Journal of Clinical Medicine最新文献

{"title":"Association of \"Ippatsu-Gei,\" a Brief Psychosocial Interaction, with Spontaneous Activity and Adverse Events in Home-Visit Dysphagia Rehabilitation: A Retrospective Cohort Study.","authors":"Chizuko Kameda, Kohei Yamaguchi, Miki Ishii, Ryosuke Yanagida, Kazuharu Nakagawa, Kanako Yoshimi, Haruka Tohara","doi":"10.3390/jcm15197745","DOIUrl":"10.3390/jcm15197745","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Direct and indirect training are well established in dysphagia rehabilitation, but the role of brief psychosocial interactions in home-based care remains unclear. This retrospective cohort study examined whether provider-based exposure to \"Ippatsu-gei\" was associated with spontaneous activity and adverse events during home-visit dysphagia rehabilitation. <b>Methods</b>: Clinical records were reviewed for patients who received at least one session between January and June 2019. Exposure was defined as care from dentists who routinely incorporated Ippatsu-gei into patient communication. Spontaneous-activity analysis required complete 180-day follow-up (<i>N</i> = 148); adverse-event analysis included patients with complete follow-up or a predefined event within 180 days (<i>N</i> = 150). <b>Results</b>: Spontaneous activity was documented in 18 of 148 patients (12.2%). Ippatsu-gei exposure was associated with higher odds of spontaneous activity (adjusted odds ratio 5.42; 95% confidence interval 1.62-18.18; <i>p</i> = 0.006), although the estimate remained imprecise. Adverse events occurred in 31 of 150 patients (20.7%) and were not significantly associated with Ippatsu-gei exposure (adjusted odds ratio 0.53; 95% confidence interval 0.20-1.39; <i>p</i> = 0.195). <b>Conclusions</b>: Provider-based Ippatsu-gei exposure was associated with retrospectively documented spontaneous activity, but causal interpretation is limited by temporal uncertainty, provider-related effects, and residual confounding. No statistically significant association with adverse events was observed.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"15 19","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13665812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149193868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ocular Hypertension and Glaucoma in Graves' Orbitopathy: A Single-Center Retrospective Cross-Sectional Study.","authors":"Alexandra Magdalena Ioana, Cătălin Prodan-Bărbulescu, Alina Maria Şişu, Sorin Lucian Bolintineanu","doi":"10.3390/jcm15197741","DOIUrl":"10.3390/jcm15197741","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Elevated intraocular pressure (IOP) in Graves' orbitopathy (GO) is a recognized risk factor for glaucomatous optic neuropathy, but the extent to which it translates into measurable structural and functional damage remains unclear. This study investigated structural and functional correlations in patients with GO stratified by IOP and glaucoma status. <b>Methods:</b> In this retrospective, cross-sectional study, 165 adult patients with GO were stratified into three groups of 55 each: normal IOP, ocular hypertension, and clinically diagnosed glaucoma. All patients underwent clinical examination, optical coherence tomography (OCT), and, where available, standard automated perimetry. Structural and functional parameters were compared across all three groups, with post-hoc pairwise testing. Multivariable logistic regression (clinical and combined models, adjusted for smoking and diabetes mellitus, restricted to the ocular hypertension and glaucoma groups) was used to identify factors independently associated with glaucoma status, with model discrimination assessed by optimism-corrected receiver operating characteristic (ROC) curve analysis. <b>Results:</b> IOP increased and best-corrected visual acuity (BCVA) declined progressively across groups. Most structural and functional parameters differentiated the glaucoma group from both other groups but did not distinguish normal IOP from ocular hypertension. In multivariable analysis restricted to the ocular hypertension and glaucoma groups, IOP was the factor most strongly associated with glaucoma status (odds ratio [OR] 1.44 in the clinical model and 1.61 after adjustment for structural parameters, both <i>p</i> ≤ 0.003), with BCVA also independently associated in the clinical model (<i>p</i> = 0.032). Diabetes mellitus and smoking were independently associated with glaucoma status in both models; the inverse association observed for smoking lacks an established biological explanation. Adding ganglion cell layer plus inner plexiform layer (GCL+IPL) thickness improved model discrimination (optimism-corrected area under the curve from 0.73 to 0.76) and was independently associated with glaucoma (OR 0.90, <i>p</i> = 0.036). <b>Conclusions:</b> IOP remains the factor most consistently and independently associated with glaucoma status in GO, with GCL+IPL thickness providing an additional independent contribution once smoking and diabetes mellitus are accounted for. These findings support regular IOP and visual acuity monitoring as first-line surveillance in GO, with structural OCT as a useful adjunct.