International Journal of General Medicine最新文献

{"title":"Lesion Location and Possible Etiology of Acute Unilateral Vestibulopathy.","authors":"Menglu Zhang, Jianrong Wang, Siru Xue, Shui Liu, Kangzhi Li, Tongtong Zhao, Yufei Feng, Rubo Sui, Bentao Yang, Xu Yang","doi":"10.2147/IJGM.S502798","DOIUrl":"https://doi.org/10.2147/IJGM.S502798","url":null,"abstract":"<p><strong>Objective: </strong>Acute unilateral vestibulopathy (AUVP) is quite common in clinical practice, but lesion localization and etiological diagnosis of AUVP remain the current clinical challenges, and have always been the focus for researchers. The study aimed to explore the lesion site and possible etiology of AUVP.</p><p><strong>Methods: </strong>This study is a retrospective study. Twenty-three AUVP patients who attended the neurology outpatient clinics of our hospital from January 2020 to March 2022 were included. Clinical data of patients including baseline data, cardiovascular risk factors, immunological test results and infection indicators were collected. Vestibular function tests, including video head impulse test (vHIT), caloric testing, vestibular evoked myogenic potentials (VEMPs) and post-contrast delayed 3D-FLAIR MRI, were performed.</p><p><strong>Results: </strong>Among 32 AUVP patients included, there were 10 males and 13 females, with a male-to-female ratio of 1:1.3, and an average age of 42.13 ± 14.57 years (range 19-76 years old). Acute persistent vertigo and relapsing-remitting vertigo accounted for 39.1% (9/23) and 60.9% (14/23) of the patients, respectively. Possible etiologies included cardiovascular risk factors (n = 11), abnormal immunological indicators (n = 8), and evidence of infection (n = 3). About 57.1% (12/21) of the patients showed abnormal vHIT (including reduced gain in horizontal canal (HC) in 14.3%, anterior canal (AC) in 4.8%, both the AC and HC in 19%, both the HC and posterior canal (PC) in 14.3%, and all three canals in 9.5% of cases). Probable entire vestibular nerve damage was found in 38.1% of the patients, only 9.5% of the patients followed the innervation pattern of the entire vestibular nerve, these patients had abnormal vHIT and VEMP results, and were considered to have definite entire vestibular nerve damage. Probable superior vestibular nerve (SVN) damage was found in 47.6% of the patients, but only 4.8% (1/21) of the patients followed the innervation pattern of SVN, with reduced VOR gains for AC and HC and abnormal oVEMP results, and were considered to have definite SVN damage. 3D-FLAIR MRI revealed high signal intensity in the SVN and vestibule in 4.8% (1/21) and 19% (4/21) of the patients, respectively.</p><p><strong>Conclusion: </strong>The majority of AUVP patients had a relapsing-remitting course and had vestibular function test results that did not follow the innervation pattern of the vestibular nerve. Post-contrast delayed 3D-FLAIR MRI revealed damage to the vestibule in some patients, suggesting that damage to the labyrinth itself in AUVP deserves clinical attention. The majority of the AUVP patients had cardiovascular risk factors and abnormal systemic immunological indicators, which might be the possible etiologies of AUVP.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"345-356"},"PeriodicalIF":2.1,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052555","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":"Study of Radioclinical and Risk Factors of Cerebral Venous Thrombosis: A Retrospective Analysis of Patients Presenting to a Tertiary Hospital in Mogadishu, Somalia.","authors":"Bakar Ali Adam, Ahmed Adam Osman, Mohamed Sheikh Hassan, Nor Osman Sidow, Mohamed Farah Osman Hidig, Abdulkadir Ahmed Mohamed, Abdiwahid Ahmed Ibrahim, Said Abdi Mohamed, Yahye Garad Mohamed, Said Abdirahman Ahmed, Mohamed Osman Omar Jeele, Mohamed Omar Hassan","doi":"10.2147/IJGM.S485129","DOIUrl":"https://doi.org/10.2147/IJGM.S485129","url":null,"abstract":"<p><strong>Background: </strong>Cerebral venous thrombosis (CVT) is a rare but potentially life-threatening condition characterized by the formation of a blood clot in the dural venous sinuses or cerebral veins. CVT presents a diverse array of clinical symptoms, making its diagnosis challenging. Understanding regional variations and specific risk factors associated with CVT is crucial, especially in low-resource settings like Somalia, where epidemiological data is limited and healthcare resources are scarce.