Journal of International Medical Research最新文献

{"title":"Dual antiplatelet therapy versus aspirin alone in acute ischemic stroke or transient ischemic attack: A meta-analysis and trial sequential analysis of randomized controlled trials.","authors":"Ramez M Odat, Sakhr Alshwayyat, Zainab I Bahdar, Mohammad Abdelraheem, Basma B Khalefa, Omar Jarah, Mohammad H Obeidat, Mohammad E Bani Khalaf, Aon J Bani Khalaf, Ayham Mohammad Hussein, Jehad A Yasin, Hamdah Hanifa, Hritvik Jain","doi":"10.1177/03000605251337035","DOIUrl":"10.1177/03000605251337035","url":null,"abstract":"<p><p>IntroductionData regarding the role of dual antiplatelet therapy in patients with ischemic stroke or transient ischemic attack are limited. This study aimed to systematically review and analyze the efficacy and safety of dual antiplatelet therapy compared with aspirin alone in patients with acute ischemic stroke or transient ischemic attack.MethodsWe searched PubMed, Embase, Scopus, Cochrane, and Web of Science databases from inception to August 2024 and identified randomized controlled trials comparing dual antiplatelet therapy with aspirin alone in patients with stroke. Pooled risk ratios with 95% confidence interval were calculated. Trial sequential analysis was conducted for the main outcomes to weigh the risks of type I and type II errors.ResultsFive studies involving 27,563 patients were included. Dual antiplatelet therapy was associated with a significantly reduced risk of recurrent ischemic stroke (risk ratio: 0.74, 95% confidence interval: 0.68-0.81) and major adverse cardiovascular events (risk ratio: 0.77, 95% confidence interval: 0.71-0.84). However, it was associated with a significantly higher risk of recurrent hemorrhagic stroke (risk ratio: 2.13, 95% confidence interval: 1.09-4.17) and bleeding (risk ratio: 2.21, 95% confidence interval: 1.48-3.32). Trial sequential analysis revealed that sufficient evidence for recurrent ischemic stroke, major adverse cardiovascular events, and bleeding was achieved.ConclusionDual antiplatelet therapy demonstrated a lower incidence of recurrent ischemic stroke and major adverse cardiovascular events compared with aspirin alone. However, further studies are warranted to provide sufficient evidence regarding recurrent hemorrhagic stroke and all-cause mortality.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 5","pages":"3000605251337035"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12075978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016898","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":"Lactate alleviates trigeminal neuralgia symptoms in mice by suppressing neuroinflammation.","authors":"Xiangbo Liu, Feiyu Long, Wujun Zou, Tao Qi","doi":"10.1177/03000605251341802","DOIUrl":"10.1177/03000605251341802","url":null,"abstract":"<p><p>ObjectivesTrigeminal neuralgia is a neuropathic pain syndrome that undesirably affects patient's quality of life. Lactate exerts extensive pathophysiological effects on the brain; however, it remains unclear whether lactate improves trigeminal neuralgia symptoms as well as the underlying mechanisms.MethodsIn our study, unilateral constriction of the infraorbital nerve was performed to establish a mouse model of trigeminal neuralgia. Conditional knockout of the astrocyte-specific lactate dehydrogenase gene was performed to decrease brain exposure to lactate. The behavioral changes were observed and the pain thresholds were detected via von Frey tests at 1, 5, 10, 15, and 30 days after surgery to evaluate the impact of lactate on trigeminal neuralgia. Intracerebroventricular injection of L-lactate was administered to evaluate the biological function of lactate in our model.ResultsWe revealed that lactate levels in the spinal trigeminal nucleus were elevated by approximately 2.5-fold (3.63 vs. 1.43 µmol/g) after surgery, which remained elevated for at least 30 days. This shift in lactate levels appeared to be independent of peripheral circulation, as plasma lactate levels remained unaltered until 30 days after surgery. Increased lactate exposure alleviated trigeminal neuralgia symptoms after the surgery. Mechanistically, lactate suppressed reactive oxygen species production and neuroinflammation.ConclusionsLactate may alleviate trigeminal neuralgia symptoms in mice by suppressing neuroinflammation.