International Journal of General Medicine最新文献

{"title":"Added Prognostic Value of MRI to CT in Acute Ischemic Stroke Patients Undergoing Mechanical Thrombectomy in the Extended Time Window.","authors":"Kangni Zhu, Jiayu Lu, Ding Xia","doi":"10.2147/IJGM.S625417","DOIUrl":"10.2147/IJGM.S625417","url":null,"abstract":"<p><strong>Background: </strong>In the 6-24-hour window, imaging must identify patients with salvageable tissue while avoiding delays and reperfusion of large established infarcts. The optimal imaging strategy remains controversial. Although computed tomography (CT) is widely used because of its accessibility and speed, magnetic resonance imaging (MRI) provides more sensitive tissue characterization. This study evaluated whether adding MRI to CT was associated with clinical outcomes in patients with acute ischemic stroke (AIS) undergoing mechanical thrombectomy (MT).</p><p><strong>Methods: </strong>We conducted a retrospective, single-center cohort study of consecutive patients with AIS due to large vessel occlusion who underwent MT between January 2022 and December 2024. Patients were grouped according to pre-procedural imaging: CT alone or MRI plus CT. Propensity score matching (1:1) was used to reduce measured baseline imbalances. The primary outcomes were excellent functional outcome (modified Rankin Scale [mRS] 0-1) and 3-month mortality; symptomatic intracranial hemorrhage (SICH) was the secondary outcome. Multivariable logistic regression was used to estimate adjusted associations.</p><p><strong>Results: </strong>After propensity score matching, 364 patients (182 pairs) were included in the final analysis. Compared with CT alone, the MRI plus CT group demonstrated significantly lower 3-month mortality (7.1% vs 18.7%, <i>P</i> < 0.01) and reduced incidence of SICH (2.2% vs 7.7%, <i>P</i> = 0.02). No significant difference was observed in excellent functional outcome at 3 months between groups. Multivariate logistic regression confirmed that MRI plus CT was independently associated with lower risks of mortality (adjusted OR=0.32, 95% CI 0.14-0.72; <i>P</i> < 0.01) and SICH (adjusted OR=0.23, 95% CI 0.05-0.96; <i>P</i>=0.04).</p><p><strong>Conclusion: </strong>Among patients with AIS undergoing MT within the 6-24-hour window, MRI plus CT was associated with lower 3-month mortality and SICH than CT alone, without a significant difference in excellent functional outcome. Because imaging allocation was non-randomized and quantitative infarct-core and perfusion data were unavailable, these findings should be interpreted as hypothesis-generating and require prospective multicenter validation.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"19 ","pages":"625417"},"PeriodicalIF":2.3,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215834","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":"Evaluation of the Berden Classification and ANCA Kidney Risk Score in Biopsy-Proven ANCA-Associated Glomerulonephritis: Associations with Clinical Characteristics and Outcomes.","authors":"Erdem Baran, Arzu Ozdemir, Murvet Yilmaz","doi":"10.2147/IJGM.S641346","DOIUrl":"10.2147/IJGM.S641346","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the associations of the Berden histopathological classification and the ANCA Renal Risk Score (ARRS) with renal outcomes and overall survival in patients with biopsy-proven ANCA-associated glomerulonephritis.</p><p><strong>Methods: </strong>This retrospective study included 54 adult patients with ANCA-associated vasculitis and biopsy-proven renal involvement between June 2016 and June 2023. Renal biopsies were categorized according to the Berden classification, and patients were stratified into low-, medium-, and high-risk groups according to the ARRS. Clinical, laboratory, treatment, renal outcome, and survival data were compared across the classification groups. Overall survival was assessed using Kaplan-Meier analysis and Cox proportional hazards regression.