Journal of International Medical Research最新文献

{"title":"A meta-analysis of the efficacy and safety of immunomodulators in the treatment of severe COVID-19.","authors":"Xuegui Ju, Jiayao Li, Haonan Huang, Yidan Qing, Bhushan Sandeep","doi":"10.1177/03000605251317462","DOIUrl":"10.1177/03000605251317462","url":null,"abstract":"<p><p>ObjectiveTo evaluate the efficacy and adverse events of immunomodulators in the treatment of severe coronavirus disease 2019 (COVID-19).MethodsA literature search for the meta-analysis was performed using PubMed, The Cochrane Library, Embase, Wanfang Data, CNKI, and Web of Science to identify randomized controlled trials assessing the outcomes of patients treated with corticosteroids alone and/or interleukin-6 receptor antagonists for COVID-19. The risk of bias was assessed using the Cochrane method. The protocol was registered with PROSPERO (registry number: CRD42022356904).ResultsCompared with patients receiving standard of care, patients treated with corticosteroids alone had an increased risk of 14-day in-hospital death, whereas those treated with interleukin-6 receptor antagonists alone or in combination with corticosteroids had a lower risk of 14-day in-hospital death. Corticosteroid therapy alone was associated with increased risk of several adverse events, including intensive care unit admission and non-invasive ventilation, whereas interleukin-6 receptor antagonists alone or in combination with corticosteroids were not linked to adverse effects.ConclusionsThe findings supported the safety and efficacy of interleukin-6 receptor antagonists, either alone or together with corticosteroids, in patients with severe COVID-19; evidence supporting the efficacy and safety of corticosteroids monotherapy is lacking.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 3","pages":"3000605251317462"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624971","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":"Advances in the study of Wellens syndrome.","authors":"Yiwen Zhang, Youlu Shen","doi":"10.1177/03000605251324480","DOIUrl":"10.1177/03000605251324480","url":null,"abstract":"<p><p>This article outlines a comprehensive analysis of the progress in the study of Wellens syndrome, which starts from a large body of relevant literature and systematically elaborates on the in-depth discussion, including the definition of the Wellens syndrome and the relationship between myocardial ischemia and coronary artery lesions. In terms of clinical manifestations, the characteristic electrocardiographic changes and related symptoms are described in detail. In terms of diagnostic methods, it ranges from the identification of electrocardiographic features to the combined use of myocardial marker testing and imaging. In conclusion, research on Wellens syndrome has further improved an understanding of its etiopathological mechanisms. This review aimed to clarify the nuances of Wellens syndrome and its impact on cardiovascular practice, raising awareness of at-risk populations and improving patient outcomes. It also provides a comprehensive and in-depth reference for the recognition, diagnosis, and treatment of Wellens syndrome to help clinicians fully understand and effectively diagnose and treat it.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 3","pages":"3000605251324480"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624973","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":"Characterizing hepatic porphyria: Insights from a quaternary care hospital in Bogotá, Colombia (2013-2023).","authors":"María C Martínez-Ávila, Eugenio Matijasevic-Arcila, Stefania Pantoja-Chica, Alieth L Acosta-Cardozo","doi":"10.1177/03000605251325183","DOIUrl":"10.1177/03000605251325183","url":null,"abstract":"<p><p>IntroductionAcute hepatic porphyrias are rare, life-threatening genetic disorders that impair heme biosynthesis, often presenting with nonspecific symptoms that lead to misdiagnosis. This diagnostic challenge and low clinical recognition can delay targeted treatment, increasing morbidity and mortality. Although there have been advances in understanding porphyrias' biochemical pathways, improved diagnostic approaches are still needed, especially in acute care. This study examined diagnostic and clinical patterns of acute hepatic porphyria at a quaternary care hospital in Bogotá, Colombia, to support earlier detection and management.Materials and MethodsThis descriptive, observational, retrospective study reviewed patients diagnosed with acute hepatic porphyria at the Internal Medicine service of a Bogotá hospital from 2013 to 2023. Patients with confirmed diagnoses recorded in the hospital database were included. Data collected covered demographic characteristics, clinical presentation, diagnostic markers, and treatment. Key outcome measures were time to diagnosis, recurrence frequency, and hospitalization duration.ResultsTen patients were included, 80% of whom were female, with a median age of 32 years. Diagnosis was confirmed by urine porphobilinogen tests. All patients reported abdominal pain during attacks; 90% had tachycardia and paresis/weakness of extremities. Attack durations ranged from 4 to 11 days, with 90% treated with hemin. Median hospital stay was 18 days. Drug use and infections were common precipitants, and 40% of female patients had premenstrual-associated attacks.ConclusionsThis study provides a clinical profile of acute hepatic porphyria in a Colombian hospital, highlighting neurovisceral symptoms and female predominance. Findings suggest the need for early diagnostic protocols to prevent treatment delays, although larger studies are required to confirm these findings across different settings.