Postgraduate Medical Journal最新文献

{"title":"Uncovering novel metabolic and inflammatory pathways in gout using Mendelian randomization.","authors":"Qiuwei Li, Ruocheng Guo, Zuomeng Wu, Chenhao Zhao, Cailiang Shen","doi":"10.1093/postmj/qgaf083","DOIUrl":"https://doi.org/10.1093/postmj/qgaf083","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to systematically evaluate the causal roles of circulating metabolites and inflammatory markers in gout using Mendelian randomization (MR), to uncover underlying pathogenic mechanisms and inform clinical interventions.</p><p><strong>Methods: </strong>Genome-wide association studies (GWAS) data from 14 824 individuals of European ancestry were utilized, covering 1400 blood metabolites and 91 inflammatory markers. Gout data were obtained from a Finnish GWAS cohort. Causal relationships between metabolites, inflammatory markers, and gout were assessed using MR methods such as inverse variance weighted (IVW), MR-Egger, and weighted median approaches. Sensitivity analyses including Cochran's Q test, MR-Egger intercept, and MR-PRESSO were conducted to ensure robustness.</p><p><strong>Results: </strong>Our MR analysis identified five metabolites with significant causal associations with gout, with the following quantified findings: Hexanoylglutamine (OR = 1.28, 95% CI: 1.17-1.41, P = 8.56 × 10-8), Glycocholenate sulfate (OR = 0.87, 95% CI: 0.82-0.92, P = 2.52 × 10-6), and Phenylacetylcarnitine (OR = 1.26, 95% CI: 1.09-1.44, P = .001) were all significantly associated with gout risk. The SLCO1B1 (PPH4 = 0.92) and GCKR (PPH4 = 0.99) loci were found to influence gout through metabolic regulation. Additionally, three inflammatory markers (CST5, FGF21, and MMP1) were causally linked to gout. Specifically, FGF21 increased the phosphate-to-mannose ratio (OR = 1.30, 95% CI: 1.17-1.46, P = 3.70 × 10-6), while MMP1 elevated glycocholenate sulfate and hexanoylglutamine levels, contributing to gout development.</p><p><strong>Conclusion: </strong>This study highlights key metabolites and inflammatory markers in gout pathogenesis, suggesting new therapeutic targets, particularly at the SLCO1B1 and GCKR loci, to improve gout management and patient outcomes.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187822","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":"Enhancing thyroid nodule malignancy prediction: integrating photoacoustic imaging-derived SO2 with clinical and ultrasound data.","authors":"Shuzhen Tang, Zhibin Huang, Jing Chen, Sijie Mo, Jiaping Feng, Guoqiu Li, Xunpeng Luo, Ziyu Li, Yuanyang Wang, Jinfeng Xu, Nan Xu, Fajin Dong","doi":"10.1093/postmj/qgaf081","DOIUrl":"https://doi.org/10.1093/postmj/qgaf081","url":null,"abstract":"<p><strong>Background: </strong>Photoacoustic imaging (PAI) has shown promise in diagnosing thyroid nodules. However, current methods rely on subjective visual assessments, lacking quantitative precision.</p><p><strong>Purpose: </strong>This study evaluates the diagnostic accuracy of PAI in distinguishing benign from malignant thyroid nodules. The study integrates PAI with ultrasound and clinical data to improve prediction accuracy.</p><p><strong>Materials and methods: </strong>A total of 407 thyroid nodules were analyzed, divided into training and testing sets (8:2). Dual-wavelength PAI was used to measure the oxygen saturation (SO2) values of lesions. Predictive factors were identified through logistic regression, resulting in three models: Mod-1 (clinical factors), Mod-2 (clinical + ultrasound factors), and Mod-3 (clinical + ultrasound + PAI-derived SO2 factors). Diagnostic performance was assessed using the area under the curve (AUC) and the DeLong test.</p><p><strong>Results: </strong>Malignant lesions exhibited significantly lower oxygen saturation values (77.25 vs. 65.08, P < .01). The AUC for average oxygen saturation parameter was 0.829. In the testing cohort, the AUCs for Mod-1, Mod-2, and Mod-3 were 0.696, 0.947, and 0.974, respectively, with Mod-3 outperforming the others.</p><p><strong>Conclusion: </strong>PAI-derived SO2 provides a quantitative, noninvasive approach for thyroid nodule diagnosis. Combining PAI with clinical and ultrasound data enhances malignancy prediction, aiding personalized management.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187821","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":"The role of resident doctor sustainability leads in tackling climate change: an editorial.","authors":"Harriet Elson, Gillian Lever","doi":"10.1093/postmj/qgaf078","DOIUrl":"https://doi.org/10.1093/postmj/qgaf078","url":null,"abstract":"","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174642","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":"Association between long working hours and poor cardiovascular health assessed by the American Heart Association's \"Life's essential 8\": findings from a nationally representative sample of Korean workers (2014-2021).","authors":"Seong-Uk Baek, Jin-Ha Yoon","doi":"10.1093/postmj/qgaf010","DOIUrl":"https://doi.org/10.1093/postmj/qgaf010","url":null,"abstract":"<p><strong>Background: </strong>Long working hours represent a major public health concern. We explored the association between working hours and the American Heart Association's \"Life's Essential 8 (LE8).