International Journal of Clinical Practice最新文献

{"title":"Where Is the Line: Defining Adherence Thresholds for PCSK9is in Terms of Clinical Outcomes and Healthcare Utilization","authors":"Ayala Rohald Stern,&nbsp;Eyal Schwartzberg,&nbsp;Shlomo Vinker,&nbsp;Tzahit Simon-Tuval","doi":"10.1155/ijcp/1458610","DOIUrl":"https://doi.org/10.1155/ijcp/1458610","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Proportion of days covered (PDC) of ≥ 80%, a widely used threshold for optimal adherence, should be reconsidered in the context of highly potent pharmaceutical therapies that are increasingly developed. This study aimed to identify the optimal threshold of adherence to proprotein convertase subtilisin/kexin Type 9 inhibitors (PCSK9is).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>A retrospective cohort study among adult enrollees of Leumit Healthcare Services whose initial prescription fill of PCSK9i was between January 2021 and June 2023 (<i>n</i> = 470). PDC ranges with the lowest variability in low-density lipoprotein cholesterol (LDL-c) change were defined by hierarchical clustering. A multivariable linear model, logistic models, and generalized linear models were used to evaluate the determinants associated with LDL-c change, newly diagnosed cardiovascular (CV) disease, and healthcare utilization (HCU), respectively, at 12 months posttreatment initiation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The optimal adherence threshold was defined as a PDC ≥ 67%. Higher reduction rates in LDL-c were observed for subjects with adherence ≥ 67% (<i>β</i> = −0.285, 95% CI: (−0.355) – (−0.214), <i>p</i> &lt; 0.001). A PDC ≥ 67% was related to fewer neurology visits (RR = 0.61, 95% CI:0.38–0.99, <i>p</i> = 0.045) and higher utilization of cardiac rehabilitation (RR = 3.90, 95% CI:1.22–12.48, <i>p</i> = 0.022). No differences were observed for other newly diagnosed CV diseases and HCU.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A substantial decrease in LDL-c was observed even at an adherence level of PDC ≥ 67%, which is lower than the widely used threshold. These findings may enable development of support programs emphasizing the advantages of even partial adherence. Further research is required to validate these findings through long-term follow-up and in similar contexts.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2026 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/1458610","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149047937","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":"Prior Ipsilateral Ureteroscopy is Not Associated With Inferior Outcomes in Subsequent Ureteroscopic Treatment for Ureteral Stones","authors":"Emrah Küçük,&nbsp;Mesut Şengül,&nbsp;Ahmet Furkan Akıllı,&nbsp;Reha Ordulu,&nbsp;Muhammed Esad Kayhan,&nbsp;Ekrem Akdeniz,&nbsp;Mahmut Ulubay,&nbsp;Mustafa Kemal Atilla","doi":"10.1155/ijcp/8611359","DOIUrl":"https://doi.org/10.1155/ijcp/8611359","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate whether previous ipsilateral ureteroscopy (URS) is associated with perioperative and postoperative outcomes during subsequent ureteroscopic treatment of ureteral stones.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively evaluated a single-center cohort of 330 adults treated with URS for ureteral stones from January 2021 through January 2026. The cohort comprised 200 patients undergoing primary URS and 130 undergoing secondary URS following a prior ipsilateral procedure. Demographic, stone-related, intraoperative, and postoperative outcomes were compared. Separate multivariable logistic regression models assessed the association between secondary URS and key outcomes after adjustment for age, body mass index, ASA score ≥ III, stone size, stone density, stone location, hydronephrosis grade, and impacted stone.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients undergoing secondary URS were older and had higher ASA scores, larger stones, and greater stone density, whereas impacted stones were more common in the primary URS group. Planned stone treatment was completed more frequently during secondary URS (99.2% vs. 92.5%; <i>p</i> = 0.007), and the stone-free rate was higher (87.7% vs. 77.5%; <i>p</i> = 0.020). Operative time and the distribution of Clavien–Dindo grades were comparable between groups. In the adjusted analyses, patients undergoing secondary URS had lower odds of difficult or failed guidewire passage (aOR 0.21, 95% CI 0.11–0.41; <i>p</i> &lt; 0.001), postoperative double-J stent placement (aOR 0.23, 95% CI 0.09–0.61; <i>p</i> = 0.003), and any postoperative complication (aOR 0.47, 95% CI 0.26–0.86; <i>p</i> = 0.014).