Medicina Clinica最新文献

Quantitative analysis of chest CT with deep learning to assess the efficacy of tofacitinib in the treatment of anti-MDA5+ dermatomyositis 应用深度学习定量分析胸部CT评价托法替尼治疗抗mda5 +皮肌炎的疗效

IF 2.1 4区医学

Medicina Clinica Pub Date : 2025-10-10 DOI: 10.1016/j.medcli.2025.107206

Na You , Xuan Cao , Hualing Nie , Tong Su , Hua Song , Ziyi Jin , Xiaoyan Xin , Dandan Wang , Lingyun Sun

{"title":"Quantitative analysis of chest CT with deep learning to assess the efficacy of tofacitinib in the treatment of anti-MDA5+ dermatomyositis","authors":"Na You , Xuan Cao , Hualing Nie , Tong Su , Hua Song , Ziyi Jin , Xiaoyan Xin , Dandan Wang , Lingyun Sun","doi":"10.1016/j.medcli.2025.107206","DOIUrl":"10.1016/j.medcli.2025.107206","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>This study aimed to clarify whether quantitative high-resolution computed tomography (HRCT) analysis can assess the condition of interstitial lung disease (ILD) associated with anti-melanoma differentiation-associated gene 5 positive (anti MDA5+) dermatomyositis (DM) and investigate the efficacy of tofacitinib in the treatment of anti-MDA5+ DM.</div></div><div><h3>Materials and methods</h3><div>Seventy patients were included in this retrospective study: 39 in the tofacitinib group and 31 in the group without tofacitinib. Patients’ HRCT were uploaded to a deep learning system to assess ILD regression. Based on patients’ quantitative HRCT results, survival and glucocorticoids (GCs) usage, the efficacy of tofacitinib in the treatment of anti-MDA5+ DM were assessed. The safety was assessed by recording the incidence of adverse reactions. Data were analyzed using SPSS26.0 and R4.4.1.</div></div><div><h3>Results</h3><div>No significant differences for baseline characteristics were observed between the two groups of patients, except for cutaneous involvement. Tofacitinib group showed higher 3-year survival and it was an independent protective factor against mortality. Elevated serum ferritin (>1000μg/L) increased the risk of death. Quantitative HRCT analysis showed a significant reduction in the percentage of whole-lung involvement in the tofacitinib group between the baseline and follow-up. The total lesion volume reduction in the whole lung after treatment was substantially higher in the tofacitinib group. The tofacitinib group had a shorter duration of GCs tapering and a higher risk of EBV infection.</div></div><div><h3>Conclusions</h3><div>Quantitative HRCT analysis can be used to assess the response of ILD to tofacitinib treatment. Tofacitinib is effective in patients with anti-MDA5+ DM-ILD but increases the risk of infection.</div></div>","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"165 6","pages":"Article 107206"},"PeriodicalIF":2.1,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145265506","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

Transthyretin stabilizer targeting for transthyretin amyloid cardiomyopathy: A systematic review and meta-analysis 转甲状腺素稳定剂靶向转甲状腺素淀粉样心肌病：系统回顾和荟萃分析

IF 2.1 4区医学

Medicina Clinica Pub Date : 2025-10-09 DOI: 10.1016/j.medcli.2025.107200

João Victor de Oliveira Ramos , João Vitor Andrade Fernandes , Yan Gadelha de Abrantes Formiga , Carlos Henrique de Oliveira Ferreira , Fabyan Esberard de Lima Beltrão , Marcelo Dantas Tavares de Melo

{"title":"Transthyretin stabilizer targeting for transthyretin amyloid cardiomyopathy: A systematic review and meta-analysis","authors":"João Victor de Oliveira Ramos , João Vitor Andrade Fernandes , Yan Gadelha de Abrantes Formiga , Carlos Henrique de Oliveira Ferreira , Fabyan Esberard de Lima Beltrão , Marcelo Dantas Tavares de Melo","doi":"10.1016/j.medcli.2025.107200","DOIUrl":"10.1016/j.medcli.2025.107200","url":null,"abstract":"<div><h3>Introduction</h3><div>Transthyretin amyloid cardiomyopathy (ATTR-CM) is a progressive disease caused by cardiac amyloid deposition. Transthyretin stabilizers (TTRS) are a potential treatment, but their efficacy and safety remain uncertain. This study aims to evaluate the effects of TTRS on all-cause mortality, functional capacity, quality of life, and adverse events in ATTR-CM patients.</div></div><div><h3>Methods</h3><div>A systematic review and meta-analysis was conducted in February 2025 using Cochrane Central, PubMed, and Embase to identify clinical trials and observational studies comparing TTRS versus no-TTRS therapies. Two reviewers independently assessed study eligibility and extracted data. Outcomes were analyzed using odds ratios (OR) and mean differences (MD) with 95% confidence intervals. Heterogeneity was evaluated using <em>I</em><sup>2</sup> statistics, and sensitivity analyses were performed where appropriate. Risk of bias was assessed using ROBINS-I V2 and RoB 2 tools.</div></div><div><h3>Results</h3><div>Seventeen studies with 5209 participants (2399 TTRS; 2810 controls) were included. TTRS significantly reduced all-cause mortality (OR 0.20; 95% CI 0.11–0.37; <em>p</em>  <0.01). No mortality benefit was observed in groups with mixed tafamidis doses (OR 0.75; 95% CI 0.41–1.38; <em>p</em>  <!-->0.14). TTRS improved quality of life (KCCQ-OS: MD 11.70) and functional capacity (6-minute walk test: SMD 50.68). Fewer adverse events (OR 0.19) and serious events (OR 0.54) were reported, with no difference in severe events.</div></div><div><h3>Conclusion</h3><div>TTRS, especially tafamidis, reduce mortality and improve outcomes in ATTR-CM.</div></div>","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"165 6","pages":"Article 107200"},"PeriodicalIF":2.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145265505","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

Metformina: paradigma de pleiotropismo terapéutico (1922-2025) 二甲双胍：治疗多效性的范例（1922-2025）。

IF 2.1 4区医学

Medicina Clinica Pub Date : 2025-10-08 DOI: 10.1016/j.medcli.2025.107189

Alberto de Leiva Hidalgo , Ferran Morell Brotad

引用次数: 0

False positive AI results due to breast implants on chest radiographs: The importance of the lateral view 胸部x线片假阳性人工智能结果：侧位视图的重要性。

IF 2.1 4区医学

Medicina Clinica Pub Date : 2025-10-07 DOI: 10.1016/j.medcli.2025.107170

Luis Gorospe, Esther Gambí-Pisonero, Ana María Ayala-Carbonero

引用次数: 0

Ultrasound in the study of soft tissue infections 超声在软组织感染研究中的应用。