International Journal of General Medicine最新文献

{"title":"Construction and Verification of Risk Predictive Nomogram in Patients of Connective Tissue Disease with Severe Pneumonia.","authors":"Chuanrong Zhang, Zhonghui Zou","doi":"10.2147/IJGM.S515976","DOIUrl":"10.2147/IJGM.S515976","url":null,"abstract":"<p><strong>Purpose: </strong>To construct Risk Predictive Nomogram in patients of connective tissue disease (CTD) with severe pneumonia.</p><p><strong>Methods: </strong>Eighty CID patients with severe pneumonia in rheumatology and respiratory department of chongqing University Three Gorges hospital from January 2020 to December 2022 were retrospectively reviewed and analyzed. Independent risk factors for severe pneumonia in CTD were screened by univariate and binomial logistic regression analysis. The nomogram was constructed by R software. Area under the curve (AUC) of receiver operating characteristic (ROC) was used to evaluate the nomogram's discrimination, and the calibration curve and Hosmer-Lemeshow test were used to reflect the nomogram's calibration.</p><p><strong>Results: </strong>The study cohort was including 48 patients in the general pneumonia group and 32 patients in the severe pneumonia group. The model variables included Ln CD4/CD8, Ln CRP, Ln PCT and Ln IFN-γ. Hosmer-lemeshow test P value less than 0.05 (χ2 = 7.753, <i>P</i> = 0.458), the area under ROC curve of nomogram was 0.9084 (95% CI: 0.8461-0.9707), and the optimal cutoff value of nomogram was 0.490, the sensitivity was 0.872, the specificity was 0.848. In a retrospective study design, 50 patients with CTD complicated with pneumonia admitted to the same hospital from January to June 2023 were selected to verify the model. The nomogram verification results showed Hosmer-Lemeshow test (χ2 = 7.1171, <i>P</i> = 0.5241), AUC value was 0.8958 (95% CI: 0.808-0.9837), and optimal cutoff value was 0.664, the sensitivity was 0.988, the specificity was 0.812.</p><p><strong>Conclusion: </strong>The prediction nomogram in this study is helpful for clinical staffs to screen high-risk patients with severe pneumonia in CTD, and has high clinical application value.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"3515-3524"},"PeriodicalIF":2.1,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560048","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":"Prediction of First-Onset Cerebral Infarction Risk in Patients with Acute Myocardial Infarction: A Retrospective Cohort Study.","authors":"Zifeng Zeng, Rongtai Luo, Weiyong Xu, Huaqing Yao, Xinping Lan","doi":"10.2147/IJGM.S523100","DOIUrl":"10.2147/IJGM.S523100","url":null,"abstract":"<p><strong>Background: </strong>The occurrence of cerebral infarction significantly increases the risk of major adverse cardiovascular events in patients with acute myocardial infarction (AMI), highlighting the importance of early identification and intervention. Currently, no validated tools exist for individualized risk stratification of cerebral infarction (CI) in patients with AMI.</p><p><strong>Objective: </strong>This study aimed to identify the most valuable predictors (MVPs) of in-hospital first-onset CI in AMI patients and construct a nomogram for risk stratification.</p><p><strong>Methods: </strong>This retrospective cohort study enrolled 1,350 AMI patients admitted to the Cardiovascular Center of Meizhou People's Hospital between January and December 2022. Clinical characteristics and laboratory parameters were analyzed. Least Absolute Shrinkage and Selection Operator regression (LASSO) was used to select MVPs. The nomogram was developed by integrating coefficients of MVPs from logistic regression, and its discrimination, calibration, and clinical utility were validated in the cohort. The optimal cutoff value of the nomogram probability was determined.