</p><p><strong>Objective: </strong>This study aims to investigate the clinical and risk factors associated with CVT in patients presenting to Mogadishu Somali-Turkey Recep Tayyip Erdogan Research and Training Hospital, a tertiary hospital in Mogadishu, Somalia.</p><p><strong>Methods: </strong>We conducted a retrospective observational study involving 68 patients diagnosed with CVT between January 2019 and December 2023. Data included demographic information, clinical presentations, risk factors, and anatomical thrombosis locations. Descriptive statistics and chi-square tests were used for analysis.</p><p><strong>Results: </strong>The majority of patients were female (86.76%) and aged 20-40 years (86.76%). Significant risk factors included the postpartum period (77.94%) and pregnancy, with statistical analysis showing strong associations between CVT and the postpartum period (χ² = 62.96, p < 0.0001) and pregnancy (χ² = 5.21, p = 0.022). Postpartum CVT was linked to thrombosis location (p = 0.025). Headache was the predominant symptom (98.53%), followed by altered mental status (83.82%), focal motor deficits (80.88%), and seizures (70.59%). The superior sagittal sinus was the most commonly involved site (57.35%).</p><p><strong>Conclusion: </strong>This study emphasizes the postpartum period as a significant risk factor for CVT in Somalia and highlights the need for clinical vigilance and early intervention strategies. Larger, multicenter studies are needed to validate these findings.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"371-378"},"PeriodicalIF":2.1,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052557","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":"AI-Assisted Compressed Sensing Enables Faster Brain MRI for the Elderly: Image Quality and Diagnostic Equivalence with Conventional Imaging.","authors":"Wenquan Gu, Chunhong Yang, Yuhui Wang, Wentao Hu, Dongmei Wu, Sunmei Cai, Guoxiong Hong, Peng Hu, Qi Zhang, Yongming Dai","doi":"10.2147/IJGM.S499950","DOIUrl":"https://doi.org/10.2147/IJGM.S499950","url":null,"abstract":"<p><strong>Purpose: </strong>Conventional brain MRI protocols are time-consuming, which can lead to patient discomfort and inefficiency in clinical settings. This study aims to assess the feasibility of using artificial intelligence-assisted compressed sensing (ACS) to reduce brain MRI scan time while maintaining image quality and diagnostic accuracy compared to a conventional imaging protocol.</p><p><strong>Patients and methods: </strong>Seventy patients from the department of neurology underwent brain MRI scans using both conventional and ACS protocols, including axial and sagittal T2-weighted fast spin-echo sequences and T2-fluid attenuated inversion recovery (FLAIR) sequence. Two radiologists independently evaluated image quality based on avoidance of artifacts, boundary sharpness, visibility of lesions, and overall image quality using a 5-point Likert scale. Pathological features, including white matter hyperintensities, lacunar infarcts, and enlarged perivascular spaces, were also assessed. The interchangeability of the two protocols was determined by calculating the 95% confidence interval (CI) for the individual equivalence index. Additionally, Cohen's weighted kappa statistic was used to assess inter-protocol intra-observer agreement.</p><p><strong>Results: </strong>The ACS images demonstrated superior quality across all qualitative features compared to the conventional ones. Both protocols showed no significant difference in detecting pathological conditions. The 95% CI for the individual equivalence index was below 5% for all variables except enlarged perivascular spaces, indicating the interchangeability of the conventional and ACS protocols in most cases. The inter-rater reliability between the two radiologists was strong, with kappa values of 0.78, 0.74, 0.70 and 0.86 for image quality evaluation and 0.74, 0.80 and 0.70 for diagnostic performance, indicating good-to-excellent agreement in their evaluations.</p><p><strong>Conclusion: </strong>The ACS technique reduces brain MRI scan time by 29.2% while achieving higher image quality and equivalent diagnostic accuracy compared to the conventional protocol. This suggests that ACS could be potentially adopted for routine clinical use in brain MRI.