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"15 19","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13666383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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 Postoperative Day 7 Hypoalbuminemia and Mortality After Surgery: A Single-Center Retrospective Landmark Cohort Study.","authors":"Tatsuro Yokoyama, Koshiro Kikkawa, Daiki Sakaguchi, Hiroha Shibata, Ryohei Ito","doi":"10.3390/jcm15197742","DOIUrl":"10.3390/jcm15197742","url":null,"abstract":"<p><p><b>Background/Objectives</b>: We evaluated postoperative day 7 serum albumin for its association with mortality after surgery and whether it varied by frailty or surgical urgency. <b>Methods</b>: This single-center landmark cohort study was conducted at an 817-bed tertiary hospital (April 2018-March 2025). Follow-up began on day 7 to reduce immortal-time bias. Of 41,506 surgical episodes, 18,296 met the landmark and 14,992 (82%) had day 7 albumin measured. Hypoalbuminemia was <3.0 g/dL. We assessed 365-day mortality by landmark Cox regression. We compared discrimination with the preoperative Surgical Outcome Risk Tool (SORT) and American Society of Anesthesiologists (ASA) physical status, added day 7 albumin to each, and tested effect modification by frailty and urgency. <b>Results</b>: Adding day 7 albumin improved discrimination of post-landmark in-hospital mortality (area under the curve 0.638 to 0.769). When added to SORT, discrimination rose from 0.662 to 0.803, and when added to ASA physical status, from 0.700 to 0.837. Temporal internal validation yielded similar AUCs (33 deaths). Day 7 hypoalbuminemia was associated with higher 365-day mortality (adjusted hazard ratio 3.43; 95% CI, 2.95-3.98), attenuating to 1.89 (95% CI, 1.60-2.23) after adjustment for preoperative albumin. No clear interaction with frailty emerged; an exploratory inverse interaction with emergency surgery was observed (odds ratio, 0.30; 95% CI, 0.13-0.68). <b>Conclusions</b>: Day 7 hypoalbuminemia, possibly reflecting the overall postoperative course, was associated with short- and long-term mortality and improved discrimination beyond routine and preoperative models. Effect modification was limited and exploratory. These hypothesis-generating findings require external validation and prospective assessment of clinical utility.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"15 19","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13665809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149193808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-Treatment Response and Safety of Stem Cell-Based Urethral Injection Therapy for Female Stress Urinary Incontinence: A Systematic Review and Meta-Analysis.","authors":"Shadha Nasser Mohammed Bahutair, Sana Fathima, Ketaki Devendra Tayade, Areebah Akhter, Rajani Dube, Mohamedanas Mohamedfaruk Patni, Rasha Aziz Attia Salama","doi":"10.3390/jcm15197737","DOIUrl":"10.3390/jcm15197737","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Background/Objectives&lt;/b&gt;: Cell-based therapies have been proposed as a regenerative treatment for female stress urinary incontinence (SUI), but their efficacy, safety, and optimal delivery characteristics remain uncertain. The aim of this review is to systematically evaluate the post-treatment clinical response and safety of cell-based injection therapies for female SUI and explore factors associated with post-treatment response. &lt;b&gt;Methods&lt;/b&gt;: PubMed, Scopus, and the Cochrane Library were searched from inception to 15 February 2026, and the search was subsequently updated through 25 April 2026 to identify newly published studies. Randomized controlled trials and prospective single-arm studies evaluating urethral injection of cell-based therapies in adult women with SUI were included. Random-effects meta-analysis was used to pool study-defined post-treatment response proportions. Subgroup analyses examined response definition, cell source, urinary incontinence type, ultrasound guidance, injection approach, and post-treatment physiotherapy. Continuous moderators were explored using univariable meta-regression. Placebo-controlled