenko,&nbsp;Dana Amanova,&nbsp;Nurlan Aukenov,&nbsp;Miras Mugazov","doi":"10.1155/2024/3015526","DOIUrl":"https://doi.org/10.1155/2024/3015526","url":null,"abstract":"<div>\u0000 <p><b>Introduction:</b> The aim of this study was to evaluate the potential biomarkers of bacterial translocation: lipopolysaccharide-binding protein (LBP) and soluble CD14 subtype (sCD14-ST), and intestinal wall damage: intestinal fatty acid binding protein (I-FABP), zonulin, and regenerating islet-derived protein-3α (REG3α), in the patients with multiple organ dysfunction syndrome (MODS).</p>\u0000 <p><b>Methods:</b> The study involved 78 patients over the age of 18 with MODS set according to the Sequential Organ Failure Assessment (SOFA) scale. Venous blood was sampled during diagnostics of MODS, on the 3rd and on the 7th day of its development. The sCD14-ST, LBP, I-FABP, REG3α, and zonulin in blood serum were determined by enzyme-linked immunosorbent assay (ELISA).</p>\u0000 <p><b>Results:</b> Out of 78 patients with MODS, 43 patients survived (55.1%) and 35 patients died (44.9%). Levels of sCD14-ST on Day 1, I-FABP on Day 3, and REG3α on Days 3 and 7 and SOFA scores on Days 1, 3, and 7, Acute Physiology and Chronic Health Evaluation II (APACHE II) scores on Days 1, 3, and 7, and Modified Nutrition Risk in Critically Ill (mNUTRIC) scores on Days 1, 3, and 7 were statistically significantly higher in deceased patients (<i>p</i> &lt; 0.05).</p>\u0000 <p><b>Conclusion:</b> In patients with MODS, an increase in sCD14-ST, I-FABP, and REG3α in blood serum can indicate the violation of intestinal barrier function and increased bacterial translocation, which ultimately may aggravate the severity of MODS and increase the risk of death. It is required to further study the factors leading to intestinal wall permeability disorders in order to screen for timely intensive care measures that can help reduce the stay of patients in the intensive care unit (ICU) as well as mortality.</p>\u0000 <p><b>Trial Registration:</b> ClinicalTrials.gov identifier: NCT06221293</p>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/3015526","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142525550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Overview of Publications on Extracellular Vesicles in Osteoarthritis from 2012 to 2022: A Bibliometric Analysis","authors":"Rui Wang,&nbsp;Zheng-ming Wang,&nbsp;Si-cheng Xiang,&nbsp;Zhao-kai Jin,&nbsp;Heng-kai Jin,&nbsp;Qi Shi,&nbsp;Lianbo Xiao","doi":"10.1155/2024/2364983","DOIUrl":"https://doi.org/10.1155/2024/2364983","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. Extracellular vesicles, particularly those derived from stem cells, have demonstrated promising potential in osteoarthritis in recent years. However, there has been no bibliometric analysis focusing on the relationship between extracellular vesicles and osteoarthritis. This study aimed to investigate trends and hotpots of publications on extracellular vesicles in osteoarthritis. <i>Methods</i>. This study collected publications on extracellular vesicles in osteoarthritis from the Web of Science Core Collection database, focusing on English-language articles and reviews. Quantitative and visual analysis was performed using Microsoft Excel, R shiny, SCImago Graphica, VOS Viewer, and CiteSpace. The data set comprised information on keywords, authors, institutions, journals, and the country or region of the included literature. Journal impact factors and H-index values were obtained from the 2021 Journal Citation Reports and SJR-International Science Ranking. Furthermore, we conducted a frequency analysis of annual publications number and fitting curves of the growth trends in the publications. Moreover, we conducted a citation burst analysis of the top 20 keywords and a related bibliometric analysis (word frequency analysis and cocitation analysis) using CiteSpace. <i>Results</i>. A total of 715 documents were analyzed. The number of publications increased annually from 2012 to 2022. China had the highest number (<i>n</i> = 394, 55.1%) of publications and total citations during the decade, followed by the United States (<i>n</i> = 105, 14.7%). Shanghai JiaoTong University contributed the highest number of publications (<i>n</i> = 28, 3.9%). Wang Y has the highest number of publications (<i>n</i> = 40, 5.6%), and Stem Cell Research &amp; Therapy is the journal with the highest number of publications (<i>n</i> = 64, 9.0%). The hotspots of extracellular vesicle research in recent years are umbilical cord blood, drug delivery, and scaffolds. <i>Conclusion</i>. Our findings indicate an increase in publications on the topic in utilizing extracellular vesicles in the context of osteoarthritis. Extracellular vesicle therapy for cartilage regeneration and repair of bone defects in osteoarthritis holds significant potential. Future research will focus on the development of novel drug delivery systems that utilize extracellular vesicles, the creation of novel biomaterials that incorporate extracellular vesicles, and the potential of extracellular vesicles as early diagnostic markers of disease.