Journal of International Medical Research最新文献

{"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}

{"title":"Posterior reversible encephalopathy syndrome in adult acute post-streptococcal glomerulonephritis.","authors":"Qiuping Han, Linlin Zhu","doi":"10.1177/03000605251318851","DOIUrl":"10.1177/03000605251318851","url":null,"abstract":"<p><p>Posterior reversible encephalopathy syndrome is characterized by abnormal white matter findings and neurological symptoms. However, it is clinically rare and can easily be misdiagnosed. Herein, we describe a case of posterior reversible encephalopathy syndrome in an adult patient with acute post-streptococcal glomerulonephritis, confirmed by renal pathology and magnetic resonance imaging, and provide diagnostic suggestions for clinicians.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 2","pages":"3000605251318851"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523417","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":"An isolated congenital absence of right pulmonary artery associated with coronary and multiple systemic collaterals: A case report and literature review.","authors":"Rola K Bsharat, Daleen Shehadeh, Raneen W Atatrah, Mahmoud R Manasra, Baha Alhadad, Bajis Amr","doi":"10.1177/03000605251320763","DOIUrl":"10.1177/03000605251320763","url":null,"abstract":"<p><p>Unilateral pulmonary artery agenesis (UPAA) is the complete absence of either the right or left pulmonary artery. It is a rare congenital malformation, usually associated with other cardiac defects; however, in some cases, it may occur as an isolated lesion, typically affecting the right side. Patients with isolated right pulmonary artery agenesis are often diagnosed incidentally on chest radiographs in adulthood. Rare cases are associated with multiple systemic collaterals that supply the affected lung. We report the case of a 69-year-old man with the absence of a right pulmonary artery, arterial supply to the right lung from the celiac trunk, and communication of the collaterals with a marginal branch arising from the right coronary artery. UPAA is a rare congenital anomaly that may present with nonspecific symptoms, such as dyspnea and recurrent chest infections. Clinicians should consider UPAA in the differential diagnosis of respiratory symptoms, particularly in adult patients with unexplained symptoms.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 2","pages":"3000605251320763"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11846099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476084","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 rare case of acrokeratosis paraneoplastica (Bazex syndrome) and a literature review.","authors":"Xiaoyan Zhang","doi":"10.1177/03000605251317998","DOIUrl":"10.1177/03000605251317998","url":null,"abstract":"<p><p>Acrokeratosis paraneoplastica is a rare and obligate paraneoplastic dermatosis most commonly associated with squamous cell carcinoma of the upper aerodigestive tract and lung. It has also been linked to adenocarcinomas of the lung, colon, and stomach. However, reports of its association with esophageal adenocarcinoma are exceedingly rare, with only one documented case to date. This condition primarily affects middle-aged White men, with limited cases reported in women. Moreover, its occurrence in the Chinese population is uncommon. We herein present a case of acrokeratosis paraneoplastica in a Chinese woman with primary esophageal adenocarcinoma, along with a review of the relevant literature. To our knowledge, this is the first documented instance of paraneoplastic acrokeratosis associated with esophageal adenocarcinoma in a woman.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 2","pages":"3000605251317998"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515746","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":"Preoperative digital design in artificial total hip arthroplasty for patients with Crowe type III and IV developmental dysplasia of the hip: A case series.","authors":"Jinxin Zheng, Wei Chen, Yancheng Xiu, Shuzhang Guo","doi":"10.1177/03000605251320223","DOIUrl":"10.1177/03000605251320223","url":null,"abstract":"<p><p>Successful complete artificial total hip arthroplasty for patients with Crowe type III or IV developmental dysplasia of the hip is challenging in clinical practice. This study aimed to explore the accuracy and effectiveness of preoperative digital design for patients with Crowe type III or IV developmental dysplasia of the hip. This case series study included patients with osteoarthritis secondary to developmental dysplasia of the hip who did not respond to conservative treatment and subsequently required total hip arthroplasty in Tianjin Third Central Hospital between January 2018 and February 2020. A total of 20 patients (5 males and 15 females) were enrolled, of whom 12 presented with Crowe type III and 8 with Crowe type IV developmental dysplasia of the hip. Total hip arthroplasty for each patient was successful. The implanted acetabular cups were one size (2 mm) smaller than the preoperatively designed size in four patients, and the implanted femoral stem prosthesis was one size (1 mm) larger than the preoperatively designed size in four patients with type IV DDH. The Harris scores differed significantly between preoperative and postoperative measurements (58.6 vs. 94.4; <i>P</i> = 0.016). No infection or joint dislocation was observed. Preoperative digital modeling may be used to predict the size of prosthesis required and location for implantation in patients undergoing total hip arthroplasty.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 2","pages":"271678X251322032"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515755","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}