International Journal of General Medicine最新文献

{"title":"Controlled Nutritional Status Score and Prognostic Nutritional Index for the Prediction of Postoperative Subdural Hematoma.","authors":"Huisong Chu, Shuang Sun, Hui Jiang, Ling Li, Yu Tian","doi":"10.2147/IJGM.S532358","DOIUrl":"10.2147/IJGM.S532358","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the predictive value of the prognostic nutritional index (PNI) and controlled nutritional status score (CONUT) on the neurological outcomes of patients with chronic subdural hematoma (CSDH) following burr-hole drainage.</p><p><strong>Methods: </strong>A retrospective analysis of patients with CSDH was conducted. The CONUT and PNI values and the modified Rankin scale (mRS) scores were calculated based on the patients' conditions at the time of hospital discharge. The poor prognosis was defined as an mRS score of 3. Receiver operating characteristic (ROC) curves were plotted to evaluate the predictive value of CONUT and PNI for the postoperative prognosis of CSDH. Nutritional risk was defined using established cutoffs: PNI < 45 and CONUT ≥ 2.</p><p><strong>Results: </strong>In 205 patients with CSDH, 17 patients (8.3%) had a poor prognosis. On ROC curve analysis, the area under the curve (AUC) for the CONUT in predicting poor prognosis of CSDH was 0.719 (95% Confidence Interval [CI]: 0.5867-0.8523, P=0.002). The AUC for the PNI and combined CONUT and PNI were 0.803 (95% CI: 0.7031-0.9042, P<0.001) and 0.805 (95% CI: 0.7039-0.9059, P<0.001), respectively. Moreover, multivariate logistic regression analysis showed that CONUT (OR=1.485, 95% CI: 1.096-2.011) and PNI (OR=0.850, 95% CI: 0.763-0.947) were independent risk factors for poor prognosis of CSDH following surgical intervention, after adjusting for age, hypertension, and pre-discharge intracranial fluid volume.</p><p><strong>Conclusion: </strong>The combined score of PNI and CONUT displayed higher sensitivity and specificity, compared to PNI or CONUT alone. Therefore, the combined score might be useful in predicting the prognosis of CSDH.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"5629-5639"},"PeriodicalIF":2.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12450375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124726","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 Preoperative [¹⁸F]FDG PET/CT-Derived Heterogeneity Index for Occult Lymph Node Metastasis in Clinical N0 Gastric Adenocarcinoma.","authors":"Bo Wu, Wen-Jie Tian, Lin Li, Yuan-Qing Zhu, Ying-Gang Sun","doi":"10.2147/IJGM.S513034","DOIUrl":"10.2147/IJGM.S513034","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the predictive value of preoperative [¹⁸F]fluorodeoxyglucose ([¹⁸F]FDG) positron emission tomography/computed tomography (PET/CT)-derived heterogeneity index (HI) for occult lymph node metastasis (OLM) in clinical N0 gastric adenocarcinoma.</p><p><strong>Methods: </strong>This retrospective study included 83 patients with clinical N0 gastric adenocarcinoma who underwent [¹⁸F]FDG PET/CT scans before radical surgery between March 2018 and June 2024. Patients were classified as OLM-positive (n=40) or OLM-negative (n=43) based on postoperative pathology. Clinical characteristics, PET/CT metabolic parameters [maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), peak standardized uptake value (SUVpeak), tumor-to-liver ratio (TLR), metabolic tumor volume (MTV), and total lesion glycolysis (TLG)], and heterogeneity indices (HI-1 and HI-2) were analyzed. Univariate and multivariate logistic regression models were applied to identify independent predictors of OLM. ROC curve analysis was performed to assess diagnostic performance. Statistical analysis was conducted using SPSS version 26.0, with P<0.05 considered statistically significant.</p><p><strong>Results: </strong>Gender, tumor differentiation, and pathological T stage differed significantly between the two groups (P<0.05). HI-2 was significantly higher, while SUVmax, SUVmean, and HI-1 were significantly lower in the OLM-positive group (P<0.05). Multivariate analysis identified pathological T stage (T3-T4, OR=4.778, P=0.022) and HI-2 >4.959 (OR=6.887, P=0.002) as independent predictors of OLM. ROC analysis revealed that HI-2 had an AUC of 0.711 (95% CI: 0.596-0.824, P=0.001), with 52.5% sensitivity and 88.37% specificity at the optimal threshold.</p><p><strong>Conclusion: </strong>HI-2 derived from preoperative [¹⁸F]FDG PET/CT is a significant independent predictor of OLM in clinical N0 gastric adenocarcinoma patients, alongside pathological T stage.