International Journal of Clinical Practice最新文献

{"title":"Guidelines for Returning to Dance Following Concussion: Adaptations From Sport Concussion Literature","authors":"Sheyi Ojofeitimi,&nbsp;Lauren McIntyre,&nbsp;Elizabeth Barchi,&nbsp;Sarah S. Rae,&nbsp;Brittney Winnitoy,&nbsp;Jeffrey A. Russell","doi":"10.1155/2024/1449433","DOIUrl":"https://doi.org/10.1155/2024/1449433","url":null,"abstract":"<div>\u0000 <p>Sport concussion receives substantial attention as a public health concern. Conversely, performing artists, including dancers, sustain concussions, but these aesthetic athletes do not receive the same level of consideration nor care for this injury as that offered to traditional athletes. The concussion literature pertaining to dance is sparse, and, to our knowledge, no recommendations exist for the crucial aspect of care related to returning to dance following a concussion. The purpose of this article is to assimilate the current knowledge about post-concussion return to activity management in sport—the closest analog of the physical demands required in dance—as a means to delineate a framework for returning to dance following a concussion. Specific guidance is provided based on a review of evidence-based practice so clinicians can ensure that dancers return safely to both their dance activity and any academic work they are required to undertake. Concussion in dance is not an infrequent occurrence and dancers and healthcare practitioners alike will benefit from dance-specific guidance for returning to dance post-concussion. Overall, the principles that form the foundation for return-to-sport decisions are remarkably robust for application to dance.</p>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2024 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/1449433","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142861550","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":"The Role of Mammographic Breast Area/Microcalcification Cluster Area (BA/MCA) Ratio in the Classification of BI-RADS 4 Lesions: A Step for Development of Artificial Intelligence in Breast Cancer Patients","authors":"Ibrahim Burak Bahçecioğlu,&nbsp;Şevket Barış Morkavuk,&nbsp;Şebnem Çimen,&nbsp;Müjdat Turan,&nbsp;Gökay Çetinkaya,&nbsp;Mehmet Ali Gülçelik","doi":"10.1155/ijcp/3533205","DOIUrl":"https://doi.org/10.1155/ijcp/3533205","url":null,"abstract":"<div>\u0000 <p><b>Introduction:</b> The working principle of artificial intelligence in medicine is primarily as follows: The data are collected and entered into the system, the computer uses an algorithm to gather information via these data, and finally, it analyzes this algorithm to utilize in the diagnosis and treatment of the disease. In this study, we investigated the achievement of mammographic breast area/microcalcification cluster area ratio (BA/MCA) in the grouping of BI-RADS 4 (a, b, c) lesions. We planned to contribute to the development of artificial intelligence in medicine with a simple calculation program to be attached to the mammography computer.</p>\u0000 <p><b>Methods:</b> 125 patients who underwent surgery with the diagnosis of mammographic BI-RADS 4 lesion (could not be detected in lesion-specific ultrasonography) between 2019 and 2022 in the Department of Surgical Oncology of Health Sciences University Gulhane Medical Faculty Training and Research Hospital were retrospectively examined. The mammographic MCA was divided by the breast area and their ratio was calculated. The relationship between the ratios we found and the BI-RADS values defined by radiology was analyzed.</p>\u0000 <p><b>Results:</b> We found the median BA/MCA value of BI-RADS 4a patients to be 24943.5, BI-RADS 4b patients to be 12609.2, and BI-RADS 4c patients to be 11547.1 (<i>p</i> = 0.003). According to ROC curve analysis, we detected the BA/MCA ratio for BI-RADS 4c to be 14183.34 (AUC = 0.686, <i>p</i> = 0.005, sensitivity 54.2%). This ratio is inversely related, and the probability of BI-RADS 4c increases in patients with a BA/MCA ratio less than 14183.34. We revealed that the malignancy rate of radiological BI-RADS 4c patients was 90%, and the cutoff value of BI-RADS 4c patients was 72%. Using both classifications together, we detected the malignancy rate to be 98%.