International Journal of General Medicine最新文献

{"title":"Sleep and Cardiometabolic Health: A Narrative Review of Epidemiological Evidence, Mechanisms, and Interventions.","authors":"Thanyaporn Direksunthorn","doi":"10.2147/IJGM.S563616","DOIUrl":"10.2147/IJGM.S563616","url":null,"abstract":"<p><strong>Background: </strong>Short or poor-quality sleep can disrupt glucose metabolism, blood pressure regulation, appetite hormones, and inflammatory pathways, potentially accelerating weight gain, atherosclerosis, and insulin resistance. However, this multidimensional role of sleep in cardiometabolic disease prevention and management remains underappreciated. Existing literature has not fully synthesized how various aspects of sleep influence the spectrum of cardiometabolic conditions, nor how improving sleep might confer health benefits.</p><p><strong>Objective: </strong>This narrative review examines epidemiological evidence linking sleep health to cardiometabolic outcomes, elucidates biological mechanisms underlying these associations, and discusses interventions aimed at optimizing sleep for cardiometabolic benefit.</p><p><strong>Methods: </strong>We searched and reviewed recent studies and meta-analyses on sleep duration, sleep quality, insomnia, obstructive sleep apnea (OSA), and circadian disruption in relation to obesity, metabolic syndrome, diabetes, cardiovascular diseases, and mortality.</p><p><strong>Findings: </strong>Abnormal sleep patterns are consistently associated with elevated risks of obesity, type 2 diabetes, hypertension, cardiovascular events, and all-cause mortality. Habitual short sleep predicts higher incidence of metabolic syndrome and type 2 diabetes, while chronic insomnia is linked to 45% greater odds of developing or dying from cardiovascular disease. Conversely, healthy sleep-typically 7-9 hours of regular, high-quality sleep per night-is associated with favorable cardiometabolic profiles and has been added to public health cardiovascular metrics. Mechanistically, inadequate sleep provokes insulin resistance, sympathetic overactivity, hormonal appetite changes, and systemic inflammation, which synergistically promote cardiometabolic disease.</p><p><strong>Conclusion: </strong>Prioritizing healthy sleep habits and treating sleep disorders should become integral to lifestyle medicine for cardiometabolic health. Emerging intervention trials suggest that extending sleep or treating OSA can modestly improve weight control, glycemic regulation, and blood pressure.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"5831-5843"},"PeriodicalIF":2.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206496","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 Correlation Between Rhabdomyolysis and the 24 Solar Terms: A Retrospective Study.","authors":"Huijin Xue, Luyao Lin, Tongyan Zhang, Weihua Zhao","doi":"10.2147/IJGM.S535234","DOIUrl":"10.2147/IJGM.S535234","url":null,"abstract":"<p><strong>Background: </strong>Rhabdomyolysis(RMI) is a life-threatening clinical disease, and its onset is correlated with climate temperature changes. However, there is a lack of research on the onset time of this disease, making it impossible to predict its occurrence from a temporal perspective.</p><p><strong>Objective: </strong>To explore the correlation between the 24 Solar Terms and the RMI.</p><p><strong>Methods: </strong>A retrospective observational study was conducted on patients with creatine kinase (CK) levels ≥1000 U/L detected at the Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine from February 4, 2022, to February 3, 2024. The data indicators observed included admission and discharge dates, length of hospital stay, underlying diseases, complications, relevant laboratory test indicators, and recovery status. The relationships between the fluctuations in the number of cases and the 24 solar terms were analyzed.</p><p><strong>Results: </strong>A total of 1124 cases of RMI were identified, with 606 cases from February 4, 2022, to January 3, 2023, and 518 cases from January 4, 2023, to February 3, 2024. Among them, 816 were male, and 308 were female. The incidence of RMI showed periodic fluctuations with the solar terms, with the highest number of cases occurring during the Great Cold period and the lowest during the Vernal Equinox and Lesser Fullness periods. Among the 781 hospitalized patients, 266 (n=34.06%) had electrolyte disorders as complications. A total of 108 patients (n=13.83%) experienced varying degrees of renal impairment, and 45 patients (n=5.76%) developed acute kidney injury (AKI), accounting for 41.67% of those with renal impairment. Among the patients with AKI, 21 (n=46.67%) died eventually.</p><p><strong>Conclusion: </strong>There is a correlation between the 24 Solar Terms and the RMI.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"5855-5868"},"PeriodicalIF":2.