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"5581-5589"},"PeriodicalIF":2.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12450381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124704","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":"Acute Cholecystitis: Integrated Traditional Chinese and Western Medicine Approaches to Epidemiology, Diagnosis, and Treatment.","authors":"Jia Luan, Kuanyu Wang","doi":"10.2147/IJGM.S540729","DOIUrl":"10.2147/IJGM.S540729","url":null,"abstract":"<p><p>Acute cholecystitis is a common clinical condition with complex pathological mechanisms and significant clinical impact. This review focuses on integrated traditional Chinese and Western medicine approaches to its management. We first summarize theoretical foundations and recent findings in epidemiology and pathophysiology. Diagnostic strategies are then discussed, with emphasis on how modern imaging methods and traditional Chinese medicine diagnostic approaches complement each other to improve accuracy. Clinical practice is reviewed in terms of therapeutic efficacy, combined medication, and surgical options, underscoring the benefits of integrative treatment. Advances such as the development of new traditional Chinese medicine preparations and the adoption of minimally invasive techniques have introduced promising directions, although controversies and challenges remain. Finally, we highlight the need for further research to optimize integrative strategies, establish standardized treatment protocols, and improve patient outcomes. By synthesizing current evidence, this review aims to inform clinical decision-making and guide future research on integrative approaches to acute cholecystitis.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"5569-5580"},"PeriodicalIF":2.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12449890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113025","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":"Anterior Disc Displacement of Temporomandibular Joint: Imaging Diagnosis and Multidisciplinary Treatment.","authors":"Jiaxun Ying, Jiayou Gao, Lixia Gao, Jing Guo","doi":"10.2147/IJGM.S539079","DOIUrl":"10.2147/IJGM.S539079","url":null,"abstract":"<p><p>Anterior disc displacement (ADD) of temporomandibular joint is a common pathological basis for temporomandibular joint disorders (TMD). A clear diagnosis of ADD is beneficial for identifying the stage of disease, determining treatment schemes, and evaluating treatment prognosis. Different imaging techniques, including magnetic resonance imaging, computed tomography, ultrasonography, etc. have their own indications for diagnosing ADD. Researchers have made great efforts to explore imaging techniques, and new methods and improvements are constantly emerging. The treatment of ADD is gradually developing towards multidisciplinary collaboration, with psychological therapy, medication therapy, physical therapy, surgical treatment, and other treatments all playing a role. The treatment methods can be divided into three categories: reversible conservative treatment, irreversible conservative treatment, and surgery. Usually in clinical practice, treatment methods are considered sequentially in this order. The multidisciplinary approach in TMD treatment demonstrates the charm of holistic concept. It is a manifestation of the biopsychosocial model and a future trend in disease prevention and treatment.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"5557-5568"},"PeriodicalIF":2.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12447971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145112964","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 Impact of Echogenicity Grading on the Diagnostic Performance of C-TIRADS.","authors":"Ge-Lang Huang, Jing-Yan Su, Rui-Qiao Liang, Xi-Yue Yang, Li-Fang Xu","doi":"10.2147/IJGM.S541530","DOIUrl":"10.2147/IJGM.S541530","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate whether echogenicity grading can improve the diagnostic performance of the Chinese Thyroid Imaging Reporting and Data System (C-TIRADS).