International Journal of General Medicine最新文献

{"title":"The Combined Predictive Value of the GRACE Score and the ARC-HBR Criteria for Bleeding Risk After Percutaneous Coronary Intervention in STEMI Patients.","authors":"Xiaoying Wang, Yuanyuan Ning, Xiaojuan Wang, Guangli Li, Dong Wu, Xiaowu Wang, Zhen Huang","doi":"10.2147/IJGM.S605618","DOIUrl":"https://doi.org/10.2147/IJGM.S605618","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the incremental predictive value of the Global Registry of Acute Coronary Events (GRACE) score combined with the Academic Research Consortium for High Bleeding Risk (ARC-HBR) criteria for bleeding risk after percutaneous coronary intervention (PCI) in patients with ST‑segment elevation myocardial infarction (STEMI).</p><p><strong>Methods: </strong>This prospective observational study enrolled 338 STEMI patients who underwent their first PCI at Fuyang People's Hospital from January 2023 to March 2024. Bleeding events were defined according to the Bleeding Academic Research Consortium (BARC) types 1-5. Patients were stratified by GRACE score (low/middle/high) and ARC‑HBR status (high/low). The predictive performance of the model was assessed using receiver operating characteristic (ROC) curves, net reclassification improvement (NRI), integrated discrimination improvement (IDI), decision curve analysis (DCA), and calibration plots. Internal validation was performed via bootstrap resampling (1,000 iterations).</p><p><strong>Results: </strong>Bleeding occurred in 83 patients (24.56%), with 63 in‑hospital events (18.64%) and 34 out‑of‑hospital events (10.06%). The majority were mild (BARC type 1, 82.54% in‑hospital; 73.53% out‑of‑hospital). The combined GRACE + ARC‑HBR model achieved an area under the ROC curve (AUC) of 0.774 (95% CI 0.726-0.818), compared with 0.712 (95% CI 0.660-0.759) for GRACE alone and 0.667 (95% CI 0.614-0.717) for ARC‑HBR alone. Versus GRACE, the combined model showed a non‑significant NRI (-0.0509; P = 0.0945) but a significant IDI (0.0560; P = 0.0006). Versus ARC‑HBR, both NRI (0.3277; P = 0.0007) and IDI (0.0768; P < 0.0001) were significantly positive. DCA demonstrated the highest net benefit for the combined model across most threshold probabilities. The calibration curve yielded a Brier score of 0.147, and the Hosmer-Lemeshow test confirmed good calibration (χ²=3.568, P=0.8938). Bootstrap internal validation produced a bias‑corrected AUC of 0.775.</p><p><strong>Conclusion: </strong>Compared with either score alone, the combination of the GRACE score and the ARC-HBR criteria provides incremental predictive value for post-PCI bleeding in STEMI patients.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"19 ","pages":"605618"},"PeriodicalIF":2.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13142719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837702","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 COQ10B in Tumor Progression and Its Association with Immune Escape in Esophageal Squamous Cell Carcinoma: A Multi-Omics and Functional Analysis.","authors":"Leiyu Cao, Xingfang Wei, Yu Wei, Xiaoli Ma, Yan Gao, Chengcheng Qu, Wen Yi, Kalima Muhetaer, Li Zhang","doi":"10.2147/IJGM.S581929","DOIUrl":"https://doi.org/10.2147/IJGM.S581929","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to investigate the role of coenzyme Q10B (COQ10B) in esophageal squamous cell carcinoma (ESCC) and elucidate its potential mechanisms in regulating the tumor immune microenvironment.</p><p><strong>Patients and methods: </strong>This study integrates bioinformatics, in vitro cell experiments, and in vivo animal models. First, the TCGA and GEO databases were used to analyze correlations between COQ10B expression and ESCC prognosis, signaling pathways, and immune cell infiltration, and single-cell sequencing data were combined to establish its cellular expression profile. Second, TE-1 cells were lentivirally transfected to overexpress COQ10B, and colony formation, EdU, scratch, and Transwell assays were conducted to assess the effects on proliferation, migration, and invasion. Finally, a subcutaneous xenograft model in C57BL/6 mice evaluated COQ10B overexpression and PI3K inhibitor (LY294002) effects on tumor growth, PD-L1 expression, PI3K/AKT/HIF-1A pathway, and immune cell (CD4+ T cells, M2 macrophages) infiltration via Western blotting and flow cytometry.