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 5","pages":"3000605251341802"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12117245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142703","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":"Persistent trichomoniasis in a man in his early 90s with a history of prostatic hyperplasia: A case report.","authors":"Mahdi Fakhar, Shadi Shayesteh Azar, Shirafkan Kordi, Seyedeh Samaneh Borhani, Ahmad Nooreddini, Arshia Nozari, Hassan Nahanghi, Eissa Soleymani","doi":"10.1177/03000605251344201","DOIUrl":"10.1177/03000605251344201","url":null,"abstract":"<p><p>The protozoan <i>Trichomonas vaginalis</i> is a parasite associated with numerous sexually transmitted infections worldwide. In males, although <i>Trichomonas vaginalis</i> infection (also known as trichomoniasis) often remains asymptomatic, it can lead to conditions such as prostatitis or urethritis. Herein, we report the case of a man in his early 90s who was admitted to a hospital in northern Iran with mild dysuria, whose precise onset remained unclear. He had a history of chronic prostate discomfort for several years and acknowledged having multiple sexual partners over the past two decades. He complained of dysuria; therefore, urinalysis was performed, which detected trichomoniasis. He received treatment with metronidazole, resulting in the resolution of urinary symptoms and elimination of the parasite. This case highlights the importance of considering the possibility of trichomoniasis in men, especially older men, as they may face an increased risk of inflammation and prostate cancer.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 5","pages":"3000605251344201"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174169","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":"Effect of surgery for encapsulating peritoneal sclerosis on mortality in patients undergoing peritoneal dialysis: A meta-analysis.","authors":"Wei Huan, Gan Wenyuan, Liu Changxuan, Chen Wenli","doi":"10.1177/03000605251340162","DOIUrl":"10.1177/03000605251340162","url":null,"abstract":"<p><p>ObjectiveThis study aimed to evaluate the effect of surgical versus nonsurgical treatment on mortality in patients with encapsulating peritoneal sclerosis who underwent peritoneal dialysis.MethodsA comprehensive search using PubMed, Google Scholar, MEDLINE, Science Direct, Scopus, and CNKI databases was conducted to extract relevant data based on predefined inclusion criteria. RevMan5.2 was applied to analyze and compare the effect of surgical versus nonsurgical treatment on mortality in patients with encapsulating peritoneal sclerosis who underwent peritoneal dialysis.ResultsA total of 7 studies involving 70 surgical and 57 nonsurgical patients were included, with 61.4% females and 38.6% males. Among them, 69 were Asian and 58 were European patients, with 37.7% and 75.9% of Asian and European patients accepting surgical treatment, respectively. Pooled data analysis indicated that surgical treatment was associated with significantly lower mortality than nonsurgical treatment in patients with encapsulating peritoneal sclerosis (odds ratio = 0.25, 95% confidence interval: 0.11-0.57, Z = 3.29; <i>P </i>=<i> </i>0.001). Subgroup analysis revealed that Asian patients who accepted surgical treatment had significantly lower mortality than those receiving nonsurgical treatment (odds ratio = 0.19, 95% confidence interval: 0.06-0.57, Z = 2.93; <i>P </i>=<i> </i>0.003), whereas no significant difference was observed in mortality between surgical and nonsurgical treatments in European patients (odds ratio = 0.38, 95% confidence interval: 0.10-1.41, Z = 1.45; <i>P </i>=<i> </i>0.15).ConclusionsSurgical treatment was associated with reduced mortality in patients with encapsulating peritoneal sclerosis compared with nonsurgical treatment; however, this benefit was more significant in Asian patients than in European patients.