Journal of International Medical Research最新文献

{"title":"A novel bendable suction sheath in flexible ureteroscopy for renal calculi.","authors":"Jiyu Zhao, Jiajing Wang, Sheng Yang, Jia Liu, Junzhe Xia, Xianen Gu, Jianhua Long","doi":"10.1177/03000605251386570","DOIUrl":"https://doi.org/10.1177/03000605251386570","url":null,"abstract":"<p><p>ObjectivesThis study aimed to evaluate the clinical efficacy and cost-effectiveness of using a disposable bendable negative pressure suction sheath in combination with a disposable ureteroscope for treating upper urinary tract calculi and to compare it with the conventional ureteral access sheath with a lassoed mesh basket.MethodsA retrospective analysis was conducted on clinical data from patients with upper urinary tract calculi who underwent flexible ureteroscopy at a tertiary hospital in Beijing between March 2023 and March 2024. The study included two groups: 69 patients were treated with disposable bendable negative pressure suction sheaths (negative pressure group) and 83 with conventional ureteral access sheath combined with lassoed mesh baskets (conventional group). Variables analyzed included operative time, stone-free rate, length of postoperative hospital stay, postoperative complication rate, and hospitalization cost.ResultThe operative time for the negative pressure group was 119.8 ± 10.4 min, which was longer than that in the conventional group (93.2 ± 9.8 min). The postoperative hemoglobin drop was 5.3 ± 2.2 g/L in the negative pressure group and 4.7 ± 1.2 g/L in the conventional group. The hospitalization cost for the negative pressure group was ¥28,273 ± 5389, which was significantly lower than that for the conventional group (¥30,786.1 ± 4055). The stone-free rate at 1 week postoperatively was 84.1% (58/69) in the negative pressure group, which was significantly higher than that in the conventional group (68.7%). However, there was no statistically significant difference in stone-free rate at 1 month postoperatively between the two groups.ConclusionsThe use of a disposable ureteroscope with a bendable negative pressure suction sheath can improve short-term postoperative stone-free rate. However, this approach may increase surgical complexity, extend operative time, and heighten the risk of intraoperative bleeding. This procedure is recommended to be performed by physicians with extensive experience in flexible ureteroscopy to ensure safety and efficacy.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 10","pages":"3000605251386570"},"PeriodicalIF":1.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145336673","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":"Thoracic blunt trauma causing fatal cardiac rupture and aortic dissection: A narrative review.","authors":"Ling Wang, Shitong Su, Lianjing Liang, Haifang Yu","doi":"10.1177/03000605251386164","DOIUrl":"10.1177/03000605251386164","url":null,"abstract":"<p><p>Thoracic blunt injuries are not uncommon, and they can cause severe cardiac and major vascular damage, leading to high mortality. Blunt cardiac rupture and traumatic aortic dissection are the primary fatal outcomes of these injuries. Many patients do not survive long enough to reach the hospital, and even those who present to emergency departments face challenges in timely diagnosis and management. This narrative review was conducted in accordance with the core principles of the Scale for the Assessment of Narrative Review Articles. A literature search was performed to summarize current evidence on blunt cardiac rupture and traumatic aortic dissection in thoracic blunt trauma settings. Early recognition of life-threatening complications from thoracic blunt trauma is essential for prompt and accurate diagnosis as well as appropriate clinical interventions. Cardiac rupture and traumatic aortic dissection from thoracic blunt trauma have traditionally been considered distinct entities, exhibiting different injury mechanisms and clinical outcomes. This review provides a comprehensive overview of the etiology, injury mechanisms, diagnosis, and management of fatal cardiac rupture and aortic dissection resulting from thoracic blunt trauma. The review is limited by the scarcity of high-quality studies and the predominance of case reports, but it highlights critical patterns in diagnosis and management that may inform clinical practice and guide future research. Overall, the findings underscore that improved understanding and awareness of these conditions can facilitate earlier diagnosis and treatment, ultimately reducing mortality and improving patient care in real-world clinical settings.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 10","pages":"3000605251386164"},"PeriodicalIF":1.