</p><p><strong>Results: </strong>Bioinformatics showed that COQ10B was highly expressed in ESCC and was significantly associated with poor prognosis. Its expression positively correlated with the PI3K-AKT and HIF1 pathways, cancer stem cell genes, and macrophage infiltration. In vitro, COQ10B overexpression enhanced ESCC cell proliferation, migration, and invasion. In vivo, it promoted tumor growth, upregulated PD-L1, p-PI3K, p-AKT, and HIF-1A, reduced CD4+ T cells, and increased M2 macrophages. The PI3K inhibitor LY294002 reversed these pro-tumor and immunosuppressive effects.</p><p><strong>Conclusion: </strong>High COQ10B expression is closely associated with ESCC progression and poor prognosis. These malignant biological behaviors and the associated immunosuppressive tumor microenvironment are potentially mediated via the activation of the PI3K/AKT/HIF-1A signaling pathway.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"19 ","pages":"581929"},"PeriodicalIF":2.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13142268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting Post-Craniotomy Intracranial Infection Using Perioperative and Early Postoperative Variables: A Retrospective Machine Learning Study.","authors":"Zian Zhong, Liangjin Zhang, Ping Yu, Bing Xu","doi":"10.2147/IJGM.S596122","DOIUrl":"https://doi.org/10.2147/IJGM.S596122","url":null,"abstract":"<p><strong>Objective: </strong>To identify perioperative clinical and surgical variables associated with intracranial infection (ICI) after craniotomy, and establish an accurate machine learning prediction model for clinical risk stratification and early intervention.</p><p><strong>Methods: </strong>A retrospective study included 419 patients who underwent craniotomy surgery at Xiangyang Central Hospital from May 2017 to April 2024. Perioperative variables were collected. Univariate and multivariate logistic regression were used to screen for risk factors. Four models (LR, RF, XGBoost, LightGBM) were constructed and validated through AUC, sensitivity, specificity, PPV, NPV, calibration curve, and DCA were used to evaluate the performance.</p><p><strong>Results: </strong>53 patients (12.6%) developed ICI. Independent risk factors included prolonged surgical time, significant intraoperative bleeding, postoperative cerebrospinal fluid leakage, multiple surgeries (≥ 2), and frequent cerebrospinal fluid sampling/drug injection through drainage tubes. LightGBM achieved the best performance: training set AUC 0.873 (95% CI 0.819-0.927), test set AUC 0.811 (95% CI 0.758-0.924), sensitivity 81.0%, specificity 79.3%, PPV 38.6%, NPV 95.7%. Good calibration and high clinical practicality were confirmed.</p><p><strong>Conclusion: </strong>Machine learning models, especially LightGBM, can effectively predict postoperative ICI. The identified risk factors and best models support personalized risk assessment and clinical prevention.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"19 ","pages":"596122"},"PeriodicalIF":2.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13142724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837706","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":"CLEC4D as an Effective Indicator for Assessing Severity of Illness in Critically Ill Patients: A Prospective Study.","authors":"Guangjian Wang, Zhimao Li, Xinyue Zhao, Xiaoru Wang, Hui Lian, Yecheng Liu","doi":"10.2147/IJGM.S587855","DOIUrl":"https://doi.org/10.2147/IJGM.S587855","url":null,"abstract":"<p><strong>Background: </strong>Accurate assessment of illness severity is crucial in critically ill patients. The APACHE II score is widely used but complex and fails to reflect underlying immune-inflammatory dysregulation. C-type lectin domain family 4 member D (CLEC4D), a pattern recognition receptor on myeloid cells, is pivotal in immune responses. We investigated whether circulating CLEC4D levels could serve as a novel biomarker for severity of illness.