</p><p><strong>Results: </strong>Among 54 patients, 33.3% were classified as crescentic, 31.5% as focal, 20.4% as mixed, and 14.8% as sclerotic according to the Berden classification; 14.8%, 46.3%, and 38.9% were categorized as low-, medium-, and high-risk according to the ARRS, respectively. Baseline serum creatinine differed significantly across both Berden classes (p=0.025) and ARRS categories (p=0.035). Progression to end-stage renal disease (ESRD) also differed significantly across Berden classes (p=0.046) and ARRS categories (p=0.012), with the highest frequencies observed in the sclerotic class (50.0%) and high-risk ARRS group (33.3%). All eight ESRD events occurred in patients with baseline eGFR <15 mL/min/1.73 m² (27.6% vs 0% among those with eGFR ≥15 mL/min/1.73 m²; p=0.005). In contrast, mortality did not differ significantly across either classification system. Kaplan-Meier analysis showed no significant differences in overall survival across Berden classes (log-rank p=0.657) or ARRS categories (log-rank p=0.892). Neither classification system was independently associated with mortality in multivariable Cox regression.</p><p><strong>Conclusion: </strong>The Berden classification and ARRS were associated with renal disease severity and progression to ESRD but not with overall survival in this cohort. Severe renal dysfunction at presentation, particularly an eGFR <15 mL/min/1.73 m², was strongly associated with subsequent ESRD. These findings support the utility of renal histopathological and clinical risk stratification for kidney-specific outcomes while highlighting their limited ability to predict overall mortality.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"19 ","pages":"641346"},"PeriodicalIF":2.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216108","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":"Knowledge, Fasting Practices, and Ramadan-Related Complications Among Adults with Type 1 Diabetes Mellitus in Saudi Arabia: A Cross-Sectional Survey.","authors":"Osamah M Alfayez, Ghadeer L Alfuhaydi, Omar S Alkhezi, Yara H Sawan, Rahaf M Almutairi, Abdullah A Alahmed, Muath A Alsalloum, Metab A Algeffari","doi":"10.2147/IJGM.S636533","DOIUrl":"10.2147/IJGM.S636533","url":null,"abstract":"<p><strong>Purpose: </strong>Many individuals with type 1 diabetes mellitus (T1DM) choose to fast during Ramadan despite being at increased risk of fasting-related complications. Understanding patients' knowledge and fasting practices is important to support safer Ramadan fasting. However, data on Ramadan-related knowledge, fasting practices, and complications among adults with T1DM in Saudi Arabia remain limited. This study aimed to assess these factors among adults with T1DM in the Qassim region of Saudi Arabia.</p><p><strong>Methods: </strong>A single-center, cross-sectional survey was conducted among adults with T1DM who attended a specialized diabetes center in Saudi Arabia. The questionnaire assessed patient characteristics, Ramadan-related knowledge, pre-Ramadan preparation, insulin management practices, fasting behavior, and self-reported complications. A knowledge score ranging from 0 to 5 was calculated based on five knowledge items.</p><p><strong>Results: </strong>A total of 69 participants were included, with a median age of 24 years (IQR 21-30) and median diabetes duration of 9 years (IQR 4.5-16.0). Most participants consulted a healthcare provider before Ramadan (68.1%) and received diabetes-specific education (89.9%). Nearly all participants fasted during Ramadan (92.8%), with a median of 27 fasting days. Knowledge levels were high, with 92.8% demonstrating good knowledge and a mean knowledge score of 4.70 ± 0.60. Most participants reported reducing their basal (69.6%) and rapid-acting (55.1%) insulin doses and increasing blood glucose monitoring during Ramadan (65.2%). Despite these practices, hypoglycemia and hyperglycemia were reported by 81.3% and 62.5% of participants, respectively, while 7.8% required hospitalization for diabetic ketoacidosis (DKA). More than two-thirds (70.3%) reported breaking their fast because of diabetes-related complications.</p><p><strong>Conclusion: </strong>Adults with T1DM demonstrated high levels of Ramadan-related knowledge and generally appropriate fasting practices. Nevertheless, fasting-related complications remained common, highlighting the need for additional strategies beyond education alone to improve the safety of Ramadan fasting in this population.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"19 ","pages":"636533"},"PeriodicalIF":2.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216066","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":"Seizure Recurrence and Long-Term Outcomes After a Second Antiseizure Medication Withdrawal Attempt in Patients with Epilepsy: A Retrospective Cohort Study.","authors":"Yanfang Zhang, Xiaying Gu, Haiyan Ma, Nian Yu, Qing Di","doi":"10.2147/IJGM.S635021","DOIUrl":"10.2147/IJGM.S635021","url":null,"abstract":"<p><strong>Objective: </strong>Evidence on a second antiseizure medication (ASM) withdrawal attempt after relapse following a first attempt is limited. We evaluated seizure recurrence, long-term outcomes, and factors associated with recurrence in this selected population.