Medical hypotheses最新文献

Endogenous conversion of alcohol to norepinephrine and epinephrine may contribute to hangover 内源性酒精转化为去甲肾上腺素和肾上腺素可能有助于宿醉

IF 2.1 4区医学

Medical hypotheses Pub Date : 2025-07-14 DOI: 10.1016/j.mehy.2025.111716

Paul J. Fitzgerald , Piotr Wlaź , Katarzyna Socała

{"title":"Endogenous conversion of alcohol to norepinephrine and epinephrine may contribute to hangover","authors":"Paul J. Fitzgerald , Piotr Wlaź , Katarzyna Socała","doi":"10.1016/j.mehy.2025.111716","DOIUrl":"10.1016/j.mehy.2025.111716","url":null,"abstract":"<div><div>Several theoretical publications have suggested that there may be a novel biosynthetic pathway or pathways that transform alcohol (ethanol) into the catecholaminergic neurotransmitters dopamine, norepinephrine (NE), and epinephrine (EPI). A recent empirical, high-resolution mass spectrometry study in mice found that ethanol indeed boosts hippocampal NE in a molecularly selective manner, where such NE could be converted to EPI. The current publication puts forth a new but related hypothesis: boosting of NE and EPI by ethanol may play an important role in the alcohol-related hangover (AH). Aversive symptoms of AH such as fatigue, headache, dry mouth, nausea, elevated blood pressure, sweating, sensitivity to light and sound, anxiety, irritability, dehydration, and disrupted sleep, may all be partially related to elevated NE and EPI, both in the brain and in the periphery. Some of these symptoms have previously been associated with noradrenergic or adrenergic signaling. If conversion of ethanol to these two catecholamines really is a prominent factor in AH, then noradrenergic transmission reducing drugs such as clonidine, guanfacine, propranolol, and prazosin may have therapeutic properties in this condition. Lastly, if consumption of excessive amounts of alcohol can result in dangerously high levels of NE and EPI through acute biosynthesis, this could play a role in alcohol poisoning and its potential lethality.</div></div>","PeriodicalId":18425,"journal":{"name":"Medical hypotheses","volume":"201 ","pages":"Article 111716"},"PeriodicalIF":2.1,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144655714","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}

引用次数: 0

Local hematoma may be a cause of peripheral fusion after spinal surgery 局部血肿可能是脊柱手术后周围融合的原因

IF 2.1 4区医学

Medical hypotheses Pub Date : 2025-07-14 DOI: 10.1016/j.mehy.2025.111717

Lei Zhou, Yong Tang, Jihong Jiang, Changwei Chen

引用次数: 0

Mitigating arterial compliance to diminish migraine risk: A hypothesis 减轻动脉顺应性以减少偏头痛风险：一种假设

IF 2.1 4区医学

Medical hypotheses Pub Date : 2025-07-14 DOI: 10.1016/j.mehy.2025.111715

Yaheng Zhao , Xiaoyan Qin , Guoli Zhao , Zeguo Feng , Shaohua You

{"title":"Mitigating arterial compliance to diminish migraine risk: A hypothesis","authors":"Yaheng Zhao , Xiaoyan Qin , Guoli Zhao , Zeguo Feng , Shaohua You","doi":"10.1016/j.mehy.2025.111715","DOIUrl":"10.1016/j.mehy.2025.111715","url":null,"abstract":"<div><div>Migraine is a disabling neurovascular disorder that primarily affects young people and women, despite their generally high arterial compliance. We hypothesize that a reduction in arterial compliance may lower the risk of migraine. This counter – intuitive view is supported by the observation that young people and women, who typically have better vascular compliance, have the highest prevalence of migraine, while diseases associated with reduced compliance, such as diabetes, show a lower incidence of migraine. Using Mendelian randomization with genetic variants related to pulse pressure as a proxy for arterial compliance, our study found that a higher pulse pressure (indicating lower compliance) was associated with a reduced risk of migraine. This is consistent with the mechanisms of current migraine treatments, such as triptans, CGRP inhibitors, and warfarin, which reduce arterial compliance, and vasodilators like nitroglycerin, which can trigger migraines by increasing compliance. If confirmed, this hypothesis could transform our understanding of the pathophysiology of migraine and inspire new treatment strategies targeting arterial compliance. Future research should further explore this relationship through clinical and experimental studies to elucidate the potential mechanisms and applications for migraine prevention and treatment.</div></div>","PeriodicalId":18425,"journal":{"name":"Medical hypotheses","volume":"201 ","pages":"Article 111715"},"PeriodicalIF":2.1,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144634576","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}