</p>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/2364983","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142525509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Knowledge, Attitude, and Practice of Therapeutic Drug Monitoring Among Hospital Pharmacists in Saudi Arabia","authors":"Sharaf E. Sharaf,&nbsp;Abdulhamid Dahlawi,&nbsp;Abdulrahman Alhajjaji,&nbsp;Afnan Alqurashi,&nbsp;Mmyada Albarakati,&nbsp;Mustafa Badawi,&nbsp;Nouf Alhassani,&nbsp;Omar Alshareef,&nbsp;Sultan Bajawi,&nbsp;Walid Alsufyani,&nbsp;Widad Alfahmi,&nbsp;Yomna Qudus,&nbsp;Anas Shamsi","doi":"10.1155/2024/3435718","DOIUrl":"https://doi.org/10.1155/2024/3435718","url":null,"abstract":"<div>\u0000 <p><b>Objective:</b> Optimal therapeutic drug monitoring (TDM), including clinical pharmacokinetics, appropriate interpretation, and dose adjustment of drugs, is required to effectively monitor specific therapeutic drugs. Hospital pharmacists (HPs), being the most qualified healthcare professionals to implement TDM, must understand its applications to determine and adjust drug doses and avoid adverse drug reactions and toxicity. Therefore, in this knowledge, attitude, and practice (KAP) study, we assessed TDM level among HPs in Saudi Arabia.</p>\u0000 <p><b>Methods:</b> This cross-sectional study was conducted with 414 HPs in the Makkah region with a valid pharmacy license from the Saudi Commission for Health Specialties. An overall score of 50% or higher of the total responses in each section was considered good, whereas an overall score lower than 50% was considered poor. Categorical data are expressed as frequency and percentage. Correlations were measured using Pearson’s correlation coefficient (<i>r</i>).</p>\u0000 <p><b>Results:</b> The TDM-KAP levels of the participants were 50%, 80%, and 62% for KAP, respectively. Significant positive linear correlations were found between knowledge and attitude, knowledge and practice, attitude and practice, knowledge and classification, practice and classification, practice and experience, and knowledge and experience. The participants showed acceptable knowledge and practice of TDM levels with elevated attitude levels.</p>\u0000 <p><b>Conclusion:</b> As a lack of TDM knowledge directly contributes to reduced practice levels, increasing TDM knowledge and practice by introducing more intensive pharmaceutical programs that illustrate TDM clinical applications in hospitals is recommended, which will enhance HP integration.</p>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/3435718","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142525085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circulating FGF-23 Is Associated With Increased Risk of Osteoporosis and Fractures in Hemodialysis Patients: A Prospective Observational Study","authors":"Dong Liu,&nbsp;Hongyan Yang,&nbsp;Qirong Liao,&nbsp;Baocao Chang,&nbsp;Weiwei Zhang,&nbsp;Xiaoxiong Li,&nbsp;Jinping Li,&nbsp;Mingliang Hou,&nbsp;Linqiu Ma,&nbsp;Yating Liu,&nbsp;Jing Lu,&nbsp;Rui Zhou","doi":"10.1155/2024/1070492","DOIUrl":"https://doi.org/10.1155/2024/1070492","url":null,"abstract":"<div>\u0000 <p><b>Background and Objective:</b> It is still controversial whether circulating fibroblast growth factor 23 (FGF-23) can be used as a biomarker for the diagnosis of osteoporosis and fractures in patients with chronic kidney disease undergoing hemodialysis. We investigated the association of circulating FGF-23 concentrations with an increased risk of osteoporosis and fractures of hemodialysis patients in the prospective study.</p>\u0000 <p><b>Methods:</b> These data were collected in adult patients with hemodialysis in China from January 1 to December 30, 2016, and patients were followed up for 3.5 years. The association of circulating FGF-23 with the risk of osteoporosis and fractures was analyzed by multivariate analysis.