</p><p><strong>Methods: </strong>368 adult ICU patients were enrolled. Serum CLEC4D levels, APACHE II scores, and immune-inflammatory parameters were measured within 24 hours of admission. Associations were analyzed using generalized additive models and multiple linear regression.</p><p><strong>Results: </strong>Patients with high APACHE II scores (≥16) exhibited significantly elevated CLEC4D levels compared with those with lower scores (344.20 ± 65.75 pg/mL vs. 321.28 ± 73.31 pg/mL, <i>P</i> = 0.002). Multiple linear regression demonstrated a robust positive association between CLEC4D and APACHE II scores, with each 1 pg/mL increase in CLEC4D corresponding to a 0.016-point rise in APACHE II (<i>P</i> < 0.05). CLEC4D was inversely correlated with lymphocyte (β = -0.028, <i>P</i> < 0.001) and IL-6 (β = -1.404, <i>P</i> = 0.021) but positively correlated with PCT (β = 0.022, <i>P</i> = 0.031). Subgroup analyses confirmed the stability of this correlation across tumor and non-tumor cohorts and revealed a markedly stronger association among patients with sepsis (β = 0.030, <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>Circulating CLEC4D levels positively correlate with APACHE II scores in critically ill patients, potentially associated with dynamic shifts in immune-inflammatory markers. CLEC4D represents a promising biomarker for assessing illness severity, especially in sepsis.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"19 ","pages":"587855"},"PeriodicalIF":2.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive Value of Residual Cholesterol Inflammatory Index for Left Atrial Thrombus or Spontaneous Echo Contrast in Patients with Nonvalvular Atrial Fibrillation with Low CHA₂DS₂-VASc Scores.","authors":"Jiaqi Wang, Yaqiong Jin, Li Wang, Yunmeng Wang, Jingchao Lu","doi":"10.2147/IJGM.S604377","DOIUrl":"https://doi.org/10.2147/IJGM.S604377","url":null,"abstract":"<p><strong>Background: </strong>Left atrial thrombus (LAT) is the main cause of ischemic stroke in patients with atrial fibrillation. Left atrial thrombus or spontaneous echo contrast (SEC) can be best displayed by transesophageal echocardiography (TEE). This study aimed to evaluate non-valvular atrial fibrillation (NVAF) patients with LAT/SEC confirmed by transesophageal echocardiography compared with those without LAT/SEC, using residual cholesterol inflammatory index (RCII) as a sensitive biomarker.</p><p><strong>Methods: </strong>This study was a retrospective study of 967 NVAF patients who underwent transesophageal echocardiography at a single center. Patients were divided into two groups based on the presence or absence of LAT/SEC on TEE. The levels of RCII and left atrium diameter (LAD) were compared.</p><p><strong>Results: </strong>RCII was identified as an independent variable in patients with LAT/SEC detected by transesophageal echocardiography. (OR: 1.232, CI:1.159-1.309, <i>p</i> < 0.001) The combination of RCII, LAD, and CHA2DS2-VASc scores had the highest area under the curve (AUC) value (AUC:0.787 CI:0.748-0.826 <i>p</i> <0.001).</p><p><strong>Conclusion: </strong>Our study demonstrates that RCII and LAD are risk factors for LAT/SEC. CHA2DS2-VASc score combined with RCII and LAD can significantly improve the predictive ability of LAT/SEC.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"19 ","pages":"604377"},"PeriodicalIF":2.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837717","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":"Dynamic Shifts in Respiratory Pathogens During the First Post-COVID-19 Autumn-Winter in Beijing.","authors":"Yufeng Sun, Xiaobo Tian, Jiaguo Wu, Yuting Xue, Yichuan Qin, Xiangyi Liu","doi":"10.2147/IJGM.S603441","DOIUrl":"https://doi.org/10.2147/IJGM.S603441","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic and its associated nonpharmaceutical interventions have profoundly changed the epidemiology of respiratory pathogens. Following the lifting of COVID-19 restrictions in December 2022 and its adjustment to Class B management, respiratory infections have resurged in China. This study aimed to understand the infection spectrum, mixed infection pattern and temporal dynamic changes of respiratory pathogens in the first autumn-winter after the outbreak of COVID-19 in Beijing.