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"379-390"},"PeriodicalIF":2.1,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052519","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":"Diagnostic Value of Measurements of Median Nerve Diameter at the Site of the Maximal Stenosis in Carpal Tunnel Syndrome.","authors":"Agnieszka Fryźlewicz, Gabriela Rusin, Wojciech Rudnicki, Marzena Ułamek-Kozioł, Jakub Antczak","doi":"10.2147/IJGM.S502961","DOIUrl":"https://doi.org/10.2147/IJGM.S502961","url":null,"abstract":"<p><strong>Introduction: </strong>Ultrasonography is increasingly used to diagnose the carpal tunnel syndrome (CTS). Most frequently, the enlargement of the nerve cross-sectional area (CSA) at the tunnel inlet serves to confirm the diagnosis. Recent research has shown that the nerve diameter is decreased within the tunnel, when measured at the level of pisiforme or capitatum. The stenosis index (SI), which uses the ratio of the diameter of median nerve at the tunnel inlet to the diameter within the tunnel (SI diameter), was proposed as the diagnostic marker of CTS. In this study, we compared the diameter of the median nerve measured at the site of maximal stenosis (DMS) between patients with CTS and controls. Additionally, we investigated the diagnostic utility of the modified SI, which uses the ratio of CSA at the inlet to the diameter within the tunnel (SI CSA).</p><p><strong>Methods: </strong>Forty-eight patients (72 hands) with CTS and 18 asymptomatic controls (28 hands) underwent electrodiagnostic testing and ultrasonography.</p><p><strong>Results: </strong>CSA at the inlet was larger in patients, whereas DMS showed only trend towards being smaller in CTS. CTS was also associated with more distal localization of maximal stenosis. Both SI diameter and SI CSA were higher in patients, however the discriminative effect of SI CSA was stronger. SI diameter, SI CSA, CSA at the inlet and DMS correlated with the electrodiagnostic severity grade of CTS. The post-hoc analysis revealed that patients with moderate and severe electrodiagnostic grade of CTS have smaller DMS, whereas patients with mild CTS did not differ from controls.</p><p><strong>Conclusion: </strong>DMS seems to have only limited diagnostic potential in mild CTS, but it may be a marker of more advanced cases. CTS may be associated with the distal shift of DMS. SI CSA may have significant diagnostic potential in CTS.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"357-369"},"PeriodicalIF":2.1,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052532","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":"Correlation Between Inflammatory Markers and Pathogenic Bacteria in Children's Winter Respiratory Infections in Xinjiang.","authors":"Lixia Wang, Wei Wang, Jian Wang, Ling Zhu, Jianjiang Luo","doi":"10.2147/IJGM.S499696","DOIUrl":"10.2147/IJGM.S499696","url":null,"abstract":"<p><strong>Background: </strong>This study examines the distribution characteristics of pathogenic bacteria in respiratory infections and their relationship with inflammatory markers to guide clinical drug use.</p><p><strong>Methods: </strong>We selected 120 patients with lower respiratory tract infection in the electronic medical record system of Xinjiang Provincial People's Hospital from March 2019 to March 2023 for a case-control study. Using Indirect Immunofluorescence Antibody test(IFA), blood routine, C-reactive Protein (CRP), and High-sensitivity C-reactive Protein(hsCRP), we detected nine respiratory pathogens (Respiratory syncytial virus; Influenza A virus; Influenza B virus; Parainfluenza virus; Adenovirus; Mycoplasma pneumoniae; Chlamydia pneumoniae; Legionella pneumophila type 1; Rickettsia Q) in all patients and analyzed their distribution and correlation. The patients were divided into three groups [Respiratory Syncytial Virus Immunoglobulin M(RSV-IgM) positive group A, Mycoplasma Immunoglobulin M(MP - IgM) positive group B, antibody - negative group with elevated hsCRP, 40 patients each]. We compared differences in hsCRP, platelet count, White Blood Cells(WBC), and Neutrophil(NE) among the groups.</p><p><strong>Results: </strong>We conducted a systematic sorting and analysis of variables exhibiting significant differences. The results of the multivariate logistic regression analysis indicated that inflammatory markers, including white blood cell count (WBC) (OR 3.85, 95% CI: 1.116-1.623), neutrophils (NE) (OR 2.26, 95% CI: 1.091-1.312), high-sensitivity C-reactive protein (HsCRP) (OR 1.95, 95% CI: 1.068-14.640), lymphocytes (OR 1.30, 95% CI: 1.045-1.134), platelet count (OR 1.34, 95% CI: 1.625-2.760), and C-reactive protein (CRP) (OR 3.80, 95% CI: 1.232-2.379), were significantly associated with the presence of pathogenic bacteria.