引用次数: 0

Optimizing post-anesthesia recovery in pediatrics: The opportunities and challenges 优化儿科麻醉后恢复：机遇与挑战

IF 2.1 4区医学

Medical hypotheses Pub Date : 2025-07-13 DOI: 10.1016/j.mehy.2025.111712

Rohan Magoon , Jes Jose

引用次数: 0

Long Vax is delayed onset Long COVID “Long Vax”为延时型“Long COVID”

IF 2.1 4区医学

Medical hypotheses Pub Date : 2025-07-09 DOI: 10.1016/j.mehy.2025.111711

Thomas Bunker

{"title":"Long Vax is delayed onset Long COVID","authors":"Thomas Bunker","doi":"10.1016/j.mehy.2025.111711","DOIUrl":"10.1016/j.mehy.2025.111711","url":null,"abstract":"<div><div>Long COVID is a common chronic health condition that impairs daily functioning and social connection. It affects multiple organs and is marked by fatigue, post-exertional malaise, cognitive impairment, and many autonomic dysfunctions. Post COVID-19 Vaccination Syndrome (PCVS), Post Acute Covid Vaccination Syndrome (PACVS), or simply ‘Long Vax’ is a large set of similar symptoms that first manifest hours, days or weeks following a COVID-19 vaccination. Perhaps because of the pandemic’s public health imperative to vaccinate populations and prevent acute COVID-19 deaths, the Long Vax phenomenon has been slow to be acknowledged and to the frustrated patient community post-vaccine issues seem like a taboo medical topic. Meanwhile, evidence is accumulating that low-level persistence of SARS-CoV-2 virus in a variety of cell types and tissues may be the root cause of Long COVID symptoms. We propose that based on the similarity of patient-reported symptoms, symptom prevalence, and patient demographics that Long COVID and Long Vax are the same medical condition. Furthermore, we propose that both have the same underlying pathobiology; viral persistence of SARS-CoV-2. This hypothesis implies that the same treatments that help Long COVID patients will also help Long Vax patients. It is important that Long Vax patients be identified in Long COVID cohorts and included for subgroup analyses in Long COVID clinical trials. As biomarkers and diagnostic tests for Long COVID are developed and validated, this hypothesis becomes easily testable as it predicts that the same measures will also be useful for characterizing Long Vax patients.</div></div>","PeriodicalId":18425,"journal":{"name":"Medical hypotheses","volume":"201 ","pages":"Article 111711"},"PeriodicalIF":2.1,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605844","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}

引用次数: 0

Creatine supplementation as a dual therapeutic strategy for sarcopenia and immune dysregulation in systemic lupus erythematosus: A hypothesis-driven approach 补充肌酸作为系统性红斑狼疮肌肉减少症和免疫失调的双重治疗策略：一种假设驱动的方法

IF 2.1 4区医学

Medical hypotheses Pub Date : 2025-07-08 DOI: 10.1016/j.mehy.2025.111710

Emanuel Amezcua-Castillo , Luis M Amezcua-Castillo , Laura Barragán-Huerta , Diana Castillo-Martínez , Luis M Amezcua-Guerra