</p>\u0000 <p><b>Conclusion:</b> The increase in the ratio of MCA to BA might have a place in the differentiation of BI-RADS 4 lesions. We foresee that artificial intelligence could also have a place in the classification of BI-RADS lesions with software to be installed on the mammography computer.</p>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2024 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/3533205","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142764296","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":"Enhancing Medication History Accuracy in a Tertiary Hospital: Pharmacist-Led Counseling With Nationwide Medication History Sharing Program Versus Conventional Methods","authors":"Hyunwoo Chae,&nbsp;Subin Yoon,&nbsp;Soyoung Park,&nbsp;A Jeong Kim,&nbsp;Kyu-Nam Heo,&nbsp;Yookyung Kim,&nbsp;Jeong Yeon Seok,&nbsp;Sung Hwan Kim,&nbsp;Taeyoung Yun,&nbsp;Ji Hyeon Park,&nbsp;Yoon Sook Cho,&nbsp;Young Tae Kim,&nbsp;Hyun Joo Lee,&nbsp;Ju-Yeun Lee","doi":"10.1155/ijcp/4554730","DOIUrl":"https://doi.org/10.1155/ijcp/4554730","url":null,"abstract":"<div>\u0000 <p><b>Aims:</b> Medication discrepancies during transitions of care pose substantial risks, particularly in older patients receiving complex medication regimens. Obtaining the best possible medication history (BPMH) is crucial to minimize this risk. This study aimed to evaluate the effectiveness of a pharmacist-led BPMH using various information sources including a nationwide medication history sharing program compared to conventional interviews in a tertiary hospital setting. In addition, we identified factors contributing to medication inaccuracies.</p>\u0000 <p><b>Methods:</b> A single-center prospective study involving older patients scheduled for thoracic surgery at a tertiary hospital was conducted. Medication histories obtained through conventional interviews during the initial assessment on admission were compared with those obtained through BPMH by pharmacist-led interviews. Logistic regression analysis was used to identify factors associated with medication inaccuracies.</p>\u0000 <p><b>Results:</b> This study included 216 patients, a significant proportion of whom were experiencing polypharmacy. The pharmacist-led BPMH approach demonstrated superior accuracy in documenting medication histories, with conventional methods showing inaccuracies in over 70% of the cases. Factors that significantly increased the likelihood of inaccuracies included the number of medications and number of prescribers. Nonoral and as-needed medications are particularly prone to inaccuracies.</p>\u0000 <p><b>Conclusions:</b> Pharmacist-led BPMH significantly improved medication history accuracy compared to conventional methods, which had inaccuracies in over 70%. It is important to be careful when obtaining BPMH for older adults, particularly those with complex medication regimens, nonoral medications, or PRN medications, to enhance patient safety and reduce medication-related risks.</p>\u0000 <p><b>Trial Registration:</b> Clinical Trial Registry identifier: KCT-006813.</p>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2024 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/4554730","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142749281","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":"Clostridium innocuum: More Important Than Ever","authors":"Xujuan Luo,&nbsp;Xiaobo Wang,&nbsp;Jun Wang","doi":"10.1155/ijcp/5797671","DOIUrl":"https://doi.org/10.1155/ijcp/5797671","url":null,"abstract":"<div>\u0000 <p><i>Clostridium innocuum</i> (CI) is an emerging pathogen associated with a diverse range of diseases. This review primarily delves into clinical studies pertaining to CI and its potential pathogenic mechanisms, aiming to provide guidance for future research endeavors on this topic.</p>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2024 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/5797671","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142737429","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 Polycystic Ovary Syndrome and Pancreatic Cancer in a Retrospective Case-Control Study","authors":"Pei-Ying Chung,&nbsp;Kuan-Fu Liao,&nbsp;Yu-Hung Kuo,&nbsp;Shih-Wei Lai","doi":"10.1155/ijcp/9066933","DOIUrl":"https://doi.org/10.1155/ijcp/9066933","url":null,"abstract":"<div>\u0000 <p><b>Objective:</b> To assess the association between polycystic ovary syndrome and pancreatic cancer in Taiwan.