</p><p><strong>Patients and methods: </strong>Ultrasonic (US) images of 646 thyroid nodules (TNs) were retrospectively reviewed. The sonographic features of each nodule were analyzed and noted, including the orientation, margin, composition, echogenicity, echogenic foci, and extrathyroidal extension. Hypoechoic was further graded as mildly, moderately and markedly hypoechoic, and the malignancy risk at different echogenicity levels was compared. Each nodule was categorized according to C-TIRADS using markedly hypoechoic, modified markedly hypoechoic, and hypoechoic as malignant indicators, and the classification results were recorded as TI-RADS 1, 2, and 3, respectively. The diagnostic sensitivity, specificity, and area under the curve (AUC) of the different echogenicity and TIRADS were compared using chi-square analysis and Receiver Operating Characteristic curves (ROC). Binary logistic regression analysis was used to calculate cancer risk for different echogenicity. The interobserver agreement in the grading of echogenic of the nodules was also assessed.</p><p><strong>Results: </strong>Most malignant nodules were hypoechoic (85.2%), and the malignancy risk of hypoechoic nodules was significantly higher than that of iso-hyperechoic nodules (34.4% vs 9.8%). The malignancy risk gradually increased as nodule echogenicity decreased (odd ratios (ORs) of 2.132, 10.009, and 15.006, respectively). There was no significant difference in the malignancy risk between moderately and markedly hypoechoic nodules (<i>P</i>=0.203). The modified markedly hypoechoic region showed the highest AUC and the most balanced sensitivity and specificity for the diagnosis of thyroid cancer. The diagnostic performance of TI-RADS 2 was significantly higher than that of TI-RADS 1 and 3 (AUC of 0.715, 0.608, and 0.656, respectively). Substantial agreement was obtained between the two observers in grading markedly hypoechoic and modified markedly hypoechoic (κ = 0.79 and 0.75; 95% CI: 0.75,0.83 and 0.64,0.86).</p><p><strong>Conclusion: </strong>Stratifying hypoechogenic to three degrees enhances confidence in evaluating malignancy risk. Compared to markedly hypoechoic, the modified markedly hypoechoic significantly boosted the ability of C-TIRADS to differentiate benign TNs from malignant ones.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"5509-5517"},"PeriodicalIF":2.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113014","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":"Potential Mechanisms of Traditional Chinese Medicine for the Treatment of Allergic Rhinitis: Evidence from Molecular and Clinical Studies.","authors":"Boyang Dong, Liangzhen Xie, Yan Li","doi":"10.2147/IJGM.S536944","DOIUrl":"10.2147/IJGM.S536944","url":null,"abstract":"<p><p>Allergic rhinitis (AR) is a common chronic inflammatory disease of the upper respiratory tract and has become a significant global public health issue. With increasing globalization and environmental challenges, the factors contributing to AR pathogenesis have expanded, leading to a marked rise in its global incidence. Current clinical treatment guidelines recommend antihistamines, glucocorticoids, and leukotriene receptor antagonists for managing the clinical symptoms and pathological changes associated with AR. However, as patients' expectations for quality of life increase, concerns regarding the recurrent nature of AR and the long-term use of pharmacological treatments have grown, particularly concerning the potential side effects and sustained efficacy of these medications. Therefore, the pathogenesis of AR remains a key research focus and a critical entry point for therapeutic intervention. In this context, Traditional Chinese Medicine (TCM), with over 2500 years of clinical experience and a comprehensive theoretical framework, has long recognized the condition and offers therapeutic strategies to treat or delay its onset. TCM exerts its effects through multiple mechanisms, including immunomodulation, suppression of oxidative stress, regulation of gut microbiota, inhibition of inflammatory responses, and restoration of normal cellular autophagy and apoptosis. This paper reviews ex vivo and in vivo studies on the use of TCM in AR treatment, focusing on the modulation of various pathogenic mechanisms and the underlying theoretical basis. It aims to identify potential drug sources and expand therapeutic options for AR. In addition, this review analyzes the administration routes and treatment durations of various TCM interventions, offering insights into the development of safe and effective targeted therapies. It also provides guidance for future experimental and clinical research while highlighting the current challenges facing TCM in the management of AR.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"5519-5555"},"PeriodicalIF":2.