</p><p><strong>Results: </strong>CI occurred in 60 patients (4.44%). MVPs included Killip classification (<i>OR</i> = 1.42, <i>95% CI</i> 1.05-1.93), PCI therapy (<i>OR</i> = 0.29, <i>95% CI</i> 0.16-0.51), C-reactive protein (CRP: <i>OR</i> = 1.01, <i>95% CI</i> 1.00-1.01), blood urea nitrogen (BUN: <i>OR</i> = 1.03, <i>95% CI</i> 0.99-1.07), and neutrophil-to-lymphocyte ratio (NLR: <i>OR</i> = 1.02, <i>95% CI</i> 0.99-1.05). The discriminatory ability of the nomogram was up to 0.804(<i>95% CI</i> 0.749-0.859). Additionally, the nomogram showed good calibration and clinical utility in the cohort. Furthermore, the optimal cutoff value of the nomogram probability for distinguishing those who will experience in-hospital first-onset CI was 0.035 (sensitivity 78.3%, specificity 71.1%).</p><p><strong>Conclusion: </strong>The first nomogram integrating multimodal predictors for discerning AMI patients who will experience in-hospital first-onset CI was developed and validated, which will aid clinicians in clinical decision-making.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"3501-3513"},"PeriodicalIF":2.1,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540090","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":"Effects of Dexmedetomidine or Propofol on Postoperative Oxygenation Index During Invasive Ventilation in Patients After off-Pump Coronary Artery Bypass Grafting: a Single-Center Retrospective Study.","authors":"Fang Li, Luwei Ma, Suhua Yan, Dongyi Liu","doi":"10.2147/IJGM.S524691","DOIUrl":"10.2147/IJGM.S524691","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to compare the effects of dexmedetomidine (DEX) and propofol on patients undergoing invasive ventilation after off-pump coronary artery bypass grafting (OPCABG) with regard to oxygenation index (OI) (PaO2/FiO2), hemodynamic changes, extubation time, and adverse reactions.</p><p><strong>Patients and methods: </strong>This single-center retrospective study included 195 patients admitted to the cardiovascular surgery intensive care unit (CVICU) after OPCABG between January 2022 and June 2024. According to the postoperative invasive mechanical ventilation for sedation with only DEX or propofol, the patients were classified into groups D and P. The primary outcome was oxygenation index (OI) before and after extubation. The secondary outcomes included mean arterial pressure (MAP) and heart rate (HR) before and after extubation, extubation time, and adverse reactions after surgery.</p><p><strong>Results: </strong>DEX was significantly associated with an increased likelihood of OI before and after extubation composed to propofol (<i>P</i> < 0.05). MAP and HR after extubation were significantly higher than before extubation in Group P (<i>P</i> < 0.05). However, there were no significant differences between before and after extubation in Group D (<i>P</i> < 0.05). Furthermore, MAP and HR were significantly lower in Group D than in Group P before and after extubation (<i>P</i> < 0.05). In addition, the extubation time was significantly shorter in Group D in comparison of propofol (<i>P</i> < 0.05). Additionally, the incidence of delirium and severe cough at extubation after surgery was significantly lower in Group D than in Group P (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>DEX may support satisfactory OI, good hemodynamic stability, rapid extubation time, and a lower incidence of adverse reactions for sedation of mechanically ventilated patients following OPCABG surgery compared to propofol, although the difference with OI did not reach the MCID.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"3463-3476"},"PeriodicalIF":2.1,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12214473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553456","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":"Alpha-Gal Syndrome: Often Hidden, Under-Recognized, and in Need of Attention-A Rapid Review.","authors":"Carol C Thompson, Benjamin Saracco, Anika Pruthi, Elizabeth Cerceo","doi":"10.2147/IJGM.S519844","DOIUrl":"10.2147/IJGM.S519844","url":null,"abstract":"<p><p>Alpha-gal syndrome (AGS), a tick-borne allergy, is increasing as its vectors migrate throughout the US and the world. There were an estimated 450,000 cases in the US. AGS reactions to mammalian foods and medical products include delayed anaphylaxis, urticaria, gastrointestinal and cardiac symptoms often difficult to connect to the source. Despite its seriousness, provider knowledge is limited. This rapid review investigated published works on AGS