</p>\u0000 <p><b>Methods:</b> We used the 2013–2020 claims data of Taiwan National Health Insurance Program. A case-control study was performed, including female subjects 20 years or older with and without pancreatic cancer. Cases comprised female subjects diagnosed with pancreatic cancer, identified based on diagnosis codes. Controls were selected from female subjects without pancreatic cancer and matched to cases on age and comorbidities. Polycystic ovary syndrome was identified through diagnosis codes. A conditional logistic regression model was used to assess the association between polycystic ovary syndrome and pancreatic cancer, with results presented as odds ratio (OR) and 95% confidence interval (CI).</p>\u0000 <p><b>Results:</b> This case-control study included 12,466 cases with pancreatic cancer and 49,864 matched controls. The proportions of polycystic ovary syndrome were 2.6% among cases with pancreatic cancer and 1.4% among controls without pancreatic cancer (<i>p</i> &lt; 0.001). After controlling for confounding factors, the conditional logistical regression model revealed a statistically significant association between polycystic ovary syndrome and pancreatic cancer, with an OR of 1.38 (95% CI = 1.21–1.59, <i>p</i> &lt; 0.001).</p>\u0000 <p><b>Conclusion:</b> This case-control study reveals that there is a statistically significant association between polycystic ovary syndrome and pancreatic cancer. More studies are needed to provide robust evidence.</p>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2024 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/9066933","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142708337","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":"Hydrochlorothiazide Improves Cardiac Remodeling in Heart Failure Rats by Reducing Oxidative Stress","authors":"Jinghong Luo,&nbsp;Juncong Li,&nbsp;Ling Li,&nbsp;Jizhang Ye,&nbsp;Shudan Chen,&nbsp;Qingchun Zeng","doi":"10.1155/2024/8014044","DOIUrl":"https://doi.org/10.1155/2024/8014044","url":null,"abstract":"<div>\u0000 <p><b>Background and Aims:</b> The impact of thiazide diuretics on cardiac remodeling and prognosis in heart failure remains uncertain. This study aims to investigate whether hydrochlorothiazide can improve cardiac function and remodeling by inhibiting oxidative stress.</p>\u0000 <p><b>Methods:</b> The rat model of heart failure was established by ligating the left anterior descending branch of the coronary artery, and hydrochlorothiazide (12.5 mg/kg, ig, Qd) was administered by gavage for 6 weeks. The cardiac function was evaluated using echocardiography and hemodynamics. Various methodologies were used to evaluate the effects of hydrochlorothiazide on myocardial fibrosis, inflammation, oxidative stress, and apoptosis. The effects of hydrochlorothiazide were validated in vitro using H9c2 cell cultures. The binding mechanism of hydrochlorothiazide to carbonic anhydrase 2 (CAII) was investigated using molecular docking and dynamics simulations.</p>\u0000 <p><b>Results:</b> The decreases in ejection fraction, fractional shortening, and left ventricular end-systolic pressure and the increases in left ventricular end-diastolic diameter, left ventricular end-diastolic pressure, and B-type natriuretic peptide in heart failure rats were improved by hydrochlorothiazide. Hydrochlorothiazide can reduce the expression of myocardial collagen I. In terms of oxidative stress, hydrochlorothiazide can decrease MDA, p47phox, and p67phox while increasing SOD2, total oxidation capacity, and mitochondrial respiratory chain complexes I and IV. Additionally, hydrochlorothiazide can inhibit the p38MAPK/JNK signaling pathway, leading to reduced expression of inflammatory markers (NF-ĸB p65) and apoptotic markers (Bax, caspase3, and cytochrome C). The possible mechanism involves hydrochlorothiazide inhibiting the expression of sodium hydrogen exchanger 1 (NHE1), which is an upstream molecule involved in oxidative stress. H9c2 cell culture further confirmed the effects of hydrochlorothiazide on oxidative stress, inflammation, and apoptosis. Molecular docking and dynamics simulation results demonstrated that hydrochlorothiazide directly binds to CAII forming an unstable conformation. Gene knockout studies showed that CAII knockout reduces the expression of NHE1, NCX1, p67phox, Bax, and NF-ĸB p65.