International Journal of Clinical Practice最新文献

{"title":"Novel Insights Into the Role of Immune Cells and Plasma Metabolites in Fibromyalgia: A Two-Sample Mendelian Randomization and Mediation Analysis","authors":"Xuanli Gong,&nbsp;Jie He,&nbsp;Mengjiao He,&nbsp;Xi Xu,&nbsp;Xin Zhao,&nbsp;Wei Zou","doi":"10.1155/ijcp/4385489","DOIUrl":"https://doi.org/10.1155/ijcp/4385489","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Fibromyalgia (FM) is a complex chronic pain disorder of indeterminate etiology. This study aimed to investigate the potential causative effects of immune-related factors and plasma metabolites on the development of FM using Mendelian randomization (MR) analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This research used two-sample MR analysis was performed using summary data from comprehensive genome-wide association studies. Genetic instruments were selected for immune cell traits and plasma metabolites. The causal effects on FM risk were estimated, followed by a two-step MR analysis to assess the mediating pathways.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eight immune cell types, including CD8^bright NKT %T cells and CD45 expression on HLA-DR⁺ NK cells, were recognized as possible risk factors for FM. In contrast, 11 phenotypes, including CD28 expression on CD39⁺ resting Treg cells and CD3 expression on CD39⁺ CD4⁺ cells, demonstrated potential protective effects. In addition, 55 plasma metabolites were causally associated with FM, implicating pathways involved in neuroendocrine regulation, inflammation, lipid metabolism, and energy homeostasis. Two-step MR further revealed that 5-hydroxyindole sulfate partially mediated the effect of CD8^bright NKT cell %T on FM risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study provides novel evidence for the immunological and metabolic mechanisms underlying FM. Recognizing specific immune characteristics and metabolites as causal or mediating elements aids in the development of focused diagnostic and treatment approaches for FM.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2026 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/4385489","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147708230","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":"Periodontal Disease Increases the Risk of Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis","authors":"Limei Yang,&nbsp;Dong Zhang,&nbsp;Haiqiong Ran,&nbsp;Wenting Shao,&nbsp;Kangle Guo","doi":"10.1155/ijcp/5296012","DOIUrl":"https://doi.org/10.1155/ijcp/5296012","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Gestational diabetes mellitus (GDM) and periodontal disease (PD) are metabolic and chronic inflammatory conditions, respectively, prevalent and often co-occurring during pregnancy. This study aims to determine the overall prevalence of PD during pregnancy and investigate the potential association between PD and GDM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Observational studies reporting the prevalence of PD during pregnancy or investigating the relationship between PD and GDM were systematically searched in English and Chinese databases. Two independent researchers conducted literature screening and assessed the quality of the included studies. A meta-analysis was performed using R software to combine the prevalence of PD, presented as an estimate and the 95% confidence interval (CI), while the association between PD and GDM was pooled using the odds ratio (OR) and the 95% CI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 21 studies were included, comprising case–control, cohort, and cross-sectional designs. The quality assessment revealed that all studies achieved an average score of 7 points. The meta-analysis showed that the prevalence of PD during pregnancy was 43% in case–control studies, 40% in cross-sectional studies, and 53% in cohort studies. The subgroup analysis indicated that PD was associated with an increased risk of GDM in case–control (OR = 1.61, 95% CI: 1.16–2.22) and cohort studies (OR = 2.22, 95% CI: 1.24–3.96).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The prevalence of PD during pregnancy was found to be notably high and was identified as a risk factor for GDM. However, due to the inconsistency among studies, further investigations are needed to elucidate the association between PD and GDM.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2026 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/5296012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147708086","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":"Self-Rated Health as a Risk Factor for Self-Reported Chronic Lung Disease: A Prospective, Population-Based Cohort Study","authors":"Bill Calvey,&nbsp;Jennifer Deane-King","doi":"10.1155/ijcp/9774815","DOIUrl":"https://doi.org/10.1155/ijcp/9774815","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Self-rated health (SRH) is an established predictor for various acute and chronic conditions, but its association with chronic lung disease (CLD) is less clear. We investigated whether SRH scores are associated with the risk of incident self-reported CLD in European adults.