International Journal of General Medicine最新文献

{"title":"Dynamic Characteristics of Lymphocyte Subsets and Their Predictive Value for Disease Progression and Prognosis in Primary Infection and Unvaccinated COVID-19 Patients.","authors":"Xinyi Zhang, Zhu Chen, Jun Zheng, Chen Feng, Bennan Zhao, Lijuan Lan, Dafeng Liu","doi":"10.2147/IJGM.S478912","DOIUrl":"https://doi.org/10.2147/IJGM.S478912","url":null,"abstract":"<p><strong>Aim: </strong>Our cohort study aimed to investigate the dynamic changes of lymphocyte subsets and their abilities to predict disease severity and prognosis in primary infection and unvaccinated COVID-19 patients.</p><p><strong>Methods: </strong>A total of 773 cases, including 718 primary infection and unvaccinated COVID-19 patients and 55 controls. COVID-19 patients were assigned to severe and nonsevere groups according to disease severity, as well as survival and death groups according to prognosis. Serum samples were collected to measure the numbers of total lymphocytes and lymphocyte subsets. The differences among different severity groups were analyzed. Spearman correlation was performed to assess associations between lymphocyte subsets and disease severity and prognosis. Meanwhile, receiver operating characteristic (ROC) curves were also analyzed to find optimal cutoff points.</p><p><strong>Results: </strong>At admission, the severe group demonstrated significantly lower total lymphocyte counts and percentages, CD3⁺ and CD3⁺CD4⁺ T cell counts and percentages, CD3⁺CD8⁺ T cell counts, CD19⁺ B cell counts and CD56⁺ NK cell counts and percentages than the nonsevere group. Meanwhile, compared with the survival group, the death group also had lower total lymphocyte counts and percentages, CD3⁺, CD3⁺CD4⁺ and CD3⁺CD8⁺ T cell counts. Additionally, differences in these parameters were also noticed within four weeks after admission. Furthermore, Spearman analysis reported that disease severity was negatively correlated with lymphocyte counts and percentages, CD3⁺, CD3⁺CD4⁺ and CD3⁺CD8⁺ T cell counts, CD3⁺ and CD3⁺CD4⁺ T cell percentages (<i>r</i>=-0.166, -0.179, -0.173, -0.186, -0.127, -0.117, -0.149, respectively)(all <i>P</i><0.05). The prognosis of death was also negatively correlated with total lymphocyte counts and percentages, CD3⁺, CD3⁺CD4⁺ and CD3⁺CD8⁺ T cell counts (<i>r</i>=-0.125, -0.121, -0.123, -0.123, -0.091, respectively)(all <i>P</i><0.05).</p><p><strong>Conclusion: </strong>In primary infection and unvaccinated COVID-19 patients total lymphocytes and T cell, B cell and NK cell subsets at COVID-19 onset play valuable roles in predicting disease severity and prognosis.</p><p><strong>Clinical trial registry: </strong>Chinese Clinical Trial Register ChiCTR2000034563.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11472736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464719","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":"JAK2 Mutation Assessment in Thrombotic Events at Unusual Anatomical Sites: Insights from a High-Altitude Cohort.","authors":"Husain Yahya Alkhaldy, Ayel Omar Yahya, Abdullah Mohammed Algarni, Omayma S E Bakheet, Mohammed Assiri, Muhammad Saboor","doi":"10.2147/IJGM.S480705","DOIUrl":"https://doi.org/10.2147/IJGM.S480705","url":null,"abstract":"<p><strong>Introduction: </strong>Thrombosis stands as a significant contributor to both morbidity and mortality in individuals afflicted with myeloproliferative neoplasms. This retrospective study investigated the association between JAK2 mutations and venous thrombosis at unusual sites, and in young individuals with ischemic stroke, residing at high altitudes in the Aseer region, Saudi Arabia.</p><p><strong>Patients and methods: </strong>Data were collected from two high-altitude referral hospitals over three years (2020-2022). Records of all JAK2 mutation tests were reviewed. Those requested as part of evaluation of thrombosis events, without known myeloproliferative neoplasms (MPNs) were analysed.</p><p><strong>Results: </strong>Among the 208 JAK2 tests, 40 (19.2%) were linked to thrombotic event evaluations. The cohort, with a median age of 41, included 17 (42.7%) males and 23 females, with 57.5% having completely normal complete blood counts (CBC). Thrombotic events were divided between splanchnic vein thrombosis (36.6%) and cerebral thrombosis (34.1%), while the remaining cases involved unprovoked deep vein thromboses/pulmonary embolisms and portal vein thrombosis. Only 2 (5%) participants tested positive for JAK2 mutations: a 17-year-old male diagnosed concurrently with polycythemia vera after renal vein thrombosis and a 31-year-old woman with hepatic vein thrombosis and a normal CBC.