</p>\u0000 <p><b>Conclusions:</b> Hydrochlorothiazide can enhance cardiac function and mitigate cardiac fibrosis remodeling in rats with heart failure by reducing the oxidative stress and inhibiting the p38MAPK/JNK signaling pathway, wherein CAII and NHE1 play a crucial role.</p>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2024 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/8014044","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142708145","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":"The Evaluation of the Relationship Between Coronary Ectasia and Trimethylamine N-Oxide","authors":"Hasan Sari,&nbsp;Yakup Alsancak,&nbsp;Ahmet Seyfeddin Gurbuz,&nbsp;Oznur Keskin,&nbsp;Sefa Tatar,&nbsp;Mehmet Akif Duzenli","doi":"10.1155/ijcp/7356380","DOIUrl":"https://doi.org/10.1155/ijcp/7356380","url":null,"abstract":"<div>\u0000 <p><b>Introduction:</b> It is now known that the microbiota is far beyond the microbial communities living in certain parts of our body and functions like a metabolic organ. In addition, the microbiota, through its metabolites, is involved in the pathophysiology or progression of a wide range of diseases, from atherosclerotic diseases to metabolic diseases and even neurological diseases. Among these metabolites, trimethylamine n-oxide metabolite has been shown to be particularly effective in atherosclerotic heart diseases.</p>\u0000 <p><b>Materials and Methods:</b> A total of 155 patients, who underwent coroner angiography for stable angina were included in the study. Of these patients, 81 patients with coronary artery ectasia (patient group) and 74 patients without coronary artery ectasia (control group) were evaluated for trimethylamine n-oxide metabolite.</p>\u0000 <p><b>Results:</b> Statistically significantly higher trimethylamine n-oxide metabolite levels were observed in the coronary artery ectasia group compared to the control group.</p>\u0000 <p><b>Conclusion:</b> The significantly higher trimethylamine n-oxide levels in patients with coronary artery ectasia without coronary artery disease suggest that the microbiota and its metabolites independently play a role in the pathophysiology or progression of vascular remodeling or endothelial dysfunctions. Also, its effect on the endothelial surface may depend on the threshold value.</p>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2024 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/7356380","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142707718","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":"Genetically Predicted Immune Cells Mediate the Association Between Gut Microbiota and Gastroesophageal Reflux Disease","authors":"Jia Wang,&nbsp;Bojian Fei,&nbsp;Chao Wang","doi":"10.1155/2024/8242903","DOIUrl":"https://doi.org/10.1155/2024/8242903","url":null,"abstract":"<div>\u0000 <p><b>Background:</b> Recent evidence increasingly acknowledges the close interrelationship between immunity and gut microbiota (GM) in humans. Furthermore, previous studies have demonstrated a strong correlation between GM and gastroesophageal reflux disease (GERD). However, the specific impact of GM on immune factors in GERD remains largely unexplored. Therefore, we conducted the Mendelian randomization (MR) analysis to investigate the precise causal relationships and underlying mechanisms linking GM, immunity, and GERD.</p>\u0000 <p><b>Method:</b> We employed the mediation MR utilizing summary statistics derived from Genome-Wide Association Study (GWAS) data to investigate the causal effects of 207 taxa and 205 bacterial pathways on GERD. The analysis concentrated on 731 immune cell traits as potential mediators. The inverse variance weighted (IVW) approach was the primary analytical method. To ensure robustness, we employed additional MR methods, including Bayesian weighted MR (BWMR), MR-Egger, Weighted Median, Weighted Mode, and Simple Mode. Furthermore, a series of sensitivity analyses, such as the Cochran’s <i>Q</i> test, leave-one-out test, MR-Egger intercept analysis, and MR-PRESSO test, were conducted to ensure the reliability and consistency of the findings.