</p><p><strong>Conclusion: </strong>There was significant correlation between inflammatory markers and pathogenic bacteria in patients with lower respiratory tract infection in Xinjiang region.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"331-343"},"PeriodicalIF":2.1,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11766147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045887","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":"Risk Factors of Hemophagocytic Lymphohistiocytosis in Adults with Fever of Unknown Origin: A Retrospective Study.","authors":"Fangbing Tian, Nana Xie, Wenjin Sun, Wencong Zhang, Wenyuan Zhang, Jia Chen, Qiurong Ruan, Jianxin Song","doi":"10.2147/IJGM.S504345","DOIUrl":"https://doi.org/10.2147/IJGM.S504345","url":null,"abstract":"<p><strong>Purpose: </strong>Hemophagocytic lymphohistiocytosis (HLH) is a critical syndrome with a high mortality rate. In clinical practice, some patients with fever of unknown origin (FUO) can develop HLH, further complicating the diagnosis and treatment. However, studies on HLH in adults with FUO are limited. This study aimed to investigate the clinical characteristics of adult patients with FUO to facilitate the early identification of those at high risk of developing HLH.</p><p><strong>Patients and methods: </strong>We collected data from hospitalized patients with FUO between January 2014 and December 2020. Risk factors for HLH in adults with FUO were analyzed using univariate and multivariate analysis.</p><p><strong>Results: </strong>A total of 988 patients with FUO were included in the study. The incidence of HLH in adults with FUO was 6.4%, with hematological tumors being the primary cause. Multivariate analysis indicated that skin rash and elevated alanine aminotransferase, total bilirubin, triglycerides, lactate dehydrogenase, and ferritin levels were independent risk factors for HLH in adults with FUO.</p><p><strong>Conclusion: </strong>This study revealed the incidence rate, etiology distribution, and risk factors for HLH in adults with FUO. Comprehensive assessment of clinical and laboratory data at admission can assist in the early identification of FUO patients at risk for HLH.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"321-330"},"PeriodicalIF":2.1,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11769724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052556","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":"Role of Huangqin Qingre Chubi Capsule in the Reduction of the Risk of Re-Admission in Patients With Ankylosing Spondylitis: A Cohort Study.","authors":"Yajun Qi, Jian Liu, Yiming Chen, Yuedi Hu, Qiao Zhou, Dan Huang, Chengzhi Cong, Yang Li","doi":"10.2147/IJGM.S501903","DOIUrl":"10.2147/IJGM.S501903","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluates whether Huangqin Qingre Chubi Capsule (HQC), a traditional Chinese medicine (TCM) compound, is associated with the risk of re-admission in patients with ankylosing spondylitis (AS).</p><p><strong>Methods: </strong>In this study, we retrospectively collected the clinical data of 1,296 AS patients. Patients were allocated into HQC and non-HQC groups. Baseline data between the two groups were matched with propensity score matching (PSM). Influencing factors for the risk of re-admission in AS patients were analyzed with the Cox proportional hazards model. The effect of HQC intervention duration on the risk of re-admission was assessed with Kaplan-Meier survival curves. The random walk model and association rule analysis were utilized to determine the correlation between HQC and improvements in immunoinflammatory markers.</p><p><strong>Results: </strong>The re-admission rate was significantly lower in the HQC group than in the non-HQC group (<i>P</i> < 0.01). The risk of re-admission was significantly lower in patients aged > 40 years (<i>P</i> < 0.01) than in patients aged < 40 years and also markedly lower in HQC users than in non-HQC users (<i>P</i> < 0.01), suggesting that age and the use of HQC were key factors influencing the risk of re-admission. Longer HQC intervention duration was associated with better improvements in ESR, CRP, and C4, and HQC was closely correlated with improvements in ESR, CRP, IgA, and C4.</p><p><strong>Conclusion: </strong>HQC treatment can reduce the risk of re-admission in AS patients, which may be associated with improvements in ESR, CRP, IgA, and C4. The risk decreases with prolonged HQC treatment.