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Secondary URS was not associated with inferior perioperative or postoperative outcomes compared with primary URS. The more favorable access-related and postoperative findings observed in the secondary group should be interpreted as associations rather than direct effects of the preceding procedure.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2026 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/8611359","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148994344","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 of Blood Glucose Variability During the First 3 Days After ICU Admission With 28-Day All-Cause Mortality in Critically Ill Patients With Acute Myocardial Infarction","authors":"Zhu Zhang,&nbsp;Chunshu Hao,&nbsp;Lijuan Chen","doi":"10.1155/ijcp/9520435","DOIUrl":"https://doi.org/10.1155/ijcp/9520435","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This investigation focused on assessing the link between blood glucose variability (BGV) and 28-day all-cause mortality in individuals with critically ill AMI, as well as determining whether this relationship differed based on diabetes status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The MIMIC-III database yielded 1720 critically ill patients with AMI for inclusion. The coefficient of variation (CV) of glucose was utilized to quantify BGV, derived from all blood glucose determinations recorded throughout the initial 72-h post-ICU admission. The 28-day all-cause mortality constituted the primary outcome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 1720 critically ill patients with AMI, 28-day mortality following ICU admission occurred in 200 cases (11.63%). After full adjustment, a one-unit increment in log-transformed glucose CV was linked to greater odds of 28-day all-cause mortality (OR: 1.50, 95% CI: 1.13–1.99, <i>p</i>-value = 0.01). A positive link was verified through restricted cubic spline (RCS) analysis, and no nonlinear trend was apparent (<i>p</i> for nonlinearity = 0.205). Moreover, in individuals without diabetes, glucose CV was positively linked to 28-day all-cause mortality (OR: 2.49, 95% CI: 1.58–3.93, <i>p</i>-value &lt; 0.001), whereas no significant connection was identified in individuals with diabetes (OR: 0.93, 95% CI: 0.62–1.39, <i>p</i>-value = 0.71). These observations showed consistency when evaluated through subgroup and sensitivity analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Among critically ill AMI patients, glucose CV within 72-h post-ICU admission independently forecasted 28-day all-cause mortality. This association reached statistical significance in patients without diabetes, yet failed to do so in those with diabetes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2026 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/9520435","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148994342","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":"Radiological Assessment of Keros Classification and Anterior Ethmoidal Artery Pathway: A CT-Based Anatomical Correlation Study in a Jordanian Population","authors":"Hasan Ibrahim Al-Balas,&nbsp;Almu’atasim Khamees,&nbsp;Lna Alomari,&nbsp;Baraa Alfaraj,&nbsp;Hala Dalgamouni,&nbsp;Asma’a Mohammad Al-Mnayyis,&nbsp;Mahmoud Tanash","doi":"10.1155/ijcp/1180129","DOIUrl":"https://doi.org/10.1155/ijcp/1180129","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Understanding the anatomical variations of the anterior ethmoidal artery (AEA) and the depth of the olfactory fossa (Keros classification) is essential to prevent complications during endoscopic anterior skull base procedures. This study aimed to evaluate the relationship between Keros classification and AEA location in a Jordanian population using computed tomography (CT).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cross-sectional study was conducted on 498 paranasal sinus CT scans (277 males, 221 females). Scans were analyzed by two independent consultants, with excellent interobserver agreement for both Keros classification (Kappa = 0.85) and AEA location (Kappa = 0.82). The depth of the olfactory fossa was classified according to Keros, and the AEA location was categorized as skull base or mesenteric.