from 2020 to 24; it also sought to determine the breadth of AGs publications across different fields and specialties. We identified 355 studies of AGS diagnosis and management from 2020 to 2024 via Cochrane Central, Medline via the PubMed interface, and Embase (additional grey literature via Web of Science and Google Scholar). Studies were assessed for quality and risk of bias using JBI critical appraisal tools. Two hundred and nineteen studies met the criteria. One hundred and sixty-eight (77%) were full studies; 51 (23%) were conference presentations. Studies remained largely confined to allergy and immunology literature, despite their implications for other organ systems. Although patients present with symptoms to emergency departments and dermatology clinics there is a paucity of literature in those fields and others; several studies document practitioners' lack of knowledge. Inclusion of content within medical school curricula is needed to establish foundational knowledge on the topic. With the increase in patients presenting with AGS, and with the reach of AGS across multiple fields, physicians and other health care providers need to be able to diagnose and then manage AGS with their patients. This rapid review has documented the problem of silos in disseminating information about AGS widely through the medical field. The remedy for a lack of practitioner knowledge is education.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"3477-3488"},"PeriodicalIF":2.1,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540087","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":"Combined Predictive Value of Neutrophil-to-Lymphocyte Ratio and CHA2DS2-VASc Score for Cardiogenic Cerebral Embolism in NVAF Patients.","authors":"Jie Hu, Jing-Jing Wang, Long Wang, Yong-Hong Cao, Jun-Cang Wu","doi":"10.2147/IJGM.S523480","DOIUrl":"10.2147/IJGM.S523480","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to determine the identification role of neutrophil-to-lymphocyte ratio (NLR) combined with CHA2DS2-VASC score for cardiogenic cerebral embolism (CCE) in acute ischemic stroke patients with non-valvular atrial fibrillation (NVAF).</p><p><strong>Methods: </strong>From January 2019 to August 2024, a total of 402 acute ischemic stroke patients with NVAF were enrolled in this retrospective study and were divided according to the occurrence of CCE into the CCE or non-CCE groups. Clinical data were collected from both groups, which included demographic data, medical history, CHA2DS2-VASC score, and laboratory tests (blood cell counts and blood biochemistry indicators). A predictive model based on blood indexes and the CHA2DS2-VASC score was constructed using least absolute shrinkage and selection operator (LASSO) regression analysis.</p><p><strong>Results: </strong>Multiple regression analysis showed that the CHA2DS2-VASc score (OR = 2.95, 95% CI = 2.19-3.99, p < 0.001), white blood count (OR = 1.43, 95% CI = 1.15-1.78, p = 0.001), neutrophil-to-lymphocyte ratio (NLR; OR = 1.63, 95% CI = 1.29-2.05, p < 0.001), and D-dimer levels (OR = 1.56, 95% CI = 1.15-2.12, p = 0.005) were independent risk factors for CCE. Spearman correlation analysis showed that NLR and the CHA2DS2-VASc score had a significant positive correlation (R = 0.449, p < 0.001). The area under the receiver operating characteristic (ROC) curve (AUC) for NLR and the CHA2DS2-VASc score were 0.869 (95% CI = 0.843-0.901) and 0.859 (95% CI = 0.820-0.898), respectively. A composite index for distinguishing CCE risk was constructed using LASSO regression analysis, which yielded an AUC value of 0.924 (95% CI = 0.898-0.950).</p><p><strong>Conclusion: </strong>NLR is an independent risk factor for CCE in NVAF patients, and combining it with CHA2DS2-VASC score provides a more useful composite index for identifying the CCE risk of patients with NVAF. This composite score may serve as a promised tool in clinical workflows, and it could even contribute to individualized anticoagulation strategies by identifying high-risk patients who may benefit from more positive preventive methods.