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"309-319"},"PeriodicalIF":2.1,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11761535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046256","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":"Anti-Osteoporosis Is Imperative in Prevention of Progress of Ankylosing Spondylitis.","authors":"Bin Zheng, Panfeng Yu, Haiying Liu, Yan Liang","doi":"10.2147/IJGM.S509296","DOIUrl":"10.2147/IJGM.S509296","url":null,"abstract":"<p><strong>Background: </strong>Ankylosing spondylitis (AS) is a chronic autoimmune disease that affects the spine and peripheral joints, often leading to kyphosis, joint stiffness, and even ankylosis. Sagittal parameters, such as total thoracic kyphosis (TTK), thoracic kyphosis (TK), major thoracic kyphosis (MTK), and thoracolumbar kyphosis (TLK), are crucial indices for evaluating spinal alignment in AS patients and can reflect disease progression. This study aims to explore the relationship between bone mineral density (BMD), sagittal parameters, and joint ankylosis in AS patients.</p><p><strong>Methods: </strong>A retrospective study was conducted on 147 AS patients. Participants were divided into three groups based on cervical and hip joint mobility. BMD was measured using quantitative computed tomography (QCT). Sagittal parameters (TTK, TK, MTK, TLK) were assessed using X-rays. Ordinal multinomial logistic regression and Spearman correlation analyses were performed to identify factors influencing joint stiffness.</p><p><strong>Results: </strong>Significant differences in age, BMD, and sagittal parameters (TTK, TK, MTK, TLK) were observed among the groups. Ordinal logistic revealed that BMD (Estimate = 0.012) was negatively correlated with joint stiffness, while TTK (Estimate = 0.020) and TLK (Estimate = 0.030) were positively correlated. Age, TK, and MTK do not have a significant impact on joint stiffness. Spearman analysis showed no correlation between BMD and sagittal parameters (TTK and TLK). Besides, TTK and TLK were correlated.</p><p><strong>Conclusion: </strong>In AS patients, BMD is an independent protective factor against joint stiffness, whereas sagittal parameters (TTK and TLK) contribute to increased joint stiffness. These findings highlight the importance of monitoring both bone mineral density and key sagittal parameters in clinical practice. Early anti-osteoporosis treatment, alongside interventions targeting abnormal spinal alignment, may help preserve joint mobility and potentially prevent progression to joint ankylosis.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"291-297"},"PeriodicalIF":2.1,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11756905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028777","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":"Effect of Lamotrigine on Refractory Epilepsy: Clinical Outcomes and EEG Changes.","authors":"Zheng Li, Peng Wu, Qiushuo Chen, Xinqiang Tong, Qichao Yang","doi":"10.2147/IJGM.S505040","DOIUrl":"10.2147/IJGM.S505040","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Refractory epilepsy poses significant challenges in clinical management due to its resistance to standard antiepileptic therapies, necessitating the exploration of more effective treatment regimens. Lamotrigine, with its proven efficacy and tolerability, offers potential benefits when combined with traditional medications like valproate, though its comprehensive impact on clinical outcomes and neurological markers requires further study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To analyze the improvement effect of combined application of lamotrigine on refractory epilepsy patients and its impact on patients' EEG and neurological function.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective cohort study analyzed the clinical data of 93 patients with refractory epilepsy who were admitted to our hospital between January 2023 and June 2024. Based on the treatment interventions received, patients were divided into a control group (n=46, treated with valproate) and an observation group (n=47, treated with lamotrigine in addition to valproate). The clinical treatment effects, EEG (δ, θ, α, β) power levels, neurological function indicators [brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF), pro-apoptotic protein Bcl-2, Bax], inflammatory response indicators [interleukin-1β (IL-1β), interleukin-6 (IL-6), prostaglandin E2 (PGE2)], and the incidence of adverse reactions were compared between the two groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The clinical treatment effect in the observation group was significantly