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Keros Type II was the most prevalent (57.6%), followed by asymmetry (27.3%), Type III (12.2%), and Type I (2.8%), with no significant gender differences. The AEA was located in the skull base in 64.5% of cases and within a mesenteric course in 35.5%. A significant gender disparity was observed (<i>χ</i>² = 19.529, df = 1, <i>p</i> &lt; 0.001), with mesenteric course AEA more common in females (46.2%, 102/221) than in males (27.1%, 75/277). Females had 2.31 times higher odds of mesentery compared to males (OR = 2.31, 95% CI: 1.59–3.36). Crucially, a strong association was found between Keros classification and AEA location (<i>χ</i>² = 68.494, df = 3, <i>p</i> &lt; 0.001, Cramer’s V = 0.371). Keros Type III was a strong predictor of a mesenteric course AEA, with 80.3% of Type III fossae having a mesenteric artery. Multivariable logistic regression demonstrated that Keros Type III remained an independent predictor of a mesenteric AEA course after adjusting for age and gender (aOR = 11.68, 95% CI: 5.83–23.39, <i>p</i> &lt; 0.001). Female gender was also independently associated with mesenteric AEA (aOR = 2.75, 95% CI: 1.82–4.15, <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>There is a significant association between Keros Type III and a mesenteric course of the AEA. Preoperative identification of Keros Type III on CT scan should be taken into consideration during surgical planning, as it indicates a high probability of encountering a dehiscent AEA. This can help mitigate the risk of major vascular injury and other skull base complications.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2026 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/1180129","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148994343","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":"Efficacy and Safety of Adjunctive Intra-Arterial Thrombolysis Following Endovascular Thrombectomy in Acute Ischemic Stroke: An Updated Meta-Analysis of Randomised Controlled Trials","authors":"Yuyan Xia,&nbsp;Rui Pan,&nbsp;Xue Gong,&nbsp;Xiao Tan,&nbsp;Haibin Wang,&nbsp;Li Gao,&nbsp;Hongsheng Tan","doi":"10.1155/ijcp/2901731","DOIUrl":"https://doi.org/10.1155/ijcp/2901731","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The efficacy of adjunctive intra-arterial thrombolysis (IAT) after endovascular thrombectomy (EVT) for acute ischaemic stroke remains uncertain due to inconsistent evidence. We reviewed international guidelines and conducted a meta-analysis of randomised controlled trials (RCTs) to evaluate the safety and effectiveness of IAT and identify subgroups most likely to benefit.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>International stroke guidelines were summarised. For the meta-analysis, PubMed, Embase and ClinicalTrials.gov were searched through 1 April 2025 for RCTs comparing EVT + IAT with EVT alone (PROSPERO: CRD420251031933). The primary outcome was a 90-day disability-free survival (mRS 0–1); secondary outcomes were functional independence (mRS 0–2), mortality and symptomatic intracranial haemorrhage (sICH).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Across 52 guidelines from 11 countries, recommendations for adjunctive IAT varied substantially, as stated in the original guideline texts. Six RCTs (<i>n</i> = 1807) showed that IAT significantly improved disability-free survival (OR 1.38; 95% CI:1.14–1.67) without increasing mortality or symptomatic intracranial haemorrhage. Although several subgroup analyses suggested possible differential treatment effects, a statistically significant treatment-by-subgroup interaction was observed only for sex (<i>P</i> for interaction = 0.009). These findings suggest a potential benefit of adjunctive IAT after EVT, but further studies are needed to confirm these results and clarify potential sex-specific treatment responses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>International guidance on adjunctive IAT remains inconsistent. This updated meta-analysis suggests that adjunctive IAT may be a safe and effective adjunct to EVT, particularly in selected patient subgroups.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2026 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/2901731","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148994600","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":"A Urinalysis-Based Predictive Model for Early Identification of Urinary Tract Infection","authors":"Hao Xiao,&nbsp;Xinyu Yang,&nbsp;Fangbo Lin","doi":"10.1155/ijcp/4867929","DOIUrl":"https://doi.org/10.1155/ijcp/4867929","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To develop and internally validate a rapid, low-cost model for early identification of urinary tract infection (UTI) in hospitalised adults using routinely available urinalysis parameters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This