</p><p><strong>Methods: </strong>This single-center retrospective cohort included 45 patients who relapsed after a first ASM withdrawal, restarted treatment and regained seizure control, and subsequently initiated a second withdrawal attempt. Time to recurrence was calculated from the initiation of tapering, and recurrences during tapering were counted as events. Kaplan-Meier analysis was applied to estimate recurrence. A prespecified Cox model was used to evaluate sex, inter-withdrawal interval, and seizure-free duration. A favorable outcome was defined as seizure freedom during the final year of follow-up. Final-year seizure status was assessed exploratorily because only 7 patients had an unfavorable outcome.</p><p><strong>Results: </strong>Median follow-up was 66.4 months (range 12.0-226.2). Twenty-five patients (55.6%) had recurrence, including 13 (52.0% of recurrences) during tapering; 80.0% of recurrences occurred within 1 year. In the adjusted model, female sex was associated with recurrence (hazard ratio [HR], 2.867; 95% confidence interval [CI], 1.223-6.722; P=0.015), whereas inter-withdrawal interval (per year: HR, 0.748; 95% CI, 0.524-1.067; P=0.109) and seizure-free duration (per year: HR, 0.815; 95% CI, 0.528-1.258; P = 0.355) were not. Thirty-eight patients (84.4%) achieved seizure freedom during the final year. Of 25 patients with recurrence, 18 (72.0%) were seizure-free during the final year, and only one developed drug-resistant epilepsy.</p><p><strong>Conclusion: </strong>Recurrence was common after a second ASM withdrawal attempt in this small, predominantly pediatric-onset cohort, but most patients who relapsed later regained seizure control. Female sex was associated with recurrence, whereas no independent association was detected for either the inter-withdrawal interval or the seizure-free duration before the second attempt. These findings are exploratory and do not establish a specific timing threshold for a second withdrawal attempt.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"19 ","pages":"635021"},"PeriodicalIF":2.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216106","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":"Adjunctive Herbal Medicine Use and Chemotherapy-Induced Thrombocytopenia in Acute Myeloid Leukemia: A Nested Case-Control Study.","authors":"Hou-Hsun Liao, Yu-Sheng Liu, Ying-To Hsu, Ming-Hsien Yeh, Szu-Chin Li, Tzung-Yi Tsai","doi":"10.2147/IJGM.S646345","DOIUrl":"10.2147/IJGM.S646345","url":null,"abstract":"<p><strong>Background: </strong>Systemic chemotherapy increases the risk of thrombocytopenia in patients with acute myeloid leukemia (AML), which may lead to risk of bleeding and treatment interruption. Accumulating evidence indicates that traditional Chinese medicinal herbs (TCMH) may accelerate symptom relief. We hypothesized that integrating TCMH alongside standard treatment may decrease the risk of chemotherapy-induced thrombocytopenia (CIT) in patients with AML.</p><p><strong>Aim: </strong>To compare the likelihood of CIT among patients with AML who received adjunctive TCMH plus standard treatment and those who received standard treatment alone.</p><p><strong>Methods: </strong>This nested case-control study analyzed individuals aged 20 and older who were newly diagnosed with AML, had no pre-existing CIT, and were identified from the Taiwan National Health Insurance Research Database between 2002 and 2010. Five controls were then randomly matched to each CIT case from the remaining eligible cohort. All participants were followed until December 31, 2013. Conditional logistic regression was used to assess the association between TCMH use and risk of developing CIT.</p><p><strong>Results: </strong>TCMH was prescribed in 5.5% of cases and 20.6% of controls. Combining TCMH treatment with standard therapy substantially reduced risk of CIT (OR= 0.21; 95% CI:0.11-0.39). The inverse association between adjunctive TCMH use and CIT was strongest among patients who received TCMH for more than 180 days. Age and gender did not influence the association between TCMH use and the risk of CIT.</p><p><strong>Conclusion: </strong>The current research emphasized the importance of framing a collaborative healthcare model for AML persons, especially involvement of TCMH, to effectively manage the poor complications that arise from cancer therapy.