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12536176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145301386","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":"Congenital extrahepatic portosystemic shunts (Abernethy malformation): A report of two cases.","authors":"Yiqi Ma, Zhiming Cui, Jibo Hu","doi":"10.1177/03000605251388884","DOIUrl":"https://doi.org/10.1177/03000605251388884","url":null,"abstract":"<p><p>Abernethy malformation, also known as congenital extrahepatic portosystemic shunt, is an extremely rare vascular anomaly that alters systemic hemodynamics and may lead to progressive liver dysfunction, portal hypertension, and, in advanced stages, malignant transformation or hepatic encephalopathy. The condition is frequently associated with other congenital anomalies, most notably cardiac malformations such as septal defects, patent foramen ovale, Tetralogy of Fallot, and valvular regurgitation as well as skeletal abnormalities. We report the cases of two patients-one with type Ib and the other with type II Abernethy malformation. Both patients were asymptomatic, with the diagnosis established through contrast-enhanced computed tomography and magnetic resonance imaging. Clinical, laboratory, and imaging data were collected. Given the absence of overt clinical manifestations, both patients are being managed with semiannual follow-up. Abernethy malformation is difficult to diagnose based on clinical presentation alone; however, characteristic imaging features can facilitate a definitive diagnosis. Recognition of this rare entity and its potential comorbidities is essential for timely diagnosis and appropriate management.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 10","pages":"3000605251388884"},"PeriodicalIF":1.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145355038","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":"Utility of admission biomarkers in predicting severe outcomes and triage in acute febrile illness: A cohort study.","authors":"Thejesh Srinivas, Nitin Gupta, Gagana Hanumaiah, Shwethapriya R, Prithvishree Ravindra, Kavitha Saravu, Ravindra Maradi, Souvik Chaudhuri","doi":"10.1177/03000605251375552","DOIUrl":"10.1177/03000605251375552","url":null,"abstract":"<p><p>ObjectivesTo determine the role of biomarkers in acute febrile illness patients at admission in predicting moderate-to-severe multiorgan dysfunction at 24 h of hospitalization and the need for invasive mechanical ventilation at 48 h of hospitalization.MethodsThis prospective cohort study was conducted among 100 acute febrile illness patients brought to the emergency department. Biochemical and clinical parameters at hospital admission were recorded. The highest Sequential Organ Failure Assessment score was calculated at 24 h of hospitalization. The need for invasive mechanical ventilation at 48 h of hospitalization was evaluated.ResultsOf the 95 acute febrile illness patients, 60 (63.15%) had moderate-to-severe multiorgan dysfunction. Multivariable logistic regression showed that admission aspartate aminotransferase level ≥89 U/L (P < 0.001; area under the curve, 0.752), C-reactive protein level ≥161 mg/dL (P < 0.001; area under the curve, 0.751), and urea level ≥74 mg/dL (P < 0.001; area under the curve, 0.855) were independent predictors of moderate-to-severe multiorgan dysfunction at 24 h. Serum interleukin-6 level ≥84.48 pg/mL (P = 0.002; area under the curve, 0.728) on admission was an independent predictor of the need for invasive mechanical ventilation.ConclusionsUrea, aspartate aminotransferase, and C-reactive protein levels on admission may independently predict moderate-to-severe multiorgan dysfunction in acute febrile illness patients at 24 h of hospitalization. In addition, interleukin-6 level may be an independent predictor of the need for invasive mechanical ventilation at 48 h of hospitalization.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 10","pages":"3000605251375552"},"PeriodicalIF":1.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12536115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145301401","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":"Hypoxia-inducible factor-1 alpha expression in endometriosis: A retrospective observational case-control study of ovarian cyst capsules and endometrial tissue samples.","authors":"Ezgi Tolu Cenk, Ceyda Sancakli Usta, Akin Usta, Gulay Turan, Gurhan Guney, Selim Afsar, Mine Islimye Taskin","doi":"10.1177/03000605251386208","DOIUrl":"https://doi.org/10.1177/03000605251386208","url":null,"abstract":"<p><p>BackgroundThis study aimed to compare the expression patterns of hypoxia-inducible factor-1α in ovarian cyst capsules and endometrial tissue samples from patients with and without endometriosis to evaluate its potential as a biomarker of hypoxia in endometriosis.MethodsThis retrospective observational case-control study included 87 women of childbearing age (20-45 years) who underwent ovarian cystectomy at Balıkesir University Hospital between 2015 and 2020. Of these, 40 patients with confirmed endometriosis constituted the study group, while 47 patients with benign ovarian cysts comprised the control group. Immunohistochemical staining was used to assess the expression of hypoxia-inducible factor-1-alpha in ovarian cyst capsules and endometrial tissue samples. The relationship between the expression of hypoxia-inducible factor-1-alpha and clinical parameters, including age, body mass index, and endometriosis