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using data from the Survey of Health, Ageing and Retirement in Europe, we followed 51,893 European adults aged 40+ years at baseline across a 12-year period of data collection (2010–2022), through a prospective, observational cohort design. Competing risks Cox regression models investigated whether SRH scores were associated with self-reported diagnoses of CLD, adjusting for standard sociodemographic characteristics and clinical risk factors, while also accounting for death as a competing risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Over a 12-year follow-up, 6.78% reported a new diagnosis of CLD. After adjustment for standard sociodemographic and clinical risk factors, each incremental improvement in SRH was associated with a 16% reduced risk of self-reported CLD (subdistribution hazard ratio [sHR] = 0.84 and 95% confidence interval [CI] = 0.81, 0.87). This association was similar across males (sHR = 0.85 and 95% CI: 0.80, 0.90) and females (sHR = 0.83 and 95% CI: 0.78, 0.88).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>SRH is a robust predictor of self-reported CLD in European adults. Integrating SRH into routine risk assessments for CLD could enhance early detection of at-risk individuals, beyond what traditional risk factors alone can explain.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2026 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/9774815","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147708088","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":"Association Between Metformin and Mortality in T2DM Patients With Different Subtypes of Ischemic Stroke in MIMIC-IV: A Retrospective Cohort Study","authors":"Zhenyu Sun,&nbsp;Haijing Sui,&nbsp;Yue Bu,&nbsp;Chang liu,&nbsp;Hongjie Xi","doi":"10.1155/ijcp/1779938","DOIUrl":"https://doi.org/10.1155/ijcp/1779938","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>While Type 2 diabetes mellitus (T2DM) is a recognized risk factor for ischemic stroke (IS), metformin’s effect on mortality across distinct IS subtypes remains unclear. This study aimed to investigate the association between metformin and all-cause mortality in patients with concurrent T2DM and IS, exploring TOAST subtype-specific efficacy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective MIMIC-IV cohort study included T2DM and IS patients receiving glucose-lowering agents. Primary and secondary endpoints were 90- and 365-day all-cause mortality. Propensity score matching (PSM) and multivariate logistic regression evaluated associations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 1946 patients, 375 received metformin. Post-PSM (nonmetformin <i>n</i> = 750; metformin <i>n</i> = 375), 90-day mortality was significantly lower in the metformin cohort (9.6% vs. 15.1%, <i>p</i> = 0.014). Multivariate regression confirmed metformin’s independent association with decreased 90-day (odds ratio [OR] = 0.63, 95% confidence interval [CI]: 0.42–0.94, <i>p</i> = 0.025) and 365-day (OR = 0.59, 95% CI: 0.42–0.83, <i>p</i> = 0.002) mortality. Subgroup analyses exploring TOAST classification heterogeneity revealed that in the unmatched cohort, metformin was associated with reduced 90-day mortality in cardioembolism (CE) and stroke of other determined etiology (SOE), as well as reduced 365-day mortality in large-artery atherosclerosis (LAA), CE, SOE, and stroke of undetermined etiology (SUE). However, following PSM adjustment, significant 365-day mortality reduction persisted solely in the SUE subtype (OR = 0.38, 95% CI: 0.16–0.90, <i>p</i> = 0.027).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Metformin is significantly associated with reduced short- and long-term mortality in patients with T2DM and IS. Prognostic benefits exhibit heterogeneity across stroke etiologies, highlighting the necessity for tailored glucose-lowering strategies based on TOAST classifications.