single-centre retrospective case-control study included 619 inpatients treated between January 2022 and May 2025. UTI cases required a compatible clinical diagnosis and a positive urine culture meeting the prespecified colony-count threshold; controls did not meet these criteria. Admission urine specimens underwent automated reagent-strip testing and automated particle analysis. Candidate predictors were age, sex, documented diabetes history and 12 routinely reported urinalysis variables. Least absolute shrinkage and selection operator (LASSO) regression with ten-fold cross-validation was applied in the 70% development set; retained predictors were entered into multivariable logistic regression and evaluated in a 30% hold-out test set.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Six urinalysis variables—microscopic white-blood-cell grade, leukocyte esterase, urinary blood, nitrite, vitamin C and turbidity—were retained. The nomogram achieved an area under the receiver operating characteristic curve of 0.949 (95% CI: 0.922-0.976) in the test set and showed close agreement between predicted and observed probabilities (mean absolute error: 0.016). Decision curve analysis suggested greater net benefit than ‘treat all’ or ‘treat none’ strategies across threshold probabilities of 10%–70%. SHAP analyses identified white-blood-cell grade and turbidity as the strongest contributors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A model based on six admission urinalysis variables showed strong internal discrimination for identifying UTI in this single-centre sample. Prospective multicentre validation, local recalibration and workflow evaluation are required before clinical use.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2026 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/4867929","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148994555","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":"Unraveling the Causal Pathways Connecting Gut Microbiome, Plasma Metabolites, and Systemic Lupus Erythematosus Through Mendelian Randomization","authors":"Jiaxiang Shang,&nbsp;Xingjian Zhang,&nbsp;Shuting Hou,&nbsp;Xiaodi Zhou,&nbsp;Hongbin Xie,&nbsp;Ruixia Ma","doi":"10.1155/ijcp/6635057","DOIUrl":"https://doi.org/10.1155/ijcp/6635057","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>We investigated the genetically predicted associations of the gut microbiome (GM) and plasma metabolome (PM) with systemic lupus erythematosus (SLE) and assessed potential GM–PM–SLE mediation pathways.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Summary-level genome-wide association study (GWAS) data were obtained for GM from the Dutch Microbiome Project (<i>n</i> = 7738), PM from the Canadian Longitudinal Study on Aging (<i>n</i> = 8299), and SLE (7219 cases and 15,991 controls). Bidirectional Mendelian randomization (MR) was used to evaluate GM–SLE and PM–SLE associations. Two-step Mendelian randomization (TSMR) and multivariable Mendelian randomization (MVMR) were then applied to identify candidate mediation pathways. Conditional F-statistics, summary statistics–based bootstrap sensitivity analysis, linkage disequilibrium score regression (LDSC), and metabolic pathway analysis were used to assess instrument strength, mediation robustness, genetic correlation, and pathway enrichment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified 24 GM components and 109 PM components associated with SLE. Among the PM components, 1-palmitoyl-2-arachidonoyl-GPI (16:0/20:4) showed the strongest statistical evidence (OR = 1.38, 95% CI: 1.19–1.61; <i>P</i> = 1.71 × 10⁻⁵). Four Tier 2b candidate mediation pathways were identified. PWY-5022 was associated with SLE through the oleoyl-linoleoyl-glycerol to linoleoyl-arachidonoyl-glycerol ratio, with an estimated mediation proportion of 7.47%. Glutamate was identified as a candidate mediator of the Prevotellaceae[f]–SLE association, with a mediation proportion of 15.21%. Two <i>Bacteroides vulgatus</i>[s]–SLE pathways involved the cholesterol to linoleoyl-arachidonoyl-glycerol ratio and the cholate to adenosine 5′-monophosphate ratio, with mediation proportions of 24.09% and 13.63%, respectively. LDSC provided no evidence of significant genetic correlation in the evaluable pairs. Metabolic pathway analysis suggested the involvement of phenylalanine, tyrosine, and tryptophan biosynthesis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study identified candidate GM and PM components associated with SLE and four potential GM–PM–SLE mediation pathways. These findings provide