{"title":"Creatine supplementation as a dual therapeutic strategy for sarcopenia and immune dysregulation in systemic lupus erythematosus: A hypothesis-driven approach","authors":"Emanuel Amezcua-Castillo , Luis M Amezcua-Castillo , Laura Barragán-Huerta , Diana Castillo-Martínez , Luis M Amezcua-Guerra","doi":"10.1016/j.mehy.2025.111710","DOIUrl":"10.1016/j.mehy.2025.111710","url":null,"abstract":"<div><div>Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder characterized by profound immune dysregulation, primarily driven by abnormal toll-like receptor (TLR) signalling and the subsequent overproduction of type I and III interferons. Activated TLRs contribute to B cell hyperactivity, dendritic cell maturation, and the expansion of proinflammatory T cell subsets, thereby perpetuating systemic inflammation and tissue damage. Concurrently, patients with SLE often develop sarcopenia, a progressive loss of skeletal muscle mass and function, leading to frailty, reduced physical performance, and increased morbidity and mortality.</div><div>Creatine, a naturally occurring compound essential for ATP regeneration, is widely recognized for its ergogenic effects and is increasingly appreciated for its anti-inflammatory and immunomodulatory properties. Recent preclinical evidence suggests that creatine may attenuate TLR-mediated signalling and reduce the expression of proinflammatory cytokines.</div><div>Here, we propose a dual-action hypothesis whereby creatine supplementation in SLE may: (1) modulate innate immune activation by inhibiting TLR signalling and, consequently, dampen type I and III interferon responses; and (2) counteract sarcopenia by enhancing muscle bioenergetics and mitigating inflammation-induced catabolic processes.</div><div>The convergence of these mechanisms—orchestrated by creatine, an accessible and well-tolerated compound even at relatively high doses—may restore immunological homeostasis, preserve muscle function, and improve long-term clinical outcomes in patients with SLE.</div></div>","PeriodicalId":18425,"journal":{"name":"Medical hypotheses","volume":"201 ","pages":"Article 111710"},"PeriodicalIF":2.1,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144611758","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}

引用次数: 0

Hyoid slump hypothesis: A rational approach to understanding obstructive sleep apnea and related airway disorders 舌骨塌陷假说：理解阻塞性睡眠呼吸暂停及相关气道疾病的合理途径

IF 2.1 4区医学

Medical hypotheses Pub Date : 2025-07-06 DOI: 10.1016/j.mehy.2025.111709

Björn U. Winter, John Mew

{"title":"Hyoid slump hypothesis: A rational approach to understanding obstructive sleep apnea and related airway disorders","authors":"Björn U. Winter, John Mew","doi":"10.1016/j.mehy.2025.111709","DOIUrl":"10.1016/j.mehy.2025.111709","url":null,"abstract":"<div><div>Obstructive sleep apnea (OSA) significantly affects health; however, its pathogenesis remains unclear. We propose the Hyoid Slump Hypothesis, which identifies the caudal displacement (“slump”) of the hyoid bone as a central etiological factor underlying OSA. Traditional models emphasize obesity and soft tissue redundancy in adults. In contrast, adenotonsillar hypertrophy is typically the primary cause of upper airway obstruction in children, although soft tissue factors become increasingly relevant with age and obesity. Accumulating evidence indicates that craniofacial development and neuromuscular function are critical for maintaining airway patency. Poor oral posture and dysfunctional breathing predispose individuals to a lower hyoid position, thereby reducing airway stability. Cephalometric radiography studies have consistently linked an increased mandibular plane-to-hyoid (MP-H) distance to OSA severity. Dynamic imaging methods have demonstrated significantly inferior hyoid displacement during airway collapse events. Therapeutic interventions targeting hyoid elevation, such as mandibular advancement, orthopedic maxillary expansion, hyoid suspension and myofunctional therapy, provide additional support. Despite promising evidence, limitations include reliance on observational data, lack of standardized measurement protocols, and the multifactorial nature of OSA. Prospective studies are needed to clarify causality, refine diagnostics, and guide individualized interventions. Confirmation of this hypothesis would enhance diagnostic precision, support early preventive strategies in childhood, and allow targeted therapeutic approaches tailored to the distinct anatomical phenotypes of airway obstruction.</div></div>","PeriodicalId":18425,"journal":{"name":"Medical hypotheses","volume":"201 ","pages":"Article 111709"},"PeriodicalIF":2.1,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144579743","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}

引用次数: 0

Female urinary continence mechanism: a dynamic biomechanical balance 女性尿失禁机制：动态生物力学平衡

IF 2.1 4区医学

Medical hypotheses Pub Date : 2025-07-06 DOI: 10.1016/j.mehy.2025.111708

Daoming Tian, Ling Li, Yubin Wen, Yuan Li, Hongcheng Li, Jiangna Gu, Qian Luo, Jihong Shen