</p>\u0000 <p><b>Results:</b> The study identified three taxa and eight bacterial pathways that exhibited a negative correlation with GERD. Mediation MR analyses indicated that four bacterial pathways influence GERD through four immune cell types acting as mediators. For instance, the “arginine, ornithine, and proline interconversion” pathway was implicated in reducing the risk of GERD via “PDL-1 on CD14- CD16+ monocyte” cells, with a total effect of −0.0484 and a mediation effect of −0.0093. Sensitivity analyses provided additional validation for the reliability of the MR findings.</p>\u0000 <p><b>Conclusion:</b> Our study contributes evidence to the close causal relationship between the GM and GERD, emphasizing the possible role of immune cells as mediators. Future research should focus on developing microbiome-oriented therapeutic approaches for managing GERD.</p>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2024 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/8242903","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142641807","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":"Hemodynamic Alterations in Cardiac Function Among Patients With Stroke and SARS-CoV-2 Infection: A Retrospective Cohort Study","authors":"Mingchao Zhou,&nbsp;Fubing Zha,&nbsp;Liuyang Zhao,&nbsp;Dongxia Li,&nbsp;Jiao Luo,&nbsp;Yao Wang,&nbsp;Fang Liu,&nbsp;Jing Zhou,&nbsp;Zeyu Zhang,&nbsp;Yucong Zou,&nbsp;Feng Xiong,&nbsp;Dianrui Hou,&nbsp;Fei Li,&nbsp;Mingjun He,&nbsp;Yongjie Zhu,&nbsp;Yulong Wang","doi":"10.1155/2024/2047103","DOIUrl":"https://doi.org/10.1155/2024/2047103","url":null,"abstract":"<div>\u0000 <p><b>Objective:</b> Cardiovascular complications associated with COVID-19 are being increasingly recognized. They include potential long-term effects on the heart, although how these complications manifest in patients with stroke who are already vulnerable to cardiovascular issues is lacking. This study addressed this gap by investigating the influence of SARS-CoV-2 infection on cardiac hemodynamic changes in inpatients with stroke, thereby providing valuable insights into the management of cardiac complications in this population.</p>\u0000 <p><b>Methods:</b> This retrospective cohort study enrolled inpatients with stroke who did or did not experience SARS-CoV-2 infection in Shenzhen Second People’s Hospital. Clinical information, hemodynamics data, serum myocardial enzyme levels, functional levels, including Barthel index, and Longshi scale assessment (bedridden, domestic, and community) were extracted from clinical records. An independent sample <i>t</i>-test and the Mann–Whitney <i>U</i> test were used for comparison between groups. Multiple logistic regression analysis was used to identify indicators associated with decline in cardiac function in patients with stroke post-COVID-19.</p>\u0000 <p><b>Results:</b> Eighty-three patients with stroke (average age of 66.0 ± 15.5 years) were recruited (42 patients in the study group and 41 in the control group). No significant difference in general characteristics was observed between the groups. The ejection fraction (EF, 56.45 ± 12.46 vs. 47.64 ± 14.76, <i>p</i> = 0.04) was decreased, and the end-diastolic volume (EDV, 142.74 ± 80.00 vs. 193.34 ± 140.17, <i>p</i> = 0.001) was increased significantly in patients infected with SARS-CoV-2 compared with the noninfected participants. SARS-CoV-2 infection was an independent risk factor for EF (−10%) decrease (OR: 5.205, 95% CI: 1.621–16.720, <i>p</i> = 0.006). The risk of cardiac function decline among bedridden infected patients was 15.43 times higher than that of uninfected nonbedridden patients (OR: 15.430, 95% CI: 1.402–169.805, <i>p</i> = 0.025).</p>\u0000 <p><b>Conclusion:</b> Patients who are bedridden after stroke face a higher potential risk of cardiac hemodynamic impairment following SARS-CoV-2 infection, emphasizing the need for meticulous hemodynamic monitoring during treatment and rehabilitation of these patients to prevent any potential cardiovascular complications.</p>\u0000 <p><b>Trial Registration:</b> ClinicalTrials.gov identifier: ChiCTR2300071376.</p>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2024 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/2047103","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142641444","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":"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":"2024 1","pages":""},"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}