Journal of International Medical Research最新文献

{"title":"Gut microbial profiles of patients with optic neuritis or myasthenia gravis.","authors":"Tao Wu, Hanqiu Jiang, Chen Lin, Jingting Peng, Xiuyun Kong, Jie Yu, Jiawei Wang, Shilei Cui","doi":"10.1177/03000605251314817","DOIUrl":"10.1177/03000605251314817","url":null,"abstract":"<p><strong>Objective: </strong>To characterize the gut microbial composition of patients with optic neuritis (ON) or myasthenia gravis (MG).</p><p><strong>Methods: </strong>Stool samples were collected from 45 patients with ON, 13 patients with MG, and 20 healthy controls. Microbial genomic DNA was extracted, and the V3-V4 regions of bacterial 16S rRNA genes were amplified and sequenced. Bioinformatic analyses was performed to compare the alpha-diversity, beta-diversity, taxonomic assignments, and bacterial richness of the groups. Differences in the abundances of microbial taxa were identified using linear discriminant analysis effect size (LEfSe) and analysis of variance.</p><p><strong>Results: </strong>Beta-diversity analysis showed distinct clustering of patient samples from the healthy controls. At the phylum and genus levels, <i>Actinobacteria</i>, <i>Bacteroidetes</i>, <i>Firmicutes</i>, and <i>Proteobacteria</i> predominated, but their proportions varied between groups. LEfSe analysis identified microbial taxa that were associated with each group. The patients showed lower abundances of certain intestinal probiotics, including <i>Bifidobacterium</i>, <i>Bacteroides</i>, and <i>Roseburia</i>, than the controls. No significant differences were found between the disease subgroups. The <i>Carnobacteriaceae</i> family was significantly less abundant in the ON than in the MG group.</p><p><strong>Conclusion: </strong>We have identified significant alterations in the gut microbiota of patients with ON or MG, and importantly, a notable reduction in intestinal probiotics.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 2","pages":"3000605251314817"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11795606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189575","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":"Lowering B-type natriuretic peptide levels and increasing cardiac function: the role of levosimendan in the treatment of heart failure.","authors":"Jianfeng Meng, Ye Zuo","doi":"10.1177/03000605241311434","DOIUrl":"10.1177/03000605241311434","url":null,"abstract":"<p><strong>Objective: </strong>In this study, we examined whether levosimendan could lower B-type natriuretic peptide (BNP) and improve cardiac function in patients with heart failure who have diuretic resistance and low ejection fraction.</p><p><strong>Methods: </strong>We conducted a cohort study among 120 participants from September 2022 to August 2023. We investigated the efficacy of treatment with levosimendan in patients with HF who exhibited diuretic resistance and had a low ejection fraction. All patients received recombinant human neuronal natriuretic peptide (rhBNP) and the treatment group additionally received levosimendan. In addition to the primary endpoints, safety measures were assessed, encompassing the monitoring of blood pressure, heart rate, and serum creatinine levels.</p><p><strong>Results: </strong>Patients in the treatment and control groups were similar in age, sickness duration, weight, and sex ratio. Medication use, New York Heart Association classification, ejection fraction percentage, and other factors were evenly distributed. The treatment group showed increased urine volume and weight loss. Both groups had similar post-treatment systolic blood pressure, heart rate, and serum creatinine levels, indicating good safety.</p><p><strong>Conclusion: </strong>Levosimendan in combination with rhBNP may improve diuretic resistance in patients with HF and low ejection fraction. Further multicenter trials are needed to confirm our findings.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 2","pages":"3000605241311434"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Refractory cardiogenic shock in hypertrophic cardiomyopathy complicated by apical ballooning: A case report.","authors":"Matej Strycek, Rostislav Polasek, Pavol Tomasov, Jiri Karasek","doi":"10.1177/03000605251315345","DOIUrl":"10.1177/03000605251315345","url":null,"abstract":"<p><p>Hypertrophic cardiomyopathy can be accompanied by dynamic obstruction in the left ventricular outflow tract and acute apical ballooning, which are among the very rare causes of cardiogenic shock. This condition requires a specific treatment approach that in many ways differs from the treatment of other causes of cardiogenic shock. We present a case and our treatment strategy (including extracorporeal life support) for refractory cardiogenic shock in a patient with previously undiagnosed hypertrophic cardiomyopathy.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 2","pages":"3000605251315345"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11806472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374182","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":"Vaginal bleeding during pregnancy: a retrospective cohort study assessing maternal and perinatal outcomes.","authors":"Maroun Matar, Georges Yared, Christopher Massaad, Kariman Ghazal","doi":"10.1177/03000605251315349","DOIUrl":"10.1177/03000605251315349","url":null,"abstract":"<p><strong>Objective: </strong>Vaginal bleeding is a relatively common problem during pregnancy, with up to 25% of women experiencing some level of bleeding or spotting during pregnancy. Although not always a concern, pregnancy-related vaginal bleeding may detrimentally impact maternal and fetal health, and can arise at any stage during the pregnancy, usually linked with preterm labor, miscarriage, placental abnormalities, or implantation bleeding. As vaginal bleeding may compromise newborn health outcomes, for example, leading to low birth weight and neonatal intensive care unit (NICU) hospitalizations, it is imperative to understand the etiology of the bleed and effectively manage the patient's condition. Thus, the aim of this study was to evaluate the prognostic value of vaginal bleeding as an indicator for at-risk pregnancies, aiming to elucidate its association with perinatal outcomes and pregnancy complications.