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2026 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/1779938","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147708122","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":"Comparison of Bioelectrical Impedance Analysis With Dual-Energy X-Ray Absorptiometry in the Assessment of Sarcopenia in Individuals With Type 2 Diabetes: A Cross-Sectional Study","authors":"Thyago Bruno de Lira dos Santos,&nbsp;Livia Laeny Henrique Pontes,&nbsp;Felipe Rodrigues Lima Mágero,&nbsp;Giselle Rabelo Maciel,&nbsp;Francisco Bandeira","doi":"10.1155/ijcp/2580122","DOIUrl":"https://doi.org/10.1155/ijcp/2580122","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Low muscle mass is a key component of sarcopenia and is common in individuals with type 2 diabetes mellitus (T2DM), contributing to poorer metabolic control and increased health risks. Dual-energy X-ray absorptiometry (DXA) is the reference method for estimating appendicular muscle mass, but its availability is limited. This study evaluated the diagnostic performance of bioelectrical impedance analysis (BIA) versus DXA for identifying low muscle mass in adults with T2DM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this cross-sectional study, 97 adults with T2DM (49 men and 48 women) underwent body composition assessment using a BIA device (InBody 120) and DXA (GE Lunar Prodigy). Low muscle mass was defined using sex-specific cut-offs for BIA- and DXA-derived indexes. Correlations between methods were examined separately by sex.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Low muscle mass was identified in 43.75% of women (<i>n</i> = 21) and 51.04% of men (<i>n</i> = 25). Strong correlations were observed between BIA and DXA across multiple parameters. Among men, skeletal muscle mass index by BIA correlated strongly with the Baumgartner index by DXA (<i>r</i> = 0.861, <i>p</i> = 0.001), and fat mass index showed a similar correlation (<i>r</i> = 0.776, <i>p</i> = 0.001). Among women, strong correlations were observed for fat mass index (<i>r</i> = 0.900, <i>p</i> = 0.001), appendicular skeletal muscle mass index (<i>r</i> = 0.879, <i>p</i> = 0.001), and fat-free mass index (<i>r</i> = 0.879, <i>p</i> = 0.001). A small number of outliers were observed, particularly among women, suggesting measurement discrepancies potentially related to higher adiposity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>BIA demonstrated high concordance with DXA for estimating muscle mass in adults with T2DM, supporting its role as an accessible screening method where DXA is unavailable. Further studies incorporating muscle strength and performance measures are needed to clarify the role of BIA within diagnostic frameworks for sarcopenia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2026 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/2580122","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147708004","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":"Loop Diuretics and Mortality in Heart Failure: A Propensity Score–Matched Study","authors":"Inci Tugce Colluoglu,&nbsp;Tugba Kapansahin,&nbsp;Ahmet Bertug Celik,&nbsp;Yesim Akın","doi":"10.1155/ijcp/5524617","DOIUrl":"https://doi.org/10.1155/ijcp/5524617","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>While loop diuretics remain a cornerstone of heart failure (HF) management, evidence directly comparing the clinical outcomes of torasemide and furosemide is still not clear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>We aimed to assess the comparison of mortality between furosemide and torasemide in patients with HF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This single-center, retrospective, and observational cohort study included 627 patients with HF who were regularly prescribed furosemide or torasemide and were admitted to the emergency department or cardiology outpatient clinic between January 1, 2022, and June 30, 2023. Patients were divided into the two groups as follows: the furosemide group and the torasemide group. The primary outcome was defined as 1-year all-cause mortality. The primary outcome was assessed by Kaplan−Meier analyses in the whole study population and the 1:1 propensity score−matched cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 627 eligible patients with HF, 497 were treated with furosemide, while 130 received torasemide. After propensity score matching analysis, 82 patients with HF in the furosemide group were compared with 82 patients with HF in the torasemide group. In the furosemide group, 1-year all-cause mortality was observed in 15 (18.3%) patients with HF, compared to 13 (15.9%) patients with HF in the torasemide group (<i>p</i>: 0.678). Kaplan−Meier analysis showed that cumulative survival rates were comparable between the HF patients treated with furosemide and those treated with torasemide (log-rank <i>p</i>: 0.661).