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 5","pages":"3000605251340162"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12106972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142700","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":"Continuous renal replacement therapy for severe transient hyperammonemia in a preterm infant weighing 1120 g: A case report.","authors":"Jinglin Xu, Jiahuai Liu, Hongyuan Yang, Weifeng Zhang, Dongmei Chen, Zhiyong Liu","doi":"10.1177/03000605251340556","DOIUrl":"10.1177/03000605251340556","url":null,"abstract":"<p><p>Transient hyperammonemia of the newborn is a rare form of hyperammonemia with an unclear, likely nongenetic etiology, primarily affecting larger preterm infants. However, lower birth weight and gestational age are associated with higher ammonia levels, increasing the risk of neurotoxicity and hepatotoxicity. Transient hyperammonemia of the newborn typically manifests as respiratory distress within the first 24 h post-birth, progressing to seizures and coma within 48 h. Continuous renal replacement therapy has demonstrated considerable efficacy in managing severe transient hyperammonemia of the newborn due to its high ammonia clearance rate; however, its application remains limited in very low birth weight preterm infants. Herein, we report the case of a male infant born at 28⁺² weeks gestation, weighing 1120 g, who developed transient hyperammonemia of the newborn 22 h post-birth. Despite initial pharmacotherapy and peritoneal dialysis, his ammonia levels continued to rise, necessitating continuous renal replacement therapy. After 42 h of continuous renal replacement therapy, his ammonia levels decreased significantly and he recovered fully, eventually being discharged in good health. This case highlights continuous renal replacement therapy as a viable, life-saving intervention for severe transient hyperammonemia of the newborn, even in very low birth weight preterm infants.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 5","pages":"3000605251340556"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078498","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":"Corrigendum to \"Hypomethylation of the LncRNA H19 promoter accelerates osteogenic differentiation of vascular smooth muscle cells by activating the Erk1/2 pathways\".","authors":"","doi":"10.1177/03000605251347332","DOIUrl":"10.1177/03000605251347332","url":null,"abstract":"","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 5","pages":"3000605251347332"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181128","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":"Development and validation of a predictive model for hospital mortality in patients with community-acquired pneumonia admitted to the intensive care unit.","authors":"Xuefeng Song, Qiang Zhang, Zhijiang Qi, Bo Liu","doi":"10.1177/03000605251340304","DOIUrl":"10.1177/03000605251340304","url":null,"abstract":"<p><p>ObjectiveThis retrospective cohort study aimed to develop and validate a nomogram for predicting in-hospital mortality among patients with community-acquired pneumonia admitted to the intensive care unit.MethodsData of patients meeting the inclusion criteria were extracted from the Medical Information Mart for Intensive Care-IV database, and the patients were randomly allocated into training (n = 3798, 70%) and validation (n = 1629, 30%) cohorts. First-day intensive care unit admission parameters were averaged. Least Absolute Shrinkage and Selection Operator regression and multivariate logistic regression analyses were used to identify mortality risk factors in the training cohort, followed by nomogram construction. Model performance was evaluated based on discrimination (area under the curve), calibration (Hosmer-Lemeshow test and bootstrap resampling), and clinical utility (decision curve analysis). Data from emergency intensive care unit were used to perform external validation of the value of the model.ResultsIn total, 5427 patients were included. Age, red cell distribution width, Sequential Organ Failure Assessment, Acute Physiology Score-III, blood urea nitrogen-to-serum creatinine ratio, anion gap, osmolarity, and sepsis were identified as independent risk factors for hospital mortality. The nomogram demonstrated superior discrimination compared with Sequential Organ Failure Assessment and Acute Physiology Score-III in the validation (area under the curve: 0.772 vs. 0.685-0.724) and training (area under the curve: 0.787 vs. 0.708-0.740; <i>p </i><<i> </i>0.05) sets. Calibration and decision curve analyses confirmed robust performance (Hosmer-Lemeshow <i>p </i>=<i> </i>0.11; net benefit threshold: 20%-80%). In both cohorts, calibration and decision curve analyses showed that the nomogram had good calibration degree, discriminative ability, and clinical benefits. Data from emergency intensive care unit showed that the area under the curve of the model was 0.7864 (95% confidence interval, 0.76-0.81), area under the curve of Sequential Organ Failure Assessment was 0.7217 (95% confidence interval, 0.69-0.75), and area under the curve of Acute Physiology Score-III was 0.7055 (95% confidence interval, 0.68-0.73).ConclusionsThis nomogram provides moderate predictive accuracy for hospital mortality in critically ill patients with community-acquired pneumonia and may aid prognosis assessment.