genetically informed hypotheses for future mechanistic studies, targeted metabolomic validation, and biomarker research mediation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2026 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/6635057","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148994568","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":"Global, Regional, and National Burden of Sexually Transmitted Infections From 1990 to 2021: An Analysis of Temporal Trends and Inequalities","authors":"Rui Yuan,&nbsp;Bocheng Li,&nbsp;Haibo Long,&nbsp;Aijun Chen","doi":"10.1155/ijcp/8834058","DOIUrl":"https://doi.org/10.1155/ijcp/8834058","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Sexually transmitted infections (STIs) remain a major and inequitably distributed global health burden. COVID-19 disrupted STI prevention and care in many settings. However, whether and how the trajectories of HIV and STIs excluding HIV changed after 2019, particularly across Sociodemographic Index (SDI) strata, remains insufficiently characterized in the Global Burden of Disease Study (GBD)–based analyses. We quantified the STI burden from 1990 to 2021 and assessed post-2019 shifts globally and across SDI strata.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Estimates of prevalence, incidence, deaths, and disability-adjusted life years (DALYs) were obtained from GBD 2021. Long-term trends (1990–2021) were summarized using the estimated annual percentage change (EAPC). Recent changes (2015–2021) were assessed using a two-segment piecewise log-linear model with a fixed 2019 breakpoint.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>For STIs excluding HIV, in 2021, there were approximately 723 million (95% uncertainty interval (UI) 608–873 million) incident cases globally. From 1990 to 2021, the age-standardized incidence rate (ASIR) changed little (EAPC −0.02%, 95% confidence interval (CI) −0.07 to 0.03), while the age-standardized DALY rate (ASR of DALYs) declined overall (EAPC −1.09%, 95% CI −1.28 to −0.90). With 2019 as a breakpoint, the ASR of DALYs was broadly stable during 2015–2019 but increased during 2019–2021, with heterogeneous patterns across SDI strata. For HIV, in 2021, there were 1.65 million (95% UI 1.48–1.82 million) incident cases. From 1990 to 2021, the HIV ASIR declined (EAPC −2.56%, 95% CI −2.94 to −2.17), while the ASR of DALYs changed little (EAPC −0.54%, 95% CI −2.04 to 0.98). During 2019–2021, the HIV ASR of DALYs continued to decrease. The STI burden remained high in sub-Saharan Africa and lower-SDI settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The STI burden remains large and unequal. Post-2019 patterns differed between HIV and STIs excluding HIV, supporting equity-oriented actions and the strengthening of routine STI services in high-burden settings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2026 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/8834058","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148994043","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":"Unveiling the Inflammatory Predictors: Systemic Immune–Inflammation Index and Interleukin-6 as Key Indicators of Early Poststroke Cognitive Decline","authors":"Xiaoli Wang,&nbsp;Ting Yao,&nbsp;Feng Yang","doi":"10.1155/ijcp/7837667","DOIUrl":"https://doi.org/10.1155/ijcp/7837667","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Systemic inflammation is a key contributor to poststroke cognitive impairment (PSCI) and subsequent poststroke dementia (PSD). This prospective cohort study evaluated the predictive efficacy of inflammatory markers for early PSCI/PSD and examined their associations with cognitive subdomains.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A total of 128 patients with acute cerebral infarction were categorized into PSCI (&lt;i&gt;n&lt;/i&gt; = 70) and non-PSCI (&lt;i&gt;n&lt;/i&gt; = 58) groups; the PSCI group was further divided into PSD (&lt;i&gt;n&lt;/i&gt; = 43) and non-PSD (&lt;i&gt;n&lt;/i&gt; = 27) subgroups. Blood levels of systemic immune–inflammation index (SII), high-sensitivity C-reactive protein (hs-CRP), interleukin-1β (IL-1β), IL-6, and tumor necrosis factor-α (TNF-α) were measured within 24 h of admission. Logistic regression, receiver operating characteristic (ROC) curve analysis, DeLong test, and internal validation using 2000 bootstrap resamples were performed to assess model stability, with events per variable (EPV) and optimism values calculated. Correlation analyses were performed between biomarkers and Montreal Cognitive Assessment (MoCA) scores.