</p><p><strong>Methods: </strong>A total of 864 unique throat swab specimens from patients with respiratory infections at Beijing Tongren Hospital were analyzed, with no repeated testing. Respiratory pathogens were detected by multiplex PCR against 31 viral, bacterial, and atypical pathogens. Detection rates, co-infection patterns, and temporal trends were analyzed across age groups and clinical settings.</p><p><strong>Results: </strong>The total detection rate of respiratory bacteria was 79.63% (688/864), the highest was in children (86.67%), and the lowest was in elderly patients (70.49%). The detection rate of outpatients and emergency patients was significantly higher than that of inpatients (p < 0.001). Co-infections were found in 59.16% of the positive cases, mainly viral-bacterial and bacterial-bacterial combinations. The highest detection rates of viruses were influenza A virus (27.31%), influenza B virus (10.42%) and human adenovirus (5.09%). Among bacterial pathogens, <i>Haemophilus influenzae</i> (26.62%), <i>Acinetobacter baumannii</i> (18.75%) and <i>Klebsiella pneumoniae</i> (14.47%) were most frequently detected. Weekly analyses showed alternating circulation of influenza A and B viruses, with an increase in bacterial load late in the influenza season.</p><p><strong>Conclusion: </strong>The first autumn-winter after COVID-19 outbreak in Beijing was characterized by extensive co-circulation of multiple respiratory pathogens, with high viral infection burden and frequent bacterial co-infection. These findings highlight the importance of continued molecular surveillance and integrated pathogen testing strategies for clinical management and public health response in a post-COVID-19 era.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"19 ","pages":"603441"},"PeriodicalIF":2.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837722","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":"Real-World Safety of Trastuzumab Deruxtecan in Patients with HER2-Positive and HER2-Low Metastatic Breast Cancer in Saudi Arabia: A Retrospective Cohort Study.","authors":"Abeer Abdulhadi Alhuthali, Abdullah Alshammari, Athar Yosuf Jaha, Alaa Shahbar, Lama Mohammed Almilaibi, Reem Saeed Alwadie, Alanoud Naher Alghanmi, Manal Aljohani, Abdullah F Alharthi, Mohammed Alnuhait","doi":"10.2147/IJGM.S603190","DOIUrl":"https://doi.org/10.2147/IJGM.S603190","url":null,"abstract":"<p><strong>Introduction: </strong>Trastuzumab deruxtecan (T-DXd) has become an important treatment option for patients with HER2-positive and HER2-low solid tumors, yet real-world evidence on its safety remains limited, particularly in Middle Eastern populations. This study evaluates the safety profile of T-DXd in routine clinical practice at a major tertiary center in Makkah, Saudi Arabia.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted at King Abdullah Medical City and included adults with HER2-positive or HER2-low metastatic breast cancer who received at least one dose of T-DXd between 2022 and 2024. Electronic medical records were reviewed for demographic data, prior treatments, and adverse events. Toxicities were graded according to CTCAE v5.0. The primary outcome was the incidence and severity of T-DXd-related adverse events. Secondary outcomes included treatment discontinuation rates and adherence to recommended interstitial lung disease (ILD) monitoring protocols.</p><p><strong>Results: </strong>Thirty-one patients were included (93.5% female; median age 50-59 years). Hematologic toxicities were most common, occurring in 87.1% of patients. Respiratory events including ILD and pneumonitis were documented in 28% of patients. Among patients who underwent imaging according to recommended intervals, respiratory events were identified more frequently (36%) than in those with less consistent monitoring (11%), likely reflecting increased detection of subclinical events rather than a true difference in incidence. Treatment discontinuation occurred in 25.8% of patients, primarily due to adverse events or progression.