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 5","pages":"3000605251340304"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12102541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127795","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":"Successful management of malignant hyperthermia without dantrolene: A case report.","authors":"Cailing Zhang, Huanbin Wang, Zhi Chen, Yuennong Zhang","doi":"10.1177/03000605251341803","DOIUrl":"10.1177/03000605251341803","url":null,"abstract":"<p><p>Malignant hyperthermia during surgery represents a significant challenge for anesthesiologists due to its high mortality rate and the risk of long-term physiological damage. Despite preventive measures, malignant hyperthermia cases continue to be reported. The standard and effective response involves the prompt administration of dantrolene, a specific antidote. However, dantrolene availability can differ across countries and regions; not all healthcare facilities can guarantee its immediate availability for early intervention. This case report details the successful management of malignant hyperthermia in an adult during surgery without the use of dantrolene.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 5","pages":"3000605251341803"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101949","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":"Hemoadsorption combined with continuous venovenous hemodialyfiltration in a patient with <i>Escherichia coli</i> infection and severe diabetic ketoacidosis-associated rhabdomyolysis: A case report.","authors":"Xiaochun Zhou, Xu Li, Yingying Yang, Fang Wang, Ling Zhang, Ping Fu","doi":"10.1177/03000605251337905","DOIUrl":"10.1177/03000605251337905","url":null,"abstract":"<p><p>Herein, we present a rare and complex clinical case of a patient with urinary tract infection leading to ground <i>Escherichia coli</i> sepsis, severe diabetic ketoacidosis, and severe rhabdomyolysis. The patient was admitted to the hospital with fever, abnormal mental behavior, disturbances in the internal environment, and acute kidney injury and was thoroughly evaluated by physicians to determine the underlying causes of severe rhabdomyolysis, including <i>Escherichia coli</i> infection and metabolic disturbances. After treatment with rehydration resuscitation, anti-infective agents, and hemoadsorption combined with continuous venovenous hemodialyfiltration, the patient's condition improved, renal function was restored, and hemodialysis treatment was discontinued.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 5","pages":"3000605251337905"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078503","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":"Sequential gastric and ileal perforations, a rare presentation in a man with sickle cell anemia: A case report.","authors":"John A Ashindoitiang, Victor Ic Nwagbara, Dino N Magam, Victor D Nnalue, Maurice E Asuquo","doi":"10.1177/03000605251343290","DOIUrl":"10.1177/03000605251343290","url":null,"abstract":"<p><p>The inheritance of the sickle gene (hemoglobin S) and another abnormal hemoglobin gene is described as sickle cell disease, and the homozygous form of the disease is hemoglobin SS. In sickle cell disease, abdominal pain is a common symptom attributed to circulatory stasis and vascular occlusion, along with chest and musculoskeletal pain for which nonsteroidal anti-inflammatory drugs are often prescribed. This report presents the case of a 21-year-old man with sequential gastric and ileal perforations related to nonsteroidal anti-inflammatory drug usage. Gastrointestinal perforation should be considered as a differential diagnosis in patients who present with abdominal pain accompanied with symptoms such as peritonitis, shock, or sepsis. Furthermore, perforation may be sequential with perforation of the stomach followed by that of the ileum. The use of nonsteroidal anti-inflammatory drugs in patients with sickle cell disease requires further revaluation.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 5","pages":"3000605251343290"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136116","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}