</p><p><strong>Conclusion: </strong>This study reveals that JAK2 mutations are infrequently found in high-altitude patients with unprovoked DVT, PE, or atypical thrombosis. While JAK2 testing is notably relevant for splanchnic vein thrombosis, its routine use for other thrombotic events, particularly with normal CBC results, remains uncertain. Given the study's limitations, further prospective research with larger cohorts is needed to refine guidelines for JAK2 mutation testing in various thrombotic contexts.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11470770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464723","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":"Related Factors of Syphilis Positive Rate in Blood Donors During the COVID-19 Epidemic.","authors":"Song-Xing Wang, Li-Yan Sun, Qiong Yu, Ran Li, Yun-Ping Xu, Jin-Feng Zeng","doi":"10.2147/IJGM.S481519","DOIUrl":"https://doi.org/10.2147/IJGM.S481519","url":null,"abstract":"<p><strong>Background: </strong>In Shenzhen of China, the continuous increase of syphilis infections threatens the safety of blood transfusion. In 2020, COVID-19 was discovered and spread rapidly around the world, and affected the prevalence of syphilis among blood donors.</p><p><strong>Methods: </strong>From 2013 to 2020, there were 839,161 blood samples collected in the Shenzhen Blood Center. Blood samples were screened by ELISA tests and confirmed by the TPPA (<i>Treponema pallidum</i> particle agglutination) tests and the TRUST (toluidine red unheated serum tests). All data was analyzed by the chi-square test.</p><p><strong>Results: </strong>From 2013 to 2020, the positive rate of syphilis among blood donors varied significantly among individuals in different ages, educational backgrounds, regions, and blood donation histories (<i>P</i><0.001). In 2020, It was the first time that there were more repeat blood donors than first-time blood donors and more blood donors with a higher education level than those with a lower education level, and the lowest reactive and positive rate of syphilis among blood donors was observed. Compared to 2019, the prevalence of syphilis among female and repeat blood donors decreased significantly in 2020 (<i>P</i><0.01).</p><p><strong>Conclusion: </strong>The prevalence of syphilis in blood donors is related to the characteristics of blood donors (in addition to gender) and the COVID-19 epidemic. COVID-19 can affect the prevalence of syphilis among blood donors by influencing the composition of blood donors and the number of syphile-positive donors in certain blood donors, including female and repeat blood donors.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11471886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464739","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 Infection with Different Types of <i>Helicobacter pylori</i> on Gastric Secretion Function: A Cross-Sectional Clinical Study.","authors":"Jinglei Wang, Dehong Qiao, Yunzhu Wang, Rui Xiong, Xinyi Ding, Wei Zhang, Tingting Wang, Kai Tang","doi":"10.2147/IJGM.S477480","DOIUrl":"https://doi.org/10.2147/IJGM.S477480","url":null,"abstract":"<p><strong>Purpose: </strong>Helicobacter pylori (Hp)-related gastropathies are accompanied by alterations in gastric secretion function, but the effects of infection of different Hp strains on gastric function are not yet well-elucidated. Our cross-sectional clinical study aim to research the effects of infection with different Hp types on gastric function.</p><p><strong>Patients and methods: </strong>We analyzed 525 patients' serum cytotoxin-associated protein gene A (CagA), vacuolating cytotoxin-associated protein gene A (VacA), urease (Ure), Gastrin-17 (G-17), Pepsinogen I (PGI), Pepsinogen II (PGII) and PGI/PGII ratio (PGR).</p><p><strong>Results: </strong>The PGII levels (8.19 ± 5.44 <i>vs</i> 5.98 ± 10.75, <i>P</i> = 0.013) were higher in the Hp infected group than in the uninfected, while the PGR levels (16.81 ± 8.22 <i>vs</i> 23.23 ± 8.36, <i>P</i> < 0.001) were lower. The PGR levels were higher in the uninfected group (23.23 ± 8.36, <i>P</i> < 0.001) than in Hp-I (16.47 ± 7.45) and Hp-II infected groups (17.39 ± 8.98). In the uninfected group, the G-17 level was positively correlated with the levels of PGI (Pearson coefficient = 0.177, <i>P</i> = 0.001), PGII (Pearson coefficient = 0.140, <i>P</i> = 0.008) and age (Pearson coefficient = 0.121, <i>P</i> = 0.022), negatively with the PGR levels (Pearson coefficient = -0.201, <i>P</i> < 0.001). In the Hp-I (Pearson coefficient = -0.003, <i>P</i> = 0.975) and Hp-II (Pearson coefficient = 0.018, <i>P</i> = 0.161) infected groups, the G-17 levels were not correlated with age.