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 3","pages":"3000605251325183"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674170","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":"Hepatic cystic echinococcosis (type II): A case report.","authors":"Zhiru Liang, Weihong Chen, Binbin Zhang, Lina Chen, Jing Wang, Jianjia Xiao, Geer An","doi":"10.1177/03000605251325164","DOIUrl":"10.1177/03000605251325164","url":null,"abstract":"<p><p>This article presents a case report of a rare instance of hepatic cystic echinococcosis (Type II). The patient is a young female who has resided in the Inner Mongolia region of China for an extended period and has a clear history of contact with dogs and sheep. She presented with recurrent upper abdominal pain accompanied by jaundice of skin and sclera for 2 months. Through comprehensive clinical history inquiry, physical examination, and imaging studies such as ultrasound and computed tomography, the diagnosis of hepatic cystic echinococcosis (Type II) was confirmed. The patient underwent a capsular excision, and the postoperative prognosis was good with no recurrence or implantation during short-term follow-up. This case report details the patient's clinical symptoms, signs, diagnostic process, and key points for differential diagnosis, emphasizing the crucial role of imaging studies in the diagnosis of hepatic cystic echinococcosis. Additionally, the treatment plan and postoperative follow-up for this case are discussed, aiming to provide a reference for clinical diagnosis and treatment of hepatic cystic echinococcosis.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 3","pages":"3000605251325164"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624994","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":"A retrospective observational study of risk factors for postoperative meningitis following resection of meningioma.","authors":"Yong Gu, Yuekang Zhang, Mengfei Zeng, Yangyun Han, Xiaodong Long","doi":"10.1177/03000605251327527","DOIUrl":"10.1177/03000605251327527","url":null,"abstract":"<p><p>ObjectiveThis retrospective observational study aimed to explore the risk factors for postoperative meningitis following resection of meningioma.MethodsA total of 937 patients older than 18 years who underwent meningioma resection at the Department of Neurosurgery of three grade-A general hospitals in Sichuan Province between January 2021 and June 2024 were included. Basic patient information and perioperative variables were evaluated as risk factors for meningitis. Univariate and multivariate analyses were performed to identify the risk factors for postoperative meningitis.ResultsOverall, 47 (5.0%) of the 937 patients were infected with postoperative meningitis. Univariate analysis revealed that albumin level (<3.5 mg/dL; p = 0.017), preoperative hospitalization (median: 4 days; interquartile range: 2-6 days; p = 0.034), tumor location (skull base; p < 0.001), surgery duration (>3 h; p < 0.001), and bleeding volume during operation (≥400 mL; p < 0.001) were significantly associated with postoperative meningitis following resection of meningioma. The average postoperative hospital stay in the postoperative meningitis group was 14 days, whereas it was 6 days in the nonpostoperative meningitis group (p < 0.001). Furthermore, multivariate analysis showed that tumor location (skull base; p = 0.004; odds ratio = 2.914; 95% confidence interval: 1.395-6.091), surgery duration (>3 h; p = 0.006; odds ratio = 3.024; 95% confidence interval: 1.370-6.674), and bleeding volume during operation (p = 0.034; odds ratio = 2.057; 95% confidence interval: 1.056-4.006) were independent risk factors for postoperative meningitis following resection of meningioma.ConclusionTumor location (skull base), longer surgery duration (>3 h), and higher bleeding volume during operation (≥400 mL) were independent risk factors for postoperative meningitis following resection of meningioma. Moreover, postoperative meningitis was associated with a prolonged hospital stay. These findings can help identify patients with meningioma in need of special intervention to prevent postoperative meningitis and can help surgeons preoperatively identify the risk of postoperative meningitis for meningioma.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 3","pages":"3000605251327527"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719834","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":"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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11807275/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetically determined physical activity levels, sedentary behaviours, and their association with the risk of age-related macular degeneration.","authors":"Xiangpeng Zhou, Jiang Wu, Yingjiao Shen, Shucheng He, Hanyi Guan, Lijun Shen","doi":"10.1177/03000605251318198","DOIUrl":"10.1177/03000605251318198","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the causal effects of physical activity and sedentary traits on risk of Age-related macular degeneration (AMD).</p><p><strong>Methods: </strong>A two-sample Mendelian randomization (MR) analysis was used to investigate the causal relationship between physical activity and risk of AMD. We used genome-wide association studies (GWAS) summary statistics from two publicly available biobank-scale cohorts: UK Biobank and FinnGen. Physical activity data were self-reported by 703,901 UK Biobank participants and sedentary behaviour data were gathered from 159,606 FinnGen participants. Our analysis primarily used the inverse variance weighted (IVW) method.</p><p><strong>Result: </strong>Engaging in moderate-to-vigorous physical activity significantly reduced the risk of AMD with an odds ratio of 0.77 (95% CI: 0.66-0.89). However, leisure screen time showed a slight but non-statistically significant upward trend. Sedentary behaviour at work, sedentary commuting showed no causal effects on AMD risk.</p><p><strong>Conclusions: </strong>This study used MR analysis to examine the causal relationship between physical activity, sedentary behaviour, and AMD. It offers genetic evidence suggesting that physical activity may protect against AMD, emphasizing the significance of lifestyle factors in maintaining ocular health.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 2","pages":"3000605251318198"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425502","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}