</p><p><strong>Methods: </strong>Consecutive pregnant female patients, aged 16-47 years, were included in this retrospective cohort study, and categorized into those with or without pregnancy-associated bleeding. Between-group differences and correlations in pregnancy complications and perinatal outcomes were statistically analyzed.</p><p><strong>Results: </strong>Among a total of 441 patients, the incidence of vaginal bleeding was 74.4%, predominantly occurring in the first trimester (67.1%). No significant association was found between bleeding and maternal age, parity, abortion history, or total number of pregnancies. Educational level varied, with 64.9% of moderate education level experiencing bleeding. Pre-pregnancy comorbidities, such as diabetes, hypertension, and hypothyroidism, were not significantly correlated with bleeding. However, a history of infertility and progesterone treatment during pregnancy was significantly associated with bleeding episodes. An increased risk for NICU admissions and conditions such as respiratory distress in neonates was found, alongside a significant association with post-delivery bleeding and premature labor in the later trimesters.</p><p><strong>Conclusions: </strong>Vaginal bleeding during pregnancy was not found to be significantly associated with maternal age, parity, abortion history, or total pregnancies. Nonetheless, the findings suggest a significant relationship between bleeding episodes and a history of infertility or progesterone treatment during pregnancy. Additionally, pre-pregnancy comorbidities, including diabetes, hypertension, and hypothyroidism were not associated with pregnancy bleeding. However, the latter was associated with increased risk of post-delivery bleeding, premature labor, and neonatal complications, such as respiratory distress and NICU admissions.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 2","pages":"3000605251315349"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11806467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374202","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":"Embolization for haemomediastinum due to spontaneous rupture of oesophageal branch arising from an unusual origin (inferior thyroidal artery) after vomiting: a case report.","authors":"Jin Suk Lee, Eic Ju Lim, Min Jai Cho, Yook Kim","doi":"10.1177/03000605241290716","DOIUrl":"10.1177/03000605241290716","url":null,"abstract":"<p><p>Spontaneous rupture of the oesophageal artery is rarely observed in clinical practice and may lead to a haemomediastinum, which is a potentially life-threatening condition. Among these conditions, a mediastinal haemorrhage from oesophageal branches of the bronchial artery is the most frequently reported. However, rupture of oesophageal branches arising from the inferior thyroid artery (ITA) has never been reported to date. This current case report describes a male patient in his mid-70s who experienced sudden chest pain with haemomediastinum caused by the rupture of oesophageal artery branches after vomiting. This patient was successfully treated with separate transcatheter arterial embolization of the two oesophageal branches arising from the ITA and the bronchial artery using N-butyl-cyanoacrylate. Awareness of the various potential sources of haemomediastinum is important to increase the success rate of transcatheter arterial embolization.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 2","pages":"3000605241290716"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11800261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255832","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":"Role of the CHA₂DS₂-VASc score in predicting hospital stay and 90-day readmission among patients with atrial fibrillation in Syria.","authors":"Ibrahim Antoun, Alamer Alkhayer, Alkassem Alkhayer, Yaman Mahfoud, Ahmed Kotb, Riyaz Somani, G André Ng, Mustafa Zakkar","doi":"10.1177/03000605251314807","DOIUrl":"10.1177/03000605251314807","url":null,"abstract":"<p><strong>Objectives: </strong>We assessed the CHA₂DS₂-VASc score for predicting hospital readmission risk and length of stay (LOS) in patients admitted with primary atrial fibrillation (AF).</p><p><strong>Methods: </strong>This retrospective cohort study included patients with index admission for AF to Latakia's tertiary center (May 2021-November 2023). Patients were followed 90 days to assess readmission. CHA₂DS₂-VASc was correlated with 90-day readmission, inpatient all-cause mortality, and LOS during index admission.</p><p><strong>Results: </strong>In total, 717 patients were included; 320 (45%) were readmitted to the hospital within 90 days (58% men, 65% aged <65 years). Inpatient mortality was 4%; the median LOS was 2 days. There was an increase in the incident rate ratio (IRR) of LOS starting from a CHA₂DS₂-VASc of 2 (IRR: 2, 95% confidence interval [CI]: 1.7-2.2) to a score of >6 (IRR: 5, 95% CI: 1.8-10.7), compared with a score of 0. There was an incremental increase in the hazard ratio (HR) of readmission from a score of 1 (HR: 2.3, 95% CI: 1.3-4.1) to a score of >6 (HR: 41, 95% CI: 31-72) compared with a CHA₂DS₂-VASc of 0.</p><p><strong>Conclusion: </strong>CHA₂DS₂-VASc could predict 90-day hospital readmission and LOS during the index admission in patients admitted with primary AF.