</p><p><strong>Conclusion: </strong>Hp-I with CagA and/or VacA positive and Hp-II without cytotoxicity can reduce gastric secretion function regardless of age and sex. Gastric function in patients with Hp eradication was similar to that in those without Hp infection. G-17 rises physiologically with age, but infection with Hp will affect it.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11471097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464720","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":"Assessing the Knowledge and Awareness of Obstructive Sleep Apnea among Patient Families in Saudi Arabia: A Qualitative Study [Letter].","authors":"Yilin Jiang, Narina A Samah, Heng Zhou","doi":"10.2147/IJGM.S498630","DOIUrl":"https://doi.org/10.2147/IJGM.S498630","url":null,"abstract":"","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11471061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464680","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":"Pcv-aCO₂/Ca-cvO₂ Combined with Optic Nerve Sheath Diameter in Predicting Elevated Intracranial Pressure of Patients with Traumatic Brain Injury in Prehospital Setting.","authors":"Hui Jiang, Zhihui Xie, Liu Yang, Huiting Wang","doi":"10.2147/IJGM.S475225","DOIUrl":"https://doi.org/10.2147/IJGM.S475225","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate a correlation between the central venous minus arterial CO₂ pressure to arterial minus central venous O₂ content ratio (Pcv-aCO₂/Ca-cvO₂) combined with optic nerve sheath diameter (ONSD) in predicting prehospital elevated intracranial pressure (ICP) in traumatic brain injury (TBI) patients.</p><p><strong>Patients and methods: </strong>This was a prospective observational study of all adult TBI patients from the surgical intensive care unit who underwent invasive ICP monitoring between January 2023 and December 2023. Using a Delica MVU-6300 machine with 14-5 MHz linear probe to measure ONSD. We drew blood samples for arterial and central venous blood gases to measure and calculate the following indicators such as Pcv-aCO₂, Ca-cvO₂, and Pcv-aCO₂/Ca-cvO₂ ratio. ONSD and Pcv-aCO₂/Ca-cvO₂ were recorded during the first 3 days after admission. Simultaneous ICP values were gained from the invasive monitoring. Associations between ONSD, Pcv-aCO₂/Ca-cvO₂ and simultaneous ICP were explored by Spearman correlation analysis. We constructed an ROC curve to identify the ONSD and Pcv-aCO₂/Ca-cvO₂ cutoff for the evaluation of elevated ICP.</p><p><strong>Results: </strong>We included 54 patients aged mean 57.13 (standard deviation 4.02) years and 24 (44%) were male. A significant correlation was observed between ONSD and ICP (r = 0.74, P < 0.01). The AUC was 0.861 (95% CI: 0.727-0.951), with a best cutoff value of 5.62 mm. Using a cutoff of 5.62mm, ONSD had a sensitivity of 92.8%, specificity of 80.4%. The Pcv-aCO₂/Ca-cvO₂ ratio also significantly correlated with ICP (r = 0.70, P < 0.01). The AUC was 0.791 (95% CI: 0.673-0.889). The optimal Pcv-aCO₂/Ca-cvO₂ value for predicting elevated ICP was 1.98 mmHg/mL. Using a cutoff of 1.98 mmHg/mL, Pcv-aCO₂/Ca-cvO₂ had a sensitivity of 87.3%, specificity of 77.2%. The AUC for ONSD combined with Pcv-aCO₂/Ca-cvO₂ was 0.952 (95% CI: 0.869-0.971), which had a sensitivity of 95.1%, specificity of 93.9%.</p><p><strong>Conclusion: </strong>Pcv-aCO₂/Ca-cvO₂ combined with ONSD performed best in predicting elevated intracranial pressure of patients with TBI in a prehospital setting. Our findings provide a crucial tool to improve earlier management of these patients in prehospital care, where the availability and utilization of invasive monitoring is limited. It could lead to significant changes in how TBI patients are monitored and treated before reaching a hospital.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11468361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464738","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":"Dissecting the Clinical Characteristics and Treatment Outcomes Correlates of <i>KRAS G12C</i>-Mutated Non-Small Cell Lung Cancer.","authors":"Yawan Jing, Ruixin Cheng, Hao Zeng, Qin Huang, Dongyu He, Jiayi Sun, Panwen Tian, Yalun Li","doi":"10.2147/IJGM.S484435","DOIUrl":"10.2147/IJGM.S484435","url":null,"abstract":"<p><strong>Background: </strong><i>KRAS</i> mutation is one of the most common driver oncogenes in non-small cell lung cancer (NSCLC), and the most common mutation subtype is <i>G12C</i>. However, there is still a lack of efficacy and prognosis data related to immunotherapy, which hinders the promotion of new strategies.