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"19 ","pages":"646345"},"PeriodicalIF":2.3,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215842","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":"From Pathophysiological Consensus to Integrative Potential: A Comprehensive Narrative Review of Traditional Chinese Medicine Interventions for Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and Future Directions.","authors":"Qianrong Li, Meiying Li, Zhao Liu, Junxiong Li, Ruxue Fang","doi":"10.2147/IJGM.S644845","DOIUrl":"10.2147/IJGM.S644845","url":null,"abstract":"<p><p>Metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as non-alcoholic fatty liver disease, is the most prevalent chronic liver disease globally, with a worldwide prevalence over 30%. Its complex pathogenesis involves insulin resistance, lipid metabolism disorders, mitochondrial dysfunction, gut-liver axis imbalance, chronic inflammation and genetic susceptibility. Currently, no radical pharmacological treatment is clinically approved for MASLD, resulting in a huge unmet clinical demand. Traditional Chinese Medicine (TCM) presents unique strengths in multi-target regulation and long-term prognosis improvement for MASLD, yet fragmented mechanistic evidence and inconsistent syndrome differentiation criteria limit its international application. This narrative review systematically summarizes the latest epidemiological, pathophysiological and diagnostic progress of MASLD, and clarifies the internal correlation between TCM theories and modern pathological mechanisms. Relevant domestic and foreign literature published from 2015 to 2025 was retrieved and analyzed to compare the advantages and limitations of Western medicine and TCM interventions. Western medicine mainly adopts lifestyle intervention, targeted drugs and bariatric surgery, while TCM therapies including herbal formulas, active ingredients, acupuncture and moxibustion improve MASLD through regulating lipid metabolism, stabilizing intestinal microecology, inhibiting inflammation and modulating hepatocyte autophagy, with reliable clinical efficacy. Nevertheless, non-uniform quality standards and insufficient high-level clinical trials restrict the standardized development of TCM. In conclusion, TCM's holistic and multi-target characteristics perfectly adapt to the multifactorial pathogenesis of MASLD. Future studies should combine multi-omics and precision medicine to unify TCM diagnostic and pharmaceutical standards and conduct high-quality multicenter trials, promoting the standardization and international popularization of TCM in MASLD management.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"19 ","pages":"644845"},"PeriodicalIF":2.3,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13665673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149193041","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":"Novel Modified Water Balloon for Mini-Probe Endoscopic Ultrasonography in Diagnosis of Esophageal and Gastric Submucosal Lesions: A Dual-Center Retrospective Study.","authors":"Gang Zhang, Pengcheng Yang, Yumei Ning, Xianglin Li, Xing Huang, Yue Zhu, Xiaodan Zhang, Jing Wang","doi":"10.2147/IJGM.S619082","DOIUrl":"10.2147/IJGM.S619082","url":null,"abstract":"<p><strong>Objective: </strong>Endoscopic ultrasonography (EUS) is commonly used for preoperative diagnosis of upper gastrointestinal submucosal lesions (SMLs), but it remains technically challenging due to rapid water drainage and the risk of aspiration. This study evaluated the efficacy and safety of a novel modified water balloon (WB) for mini-probe EUS compared to the conventional water immersion (WI) method.</p><p><strong>Methods: </strong>In this double-center retrospective study, 136 consecutive patients with SMLs were evaluated using novel WB and conventional WI techniques through mini-probe EUS. Notably, sedation was primarily applied in the WB group due to the fluid-confining design, which may serve as a potential confounding factor. The primary outcome, diagnostic accuracy rate, and the secondary outcomes including image quality, procedure time, and safety profile were compared between the two groups.</p><p><strong>Results: </strong>The overall diagnostic accuracy rate in the novel WB group was significantly higher than that in the conventional WI group (84.4% vs 69.4%, P = 0.04). The novel WB group achieved a higher proportion of high-quality images (P < 0.05) and significantly shorter mean procedure times (P < 0.01). No aspiration events occurred in the novel WB group, despite some cases involving deep sedation. Overall minor complication rates did not differ significantly between two groups (P > 0.05).