\"</p><p><strong>Methods: </strong>A nationwide sample comprising 21 062 Korean workers was analyzed. The LE8 scores (range 0-100) were calculated based on the following cardiovascular disease risk factors: diet, physical activity, nicotine exposure, sleep health, body mass index, blood lipid levels, blood glucose levels, and blood pressure. Cardiovascular health (CVH) was categorized as low (LE8: 0-49), intermediate (LE8: 50-59), and high (LE8: 80-100). Linear regression and multinomial logistic regression models were used for statistical analyses.</p><p><strong>Results: </strong>The means of the LE8 scores for those working <35 h, 35-40 h, 41-48 h, 49-54 h, and ≥ 55 h per week were 69.4, 68.2, 66.8, 64.7, and 61.9, respectively. Among men, working 49-54 h per week [β: -1.43; 95% confidence interval (CI): -2.40, -0.45] and ≥55 h per week (β: -3.23; 95% CI: -4.11, -2.35) were associated with lower LE8 scores. Similarly, among women, working 49-54 h per week (β: -1.62; 95% CI: -2.72, -0.52) and ≥55 h per week (β: -2.88; 95% CI: -3.88, -1.88) had negative associations with LE8 scores. Working ≥55 h per week was associated with a 2.03-fold increase (95% CI: 1.53, 2.68) in the odds of low CVH among men and a 2.02-fold increase (95% CI: 1.37, 2.98) among women.</p><p><strong>Conclusion: </strong>Long working hours are associated with poor CVH, emphasizing the necessity of mitigating excessive working hours. Key message What is already known on this topic-The American Heart Association recently introduced \"Life Essential 8 (LE8),\" a metric assessing cardiovascular health. This study explored the association between long working hours and poor cardiovascular health among Korean adult workers. What this study adds-This study demonstrates that compared with working 35-40 h per week, working ˃48 h per week is associated with a reduced LE8 score. Specifically, working 49-54 h and ≥55 h per week are associated with increased odds of having poor cardiovascular health in both men and women, compared with working 35-40 h per week. Notably, long working hours showed a strong association with the health behavior factors of LE8. How this study might affect research, practice, or policy-This study suggests that promoting cardiovascular health based on the LE8 framework can be beneficial in mitigating the health burdens of long working hours.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174630","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":"A case of euglycaemic diabetic ketoacidosis in a T2DM patient using Tirzepatide.","authors":"Natasha Chaudhury, Rohit Baslas, Kuljeet Bhamra","doi":"10.1093/postmj/qgaf079","DOIUrl":"https://doi.org/10.1093/postmj/qgaf079","url":null,"abstract":"","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132536","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":"Letter in response to \"Effects of mindfulness and sleep quality on self-efficacy of clinical decision making among resident physicians: an observational study\".","authors":"Rupak Chatterjee, Atanu Chandra","doi":"10.1093/postmj/qgaf075","DOIUrl":"https://doi.org/10.1093/postmj/qgaf075","url":null,"abstract":"","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128274","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":"Mendelian randomization analysis for identifying circulating inflammatory cytokines and risk of pancreatic cancers.","authors":"Yangni Li, Ruoshu Duan, Mengjie Hu, Ying Liu, Xiaochen Zhang, Jingjing Ren","doi":"10.1093/postmj/qgaf056","DOIUrl":"https://doi.org/10.1093/postmj/qgaf056","url":null,"abstract":"<p><strong>Objectives: </strong>Inflammation is intricately linked to the emergence and advancement of most cancers, playing a pivotal role in their malignant transformation. Observational evidence revealed the role of cytokines in pancreatic cancer (PC) carcinogenesis. However, observational studies may be limited by small sample sizes, confounding factors, and reverse causality when establishing a correlation between inflammatory cytokines and PC risk.</p><p><strong>Design: </strong>Conducting a two-sample Mendelian randomization analysis, we investigated the potential relationship between inflammatory cytokines in circulation and pancreatic cancer. Data from the most extensive genome-wide association studies (GWAS) on cytokines were utilized, involving 31 112 individuals of European descent. Additionally, the PC GWAS from the Integrative Epidemiology Unit (IEU) analysis of Finnish Biobank data was included, consisting of 605 PC cases and 218 187 controls of European ancestry.