</p><p><strong>Methods: </strong>Clinical characteristics and treatment outcomes were collected and analyzed for patients with NSCLC harboring <i>KRAS</i> mutations at West China Hospital of Sichuan University from June 2013 to March 2023.</p><p><strong>Results: </strong>Among the 231 patients with <i>KRAS</i>-mutated NSCLC, 29.4% had <i>KRAS G12C</i> mutations. Compared to the <i>KRAS non-G12C</i> NSCLC group, the <i>KRAS G12C</i> NSCLC group had a greater number of pack-years. The programmed death ligand 1 expression and the proportion of patients with a high tumor mutational burden were not significantly different between the two groups. Similar patterns of <i>TP53, STK11</i>, and <i>CDKN2A</i> mutations were observed between <i>KRAS G12C</i> and <i>KRAS non-G12C</i> NSCLC groups. The median progression-free survival (PFS) (8.4 vs 7.0 months, p=0.100) and overall survival (OS) (12.1 vs 18.1 months, p=0.590) were not statistically different between <i>KRAS G12C</i> and <i>KRAS non-G12C</i>. Compared to patients with <i>KRAS G12C</i> NSCLC who did not receive immunotherapy, patients who received immunotherapy had a better objective response rate (46.2% vs 0%, p=0.002), PFS (12.2 vs 7.5 months, p=0.087) and OS (49.9 vs 11.1 months, p=0.12).</p><p><strong>Conclusion: </strong>Patients with <i>KRAS G12C</i> were more likely to be smokers. Advanced <i>KRAS G12C</i> NSCLC patients who received immunotherapy had a better ORR than those who did not, suggesting that patients with <i>G12C</i> mutations are more likely to benefit from immunotherapy.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11461760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390441","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":"Magnitude and Determinants of Latent Tuberculosis Among Inmates of Saudi Correctional Facilities: A Cross-Sectional Study.","authors":"Abdulmajeed Alshowair, Abdullah M Assiri, Abdullah Hussein Balfas, Rakan Alkhattabi, Tilal Abdalla Eltegani, Sara Altowairib, Abdullah Hamed Almalki, Eman Ahmed Alharbi, Suad Alotai, Fahad Alobaid, Najeeb Saud S Altowiher","doi":"10.2147/IJGM.S472710","DOIUrl":"10.2147/IJGM.S472710","url":null,"abstract":"<p><strong>Purpose: </strong>To estimate the prevalence and determinants of latent tuberculosis (LTBI) among inmates of four correctional facilities in Saudi Arabia.</p><p><strong>Methods: </strong>This is a retrospective review of health records. All inmates of four correctional facilities in Saudi Arabia were screened for tuberculosis in 2022. Their LTBI status was defined as more than 10mm Mantoux test result and negative X-ray chest result. The prevalence of LTBI and their determinants like age, gender, country of origin, location of the prison, and human immunodeficiency viruses (HIV) status were studied.</p><p><strong>Results: </strong>We reviewed screening data of 10,042 inmates in four Saudi prisons. The prevalence of LTBI was 7.4%. The risk difference of LTBI was significantly higher in males compared to female inmates (P < 0.001). The highest prevalence of LTBI was noticed among males (7.7%), those older than 60 years old (26.9%), and African expatriates (12.1%). None of the female inmates or those with HIV had LTBI. The binomial regression analysis revealed a highly significant effect of older age on the risk of having LTBI.</p><p><strong>Conclusion: </strong>The prevalence of LTBI was low among inmates at Saudi correctional facilities. The males, old age, and persons from African and Asian countries had a higher risk of LTBI. The prevalence of LTBI among inmates of Saudi prisons could be predicted by knowing their age group.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11456276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380809","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":"Management and Outcomes of Pulmonary Embolism in the Oldest-Old.","authors":"Eishan Beotra, Vincent J J Ngian, Fiona Tran, Kelvin Hsu, Fintan O'Rourke, Bin S Ong","doi":"10.2147/IJGM.S475403","DOIUrl":"10.2147/IJGM.S475403","url":null,"abstract":"<p><strong>Background: </strong>Treatment for pulmonary embolism has expanded to include Direct Oral Anticoagulants (DOACs). The incidence of pulmonary-embolism (PE) in \"oldest-old\" age group (≥85 years) is rapidly increasing, but there is limited research on its management and clinical outcomes.