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145112956","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":"Is Contrast-Enhanced Imaging in the Emergency Department a Risk Factor for Contrast-Associated Acute Kidney Injury?","authors":"Leyla Abalı Üğe, Yusuf Üzüm, Mert Üğe, Zeki Soypacaci","doi":"10.2147/IJGM.S544396","DOIUrl":"10.2147/IJGM.S544396","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to determine the predisposing factors for contrast-associated acute kidney injury (CA-AKI) among patients exposed to contrast media during emergency department visits and follow-ups in internal medicine, and to evaluate subsequent outcomes such as mortality and intensive care unit (ICU) admission.</p><p><strong>Patients and methods: </strong>A total of 1483 patients who presented to the internal medicine clinic from the emergency department or outpatient clinic and underwent contrast-enhanced computed tomography (CT) were retrospectively analyzed. A total of 382 cases with kidney function tests available for the study before contrast exposure and at 24, 72, and 120 hours after exposure were included in the study. An increase in serum creatinine by 25% or more from the baseline or an absolute increase of 0.5 mg/dl (44.20 µmol/L) or more after one hour was considered as contrast nephropathy.</p><p><strong>Results: </strong>Contrast-associated acute kidney injury was observed in 17% of the study population, with the majority of cases emerging within the initial 24-hour period following contrast exposure. In 54% of these patients, contrast media had been administered in the internal medicine department. Among them, 13.9% subsequently required admission to the intensive care unit (ICU). Furthermore, individuals with a history of hypertension were found to have a 2.31-fold increased risk of developing CA-AKI compared to those without hypertension.</p><p><strong>Conclusion: </strong>The likelihood of contrast-associated nephropathy appears to be markedly increased in hypertensive individuals undergoing contrast-enhanced CT in emergency departments. Prophylactic intravenous hydration has also been demonstrated to play a crucial role in reducing CA-AKI incidence.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"5491-5501"},"PeriodicalIF":2.0,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12442917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086267","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 for Short and Long-Term Mortality in Acute Pulmonary Thromboembolism: A Retrospective Study.","authors":"Sibel Doruk, Gulistan Karadeniz, Hüseyin Örün, Sami Deniz, Gülru Polat","doi":"10.2147/IJGM.S528501","DOIUrl":"10.2147/IJGM.S528501","url":null,"abstract":"<p><strong>Purpose: </strong>Platelet-Lymphocyte Ratio (PLR) and Neutrophil-Lymphocyte Ratio (NLR) are the parameters investigated in acute pulmonary thromboembolism (aPTE) mortality. This study aimed to determine the prognostic value of NLR, PLR, and other parameters in aPTE. A retrospective cohort study was conducted in a Research and Training Hospital.</p><p><strong>Patients and methods: </strong>The study included 346 aPTE cases, and mortality at the first week, first month, and sixth month were determined as endpoints. The medical files of the cases were examined. Age, sex, date of diagnosis, vital status, the last follow-up date, hemogram, lower extremity venous Doppler ultrasonography, and intensive care unit admissions were recorded. Cox regression analysis was performed to identify prognostic factors associated with mortality, and hazard ratio (HR) and a 95% confidence interval (CI) were reported.</p><p><strong>Results: </strong>Median follow-up was 898.5 days. There was no significant difference in terms of sex on mortality. The deceased cases in the 1st month and 6th month were older than the survivors; among them, intensive care unit (ICU) admission rates were higher, and deep venous thrombosis (DVT) was less frequently detected. In the first week, ICU admission rates were higher in deceased cases, and DVT was determined less frequently among them. NLR was higher in all deceased patients, while PLR was elevated in deceased cases in the first and 6th months. ICU admission and DVT status were consistently associated with mortality across all three time points. NLR was identified as a good prognostic factor for the first month of mortality (95% CI: 1.017-1.168 HR: 1.090). PLR and age were poor prognostic factors; PLR was positively associated with 6th-month survival (95% CI: 1.001-1.005 HR: 1.003).