randomized trials reporting a common 12-month response endpoint were additionally pooled using risk ratios (RR). &lt;b&gt;Results&lt;/b&gt;: Twenty-one studies involving 885 women were included. Seventeen studies contributed to the pooled post-treatment response analysis. The overall response proportion was 63.7% (95% confidence interval [CI] 56.7-70.5%), with moderate-to-substantial heterogeneity (I&lt;sup&gt;2&lt;/sup&gt; = 62.6%). Exploratory subgroup analyses showed higher post-treatment response in ultrasound-guided cohorts than non-ultrasound-guided cohorts (78% vs. 57%; &lt;i&gt;p&lt;/i&gt; &lt; 0.001), in cohorts restricted to pure SUI compared with those including mixed urinary incontinence (76% vs. 55%; &lt;i&gt;p&lt;/i&gt; &lt; 0.001), and in cohorts incorporating post-treatment physiotherapy compared with those without physiotherapy (78% vs. 58%; &lt;i&gt;p&lt;/i&gt; &lt; 0.001). Two placebo-controlled randomized trials reporting ≥ 50% reduction in stress incontinence episode frequency at 12 months were included in an exploratory comparative meta-analysis. The analysis showed no significant difference between cell therapy and placebo (RR 1.02, 95% CI 0.85-1.23; &lt;i&gt;p&lt;/i&gt; = 0.85). Reported adverse events were predominantly minor and transient, commonly comprising irritative urinary symptoms, urinary tract infection, and biopsy- or injection-site complications. Serious treatment-related adverse events were rare, and no treatment-related deaths were reported. &lt;b&gt;Conclusions&lt;/b&gt;: Stem cell-based injection therapy for female SUI is associated with encouraging post-treatment response rates and a generally favorable short- to medium-term safety profile. However, this estimate cannot be interpreted as treatment-specific efficacy. The available placebo-controlled randomized evidence did not demonstrate a higher 12-month response with cell therapy than placebo. Cell-based therap","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"15 19","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13665857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149193694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Tomala, M.; Kłaczyński, M. Quantum Cardiovascular Medicine: From Hype to Hope-A Critical Review of Real-World Applications. <i>J. Clin. Med.</i> 2025, <i>14</i>, 6029.","authors":"Marek Tomala, Maciej Kłaczyński","doi":"10.3390/jcm15197730","DOIUrl":"10.3390/jcm15197730","url":null,"abstract":"<p><p>In the original publication [...].</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"15 19","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13665920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contemporary Clinical Spectrum and Factors Associated with Mortality in Infective Endocarditis: A Multicenter Cohort Study (COSMO-IE).","authors":"Mehmet Kış, Oktay Şenöz, Duygu İnan, Onur Akhan, Esra Canbolat Ünlü, Özlem Güler, Tuba Tatlı Kış, Şemsi Nur Karabela, Duygu Çerçioğlu Özdemir, Süleyman Çağan Efe, Pınar Şen, Hatice Özdamar, Derya Seyman, Ayşe Batırel, Utku Zeybey, Çisem Oktay, Pelin Geyik Pekin, Selin Özdemir, Adem Köse, Kemalettin Özden, Oğuz Karabay, Şafak Kaya Kavak, Ali Mert, Sena Kaçan, Tuncay Güzel, Selda Aydın, Uğur Kostakoğlu, Seyit Ali Büyüktuna, Mesut Gitmez, Esma Kepenek Kurt, Fatma Zühre Alparslan Tanyeri, Veysi Can, Lütfü Bekar, Mehmet Çelik, Nazan Tuna, Şükran Köse, Mehmet Birhan Yılmaz","doi":"10.3390/jcm15197760","DOIUrl":"10.3390/jcm15197760","url":null,"abstract":"<p><p><b>Background</b>: Despite continuous advancements in diagnostic imaging and targeted antimicrobial protocols for infective endocarditis (IE), global epidemiological data show that both disease burden and incidence continue to rise. This study aimed to evaluate real-world diagnostic and treatment approaches in accordance with the 2023 European Society of Cardiology (ESC) IE Guidelines and to identify independent predictors of mortality in a contemporary patient cohort. <b>Methods</b>: This multicenter, retrospective cohort study analyzed data from 470 consecutive adult patients diagnosed with IE across 27 academic reference centers between 1 September 2023 and 1 June 2025. Patients were managed and adjudicated according to the 2023 ESC diagnostic criteria. Demographic data, clinical characteristics, microbiological profiles, imaging findings, empirical antibiotic therapy patterns, and clinical outcomes were analyzed. Independent predictors of mortality were determined using multivariable Cox proportional hazards regression models. <b>Results</b>: The mean age of the overall study population was 58.08 ± 16.81 years, with a male predominance (60.6%, <i>n</i> = 285). <i>Staphylococcus