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In patients with HF, treatment with torasemide was associated with similar 1-year all-cause mortality compared to furosemide, underscoring the absence of a detectable prognostic difference between the two loop diuretic strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2026 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/5524617","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147708024","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":"Clear Aligners for Orthodontic Correction of Class II Malocclusions in Adult Patients Without Tooth Extraction: A Systematic Review","authors":"Gianna Dipalma,&nbsp;Angelo Michele Inchingolo,&nbsp;Merigrazia Campanelli,&nbsp;Pasquale Avantario,&nbsp;Daniela Di Venere,&nbsp;Massimo Corsalini,&nbsp;Francesco Inchingolo,&nbsp;Andrea Palermo,&nbsp;Alessio Danilo Inchingolo","doi":"10.1155/ijcp/8575930","DOIUrl":"https://doi.org/10.1155/ijcp/8575930","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective(s)</h3>\u0000 \u0000 <p>This systematic review analyzed the use of clear aligners (CAs) in adult patients with Class II malocclusion who needed orthodontic treatment. The aim was to investigate the use, effectiveness, benefits, and limitations of the CAs in orthodontic treatment in adult patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This review was conducted according to the PRISMA statement, and the protocol was registered at PROSPERO. A comprehensive search on PubMed, Scopus, and Web of Science was conducted to identify relevant papers dated from January 1, 2014, to October 25, 2024. The electronic database search identified a total of 811 articles. After eligibility, 14 records were selected for qualitative analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Settings and Sample Population</h3>\u0000 \u0000 <p>The relevant papers, randomized clinical trials, retrospective studies, case series, and case reports, in the English language, and with full text, involving adult patients, females and males, with Class II malocclusion treated with aligners.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results/Conclusion</h3>\u0000 \u0000 <p>The findings suggest that the use of CAs in Class II malocclusion is achieved with the sequential distalization of the teeth and the application of intermaxillary elastics and miniscrews. The miniscrews allow treatment with precision, control, and greater anchorage, especially in cases requiring complex tooth movements, such as distalization. The results showed, in addition to the esthetics and comfort of aligners, adequate predictability of even the most complex movements leading to the resolution of Class II malocclusion.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2026 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/8575930","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147707895","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":"Traditional Chinese Medicine in the Adjuvant Treatment for Pain With Hemorrhoidectomy: A Systematic Review and Network Meta-Analysis","authors":"Fanyu Meng,&nbsp;Xinghua Chen,&nbsp;Ting Yu","doi":"10.1155/ijcp/9533397","DOIUrl":"https://doi.org/10.1155/ijcp/9533397","url":null,"abstract":"<p>This study systematically evaluated the clinical efficacy of traditional Chinese medicine (TCM) external therapies as adjuvant treatments for pain following hemorrhoidectomy, using a network meta-analysis of randomized controlled trials (RCTs). Systematic searches were conducted in PubMed, the Cochrane Library, Embase, CNKI, SinoMed, and Wanfang databases. Seven types of TCM external therapies were included, such as acupuncture, herbal fumigation, and others. The visual analog scale (VAS) was selected as the primary outcome measure for pain assessment. We included RCTs that compared predefined TCM external therapies—acupuncture, auricular point therapy, herbal fumigation, catgut implantation at acupoints, wrist–ankle acupuncture, and moxibustion—with placebo treatments (e.g., sham acupuncture or blank control) or western medications limited to nonsteroidal anti-inflammatory drugs (NSAIDs) (mainly included indomethacin, ibuprofen, celecoxib, dezocine, and lidocaine) and opioid analgesics. Auricular point therapy significantly reduced pain within 3–8 h posthemorrhoidectomy, as indicated by the surface under the cumulative ranking curve (SUCRA). Wrist–ankle acupuncture ranked first at 24 h (SUCRA = 0.796), floating needle therapy at 48 h (SUCRA = 0.997), catgut implantation at Day 3 (SUCRA = 0.878), and herbal fumigation at Day 5 (SUCRA = 0.783). TCM external therapies effectively alleviate posthemorrhoidectomy pain. Different therapies may provide optimal analgesia at various postoperative time points. A multimodal analgesic approach incorporating TCM may offer a promising strategy for alleviating hemorrhoidectomy-related pain.