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206491","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":"Mechanism of Morbidity Based on Ulcerative Colitis: A Review of Traditional Chinese Medicine Treatment of Ulcerative Colitis.","authors":"Yan Huang, Zhuolin Ma, Xiaonan Xu, Zhaoxia Liu","doi":"10.2147/IJGM.S532534","DOIUrl":"10.2147/IJGM.S532534","url":null,"abstract":"<p><p>Ulcerative colitis (UC) is a chronic inflammatory disease of the colon and rectum that has become an increasing global health concern. Its pathogenesis is multifactorial, involving genetic susceptibility, environmental triggers, epithelial barrier dysfunction, gut microbiota imbalance, and immune dysregulation. Clinically, UC is characterized by bloody diarrhea, mucosal inflammation, and a relapsing-remitting course, with diagnosis typically confirmed by clinical, endoscopic, histological, and laboratory findings. Despite the increasing number of therapeutic options, including corticosteroids, immunosuppressants, and biologics, many patients still experience suboptimal responses or adverse events, and some ultimately require colectomy. In this context, Traditional Chinese Medicine (TCM) has attracted attention as a complementary approach due to its multi-target mechanisms and historical use in gastrointestinal diseases. This review summarizes recent evidence on the application of TCM in UC, including its theoretical foundations, active compounds, and modulation of key signaling pathways such as TLR4/NF-κB, NLRP3, JAK/STAT3, PI3K/Akt, Notch, and AMPK/mTOR. Additionally, we highlight clinical data from randomized controlled trials (RCTs) evaluating TCM formulas either as monotherapy or in combination with conventional treatments. Some studies report improvements in symptom scores, inflammatory markers, and endoscopic healing when TCM is combined with agents like mesalazine. However, these findings must be interpreted with caution. Most RCTs are single-center with small sample sizes, lack placebo control, and show considerable heterogeneity in intervention protocols and outcome assessments, making quantitative comparisons to standard therapies, such as remission rates or adverse event frequencies relative to mesalazine or biologics, being limited. Therefore, while TCM demonstrates therapeutic potential in UC management, more rigorous evidence is needed to establish its comparative efficacy and safety. Future studies should include large-scale, multicenter, placebo-controlled RCTs with standardized endpoints, and consider integrating TCM syndrome differentiation with modern pathophysiological frameworks to enhance clinical relevance and translational value.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"5811-5829"},"PeriodicalIF":2.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12478214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199202","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":"Current Status of Diagnosis and Treatment of Cap Polyposis: Insights From Chinese Studies and Comparative Analysis with Japanese Cases.","authors":"Xiaobo Liu, Wen Xu, Ziye Gao, Bo Gao, Lu Zhang, Yanyan Zheng, Danqin Zhang, Yuanjun Gao, Shu Jin","doi":"10.2147/IJGM.S545573","DOIUrl":"10.2147/IJGM.S545573","url":null,"abstract":"<p><strong>Background: </strong>Cap polyposis (CP) is a rare, non-neoplastic colorectal disorder characterized by inflammatory polyps with distinctive endoscopic and histopathological features. Although increasingly reported, particularly in East Asian populations, its etiology remains unclear, and diagnostic and treatment strategies are not well standardized. Previous studies have been limited by small sample sizes and regional focus. This review aims to systematically analyze the clinical characteristics, management, and outcomes of CP in Chinese patients, with comparative insights from Japanese cases, to improve understanding and guide clinical practice.</p><p><strong>Methods: </strong>A systematic literature search was conducted in PubMed, EMBASE, Cochrane Library, CNKI, and Wanfang databases for studies published before October 2023. Keywords included \"cap polyposis\" and \"cap-shaped polyp\". Articles were screened against predefined inclusion criteria: studies from Mainland China, pathologically confirmed CP cases, and availability of clinical and therapeutic data. Data extraction and quality assessment were performed independently by two reviewers using the Newcastle-Ottawa Scale.</p><p><strong>Results: </strong>Fourteen studies involving 57 patients were included. The most common symptoms were hematochezia (59.6%) and diarrhea (28.1%). Polyps were predominantly located in the rectum (68.4%), and 66.7% of patients had three or more polyps. Helicobacter pylori testing was positive in 57.1% of tested patients (12/21). Comparative analysis with Japanese cases revealed similar rectal predominance but suggested potential variations in gender distribution and treatment preferences. Treatments included endoscopic mucosal resection, endoscopic submucosal dissection, H. pylori eradication, and surgery. During a median follow-up of 14 months, 10 patients experienced recurrence.