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 2","pages":"3000605251314807"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11806465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374200","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":"Primary umbilical endometriosis: clinical aspects and long-term follow-up of five cases.","authors":"MengHui Li, KunNing Zhang, ChongDong Liu","doi":"10.1177/03000605251317815","DOIUrl":"10.1177/03000605251317815","url":null,"abstract":"<p><p>Umbilical endometriosis (UE) is a rare condition. We have documented the clinical characteristics, management strategies, and follow-up results for five cases treated at our hospital between 1998 and 2020, with patients aged between 31 and 44 years. Patients typically presented with umbilical swelling. In all cases, surgical removal was effective and no complications were reported. Two patients had concurrent ovarian endometriosis and one adenomyosis. No umbilical recurrence was recorded during follow-up. We believe that these findings offer valuable insights for the management of this patient population. Clinical management strategies for this disease should be tailored to each patient and carried out collaboratively by both general and gynaecological physicians.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 2","pages":"3000605251317815"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11800267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255833","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":"Early Kasai portoenterostomy in a 9-day-old newborn with extrahepatic biliary atresia: a case report highlighting improved prognosis with prompt intervention.","authors":"Mortada H F El-Shabrawi, Gamal Eltagy, Mohamed Qinawy, Mohammed Am Oshi, Amjad Algethami, Nawaf A Alhujayri, Shaker S Alharthi, Abdullah M Alelyani, Naglaa M Kamal","doi":"10.1177/03000605241311115","DOIUrl":"10.1177/03000605241311115","url":null,"abstract":"<p><p>Extrahepatic biliary atresia (EHBA) is a leading cause of neonatal cholestasis, often resulting in end-stage cirrhosis and portal hypertension without early diagnosis and treatment. This report highlights the importance of timely intervention, describing a 6-day-old male newborn diagnosed with EHBA who underwent successful Kasai portoenterostomy at 9 days of age. While the procedure is typically performed within the first 60 days of life, this exceptionally early intervention led to significantly improved outcomes. Postoperative recovery was marked by bilirubin normalization within 2 months and steady improvement in liver function tests, demonstrating the advantages of early surgery. The procedure involved creating a Roux-en-Y hepatic portojejunostomy to restore bile flow, preventing progression to biliary cirrhosis. Early intervention achieved effective bile drainage and substantial clinical improvement. At the 1-year follow-up, the infant displayed normal growth and liver function. This case supports the hypothesis that performing Kasai portoenterostomy earlier than current guidelines recommend may lead to better outcomes. It underscores the need for vigilant neonatal care to recognize early signs of cholestasis and enable prompt surgical intervention. Early diagnosis and intervention can preserve liver function, potentially delaying or preventing the need for liver transplantation.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 2","pages":"3000605241311115"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cutaneous metastases of invasive lobular breast cancer as the first clinical manifestation: a case report.","authors":"Saja Karaja, Ahmad Almohamed, Ayham Qatza, Ahmed Aldolly, Sanaa Mansour, Alae Aldin Almasri","doi":"10.1177/03000605251314804","DOIUrl":"10.1177/03000605251314804","url":null,"abstract":"<p><p>Cutaneous metastasis (CM) is a rare phenomenon, occurring in only 0.6% to 10.4% of oncology patients. Breast carcinoma represents nearly one-third of all CM cases, although it manifests in a minority of patients with breast cancer (BC). Notably, CMs are detected at the time of primary tumor diagnosis in 6.3% of patients with BC and serve as the initial clinical presentation in only 3.5% of patients. We present a case involving a 53-year-old woman with a 5-month history of asymptomatic infiltrating nodules in the axillae and trunk. Skin biopsy and immunohistochemical analysis confirmed metastatic breast carcinoma with positive estrogen receptor staining. This case underscores the importance of early detection and precise diagnostic techniques in managing metastatic adenocarcinoma with cutaneous manifestations. Despite the promising outcome of the initial treatment, the disease progression in this case highlights the aggressive nature of CMs and the ongoing need for research and advanced therapeutic strategies.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 2","pages":"3000605251314804"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11806458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364623","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":"Heat stroke with sepsis: A case report and review of the literature.","authors":"Suyu Wei, Liang Sun","doi":"10.1177/03000605251315353","DOIUrl":"10.1177/03000605251315353","url":null,"abstract":"<p><p>Heat stroke, triggered by excessive heat exposure or intense physical activity, is a medical condition characterized by a rapid rise in core body temperature, central nervous system dysfunction and multiorgan failure. A patient presented with heat stroke and was unconscious. During treatment, we identified a range of complications, including shifted flora, coagulation abnormalities, liver damage and renal failure-indicating multiorgan dysfunction. We administered antibiotic therapy, blood purification and other comprehensive treatments, leading to the patient's recovery and subsequent discharge. For cases of heat stroke in an intensive care setting, clinicians must recognize the condition early and act swiftly to reduce body temperature. Additionally, the early use of antibiotics can help prevent microbial imbalance. For eligible patients, hemodialysis should be initiated promptly to manage renal complications effectively.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 2","pages":"3000605251315353"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}