</p><p><strong>Conclusion: </strong>The novel modified WB technique provides a practical and cost-effective acoustic window for esophageal mini-probe EUS, demonstrating superior procedural efficiency and image quality. Although limited by its retrospective design and variations in sedation protocols, this technique shows potential in mitigating aspiration risks under sedation.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"19 ","pages":"619082"},"PeriodicalIF":2.3,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13665660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149193185","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":"Insulin Resistance-Related Indices as Promising Predictors of Age-Related Cataract in Chinese Adults: A Retrospective Study.","authors":"JinHua Zhou, Minhui Luo, Ying Dai, Zhimin Chen, Honglan Gao","doi":"10.2147/IJGM.S645953","DOIUrl":"10.2147/IJGM.S645953","url":null,"abstract":"<p><strong>Background: </strong>Age-related cataract (ARC) is a major cause of visual impairment in older adults, yet simple and reliable biomarkers for early risk stratification remain scarce in routine clinical practice. Insulin resistance (IR) is implicated in cataractogenesis, however, the predictive value of IR-related surrogate markers in Chinese populations has not been systematically evaluated. This study aimed to assess six IR-related indices, including triglyceride-glucose (TyG) index, TyG combined with body mass index (TyG-BMI), the metabolic score for insulin resistance (METS-IR), low-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (LDL-C/HDL-C), triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C), and total cholesterol to high-density lipoprotein cholesterol ratio (TC/HDL-C) for predicting ARC risk.</p><p><strong>Methods: </strong>This retrospective study enrolled 1536 participants aged ≥50 years. Multivariable logistic regression models, restricted cubic spline (RCS), and receiver operating characteristic (ROC) curve comparisons were performed to evaluate associations and discriminatory ability. Subgroup and threshold effect analyses were also conducted.</p><p><strong>Results: </strong>TyG, TyG-BMI, METS-IR, LDL-C/HDL-C and TG/HDL-C were independently associated with ARC after full confounder adjustment. LDL-C/HDL-C showed the highest discriminatory ability (AUC=0.638, 95% CI: 0.608-0.667), which was significantly higher than that of the other five indices (P < 0.05). The threshold effect was observed in the association between LDL-C/HDL-C and ARC risk, with an inflection point at 1.56. Above this threshold, each one-unit increase in LDL-C/HDL-C was associated with a 124% higher ARC risk (OR=2.24, 95% CI: 1.72-2.93, P < 0.001).</p><p><strong>Conclusion: </strong>The LDL-C/HDL-C ratio showed the highest discriminatory ability among the six evaluated IR-related indices for ARC, although its predictive performance remained modest. These simple and cost-effective IR markers, particularly LDL-C/HDL-C, may serve as adjunctive tools for early risk stratification when combined with other risk factors. Future multicenter prospective studies are needed to validate these findings externally and establish their clinical utility.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"19 ","pages":"645953"},"PeriodicalIF":2.3,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13665667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149193051","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":"Recent Advances in the Diagnosis and Management of Gestational Diabetes Mellitus: A Narrative Review.","authors":"Qian Wang, Yue Liu, Linlin Sun","doi":"10.2147/IJGM.S644149","DOIUrl":"https://doi.org/10.2147/IJGM.S644149","url":null,"abstract":"<p><p>Gestational diabetes mellitus (GDM) is one of the most common metabolic disorders of pregnancy and is associated with adverse short- and long-term health outcomes in both mothers and offspring. Its increasing global prevalence and substantial heterogeneity in pathogenesis and clinical presentation underscore the limitations of conventional glucose-centered approaches to risk assessment and management. Although the oral glucose tolerance test (OGTT) remains the established diagnostic standard, its relatively late diagnostic window and limited ability to predict disease development have stimulated interest in novel strategies for early