</p><p><strong>Conclusion: </strong>CP is a benign but easily misdiagnosed condition with a high recurrence rate. Diagnosis relies on combined endoscopic and histopathological findings. Treatment remains empirical, with H. pylori eradication beneficial in infected patients, and endoscopic resection effective for localized disease. Further multicenter studies are needed to establish standardized management protocols.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"5777-5801"},"PeriodicalIF":2.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12478197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199253","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":"Sex Differences in Patients with Heart Failure with Reduced Ejection Fraction Combined with Anemia and Hyperuricemia: A Retrospective Case Study.","authors":"Zhengjiang Liu, Bixia Yan, Ronghua Huang, Yi Zhou, Xingshou Pan","doi":"10.2147/IJGM.S536026","DOIUrl":"10.2147/IJGM.S536026","url":null,"abstract":"<p><strong>Objective: </strong>Heart failure with reduced ejection fraction (HFrEF) is associated with high mortality and morbidity. This study aimed to investigate sex differences in clinical characteristics, ventricular remodeling, cardiovascular risk factors, and prognosis among patients with HFrEF complicated by anemia and hyperuricemia.</p><p><strong>Subjects and methods: </strong>We analyzed data from patients with HFrEF admitted to the Affiliated Hospital of Youjiang Medical University for Nationalities between January 1, 2018, and September 1, 2022. A total of 185 patients with HFrEF, anemia, and hyperuricemia (HU) were included. Laboratory and echocardiographic parameters were examined, and Cox regression analysis was used to identify prognostic risk factors. Clinical characteristics and prognostic factors were compared between sexes.</p><p><strong>Results: </strong>Female patients had lower body weight, smaller body size, more severe anemia, and fewer ischemic causes of ventricular remodeling compared with male patients. Male patients had a higher prevalence of smoking and renal insufficiency. Serum uric acid predicted lower extremity venous thrombosis (area under the curve = 0.736). During a median follow-up of 21.78 months, no significant sex difference in cardiovascular events was observed. However, multivariate Cox proportional hazards analysis demonstrated sex-specific prognostic factors. The independent risk factors in males were body weight (HR = 1.035, 95% CI: 1.016-1.054, <i>P</i> = 0.001), total protein (HR = 0.965, 95% CI: 0.934-0.997, <i>P</i> = 0.031), albumin/globulin ratio (HR = 2.024, 95% CI: 1.093-3.749, <i>P</i> = 0.025), and atrial fibrillation (HR = 0.399, 95% CI: 0.254-0.627, <i>P</i> = 0.001). Independent risk factor in females was MCHC (HR = 1.037, 95% CI: 1.011-1.064, <i>P</i> = 0.005).</p><p><strong>Conclusion: </strong>In patients with HFrEF, anemia, and HU, males and females exhibited distinct clinical characteristics and cardiovascular risk factors, despite having similar survival outcomes. These findings underscore the importance of addressing sex-specific risk profiles in the clinical management of HFrEF.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"5755-5763"},"PeriodicalIF":2.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185885","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":"CT-Occult Primary Benign Tracheobronchial Neoplasms: A Single-Center 40-Case Clinicopathologic Series.","authors":"Qiliang Liu, Yan Hu, Minhui Mei, Xuan Wang, Jun Li, Chao Quan, Peng Liu","doi":"10.2147/IJGM.S536017","DOIUrl":"10.2147/IJGM.S536017","url":null,"abstract":"<p><strong>Background: </strong>Primary benign tracheobronchial neoplasms are rare and often misdiagnosed due to non-specific presentation.</p><p><strong>Objective: </strong>To describe the clinical, bronchoscopic, histopathologic and immunohistochemical features of these tumors in a TB-enriched population.</p><p><strong>Methods: </strong>We retrospectively identified 40 patients with primary benign tracheobronchial tumors diagnosed by bronchoscopic biopsy in a single TB center over a period of 7 years (2017-2024) and summarized clinical data, bronchoscopic characteristics, pathology, and immunophenotype.</p><p><strong>Results: </strong>Patients were predominantly middle-aged and older men. None of the tumors were detected by CT of the chest. The most common clinical symptoms were cough, sputum production, fever, hemoptysis, chest tightness and wheezing, The median symptom duration was 30 days (IQR, 7-135). The tumors were primarily located in segmental bronchi. Seventy-five percent of tumors were polypoid with wide base while 20% displayed columnar growth patterns and 5% cases had pedunculated morphology. Pathology was consistent with leiomyomas (40.0%), hamartomas (20.0%), peripheral nerve sheath tumors (22.5%) and squamous papillomas (7.5%). Rarer tumor types occupied 10.0% of all cases. Immunohistochemical analysis was consistent with pathology.