</p><p><strong>Conclusion: </strong>NLR is a good prognostic factor, and PLR and age are poor prognostic factors. DVT may help in early diagnosis, which may be associated with lower mortality.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"5465-5473"},"PeriodicalIF":2.0,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137606","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 Cluster Analysis Based on SHAP Values in Hemodialysis Patients Using Arteriovenous Fistula.","authors":"Peng Shu, Ling Huang, Xia Wang, Zhuping Wen, Yiqi Luo, Fang Xu","doi":"10.2147/IJGM.S533419","DOIUrl":"10.2147/IJGM.S533419","url":null,"abstract":"<p><strong>Background: </strong>The prognosis of hemodialysis patients using arteriovenous fistula is significantly heterogeneous and influenced by various factors, including vascular conditions and underlying diseases. This study aims to reveal patient subgroup characteristics and identify key influencing factors through cluster analysis based on SHAP values.</p><p><strong>Methods: </strong>A cohort of 974 hemodialysis patients utilizing arteriovenous fistulae was analyzed, with 55 clinical characteristics extracted for examination. Following multiple imputation, standardization, and dimensionality reduction via principal component analysis, the efficacy of K-Means, DBSCAN, and hierarchical clustering algorithms was evaluated using metrics such as the silhouette coefficient and Calinski-Harabasz index. The K-Means algorithm, with K set to 3, was chosen to develop a pseudo target variable. This was subsequently integrated with the XGBoost model, and SHAP value analysis was employed to elucidate feature contributions.</p><p><strong>Results: </strong>The K-Means clustering algorithm demonstrated superior performance, as indicated by a Silhouette Coefficient of 0.05, effectively categorizing patients into three distinct clusters. Cluster 1 is characterized by a hemoglobin concentration range from -2 to 5, with a median of 1 and the highest variability among the clusters. Cluster 2 exhibits a hemoglobin concentration predominantly between -3 and 2, with a median of 0. Cluster 3 shows a hemoglobin concentration distribution akin to Cluster 2, albeit with slightly greater variability in the tails. SHAP analysis identified hemoglobin concentration as the most significant feature, with a SHAP value of 550, indicating that variations in its distribution are the primary drivers of the clustering process. Additionally, age, BMI, total cholesterol, and other features contribute to the clustering outcomes through complex nonlinear interactions.</p><p><strong>Conclusion: </strong>Cluster analysis with SHAP values preliminarily identified heterogeneous subgroups in such patients, with hemoglobin concentration potentially a key driver. This approach may aid personalized treatment, but generalizability needs multicenter validation.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"5475-5489"},"PeriodicalIF":2.0,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12442918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086096","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":"Endometrial Changes Associated with Mifepristone: A Review.","authors":"Qianhui Lin, Yun Zhou","doi":"10.2147/IJGM.S535797","DOIUrl":"10.2147/IJGM.S535797","url":null,"abstract":"<p><p>Mifepristone is a well-established pharmaceutical agent in obstetrics and gynecology, which has expanded its therapeutic applications to Cushing's syndrome, meningioma, and even mental disease. The incidence of progesterone receptor modulator-associated endometrial changes (PAECs), characterized by cystic glandular dilatation and architectural complexity that mimic endometrial hyperplasia or carcinoma, is increasing. The precise molecular mechanisms remain incompletely understood. Hormonal influences may be central to PAECs pathogenesis. Histological heterogeneity has been observed between ectopic versus eutopic endometrium. The use of mifepristone at low doses (≤10 mg/d) in young women during the early follicular phase appears to be safe. Monitoring of estradiol(E₂) levels before the management is recommended. Risk assessment and preventive strategies, such as intermittent treatment, transvaginal ultrasound and levonorgestrel intrauterine system (LNG-IUS), should be considered.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"5503-5508"},"PeriodicalIF":2.0,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12442810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086138","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}