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"3489-3499"},"PeriodicalIF":2.1,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540089","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 Between High Jugular Bulb and Sudden Sensorineural Hearing Loss: A Computed Tomography Based Study.","authors":"Yang Wanting, Muhammad Rafiq, Juan Wu, Long Jin, Gang Liu, Chunsong Cheng","doi":"10.2147/IJGM.S528446","DOIUrl":"10.2147/IJGM.S528446","url":null,"abstract":"<p><strong>Objective: </strong>To explore the correlation between high jugular bulb (HJB) and sudden sensorineural hearing loss (SSNHL) by collecting and analyzing data from patients diagnosed with sudden sensorineural hearing loss (SSNHL) accompanied by HJB.</p><p><strong>Methods: </strong>A total of 62 patients with acute deafness admitted to the Otolaryngology ward of the First Affiliated Hospital of Anhui University of Chinese Medicine from October 2023 to June 2024 were included. Criteria were based on HJB reaching or exceeding the cochlear base. Patients were divided into two groups based on the presence of HJB. Both groups underwent thin-slice CT, pure tone threshold testing, and a tinnitus questionnaire. Age, sex, affected side, jugular bulb height, tinnitus handicap inventory (THI) score, and pure tone average (PTA) before and after treatment were recorded. The impact of these parameters on hearing loss and prognosis was analyzed, focusing on whether the elevation degree of the jugular bulb affected outcomes in sudden sensorineural hearing loss (SSNHL).</p><p><strong>Results: </strong>Before treatment, no statistically significant difference in average hearing threshold was found between the two groups (P>0.05). After treatment, both groups showed decreased average hearing thresholds (P<0.05), but the non-HJB group had significantly better improvement (P<0.01). Pre-treatment THI scores in the HJB group were significantly higher than in the non-HJB group (P<0.01). Post-treatment THI scores improved in both groups (P<0.05), with the non-HJB group showing significantly better outcomes (P<0.01). The effective treatment rate for patients with mild HJB (64.7%) was higher than those with severe HJB (42.9%), though not statistically significant (P>0.05). In the HJB group, admission and discharge PTA and THI scores were positively correlated with HJB values (P<0.05).</p><p><strong>Conclusion: </strong>Sudden sensorineural hearing loss (SSNHL) patients with high jugular bulb tend to have poorer hearing recovery and worse tinnitus outcomes compared to those without HJB.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"3413-3422"},"PeriodicalIF":2.1,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12209530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540088","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":"Expression Significance and Relationship of Serum miR-542-3p and lncRNA TUG1 in STBI Patients and Their Predictive Value for Prognosis.","authors":"Xiang Zhang, Danli Chen, Changmou Zhu, Xing Zhou, Hengshan Liu, Gaobo Zhu","doi":"10.2147/IJGM.S522223","DOIUrl":"10.2147/IJGM.S522223","url":null,"abstract":"<p><strong>Objective: </strong>Analysis of the Expression Significance and Relationship of Serum MicroRNA-542-3p (miR-542-3p) and Long Non-Coding RNA Taurine Upregulated Gene 1 (lncRNA TUG1) in Patients with Severe Traumatic Brain Injury (STBI) and Their Predictive Value for Prognosis.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 193 TBI patients, including 95 STBI (Group A) and 98 non-STBI (Group B) cases. Serum miR-542-3p and lncRNA TUG1 levels were measured upon admission. STBI patients were followed for 6 months and divided into good or poor prognosis groups. Logistic regression, correlation analyses, and ROC curves were used to assess prognostic factors and diagnostic performance.</p><p><strong>Results: </strong>Compared to Group B, Group A patients had significantly lower serum miR-542-3p levels and higher lncRNA TUG1 levels (P < 0.05). A negative correlation was observed between miR-542-3p and lncRNA TUG1 (r = -0.607, P < 0.001). Among STBI patients, 33 (34.74%) had poor prognosis. Brain herniation, brainstem injury, hypoalbuminemia, and high lncRNA TUG1 were identified as independent risk factors, while high miR-542-3p was a protective factor (P < 0.05). Additionally, miR-542-3p levels were negatively correlated with poor prognosis (r = -0.643), while lncRNA TUG1 showed a positive correlation (r = 0.621). ROC analysis showed AUCs of 0.846 for miR-542-3p, 0.823 for lncRNA TUG1, and 0.925 for their combination, indicating improved predictive accuracy with combined detection.