</p><p><strong>Conclusion: </strong>T-DXd was generally tolerable in this small Saudi cohort, with hematologic and respiratory toxicities being the most frequent. The relatively higher frequency of respiratory events and the observed differences by monitoring adherence should be interpreted cautiously given the descriptive design. Larger multicenter studies are needed to better define safety patterns and optimal monitoring strategies.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"19 ","pages":"603190"},"PeriodicalIF":2.0,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13136029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837728","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":"Lovastatin Targets LIPA to Induce ER Stress-Mediated Apoptosis in Acute Myeloid Leukemia: A Multi-Omics Study.","authors":"Jie Wei, Guan Ye Nai, GuoWu Lin, Yu Mei Huang, Wei Jie Zhou, Rong Rong Liu","doi":"10.2147/IJGM.S591023","DOIUrl":"https://doi.org/10.2147/IJGM.S591023","url":null,"abstract":"<p><strong>Background: </strong>Acute myeloid leukemia (AML) remains a therapeutic challenge, necessitating the identification of novel targets and repurposable drugs. This study integrates multi‑omics and Mendelian randomization (MR) to investigate the role of lysosomal acid lipase (LIPA) in AML and to explore the potential of lovastatin as a LIPA‑targeting agent.</p><p><strong>Methods: </strong>We combined transcriptomic data from TCGA and GTEx with MR analysis using eQTLs to assess the causal relationship between LIPA expression and AML risk. A prognostic signature was constructed via LASSO and validated in external GEO cohorts. Network pharmacology, molecular docking, and molecular dynamics simulations were employed to identify drugs targeting LIPA. In vitro, AML cell lines (THP‑1, K562) were treated with lovastatin and/or the ER stress inhibitor 4‑PBA; apoptosis, ER stress markers, and ultrastructure were assessed by flow cytometry, qPCR, Western blot, and transmission electron microscopy.</p><p><strong>Results: </strong>MR established a causal link between elevated LIPA expression and increased AML risk (OR=1.32, p=0.003). A 16‑gene prognostic signature including LIPA effectively stratified patients (p<0.0001). Lovastatin was identified as a potential high‑affinity LIPA inhibitor. In vitro, lovastatin induced marked apoptosis in AML cells, which was accompanied by downregulation of ER stress markers (ATF6, CHOP, IRE1) and constricted ER morphology. Notably, the ER stress inhibitor 4‑PBA phenocopied these effects, consistent with lovastatin exerting its anti‑AML activity through suppression of ER stress.</p><p><strong>Conclusion: </strong>This multi-omics study establishes LIPA as a causal prognostic biomarker in AML and reveals that lovastatin triggers apoptosis by inhibiting ER stress, providing a mechanistic rationale for repurposing lovastatin in AML therapy.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"19 ","pages":"591023"},"PeriodicalIF":2.0,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837675","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":"Platelet Antigen Polymorphisms in Cirrhosis: Association with Esophageal Varices Development.","authors":"Heba Mohamed Abdallah, Iman Shaban Osheba, Ahmed Abdallah Salman, Nahla K Gaballa, Merhan Osama Helmi, Amr Ragab Ibrahim, Asmaa Said Shahat Atta, Mohammed Gaber Saad, Sara Mohammed Aboagiza, Hanaa Saied Abdel Hafez, Mostafa Gamal El Din El Helbawy, Ghada M K GabAllah, Ahmed Elewa, Mohamed Abdalla Salman, Nashwa Abdelmotelb Abdelmegeed","doi":"10.2147/IJGM.S581932","DOIUrl":"https://doi.org/10.2147/IJGM.S581932","url":null,"abstract":"<p><strong>Background: </strong>Esophageal varices (EVs) are a serious consequence of portal hypertension in chronic liver disease, particularly in hepatitis C virus (HCV) infection. While endoscopy remains the gold standard for diagnosis, there is growing interest in human platelet antigen (HPA) polymorphisms as potential non-invasive markers associated with EV development.</p><p><strong>Aim: </strong>To assess the association between HPA-1, HPA-2, and HPA-3 gene polymorphisms and the presence and severity of EVs in cirrhotic patients.