aureus</i> was the most frequently isolated pathogen (27.9%), with a high proportion of methicillin resistance (38.9%). Hospital-acquired IE was identified in 41.1% of cases. Surgical treatment was performed in 40.6% (<i>n</i> = 191) of the cohort. The 28-day mortality rate was 11.9%, and the overall mortality during follow-up reached 26.4%. Multivariable Cox regression analysis identified hospital-acquired IE (HR = 2.247; 95% CI: 1.216-4.167; <i>p</i> = 0.010) and the presence of major clinical complications (HR = 4.207; 95% CI: 1.556-11.378; <i>p</i> = 0.005) as the strongest independent predictors of mortality. <b>Conclusions</b>: Contemporary infective endocarditis is a highly complex and fatal disease characterized by a prominent healthcare-associated burden and a predominant staphylococcal etiology. The occurrence of major clinical complications and hospital-acquired infections were the primary independent predictors of mortality.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"15 19","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13666091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes of Endoscopic Treatment for Asymptomatic and Symptomatic Common Bile Duct Stones: Incidence and Risk Factors for Post-ERCP Pancreatitis.","authors":"Jun-Ichi Hanatani, Koh Kitagawa, Shohei Asada, Ayana Sueki, Kazuki Watanabe, Yuki Motokawa, Yui Osaki, Tomihiro Iwata, Akihiko Shibamoto, Satoshi Iwai, Yuki Tsuji, Yukihisa Fujinaga, Norihisa Nishimura, Kosuke Kaji, Shinya Sato, Tadashi Namisaki, Akira Mitoro, Hitoshi Yoshiji","doi":"10.3390/jcm15197755","DOIUrl":"10.3390/jcm15197755","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Endoscopic retrograde cholangiopancreatography (ERCP) is the standard treatment for common bile duct stones (CBDSs). Current clinical guidelines recommend ERCP irrespective of symptom status. However, accumulating evidence suggests that patients with asymptomatic CBDSs are at an increased risk of post-ERCP pancreatitis (PEP). This study aimed to compare the incidence of PEP between patients with symptomatic and asymptomatic CBDSs and to identify independent risk factors for PEP. <b>Methods</b>: A total of 660 patients with a native papilla who underwent ERCP for CBDSs were retrospectively analyzed. Patients were stratified into symptomatic (<i>n</i> = 468) and asymptomatic (<i>n</i> = 192) groups. The incidence of PEP and its associated risk factors were compared between groups. <b>Results</b>: The incidence of PEP was significantly higher in the asymptomatic than symptomatic group (9.4% vs. 4.5%; <i>p</i> = 0.03). This difference was driven primarily by an increased incidence of mild PEP (6.2% vs. 2.4%; <i>p</i> = 0.02), whereas the rates of moderate and severe PEP were comparable. Pancreatic guidewire-assisted biliary cannulation was more frequent in the asymptomatic group (17.7% vs. 10.3%; <i>p</i> = 0.01) and emerged as an independent predictor of PEP. The asymptomatic group also achieved a significantly higher complete stone removal rate than the symptomatic group (99.0% vs. 95.3%; <i>p</i> = 0.02). <b>Conclusions</b>: ERCP for asymptomatic CBDSs was associated with a higher risk of PEP, primarily mild cases, but yielded favorable stone-related treatment outcomes. Therefore, ERCP is an acceptable treatment for asymptomatic CBDSs when the potential benefits and risks are thoroughly discussed with the patient beforehand.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"15 19","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13666200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isolated Robotic Mitral Valve Replacement Across Body Mass Index Categories: Early Perioperative Outcomes.","authors":"Zinar Apaydın, Barış Timur, Batuhan Yazıcı, Mustafa Can Kaplan, Salih Güler, İsa Can, Tural Muradlı, Safa Göde, Ersin Kadiroğulları","doi":"10.3390/jcm15197756","DOIUrl":"10.3390/jcm15197756","url":null,"abstract":"<p><p><b>Background</b>: Obesity may pose additional technical and perioperative challenges in robotic mitral valve surgery. This study evaluated early perioperative outcomes of isolated robotic mitral valve replacement (MVR) across BMI categories. <b>Methods</b>: We retrospectively analyzed 146 patients who underwent isolated robotic MVR at a single center, categorized into BMI categories of <25 kg/m² (n = 60), 25.0-29.9 kg/m² (n = 38), or ≥30 kg/m² (n = 48). Preoperative characteristics, operative variables, and early postoperative outcomes were compared among groups. The study was exploratory. Four clinically selected outcomes, cardiopulmonary bypass time, ventilation duration, hospital length of stay, and postoperative left ventricular ejection fraction, were