stage, was also evaluated.ResultsThe expression of hypoxia-inducible factor-1-alpha was significantly higher in ovarian cyst capsules and endometrial tissues of patients with endometriosis than in those of controls (p < 0.05). No correlation was found between hypoxia-inducible factor-1-alpha expression and age, body mass index, or disease stage.ConclusionsIn this study, the expression of hypoxia-inducible factor-1-alpha in the ovarian and endometrial tissues was significantly elevated in patients with endometriosis compared with that in controls, independent of clinical parameters. These results support hypoxia-inducible factor-1-alpha as a stable biomarker of hypoxia in endometriosis and provide a basis for future research on hypoxia-targeted therapies for endometriosis management.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 10","pages":"3000605251386208"},"PeriodicalIF":1.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145355104","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":"See more, treat early, conceive sooner: Outpatient hysteroscopy in modern fertility care.","authors":"Gaetano Riemma, Salvatore Giovanni Vitale, Pasquale De Franciscis","doi":"10.1177/03000605251384066","DOIUrl":"10.1177/03000605251384066","url":null,"abstract":"","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 10","pages":"3000605251384066"},"PeriodicalIF":1.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12515301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258221","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":"Angiomyofibroblastoma of the scrotum: A report of two cases and literature review.","authors":"Qifan Xie, Chujin Ye, Hanzhong Chen, Zhiye Liu, Kun Wei, Fangqianyu Zhong, Xiaoyong Pu, Shang Huang","doi":"10.1177/03000605251386617","DOIUrl":"10.1177/03000605251386617","url":null,"abstract":"<p><p>Angiomyofibroblastoma is a rare benign mesenchymal tumor typically found in the genital region of adult females, but its occurrence in the male scrotum is exceptionally uncommon. This report presents two cases of angiomyofibroblastoma in the male scrotum to enhance the understanding of this rare condition. In the first case, a man in his early 60s with a recent rectal cancer diagnosis was found to have a palpable right scrotal mass. Imaging suggested metastasis, but radical resection and pathological analysis confirmed angiomyofibroblastoma, with no evidence of testicular malignancy. The patient remained tumor-free for 7 years. In the second case, a man in his early 40s presented with a nontender, slowly enlarging right inguinal mass extending into the scrotum. Surgical resection revealed a 6 × 4-cm angiomyofibroblastoma, with no recurrence for 7 years. These cases underscore the importance of considering angiomyofibroblastoma in the differential diagnosis of scrotal masses in males. Accurate diagnosis relies on understanding the clinical, imaging, and histopathologic features of angiomyofibroblastoma to ensure appropriate management and favorable outcomes.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 10","pages":"3000605251386617"},"PeriodicalIF":1.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12547103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145313064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between a history of hypothyroidism and incident chronic kidney disease and potential mediators: A cohort study with Mendelian randomization analysis.","authors":"Yaofang Zhang, Yue Shen, Aiwen Shen, Yuqi Shen, Zhu Zhu, Yining He, Wenji Wang, Xuezhu Li, Xiao Bi, Feng Ding","doi":"10.1177/03000605251387502","DOIUrl":"https://doi.org/10.1177/03000605251387502","url":null,"abstract":"<p><p>ObjectiveTo investigate the association between hypothyroidism and incident chronic kidney disease and identify potential mediators.MethodsThis study included a retrospective cohort and Mendelian randomization analysis. Data were obtained from the UK Biobank and FinnGen via the Integrative Epidemiology Unit Open Genome-Wide Association Studies Project. After exclusions, 439,381 participants were included. The risk of incident chronic kidney disease was the primary outcome. Associations were assessed using Fine and Gray models as well as stratified and sensitivity analyses, and the cumulative risk was presented using Kaplan-Meier curves. For Mendelian randomization analyses, causal effects were estimated using the inverse-variance weighted method. Mendelian randomization-Egger regression, Mendelian randomization-pleiotropy residual sum and outlier test, weighted median method, and weighted mode method were used to assess the robustness of the causal estimates. Mediation analysis was conducted to explore the effects of body mass index, inflammatory factors, and senescence-associated secretory phenotype proteins.ResultsHypothyroidism was associated with a higher risk of incident chronic kidney disease (hazard ratio: 1.35, 95% confidence interval: 1.19-1.53). Mendelian randomization analysis supported a causal effect (odds ratio: 8.23, 95% confidence interval: 3.22-21.00). Absolute risk differences increased over time (5 years, 1.10; 8 years, 1.80; 10 years, 2.40; and 12 years, 3.13). Body mass index and obesity partially mediated this effect. Senescence-associated secretory phenotype proteins were also identified as important mediators, including transforming growth factor-alpha, transforming growth factor-beta, transforming growth factor-beta receptors 2 and 3, growth differentiation factor 15, C-X-C motif chemokine-10, matrix metalloproteinase 1, and matrix metalloproteinase 9.ConclusionsHypothyroidism was associated with incident chronic kidney disease. Obesity and senescence-associated secretory phenotype proteins may mediate this relationship.