</p><p><strong>Conclusion: </strong>Primary benign tracheobronchial neoplasms are commonly small and undetectable by CT of the chest. Coupled with nonspecific symptoms this demands a high index of suspicion including in patients with coexisting conditions such as TB. Definitive diagnosis required bronchoscopy with histologic assessment.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"5765-5775"},"PeriodicalIF":2.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185913","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":"Cancer Screening Practices Among Women Living with HIV in Istanbul, Turkey: A Qualitative Study.","authors":"Dilek Yagci-Caglayik, Seyhan Hidiroglu, Fatma Burcu Doganc, Yağız Varol, Kubra Erdem, Muhammed Selim Recai, Omer Faruk Asker","doi":"10.2147/IJGM.S547809","DOIUrl":"10.2147/IJGM.S547809","url":null,"abstract":"<p><strong>Purpose: </strong>Women living with HIV (WLWH) are at a higher risk of developing cancers. Despite the presence of national cancer screening programs in Turkey, the participation and awareness of WLWH regarding these programs remain unclear. This study aims to explore the knowledge, beliefs, and behaviors of WLWH in Turkey regarding cancer screenings.</p><p><strong>Patients and methods: </strong>This is a qualitative study. In-depth interviews were conducted with women aged 20 and older who were being followed up at the HIV outpatient clinics of a training and research hospital in Istanbul, Turkey. Data was collected through phone interviews to ensure confidentiality and continued until data saturation was achieved. The collected data were analyzed using thematic content analysis with the help of Atlas.ti software.</p><p><strong>Results: </strong>A total of 14 WLWH participated in the study, with a median age of 46.5 years (IQR:21 years). Three themes emerged: Cancer Awareness, Behaviors Towards Cancer Screening, and Barriers and Motivators in Cancer Screening Participation. Participants' knowledge about cancer and screening programs varied widely, with particularly low awareness of colorectal and breast cancer screenings. While some women practiced breast self-examination, regular participation in national screening programs was found to be low. The main barriers included lack of information, HIV-related stigma, and systemic challenges in accessing healthcare services. Many participants reported negative reactions from healthcare professionals upon disclosing their HIV status, leading to avoidance of screening services. Despite these challenges, the importance of early diagnosis was widely acknowledged, and participants said they would be more likely to participate in screenings if provided with proper information and support.</p><p><strong>Conclusion: </strong>Low levels of cancer screening participation were observed among women living with HIV. To improve engagement in screening, these women need greater support, access to accurate information, and respectful care. Integrating screening into routine HIV services, providing training for health professionals, and reducing stigma are essential strategies to enhance participation and promote early detection in this vulnerable population.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"5673-5685"},"PeriodicalIF":2.0,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145148994","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":"Application of Acupuncture in Cervical Spondylotic Radiculopathy: An In-Depth Analysis and Outlook on Pathophysiological Basis and Therapeutic Mechanisms.","authors":"Yuehua Li, Qingxi Cao","doi":"10.2147/IJGM.S550285","DOIUrl":"10.2147/IJGM.S550285","url":null,"abstract":"<p><p>Cervical Spondylotic Radiculopathy (CSR) is a debilitating condition caused by nerve root compression from degenerative cervical changes, leading to pain and dysfunction. Acupuncture, a key non-pharmacological treatment, shows significant clinical promise, yet its biological mechanisms are not fully understood. This article analyzes CSR's pathophysiology and acupuncture's therapeutic actions, based on literature published between 2010 and 2025, with a focus on recent key advancements. The review covers CSR's pathology, including mechanical compression, neuro-inflammation (eg, TNF-α), and neural sensitization. It then elucidates acupuncture's mechanisms: central analgesia via endogenous opioids (eg, β-endorphin), downregulation of pro-inflammatory mediators, enhanced local microcirculation, and modulation of oxidative stress. In conclusion, acupuncture intervenes in CSR's pathology through a multi-target neuro-immune-circulatory network. Future high-quality clinical trials and deeper molecular studies are essential to provide robust scientific evidence for its clinical application.