evaluated using adjusted median quantile regression with bootstrap 95% confidence intervals, and multiplicity across postoperative outcomes was addressed using the Benjamini-Hochberg false discovery rate. <b>Results</b>: Patients with BMI ≥ 30 kg/m² were older and had a higher prevalence of diabetes and higher EuroSCORE II values. Unadjusted comparisons of cardiopulmonary bypass and aortic cross-clamp times, conversion to sternotomy, ventilation duration, intensive care unit and hospital length of stay, drainage volume, and transfusion requirements yielded <i>p</i> values > 0.05. In adjusted analyses of the four selected outcomes, all 95% confidence intervals for the BMI-group estimates included zero. Pneumonia was numerically more frequent in patients with BMI ≥ 30 kg/m² (10.4% vs. 2.6% and 1.7%), but the estimates were imprecise. In-hospital mortality was low, with one death overall. Only eight patients had BMI ≥ 35 kg/m². <b>Conclusions</b>: Among patients considered suitable for robotic MVR, the adjusted estimates showed no statistically detectable association between BMI category and the selected early outcomes. However, the confidence intervals did not establish equivalence, and the findings apply only to selected robotic surgical candidates.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"15 19","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13666070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive Impairment in Asthma: Emerging Evidence, Clinical Consequences, and Future Directions.","authors":"Aminah Mengash, Rayan A Siraj","doi":"10.3390/jcm15197761","DOIUrl":"10.3390/jcm15197761","url":null,"abstract":"<p><p>Asthma is increasingly recognised as a systemic inflammatory disease with effects extending beyond the respiratory system. Emerging evidence suggests that cognitive impairment may represent an under-recognised extrapulmonary manifestation with important implications for disease management and long-term neurological health. This narrative review critically synthesises current evidence regarding the epidemiology, clinical consequences, and potential mechanisms linking asthma with cognitive dysfunction. Observational and longitudinal studies indicate that asthma is associated with an increased risk of cognitive impairment, cognitive decline, and dementia. However, substantial heterogeneity in study design, cognitive assessment, asthma phenotyping, and adjustment for confounding factors limits causal inference. Cognitive deficits predominantly involve attention, executive function, memory, and, less consistently, processing speed, potentially compromising medication adherence, inhaler technique, symptom perception, and self-management. Current evidence supports a multifactorial pathophysiological model in which chronic systemic inflammation, oxidative stress, intermittent hypoxaemia, sleep disturbance, corticosteroid exposure, and psychological comorbidity interact to promote endothelial dysfunction, blood-brain barrier disruption, microglial activation, neuroinflammation, mitochondrial dysfunction, and impaired synaptic plasticity. These mechanisms may be particularly relevant in children with early-onset asthma, older adults, and patients with severe or poorly controlled disease, although direct mechanistic evidence remains limited. Future research should prioritise well-phenotyped longitudinal cohorts that integrate comprehensive cognitive assessment with neuroimaging, inflammatory biomarkers, and objective measures of disease control to establish temporal relationships, identify high-risk populations, and determine whether cognitive dysfunction is a modifiable component of asthma burden. Recognition of cognition as a clinically relevant outcome may ultimately improve risk stratification and support more personalised, holistic approaches to asthma care.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"15 19","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13666528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149193862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Zako et al. Suture or Device? A Real-World Analysis of the Closure Strategies in Patients Undergoing LAA Occlusion. <i>J. Clin. Med.</i> 2025, <i>14</i>, 5245.","authors":"Saif Zako, Kathrin Klein, Asena Öz, Maei Elsobki, Philipp Mourikis, Carolin Helten, David Naguib, Malte Kelm, Tobias Zeus, Amin Polzin","doi":"10.3390/jcm15197740","DOIUrl":"10.3390/jcm15197740","url":null,"abstract":"<p><p><b>Reference Update</b> [...].</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"15 19","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13665836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}