</p>\u0000 <p><b>Results:</b> The study included 1788 hemodialysis patients, with a median age of 56 years (50–64 years) and a female population of 54.5%. Of 1788 patients, 389 (21.8%) developed osteoporosis and 207 (11.6%) developed fractures. High concentrations of FGF-23 were significantly related to osteoporosis and fractures and were significantly related to different types of fractures (vertebral fractures, nonvertebral fractures, and hip fractures). Adjusted for all potential risk factors, high concentrations of FGF-23 were associated with the risk of osteoporosis or fractures.</p>\u0000 <p><b>Conclusion:</b> High concentrations of circulating FGF-23 were associated with the risk of osteoporosis and fractures, including vertebral fractures and hip fractures. FGF-23, along with bALP, CTX, and OC, may be used as a serum biomarker for predicting the risk of osteoporosis and fractures in patients with hemodialysis.</p>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/1070492","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142525110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting Sepsis-Related Mortality: Pitt Bacteremia Score is Superior to the Charlson Comorbidity Index","authors":"Şenay Öztürk Durmaz,&nbsp;Ayşenur Sümer Coşkun","doi":"10.1155/2024/6996399","DOIUrl":"https://doi.org/10.1155/2024/6996399","url":null,"abstract":"<div>\u0000 <p><b>Aim:</b> To assess the role of Pitt bacteremia score (PBS) and Charlson Comorbidity Index (CCI) in predicting mortality among patients with intensive care unit (ICU)–acquired Gram-negative bacterial sepsis and to investigate other factors associated with mortality.</p>\u0000 <p><b>Methods:</b> This retrospective study was carried out between January 2018 and January 2023. Patients diagnosed with ICU-acquired sepsis caused by Gram-negative bacteria were included in the study. Demographics, laboratory data, blood culture results, management, length of ICU stay, mortality, and other clinical data were recorded. PBS and CCI score were calculated based on data collected at time of blood withdrawal. The primary endpoint was mortality in ICU.</p>\u0000 <p><b>Results:</b> Among the 425 patients included in the study, mortality was observed in 268 (63%). Age and sex were distributed similarly in the mortality and survival groups. CCI score with a cutoff value of &gt; 5.5 (AUC = 0.611) and PBS with a cutoff value of &gt; 2.5 (AUC = 0.904) were able to significantly predict mortality. Multivariable logistic regression revealed that mortality was independently associated with having any comorbidity, congestive heart failure, low platelet count, high lactate, high (&gt; 2.5) PBS, and carbapenem resistance (<i>p</i> = 0.001).</p>\u0000 <p><b>Conclusion:</b> PBS was more successful than CCI in predicting mortality in patients with ICU-acquired sepsis caused by Gram-negative bacteria. In addition to higher PBS, having any comorbidity (and additionally, congestive heart failure), lower platelet, higher lactate, and carbapenem resistance were risk factors for mortality.</p>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/6996399","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142525056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical Malpractice Stress Syndrome and Defensive Medicine in Obstetricians and Gynecologists in Turkey","authors":"O. Gunenc,&nbsp;N. G. Kulhan,&nbsp;M. Geyik Bayman,&nbsp;C. Celik,&nbsp;A. Bilgi,&nbsp;C. Colluoglu,&nbsp;M. Kulhan","doi":"10.1155/2024/8226403","DOIUrl":"https://doi.org/10.1155/2024/8226403","url":null,"abstract":"<div>\u0000 <p><b>Background:</b> Medical malpractice is a significant global issue affecting various aspects of healthcare, including ethical, legal, and managerial perspectives. Defensive medicine, where physicians engage in excessive practices to avoid malpractice lawsuits, is prevalent. In Turkey, the impact of malpractice fears on obstetricians and gynecologists (OB/GYNs) has not been extensively studied. This study aims to investigate the frequency of medical malpractice lawsuits, defensive medicine practices, the prevalence of medical malpractice stress syndrome (MMSS), and potential preventive measures among OB/GYNs in Turkey.</p>\u0000 <p><b>Methods:</b> A cross-sectional survey was conducted with 212 OB/GYNs in Turkey, following ethical approval. Participants completed a questionnaire on their experiences with malpractice, defensive practices, and MMSS. The survey included sociodemographic questions, standardized scales for defensive medicine practices, and MMSS-related questions. Data were analyzed using SPSS 18 with a 95% confidence level.