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"5717-5730"},"PeriodicalIF":2.0,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149017","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":"Impact of an Infective Endocarditis Team on Management and Outcomes: A Retrospective Cohort Study.","authors":"Tetsu Sakamoto, Takanobu Hirosawa, Yukinori Harada, Ikuko Shibasaki, Toshimi Sairenchi, Riichi Nishikawa, Haruka Sakikawa, Taro Shimizu","doi":"10.2147/IJGM.S542511","DOIUrl":"10.2147/IJGM.S542511","url":null,"abstract":"<p><strong>Purpose: </strong>Multidisciplinary team approaches have been reported to improve the management of infective endocarditis (IE). This study evaluated changes in management and outcomes after the establishment of an IE team at a tertiary care facility in Japan.</p><p><strong>Patients and methods: </strong>A retrospective study was conducted on inpatients aged ≥18 years with definite IE between November 2015 and October 2023. The primary outcome was 90-day all-cause mortality. Secondary outcomes included in-hospital mortality, unplanned cardiac surgery, new cerebral embolism, bacteremia relapse within 90 days of admission, and duration of antibiotic therapy. Outcomes were compared between patients admitted before (control period) and after (intervention period) the implementation of the IE team in November 2019.</p><p><strong>Results: </strong>Characteristics were comparable between the two periods. No significant differences were found in 90-day mortality (15.2% vs 17.0%, <i>P</i> > 0.99), in-hospital mortality (19.6% vs 12.8%, <i>P</i> = 0.54), or new cerebral embolism (8.7% vs 2.1%, <i>P</i> = 0.20). The rate of unplanned cardiac surgery was lower in the intervention period (17.4% vs 2.1%, <i>P</i> = 0.02), while the duration of antibiotic therapy was longer (6.0 weeks vs 7.5 weeks, <i>P</i> = 0.02). No bacteremia relapse occurred.</p><p><strong>Conclusion: </strong>Although no significant differences were observed in 90-day mortality, the rate of unplanned surgery was significantly lower in the intervention period, supporting the usefulness of an IE team. The longer duration of antibiotic therapy in the intervention period may reflect a higher prevalence of complicated infections including muscle abscesses.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"5743-5754"},"PeriodicalIF":2.0,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145148699","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":"Different Risk Factors for Lymph Node Metastasis in Papillary Thyroid Carcinoma Patients with and without Hashimoto's Thyroiditis.","authors":"Jiwei Chen, Haifeng Zhong, Yuedong Wang","doi":"10.2147/IJGM.S538384","DOIUrl":"10.2147/IJGM.S538384","url":null,"abstract":"<p><strong>Objective: </strong>The immune response triggered by Hashimoto's thyroiditis may influence the progression of papillary thyroid cancer (PTC), such as lymph node metastasis (LNM). The purpose of this study was to study the relationship between clinicopathological features and LNM in PTC patients with and without Hashimoto's thyroiditis.</p><p><strong>Methods: </strong>The clinicopathological features of 767 PTC patients (age, gender, thyroid function, Hashimoto's thyroiditis, number of tumor lesions, tumor size, capsular invasion, preoperative circulating tumor cells (CTCs), and clinical stage) were collected. The relationship between clinicopathological features and LNM in PTC coexistent and non-coexistent with Hashimoto's thyroiditis patients was analyzed, respectively.</p><p><strong>Results: </strong>There were 210 PTC patients with Hashimoto's thyroiditis and 557 without. There was no significant difference in clinicopathological features between patients with and without Hashimoto's thyroiditis. In multivariate logistic regression analyses, multifocality (odds ratio (OR): 2.127, 95% confidence interval (CI): 1.085-4.168, <i>p</i>=0.028), maximum lesion diameter >1cm (OR: 3.858, 95% CI: 1.903-7.823, <i>p</i><0.001), and capsular invasion (OR: 2.007, 95% CI: 1.034-3.895, <i>p</i>=0.040) were associated with LNM in PTC patients with Hashimoto's thyroiditis; multifocality (OR: 2.461, 95% CI: 1.595-3.797, <i>p</i><0.001), maximum lesion diameter >1cm (OR: 4.108, 95% CI: 2.629-6.417, <i>p</i><0.001), capsular invasion (OR: 1.680, 95% CI: 1.128-2.500, <i>p</i>=0.011), and positive preoperative CTCs (OR: 1.560, 95% CI: 1.065-2.285, <i>p</i>=0.022) were associated with LNM in PTC patients without Hashimoto's thyroiditis.</p><p><strong>Conclusion: </strong>Regardless of the presence or absence of Hashimoto's thyroiditis, multifocality, maximum lesion diameter >1cm, and capsular invasion were associated with LNM in PTC patients. Positive preoperative CTCs were associated with LNM in PTC without Hashimoto's thyroiditis but not in PTC with Hashimoto's thyroiditis.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"5687-5697"},"PeriodicalIF":2.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12457774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145148701","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}