{"title":"Female urinary continence mechanism: a dynamic biomechanical balance","authors":"Daoming Tian, Ling Li, Yubin Wen, Yuan Li, Hongcheng Li, Jiangna Gu, Qian Luo, Jihong Shen","doi":"10.1016/j.mehy.2025.111708","DOIUrl":"10.1016/j.mehy.2025.111708","url":null,"abstract":"<div><div>Female urinary incontinence has been redefined as a dynamic biomechanical equilibrium governed by three synergistic mechanisms: (1) Mechanical equilibrium mechanism of bladder neck-perineal body dynamics, which stabilizes urethral closure during pressure surges; and (2) urethral kinking through mid-proximal urethral displacement differences; (3) sphincter-pelvic floor muscle synergy to amplify compressive forces. (4).Neuro-Biomechanical Synergistic Control Mechanism.This hypothesis challenges static anatomical models by emphasizing real-time adaptive biomechanics and explains stress urinary incontinence (SUI) through force transmission, neuromuscular coordination, or chronic pressure overload faults. Clinically, real-time imaging and computational modeling are advocated to replace traditional examination modalities to quantify biomechanical deficits-structural, functional, and neurogenic. Targeted interventions include perineal body reinforcement surgery and nerve retraining programs. Validation requires multidisciplinary trials: prospective cohorts linking dynamic parameters to incontinence outcomes, finite element simulations of mechanism interactions, and randomized comparisons of mechanism-specific therapies. The framework bridges biomechanics, neural control, and clinical practice, enabling a shift from symptom management to precise mechanism-based SUI treatment.</div></div>","PeriodicalId":18425,"journal":{"name":"Medical hypotheses","volume":"201 ","pages":"Article 111708"},"PeriodicalIF":2.1,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144680169","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}

引用次数: 0

Postnatal hemoglobin P50 as a surrogate marker for hypoxia-driven NEC in preterm infants: a mechanistic hypothesis P50 and NEC risk 出生后血红蛋白P50作为早产婴儿缺氧驱动NEC的替代标志物：P50和NEC风险的机制假说

IF 2.1 4区医学

Medical hypotheses Pub Date : 2025-07-04 DOI: 10.1016/j.mehy.2025.111707

Emrah Can , Yakup Karakurt

{"title":"Postnatal hemoglobin P50 as a surrogate marker for hypoxia-driven NEC in preterm infants: a mechanistic hypothesis P50 and NEC risk","authors":"Emrah Can , Yakup Karakurt","doi":"10.1016/j.mehy.2025.111707","DOIUrl":"10.1016/j.mehy.2025.111707","url":null,"abstract":"<div><div>Necrotizing enterocolitis (NEC) is a major cause of morbidity and mortality in preterm infants. Despite decades of investigation, clinicians lack an early, physiologically grounded biomarker that signals risk before clinical deterioration. We hypothesize that persistently elevated hemoglobin P<sub>50</sub> during the first 72 h of life reflects impaired oxygen unloading and evolving systemic hypoxia, particularly affecting the splanchnic circulation. This rightward shift in the oxygen dissociation curve, driven by increased 2,3-diphosphoglycerate (2,3-DPG), may precede lactate elevation and herald the onset of intestinal injury. Mechanistically, this pathway is underpinned by hypoxia-inducible factor-1α (HIF-1α) stabilization and Toll-like receptor 4 (TLR4) activation, both implicated in NEC pathogenesis. We present a physiologic rationale supported by prior data, including preliminary observations, and propose clinical and experimental approaches to validate the hypothesis. If confirmed, P<sub>50</sub> could represent a routinely accessible, noninvasive biomarker for early NEC risk stratification.</div></div>","PeriodicalId":18425,"journal":{"name":"Medical hypotheses","volume":"201 ","pages":"Article 111707"},"PeriodicalIF":2.1,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562957","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}

引用次数: 0

Nasal carbon dioxide monitoring as the optimal indicator for assessing pediatric recovery in the post-anesthesia care unit 鼻二氧化碳监测作为评估麻醉后护理单位儿童康复的最佳指标

IF 2.1 4区医学

Medical hypotheses Pub Date : 2025-06-30 DOI: 10.1016/j.mehy.2025.111706

Xu Yan , Shuzhen Liu , Shiyong Li , Xing Li , Ailin Luo , Yilin Zhao , Xue Zhang

引用次数: 0