</p><p><strong>Conclusion: </strong>miR-542-3p is downregulated and lncRNA TUG1 upregulated in STBI. Both are significantly correlated with prognosis and offer strong predictive value, especially when combined.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"3441-3450"},"PeriodicalIF":2.1,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144527832","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":"Clinical Profiles and Outcomes of rK39-Confirmed Paediatric Visceral Leishmaniasis at a General Hospital in Massawa, Eritrea: A Retrospective Study.","authors":"Nahom Asmerom Yohannes, Sirak Afewerki Teweldemedhin, Luam Ghebreab, Robel Ghirmay Ghebreigziabher, Samuel Tekle Mengistu","doi":"10.2147/IJGM.S512429","DOIUrl":"10.2147/IJGM.S512429","url":null,"abstract":"<p><strong>Background: </strong>Although timely diagnostic and treatment modalities exist worldwide for the disease Visceral leishmaniasis (VL), still a sporadic outbreak cases are reported especially in the high burden of Sub-Saharan countries.</p><p><strong>Purpose: </strong>The purpose is to identify the characteristics, distribution of the clinical parameters and treatment outcomes of VL among affected children younger than five years old.</p><p><strong>Patients and methods: </strong>A retrospective cohort study design was used by involving all patients admitted with the rk-39 serology diagnosed patients in the VL treatment center from 15th December 2021 until 7th February 2023 in Massawa. It evaluated a patients' hospital stay, progressive changes and finally assessing treatment outcome as favorable and unfavorable.</p><p><strong>Results: </strong>Our study found 97 rk-39 confirmed VL cases. Out of these, most cases were males 53.6%, median age with IQR of 32 (15-66) months, and most were from Ghelalo (62%) and Foro (35.1%) of the Northern Red Sea region of Eritrea. The mortality rate was 14.4% which is 14 out of 97 cases. The younger cases were found to have higher mortality rate. Children who recovered or those with favorable outcome were found to have better baseline hematologic parameters, without concomitant infection and few blood products given. Pre and post treatment anthropometric and hematologic comparisons showed a significant positive shift with p < 0.001 paired sample <i>T</i>-test. Finally, a time-to-event analysis revealed a 1729 days of follow-up period with overall mortality of 6.3 per 1000 child-days.</p><p><strong>Conclusion: </strong>Along with the implementation of updated diagnostic and treatment guidelines, our study discovered the need for region-specific approach of the disease, a holistic treatment approach including their nutritional status and focusing on specific socio-demographic factors, which strongly affect the outcome of the patients.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"3451-3462"},"PeriodicalIF":2.1,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144527831","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":"Nucleotide-Bound Oligomeric Domain-Like Receptor Protein 3 as a Serological Biomarker in Relation to Disease Severity and Delirium After Acute Pancreatitis: A Two-Center Prospective Cohort Study.","authors":"Zihao Tang, Xinwen Zhou, Yujun Rao, Jianye Wu","doi":"10.2147/IJGM.S534284","DOIUrl":"10.2147/IJGM.S534284","url":null,"abstract":"<p><strong>Objective: </strong>Acute pancreatitis (AP) is a very common infectious diseases, with delirium as a conventional complication. Nucleotide-binding oligomeric structural domain-like receptor protein 3 (NLRP3) is involved in inflammatory response after AP. We set out to determine whether serum NLRP3 levels are related to severity and delirium in patients with AP.