</p>\u0000 <p><b>Results:</b> The majority of participants were experienced professionals aged 30–39, predominantly female, and working in the public sector with limited subspecialty training. Defensive medicine was widespread, with 95.5% of participants engaging in such practices, and 79.2% reported altering their practice due to malpractice fears. Older age, female gender, extensive experience, private sector employment, and specific subspecialties were associated with higher defensive practices and MMSS.</p>\u0000 <p><b>Conclusion:</b> Defensive medicine is common among Turkish OB/GYNs, driven by malpractice fears. The study highlights the need for improved support systems, better legal protections, and educational interventions to address defensive practices and reduce malpractice-related stress.</p>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/8226403","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142525183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive Value of Inflammatory Indicators on the Efficacy of Preoperative Neoadjuvant Chemotherapy in Patients With Locally Advanced Rectal Cancer","authors":"Zechuan Jin,&nbsp;Dan Zhou,&nbsp;TingHan Yang,&nbsp;Ziqiang Wang","doi":"10.1155/2024/3981447","DOIUrl":"https://doi.org/10.1155/2024/3981447","url":null,"abstract":"<div>\u0000 <p><b>Objective:</b> To investigate the relationship between peripheral blood neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-C-reactive-protein ratio (LCR), and monocyte-to-leukocyte ratio (MWR) and the efficacy of neoadjuvant chemotherapy (NAC) for patients with locally advanced rectal cancer before and after chemotherapy.</p>\u0000 <p><b>Methods:</b> Seventeen rectal cancer patients who underwent NAC at West China Hospital of Sichuan University from March 31, 2022, to April 30, 2024, were selected as the study subjects, and the predictive value of peripheral blood NLR, LMR, PLR, LCR, and MWR were included in the least absolute shrinkage and selection operator (LASSO) regression analysis for the pathological efficacy, and the significant variables were screened out and the nomogram was constructed from them. Decision curve analysis (DCA) was applied to evaluate the predictive performance of the model.</p>\u0000 <p><b>Results:</b> LASSO regression screened three predictive variables of NLR, LMR and LCR before neoadjuvant therapy that could predict pathological complete remission (pCR), as well as changes in PLR, LCR, and MWR after neoadjuvant therapy that could predict chemotherapy inefficacy. Nomograms and DCA curves were drawn based on the variables, and internal validation showed that the model had good predictive ability.</p>\u0000 <p><b>Conclusion:</b> The comprehensive hematological prediction model for effective NAC in rectal cancer has a good predictive ability for NAC efficacy, which can provide guidance for individualized patient treatment.</p>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/3981447","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142443565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bidirectional Two-Sample Mendelian Randomization Analysis Unveils a Causal Correlation of Mitochondrial Function-Related Proteins with the Risk of Diabetic Nephropathy","authors":"Siyuan Song,&nbsp;Jiangyi Yu","doi":"10.1155/2024/5196897","DOIUrl":"https://doi.org/10.1155/2024/5196897","url":null,"abstract":"<div>\u0000 <p><i>Objective</i>. The genuine causal nexus between mitochondrial function-related proteins and diabetic nephropathy remains enigmatic and arduous to delineate conclusively. In this study, we employed a bidirectional two-sample Mendelian randomization analysis, a robust approach, to scrutinize and discern the causal interplay between them. <i>Methods</i>. In this investigation, the datasets pertaining to diabetic nephropathy and mitochondrial function-related proteins were meticulously extracted from the comprehensive IEU OpenGWAS Project database. The principal analytical method employed was the inverse variance weighted approach. In addition, MR-Egger regression, simple median, and weighted median methodologies were utilized as supplementary tools to interrogate the causal associations of mitochondrial function-related proteins with the risk of diabetic nephropathy. Semsitivity analyses were conducted using the Cochran’s <i>Q</i> test and MR-Egger regression intercept. The significance level, as indicated by the <i>P</i> value, was employed as the pivotal metric for interpreting the findings. <i>Result</i>. A total of 90 single nucleotide polymorphisms associated with mitochondrial function-related proteins were meticulously screened as instrumental variables. The inverse variance