</p>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2026 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/9533397","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147707821","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":"Weight-Adjusted Waist Index Mediates the Association Between Cardiovascular Health (Life’s Crucial 9) and Stress Urinary Incontinence: A NHANES Study","authors":"Chen Chen,&nbsp;Lina Huang,&nbsp;Qifeng Song,&nbsp;Zhijun Xia","doi":"10.1155/ijcp/9466687","DOIUrl":"https://doi.org/10.1155/ijcp/9466687","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Stress urinary incontinence (SUI) is a common and bothersome condition adversely affecting women’s well-being. Although growing evidence links cardiometabolic health to pelvic floor disorders, the role of multidimensional cardiovascular health metrics—particularly Life’s Crucial 9 (LC9)—has not been adequately examined. This study aimed to evaluate the association between LC9 and SUI and to investigate whether the weight-adjusted waist index (WWI), an indicator of central fat distribution, mediates this relationship.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed data from the 2005–2016 National Health and Nutrition Examination Survey (NHANES), including 8086 women with complete information. LC9 was constructed from nine components reflecting behavioral, biological, and psychological health. SUI was identified via a standardized questionnaire. Complex survey-weighted multivariable logistic models were used to estimate odds ratios (ORs) with 95% confidence intervals (CIs). Nonlinear associations were explored with restricted cubic splines, and causal mediation analysis was conducted to quantify the indirect effect through WWI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After full adjustment for confounders, a 10-point increase in LC9 score was associated with a significant reduction in SUI risk (OR = 0.82, 95% CI: 0.78–0.86). Women in the highest LC9 tertile had 45% lower odds of SUI compared to the lowest tertile (OR = 0.55, 95% CI: 0.47–0.64; <i>p</i> for trend &lt; 0.001). Conversely, each unit increase in WWI was associated with elevated odds of SUI (OR = 1.22, 95% CI: 1.12–1.32), with the top tertile showing 37% higher odds (OR = 1.37, 95% CI: 1.16–1.62). Both exposures exhibited linear dose–response patterns (<i>p</i> for overall &lt; 0.001). Mediation analysis suggested that WWI may account for 13% of the observed association between LC9 and SUI (<i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Better cardiovascular health, as measured by LC9, is independently associated with a lower prevalence of SUI, and this relationship is partially mediated by central adiposity. These findings highlight the potential of composite health metrics in risk stratification and the development of integrated prevention strategies for SUI in women.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2026 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/9466687","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147708409","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":"Artificial Intelligence and Digital Pathology: Toward Next-Generation Diagnostic Hematology","authors":"Valeriia Tsekhovska,&nbsp;Pier Paolo Piccaluga","doi":"10.1155/ijcp/3282116","DOIUrl":"https://doi.org/10.1155/ijcp/3282116","url":null,"abstract":"<p>The integration of artificial intelligence (AI) is driving a third revolution in pathology, following the transformative impacts of immunohistochemistry and genomic medicine. This review aims to summarize the current landscape of AI applications in diagnostic hematology, highlighting how machine learning (ML) and deep learning (DL) models are poised to reshape clinical practice. Our investigation found that the main applications include the automated analysis of digital pathology slides and flow cytometry data, where algorithms can identify subtle morphologic patterns often invisible to the human eye. Furthermore, AI is crucial for integrating complex, high-throughput next-generation sequencing data to refine diagnostic accuracy and prognostic predictions for hematologic malignancies. While these tools offer the potential to surpass human capabilities in classification tasks, significant challenges remain. The primary hurdles include the need for large, high-quality annotated datasets, the clinical imperative for model interpretability, and the practical difficulties of regulatory approval and workflow integration. Despite these obstacles, the continued advancement of AI in hematopathology promises to enhance diagnostic precision, reduce errors, and ultimately pave the way for a new era of personalized medicine.</p>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2026 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/3282116","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147708413","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}