</p><p><strong>Methods: </strong>In this two-center prospective cohort study, a total of 311 patients with AP were divided to study group and validation group according to the ratio of 2:1, and serum NLRP3 levels were measured in all patients and healthy controls. To assess disease severity, Acute Physiology and Chronic Health Evaluation II (APACHE II), Ranson and Sequential Organ Failure Assessment (SOFA) scores were recorded. Delirium was observed as an outcome variable. Multifactorial analysis was performed to discern severity correlations and outcome correlations. Prediction model containing independent predictors of delirium was constructed in study group and validated in validation group.</p><p><strong>Results: </strong>Serum NLRP3 levels were significantly higher in patients with AP than in controls, and were independently associated with three traditional indicators of AP severity, that is APACHE II scores, Ranson scores, and SOFA scores. When compared with the preceding traditional predictors, serum NLRP3 levels had comparable predictive ability for post-AP delirium. The four predictors were incorporated to create the predictive model of nomogram presentation. The model displayed significantly higher predictive capability than their use alone. In addition, the model was similarly effective for delirium prediction in validation group.</p><p><strong>Conclusion: </strong>Elevated serum NLRP3 levels after AP, in firm correlation with AP severity, independently predict in-hospital delirium, solidifying serum NLRP3 as a candidate for severity assessment and delirium anticipation after AP.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"3423-3440"},"PeriodicalIF":2.1,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144527836","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":"Programmed Death Ligand 1 Modulation by Bacillus Calmette-Guérin and Toll-Like Receptor Agonists in Distinct Breast Cancer Cell Subtypes.","authors":"Gabriela Barbosa, Maria Carolina Ximenes De Godoy, Caroline Cavalli Bighetto, Emily Macedo Skakum, Lívia Bitencourt Pascoal, Alessandra Gambero, Leonardo O Reis","doi":"10.2147/IJGM.S531858","DOIUrl":"10.2147/IJGM.S531858","url":null,"abstract":"<p><strong>Background: </strong>Programmed death-ligand 1 (PD-L1) is a key immune checkpoint molecule involved in tumor immune evasion. Its expression is highly heterogeneous across cancer types and subtypes, influencing therapeutic response. Understanding how different immunomodulatory agents influence PD-L1 expression in breast cancer cells could inform novel therapeutic strategies. This study aimed to investigate the temporal and dose-dependent effects of Bacillus Calmette-Guérin (BCG) and Toll-like receptor (TLR) agonists on PD-L1 expression in two breast cancer cell lines: MCF7 (luminal) and MDA-MB-231 (triple-negative).</p><p><strong>Methods: </strong>MTT (thiazolyl blue tetrazolium bromide) assays were conducted to determine non-cytotoxic concentrations of the immunomodulatory agents: 25 µM IMQ (imiquimod), 10 µg PPG (peptidoglycan), 1 mg LPS (lipopolysaccharide), and two BCG doses (200 µg/mL and 800 µg/mL). Flow cytometry assessed anti-PD-L1 (CD274) antibody expression at 24- and 48 hours post-treatment.</p><p><strong>Results: </strong>In MCF7 cells, BCG induced a dose-dependent upregulation of PD-L1 at 24 hours, which was not sustained at 48 hours, while TLR agonists had minimal or slightly suppressive effects. In contrast, MDA-MB-231 cells exhibited a time-dependent modulation of PD-L1, with an increase at 24 hours followed by a reduction at 48 hours in response to BCG, while TLR agonists consistently decreased PD-L1 levels compared to controls.</p><p><strong>Conclusion: </strong>These findings suggest distinct immunomodulatory responses between cancer subtypes, emphasizing the need for tailored approaches targeting the PD-1/PD-L1 axis. Further studies should explore the molecular mechanisms underlying these differential effects and assess the potential for combinatorial immunotherapeutic strategies in cancer.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"3401-3411"},"PeriodicalIF":2.1,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12206907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144527920","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}