</p><p><strong>Aim: </strong>To examine the differences in management and outcomes in those aged ≥85 years compared to other age groups.</p><p><strong>Methods: </strong>We performed a retrospective cohort-study of 373 consecutive patients with pulmonary embolism confirmed on imaging by Computed Tomography Pulmonary Angiogram (CTPA) or Ventilation Perfusion (VQ) Scan at a principal referral hospital in Sydney, Australia. Data collected include clinical and demographic data, Charlson comorbidity index, treatment type and outcomes including complications, recurrent venous thromboembolism, and mortality.</p><p><strong>Results: </strong>Across the age groups, DOACS were prescribed to 53.4% (n=199) of patients. In oldest-old patients with PE, LMWH bridging to warfarin was the most frequently prescribed treatment, used in 46.2% (n=18, 95% CI: 30.8%-61.5%, p=0.003) of these patients. The mortality rate for patients on LMWH was 13.9% (n=5, 95% CI: 4.2%-37.5%, p=0.553). Overall, major bleeding incidents were rare, occurring in just 1.7% (n=4, 95% CI: 0.4%-3.3%) of patients, with no significant differences in outcomes across age groups.</p><p><strong>Conclusion: </strong>DOACs are increasingly used as the treatment modality of choice in atrial fibrillation but are less well studied in pulmonary embolism, particularly in oldest-old patients. We found that the safety and efficacy profile of DOACs in pulmonary embolism treatment is similar across the age groups. Our study does not support any change in treatment protocols of PE in the oldest old, but further studies are required to confirm our findings.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11456274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380810","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":"Automatic Echocardiographic Assessment of Left Atrial Function for Prediction of Low-Voltage Areas in Non-Valvular Atrial Fibrillation.","authors":"Shuai Chang, Xiaofeng Zhang, Chenliang Ge, Yanfen Zhong, Decai Zeng, Yongzhi Cai, Tongtong Huang, Ji Wu","doi":"10.2147/IJGM.S477499","DOIUrl":"10.2147/IJGM.S477499","url":null,"abstract":"<p><strong>Purpose: </strong>Left atrial low-voltage areas (LA-LVAs) identified by 3D-electroanatomical mapping are crucial for determining treatment strategies and prognosis in patients with atrial fibrillation (AF). However, convenient and accurate prediction of LA-LVAs remains challenging. This study aimed to assess the viability of utilizing automatically obtained echocardiographic parameters to predict the presence of LA-LVAs in patients with non-valvular atrial fibrillation (NVAF).</p><p><strong>Patients and methods: </strong>This retrospective study included 190 NVAF patients who underwent initial catheter ablation. Before ablation, echocardiographic data were obtained, left atrial volume and strain were automatically calculated using advanced software (Dynamic-HeartModel and AutoStrain). Electroanatomic mapping (EAM) was also performed. Results were compared between patients with LA-LVAs ≥5% (LVAs group) and <5% (non-LVAs group).</p><p><strong>Results: </strong>LA-LVAs were observed in 81 patients (42.6%), with a significantly higher incidence in those with persistent AF than paroxysmal AF (55.6% vs 19.3%, <i>P <</i>0.001). Compared with the non-LVAs group, the LVAs group included significantly older patients, lower left ventricular ejection fraction, higher heart rate, and higher E/e' ratio (<i>P</i> <0.05). The LVAs group exhibited higher left atrial volume_max index (LAVi_max) and lower left atrial reservoir strain (LASr) (<i>P</i> <0.001). In multivariate analysis, both LAVi_max and LASr emerged as independent indicators of LVAs (OR 0.85; 95% CI 0.80-0.90, <i>P</i><0.001) and (OR 1.15, 95% CI 1.02-1.29, <i>P</i> =0.021). ROC analysis demonstrated good predictive capacity for LA-LVAs, with an AUC of 0.733 (95% CI 0.650-0.794, <i>P</i> <0.001) for LAVi_max and 0.839 (95% CI 0.779-0.898, <i>P</i> <0.001) for LASr.</p><p><strong>Conclusion: </strong>Automatic assessment of LAVi_max and LASr presents a promising non-invasive modality for predicting the presence of LA-LVAs and evaluating significant atrial remodeling in NVAF patients. This approach holds potential for aiding in risk stratification and treatment decision-making, ultimately improving clinical outcomes in patients.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11456279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380806","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}