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 10","pages":"3000605251387502"},"PeriodicalIF":1.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145345030","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":"Bilateral keratomalacia years after biliopancreatic diversion with duodenal switch surgery: A case of severe vitamin A deficiency and literature review.","authors":"Jaron C Sanchez, Omar Nusair, Dipen Kumar, Mohammad Soleimani","doi":"10.1177/03000605251387932","DOIUrl":"https://doi.org/10.1177/03000605251387932","url":null,"abstract":"<p><p>Vitamin A deficiency is an uncommon but serious complication of malabsorptive bariatric surgery in developed nations, which can manifest several years after the procedure. It can easily be overlooked, as patients often present with nonspecific signs and symptoms early in the disease course, and ocular manifestations typically appear once the deficiency reaches a severe stage. A female patient in her early 40s presented with acute vision loss 8 years after undergoing biliopancreatic diversion with duodenal switch bariatric surgery. Ophthalmic examination revealed Bitot's spots and progressive keratomalacia. Laboratory tests showed micronutrient deficiencies of vitamins A, D, E, and K1, which were attributed to noncompliance with bariatric follow-up and vitamin supplementation. Treatment with high-dose intramuscular vitamin A and total parenteral nutrition resulted in significant visual recovery and resolution of keratomalacia at 2 months after hospital discharge. Therefore, this case highlights that vitamin A deficiency can manifest years after the procedure, particularly in patients with poor adherence to nutritional guidelines. Prompt recognition and aggressive multi-modal supplementation are necessary to reverse ocular pathology and prevent permanent vision loss in this population.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 10","pages":"3000605251387932"},"PeriodicalIF":1.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145355109","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":"Impact of diabetes-specific nutrition formulas on time in range in overweight or obese Colombian patients with diabetes: A case series study.","authors":"Ana-M Gomez, Maria-P Chicue, Diana-C Henao, Oscar-M Muñoz-Velandia","doi":"10.1177/03000605251382375","DOIUrl":"10.1177/03000605251382375","url":null,"abstract":"<p><p>The use of diabetes-specific nutrition formulas reduces postprandial glucose and insulin levels and promotes satiety, thereby improving glycemic control and contributing to weight loss. The effect of diabetes-specific nutrition formulas on the percentage of time in range (70-180 mg/dL) has not yet been investigated. This longitudinal pilot study was based on a case series of overweight or obese patients diagnosed with diabetes using continuous glucose monitoring and managed at the Hospital Universitario San Ignacio in Bogotá (Colombia). We compared continuous glucose monitoring data and anthropometric variables before and after 4 weeks of using a diabetes-specific nutrition formula as replacement for breakfast and afternoon snack. Eleven patients were included in this study; of these, 63.7% were men. The mean patient age was 55 ± 14.5 years, and 81.1% had type 2 diabetes. The mean percentage of time in range increased from 64% ± 24% to 75% ± 16% (mean difference: 10.63; 95% confidence interval: 2.13, 19.14; p = 0.01). The mean percentage of time above range (>180 mg/dL) decreased from 34% ± 25% to 23% ±14% (mean difference: -11.27; 95% confidence interval: -2.48, -20.05; p = 0.02), with no difference in hypoglycemia incidence or anthropometric variables. Our study suggests that the use of a diabetes-specific nutrition formula as replacement for breakfast and afternoon snack improves glycemic control, as measured via continuous glucose monitoring, in overweight or obese patients with type 2 diabetes. This adds to the emerging evidence on the effect of this intervention on continuous glucose monitoring metrics. Further evidence is needed from larger clinical trials to support the inclusion of this intervention in routine clinical practice.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 10","pages":"3000605251382375"},"PeriodicalIF":1.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12508538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238764","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}