weighted analysis unveiled a positive causal nexus between mitochondrial glutamate carrier 2, 2,4-dienoyl-CoA reductase mitochondrial levels, 39S ribosomal protein L52 mitochondrial, ATP synthase subunit beta mitochondrial, Serine--tRNA ligase mitochondrial, itochondrial sodium/hydrogen exchanger 9B2, and Esseential MCU regulator mitochondrial, and diabetic nephropathy. Conversely, pyruvate dehydrogenase (acetyl-transferring) kinase isozyme 1 mitochondrial exhibited a negative causal relationship with diabetic nephropathy., the MR-Egger intercept test yielded non-multiplicative results (<i>P</i>  &gt;  0.05), affirming the robustness and validity of Mendelian randomization as an effective method for causal inference in this investigation. Furthermore, the reverse Mendelian randomization analysis failed to demonstrate any causal link between diabetic nephropathy and an augmented risk associated with positively identified mitochondrial function-related proteins. <i>Conclusion</i>. Pyruvate dehydrogenase (acetyl-transferring) kinase isozyme 1 mitochondrial stands out as an independent protective factor against diabetic nephropathy. The findings bear significant clinical implications, offering pivotal insights into the development of targeted preventive and therapeutic interventions, tailored specifically for combating diabetic nephropathy.</p>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/5196897","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142429266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multifocality and Detectability of Prostate Cancer with 3-Tesla Multiparametric Magnetic Resonance Imaging: Correlation with Radical Prostatectomy Mapping Histopathology","authors":"Serdar Karadağ,&nbsp;Deniz Noyan Özlü,&nbsp;Ahmet Hacıislamoğlu,&nbsp;Ömer Yıldız,&nbsp;Halil Fırat Baytekin,&nbsp;Mithat Ekşi,&nbsp;Hakan Polat,&nbsp;Alper Bitkin,&nbsp;Ali İhsan Taşçı","doi":"10.1155/2024/6114907","DOIUrl":"https://doi.org/10.1155/2024/6114907","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. We aimed to determine the multifocality and detectability of prostate cancer (Pca) with 3-Tesla (3T) multiparametric magnetic resonance imaging (mpMRI). <i>Methods</i>. The data of the patients who underwent radical prostatectomy in our institution between April 2020 and April 2021 were analyzed. Patients were included in the study at the stage of radical prostatectomy. Demographic and histopathological data were retrospectively collected, and then MRIs of eligible patients were re-evaluated for the study. Suspicious regions of interest (ROIs) were evaluated by a radiologist with 4 years of experience in uroradiology and scored based on Prostate Imaging Reporting and Data System (PIRADS) v2.1. The reader was blinded to the pathological outcomes of any biopsy specimen. Lesions with a PIRADS score ≥3 were considered positive and included in the study. All cases were evaluated histopathologically by a pathologist with ten years of experience in uropathology. We utilized the mapping method which provided exactly the same information as the whole-mount histopathology along with processing the entire prostatectomy specimen. <i>Results</i>. A total of 142 histopathologic tumoral lesions were detected among 70 patients. In relation to postoperative histopathology, tumor multifocality was established in 78.6% (<i>n</i> = 55), and 52.1% (<i>n</i> = 74) of 142 foci recognized were clinically significant. By detecting a total of 67 lesions, mpMRI showed an overall sensitivity of 47%. Whilst the sensitivity was 73% (54/74) in clinically significant lesions, the sensitivity was only 17.6% (12/68) in clinically insignificant lesions. For the group with detected tumors, the mean prostate-specific antigen (PSA) and PSA density were higher, there were more high-grade lesions, and the rate of the extraprostatic extension was significantly greater (<i>p</i> &lt; 0.05, respectively). According to the multivariate analysis, only tumor size and Gleason Score (GS) were independent predictors regarding the ability of mpMRI to detect tumor foci within the prostate (<i>p</i> &lt; 0.0001). <i>Conclusion</i>. mpMRI exhibited an acceptable sensitivity in detecting high-risk and large Pca foci. The diagnostic accuracy is observed to be markedly diminished in small, low GS, and nonindex tumors. A considerable percentage of missed lesions are clinically significant.</p>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/6114907","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142428946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}