</p><p><strong>Methods: </strong>In this case-control study, 150 patients with HCV-related cirrhosis were enrolled and divided into two groups based on endoscopic findings: 75 with EVs and 75 without. HPA genotyping was performed using polymerase chain reaction with sequence-specific primers (PCR-SSP). Statistical analysis included univariate and multivariate logistic regression, with odds ratios (ORs) and 95% confidence intervals (CIs) calculated.</p><p><strong>Results: </strong>The HPA-3 (ab + aa) genotypes were significantly associated with the presence of EVs in univariate analysis (OR: 2.244, 95% CI: 1.039-4.847, p = 0.040), but this association was not maintained in multivariate analysis (OR: 0.679, 95% CI: 0.209-2.211, p = 0.521). Higher grades of varices were significantly associated with HPA-1 (a), HPA-2 (b), and HPA-3 (a) alleles (p < 0.05). Platelet count and platelet count-to-spleen diameter (PC/SD) ratio were also significantly associated with EVs in univariate analysis (p < 0.001). In multivariate analysis, serum creatinine (OR: 0.234, 95% CI: 0.116-0.473, p < 0.001) and portal vein diameter (OR: 1.542, 95% CI: 1.231-1.930, p < 0.001) were identified as independent predictors of EVs.</p><p><strong>Conclusion: </strong>HPA polymorphisms were associated with the presence and severity of esophageal varices but were not independent predictors. Further multicenter prospective studies are needed to clarify their clinical utility.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"19 ","pages":"581932"},"PeriodicalIF":2.0,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837704","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 Serum Albumin and the ApoB/ApoA1 Ratio with Acute Post-Stroke Cognitive Impairment: A Propensity Score-Matched Case-Control Study.","authors":"Dandan Liu, Jinhua Zhang, Xiaojin Wei, Shiyao Zhang, Fuling Yan","doi":"10.2147/IJGM.S575959","DOIUrl":"https://doi.org/10.2147/IJGM.S575959","url":null,"abstract":"<p><strong>Background and purpose: </strong>Evidence regarding the associations of serum albumin and apolipoprotein-related markers with acute cognitive impairment (CI) after stroke remains limited. This study investigated the associations of serum albumin and the apolipoprotein B/apolipoprotein A1 ratio (ApoB/ApoA1) with acute CI assessed within 7 days after first-ever ischemic stroke (IS).</p><p><strong>Methods: </strong>This retrospective single-center case-control study included patients with first-ever IS who completed the Chinese version of the Mini-Mental State Examination (MMSE) within 7 days after stroke onset. Patients with an MMSE score of ≤25 were classified into the CI group, and those with an MMSE score of >25 into the non-CI group. Propensity score matching was performed in a 1:1 ratio (caliper = 0.07; without replacement) based on age, sex, and education level. Associations were evaluated using logistic regression analyses.</p><p><strong>Results: </strong>Among 371 eligible patients, 175 were in the CI group and 196 were in the non-CI group. After matching, 144 pairs were included. In the matched cohort, albumin, ApoB, and ApoB/ApoA1 were lower in the CI group. In multivariable analysis, higher albumin (adjusted odds ratio 0.934, 95% confidence interval 0.887-0.983; P=0.009) and higher ApoB/ApoA1 (adjusted odds ratio 0.429, 95% confidence interval 0.200-0.919; P=0.030) were independently associated with lower odds of acute CI after stroke. The lowest odds of acute CI were observed at albumin levels of 39.300-41.400 g/L and an ApoB/ApoA1 ratio of ≥0.883.</p><p><strong>Conclusion: </strong>In patients with first-ever IS, higher serum albumin levels and a higher ApoB/ApoA1 ratio were associated with lower odds of acute CI within 7 days after stroke. Multicenter prospective studies are needed to validate these findings and clarify the underlying mechanisms.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"19 ","pages":"575959"},"PeriodicalIF":2.0,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814774","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}