risk stratification and individualized care. Importantly, emerging approaches are not yet sufficiently validated to replace the OGTT in routine clinical practice. This narrative review summarizes recent advances in GDM diagnosis and management, focusing on emerging biomarkers, multi-omics technologies, artificial intelligence (AI), and precision medicine. We examine the potential roles of inflammatory biomarkers, adipokines, metabolomic signatures, gut microbiota, and genomic and transcriptomic profiles in the early prediction of GDM, as well as AI-based models integrating multidimensional clinical and molecular data. Advances in precision nutrition, continuous glucose monitoring, pharmacological optimization, digital health technologies, and microbiota-targeted interventions are also discussed. Particular attention is given to the distinction between clinically established strategies, promising approaches supported by emerging evidence, and exploratory technologies that remain investigational. Despite substantial progress, important challenges remain, including heterogeneity in diagnostic criteria, limited reproducibility and clinical translation of multi-omics findings, insufficient external validation of AI models, and barriers to the implementation of individualized management. Key evidence gaps include the need for prospective and external validation, cost-effectiveness assessments, regulatory evaluation, and real-world implementation studies. Precision medicine in GDM should therefore be viewed as an evolving framework that integrates molecular, metabolic, clinical, and environmental information to improve risk stratification and guide individualized management rather than as a replacement for established diagnostic standards. Future GDM care is likely to move toward integrated precision medicine models combining multi-omics profiling, AI-assisted decision support, continuous metabolic monitoring, and personalized interventions, with the ultimate goal of improving maternal and offspring health across the life course.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"19 ","pages":"644149"},"PeriodicalIF":2.3,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181742","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":"Exploring the Relationship Between Femoral Neck Torsion Angle and Anteversion Angle Through Three-Dimensional Reconstruction in a Fixed Coordinate System.","authors":"Guangliang Jiang, Xiaoyun Xue, Yingsheng Deng, Ruibao Yang","doi":"10.2147/IJGM.S633691","DOIUrl":"https://doi.org/10.2147/IJGM.S633691","url":null,"abstract":"<p><strong>Background: </strong>The femoral neck torsion angle (FNTA), an important parameter for assessing femoral neck morphology, has long been underappreciated in clinical practice. This study aimed to explore the relationship between FNTA and femoral neck anteversion angle (FNAA) through a 3D reconstruction in a fixed coordinate system (3D-R-FCS).</p><p><strong>Methods: </strong>Fifty synthetic Sawbone femoral specimens were analyzed. A 3D-R-FCS was established using superimposing consecutive axial cross-sections after CT scanning and 3D reconstruction. Two independent evaluators measured FNAA via Reikeras, Murphy methods and 3D-R-FCS, and evaluated FNTA via 3D-R-FCS.</p><p><strong>Results: </strong>The FNAA measured by 3D-R-FCS significantly differed from those assessed by Reikeras and Murphy methods (p < 0.001). Intra- and inter-rater intraclass correlation coefficients (ICCs) for the 3D-R-FCS exceeded 0.96, markedly higher than those of the Reikeras (ICC = 0.72-0.73) and Murphy methods (ICC = 0.76-0.82). A strong positive correlation was found between the FNTA and the FNAA discrepancy values measured by the two 2D methods (r > 0.95, p < 0.001).</p><p><strong>Conclusion: </strong>The 3D-R-FCS provides a highly reproducible model for quantifying femoral neck anatomy. The study finds out a poor correlation between FNTA and FNAA under 3D-R-FCS, and a positive correlation between FNTA measured by 3D-R-FCS and the FNAA discrepancy values measured by the two 2D methods. The correlation analysis suggests that traditional 2D measurement errors primarily might result from the intrinsic 3D spatial configuration of the femoral neck. However, these results need further explorations and validations in clinical practice.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"19 ","pages":"633691"},"PeriodicalIF":2.3,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181547","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}