</p><p><strong>Results: </strong>Around 47 cytokines were systematically screened, which revealed that circulating levels of IL-1ra (OR: 0.63; 95% CIs: 0.46-0.87; P-value: 4.9 × 10-4), IP-10 (OR: 0.33; 95% CIs: 0.18-0.59; P-value: 1.8 × 10-4) and macrophage inflammatory protein (MIP)-1a (OR: 1.37; 95% CIs: 1.08-1.75; P-value: 1 × 10-2) predicted by genetic criteria were prominently linked to an elevated risk of overall PC.</p><p><strong>Conclusion: </strong>Further evidence indicates that certain inflammatory cytokines play critical roles in PC carcinogenesis and that specific inflammatory cytokines can be targeted to prevent PC. Nevertheless, additional research is necessary to assess the potential of these cytokines in detecting PC at an early stage.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132464","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":"An insight into a primary care facility in Seelampur slum in Delhi.","authors":"Meghna Shah","doi":"10.1093/postmj/qgaf073","DOIUrl":"https://doi.org/10.1093/postmj/qgaf073","url":null,"abstract":"","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120197","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":"CD47 as a biomarker for ovarian cancer: prospects and challenges.","authors":"Xiaorui Cheng, Chi Yan, Jinjin Zhao, Guangjian Lu","doi":"10.1093/postmj/qgaf072","DOIUrl":"https://doi.org/10.1093/postmj/qgaf072","url":null,"abstract":"<p><p>Ovarian cancer is one of the deadliest malignant tumors in the female reproductive system. Currently, an efficient approach for the early detection and reliable prognosis assessment of ovarian cancer remains unavailable, which is still a difficult problem worthy of study. In recent years, cluster of differentiation 47 (CD47) has attracted attention in tumor biology, it provides new possibilities for solving ovarian cancer problems. Although CD47 still has many challenges in clinical practice, such as standardization of detection methods and joint application strategies with other biomarkers, it still shows its potential as a biomarker. This article reviews some serum biomarkers in ovarian cancer, the biological characteristics of CD47, prospects and challenges faced as a biomarker in ovarian cancer, aiming to provide a comprehensive analysis of CD47 application in ovarian cancer.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094641","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":"Dose-dependent association between proton pump inhibitor use and the risk of migraine: a nationwide matched case-control study.","authors":"Yuan-Zhen Ruan, Fu-Chi Yang, Ya-Mei Bai, Chia-Fen Tsai, Chih-Sung Liang, Tung-Ping Su, Shih-Jen Tsai, Tzeng-Ji Chen, Chia-Kuang Tsai, Mu-Hong Chen","doi":"10.1093/postmj/qgaf077","DOIUrl":"https://doi.org/10.1093/postmj/qgaf077","url":null,"abstract":"<p><strong>Background: </strong>Proton pump inhibitors (PPIs) are widely prescribed, but their link to migraine risk, especially in Asian populations, remains unclear. This longitudinal study aimed to answer the following question: Does PPI exposure show a dose-dependent risk of migraine, varying by subtype and PPI indication in an Asian population?</p><p><strong>Method: </strong>Using Taiwan's National Health Insurance Research Database (2000-15), we conducted a matched case-control study on PPI exposure. Adults prescribed PPIs for peptic ulcers, gastroesophageal reflux disease, or upper gastrointestinal bleeding were included, excluding those with prior migraines or incomplete data. Controls were matched 1:1 by age, sex, and residence. PPI exposure was measured in cumulative defined daily doses (cDDDs).</p><p><strong>Result: </strong>The study included 22 834 PPI users (11 417 cases, 11 417 controls) with a mean follow-up of 4.1 ± 3.3 years. The study population comprised 65.6% females and 34.4% males, with no significant sex difference (P = 1.000). Mean age was 47.27 ± 15.16 years in cases and 47.42 ± 15.14 years in controls (P = .444). The average interval from PPI initiation to migraine diagnosis was 2.4 ± 1.9 years. Compared with those with the lowest PPI exposure (cDDD ≤30), migraine risk progressively increases with greater cumulative exposure: cDDD 31-120 [aOR = 1.22, 95% confidence interval (CI) = 1.15-1.30], cDDD 121-365 (aOR = 1.42, 95% CI = 1.32-1.52), and cDDD >365 (aOR = 1.60, 95% CI = 1.41-1.80). This dose-dependent relationship was consistent across migraine subtypes and PPI indications.</p><p><strong>Conclusion: </strong>This large-scale Asian population study revealed a significant dose-dependent association between PPI exposure and increased migraine risk, emphasizing the need for cautious prescribing and monitoring of migraine symptoms in long-term PPI users, particularly in Asian populations.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094648","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}