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;PSCI patients had advanced age, lower education, and more severe stroke. SII, hs-CRP, IL-6, and TNF-α rose in PSCI patients, with SII exhibiting the highest AUC among individual inflammatory markers (0.74). After joint adjustment for the four markers, only SII independently predicted PSCI (EPV = 5.39). Bootstrap showed that the SII-based model had negligible overfitting, and the DeLong test found no AUC difference versus the four-marker model (&lt;i&gt;p&lt;/i&gt; = 0.119). Within the PSCI cohort, only SII and IL-6 increased in PSD patients (EPV = 7.17) and independently predicted PSD. Their combined model had the numerically highest AUC but no statistical superiority over single markers. Higher SII and IL-6 levels correlated with worse global, memory, and visuospatial cognition.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;After mutual adjustment for all inflammatory biomarkers, only SII independently predicted PSCI, while the combination of SII and IL-6 emerged as an independent predictor of PSD. These findings do not negate the clinical utility of hs-CRP, TNF-α, and IL-6 for evaluating systemic inflammatory status. The simplified SII-based model achieved discriminative performance comparable to the full-biomarker panel and provided a cost-effective approach to facilitate tiered cognitive risk stratification following acute ischemic stroke.&lt;/p&gt;\u0000 &lt;/sectio","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2026 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/7837667","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148942902","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":"Integrated Multiomics Analysis and In Vitro Functional Validation Highlight the CEBPD–CXCL2 Axis in Colorectal Cancer Progression and Its Association With the Immune Microenvironment","authors":"Ting Guo,&nbsp;Jing Li,&nbsp;Junzhi Xu,&nbsp;Jiangwei Zhang","doi":"10.1155/ijcp/4711974","DOIUrl":"https://doi.org/10.1155/ijcp/4711974","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>CEBPD is a transcription factor involved in inflammation and tumorigenesis. Despite its established roles, its specific functions and mechanisms in colorectal cancer (CRC) pathogenesis remain incompletely characterized.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed pan-cancer and CRC-specific analyses utilizing TCGA and other public datasets to investigate CEBPD’s transcriptional dysregulation, prognostic value, and immune associations. We integrated multiomics data, including expression, survival, and mutation correlations (TMB/MSI), with functional enrichment analysis. For CRC, single-cell RNA sequencing and CellChat analysis evaluated CEBPD’s impact on the tumor immune microenvironment. Downstream mechanisms were validated experimentally using CEBPD-overexpressing cell lines via flow cytometry, western blotting, dual-luciferase, wound-healing, and Transwell invasion assays.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>CEBPD exhibits differential expression and prognostic significance across multiple cancers. In CRC, its downregulation is prevalent, while elevated CEBPD correlates with favorable overall survival, increased immune cell infiltration, and active inflammatory signaling. Single-cell and spatial analyses revealed that CEBPD is primarily enriched in monocytes/macrophages and strongly influences intercellular communication networks. Mechanistically, dual-luciferase assays confirmed that CEBPD directly and transcriptionally activates CXCL2. Functional in vitro studies firmly established the tumor-suppressive role of CEBPD, as its overexpression significantly enhanced apoptosis and restricted CRC cell migration and invasion. Crucially, these antitumor phenotypes were effectively reversed by siRNA-mediated knockdown of CXCL2, demonstrating strict dependence on the CEBPD–CXCL2 signaling axis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study demonstrates that the CEBPD–CXCL2 axis acts as a critical tumor-suppressive pathway in CRC, driving cell apoptosis and restricting aggressive prometastatic phenotypes in vitro. Furthermore, transcriptomic profiling strongly links CEBPD expression with active immune microenvironment remodeling, highlighting its potential as a favorable prognostic biomarker and an important regulator of CRC progression.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2026 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/4711974","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148942901","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}