better than that in the control group, with a higher total effective rate (93.62% vs 76.09%, P&lt;0.05). The monthly seizure frequency was significantly reduced in both groups after treatment (P &lt; 0.05). The observation group demonstrated a significantly greater reduction in seizure frequency compared to the control group (P = 0.014). Regarding EEG power levels, both groups showed decreases in δ and θ power levels and increases in α and β power levels after treatment, with the observation group exhibiting more pronounced changes (P&lt;0.05). Neurological function indicators revealed that Bcl-2 levels decreased, while BDNF, NGF, and Bax levels increased in both groups after treatment, with the observation group showing more significant improvements (P&lt;0.05). Similarly, inflammatory response indicators, including IL-1β, IL-6, and PGE2, decreased in both groups, with the observation group demonstrating greater reductions (P&lt;0.05). The incidence of adverse reactions was comparable between the two groups, with no significant difference observed (23.40% vs 17.39%, P&gt;0.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Compared to valproate treatment alone, the combined application of lamotrigine can further enhance the efficacy in refractory epilepsy patients, Lower the seizure frequency, improve EEG power levels and neurological function, reduce inflammatory responses, and does not increase the risk of related adverse reactions.&lt;/p","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"281-290"},"PeriodicalIF":2.1,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11761849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046136","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 Advances in Utilizing Right Ventricular Function as a Predictor of Peripartum Cardiomyopathy Recovery: A Single Centre Prospective Cohort Study.","authors":"Mohammad Rizki Akbar, Sylvie Sakasasmita, Chaerul Achmad, Triwedya Indra Dewi, Melawati Hasan, Hawani Sasmaya Prameswari","doi":"10.2147/IJGM.S477008","DOIUrl":"10.2147/IJGM.S477008","url":null,"abstract":"<p><strong>Introduction: </strong>Peripartum cardiomyopathy (PPCM) is a pregnancy related cardiomyopathy with a high potential for recovery. One of the contemporary predictors studied in cardiomyopathy is right ventricular (RV) function during initial presentation.</p><p><strong>Purpose: </strong>This study aimed to determine the role of RV systolic function based on the various RV function parameters by two-dimensional transthoracic echocardiography (2DE) to predict PPCM recovery within 6 months of follow-up and identify the most accurate parameter among them.</p><p><strong>Patients and methods: </strong>This was a prospective cohort study that include all patients registered in the \"Long Term Registry on Patients with Peripartum Cardiomyopathy\" at Dr. Hasan Sadikin General Hospital Indonesia during period of September 2014 until December 2022. Right ventricular systolic dysfunction was defined as abnormal value in one or more parameter(s), including tricuspid annular plane systolic excursion (TAPSE), fractional area change (FAC), S', right ventricular free wall longitudinal strain (RVFWLS) and right ventricular global longitudinal strain (RVGLS). Left ventricular ejection fraction was measured on initial examination and after 6-month follow up to define recovery.</p><p><strong>Results: </strong>A total of 95 patients were included in this study. There were 33 patients (34.7%) with reduced initial RV systolic function. Sixty-four patients (67.4%) recovered within 6 months follow up. The recovery rate of patients with initial RV systolic dysfunction is lower than patients with normal RV systolic function (51.5% vs 75.8%, p = 0.016). This study showed that initial RV systolic dysfunction can predict poor LV function recovery in PPCM patients (OR 0.340; 95% CI:0.120-0.959; p = 0.041). Among all RV function parameters, only FAC (OR 1.076; 95% CI:1.003-1.154; p = 0.040)) and RVGLS (OR 0.768; 95% CI: 0.595-0.991; p = 0.042) emerged as independent predictors of PPCM recovery.</p><p><strong>Conclusion: </strong>Right ventricular function in terms of FAC and/or RVGLS at initial diagnosis can be used as a predictor for PPCM recovery at 6 months follow-up.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"299-308"},"PeriodicalIF":2.1,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11758858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046364","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}