Postgraduate Medical Journal最新文献

{"title":"Exploration oxidative stress underlying gastroesophageal reflux disease and therapeutic targets identification: a multi-omics Mendelian randomization study.","authors":"Jiaxin Shi, Bo Peng, Ran Xu, Xiaoyan Chang, Chenghao Wang, Xiang Zhou, Linyou Zhang","doi":"10.1093/postmj/qgae182","DOIUrl":"10.1093/postmj/qgae182","url":null,"abstract":"<p><strong>Introduction: </strong>Gastroesophageal reflux disease (GERD) is a chronic inflammatory gastrointestinal disease, which has no thoroughly effective or safe treatment. Elevated oxidative stress is a common consequence of chronic inflammatory conditions.</p><p><strong>Methods: </strong>We employed Summary-data based MR (SMR) analysis to assess the associations between gene molecular characteristics and GERD. Exposure data were the summary-level data on the levels of DNA methylation, gene expression, and protein expression, which obtained from related methylation, expression, and protein quantitative trait loci investigations (mQTL, eQTL, and pQTL). Outcome data, Genome-wide association study (GWAS) summary statistics of GERD, were extracted from the Ong's study (discovery), the Dönertaş's study (replication), and the FinnGen study (replication). Colocalization analysis was performed to determine if the detected signal pairs shared a causative genetic mutation. Oxidative stress related genes and druggable genes were imported to explore oxidative stress mechanism underlying GERD and therapeutic targets of GERD. The Drugbank database was utilized to conduct druggability evaluation.</p><p><strong>Results: </strong>After multi-omics SMR analysis and colocalization analysis, we identified seven key genes for GERD, which were SUOX and SERPING1, DUSP13, SULT1A1, LMOD1, UBE2L6, and PSCA. SUOX was screened out to be the mediator, which suggest that GERD is related to oxidative stress. SERPING1, SULT1A1, and PSCA were selected to be the druggable genes.</p><p><strong>Conclusions: </strong>These findings offered strong support for the identification of GERD treatment targets in the future as well as for the study of the oxidative stress mechanism underlying GERD.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"517-525"},"PeriodicalIF":3.6,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822665","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":"Risk factors associated with pain and pain relief in patients with chronic pancreatitis.","authors":"Bingqing Li, Yuning Chu, Xiaowei Wang, Pin Meng, Liang Fang, Zi-Bin Tian, Xiaoyu Li","doi":"10.1093/postmj/qgae185","DOIUrl":"10.1093/postmj/qgae185","url":null,"abstract":"<p><strong>Background: </strong>Abdominal pain is one of the most prominent symptoms in patients with chronic pancreatitis (CP) and can manifest intermittently or persistently. The mechanism of pain is not yet clear, and no effective treatment is currently available. This study aimed to explore the risk factors for pain in patients with CP, which may provide new insights for developing effective pain control modalities.</p><p><strong>Methods: </strong>This clinical study was based on a single-centre research database that included 570 patients with CP. We compared the differences in baseline data, clinical characteristics, and psychophysiology traits between patients with and without pain. Subsequently, patients will be followed up to assess changes in their risk factors and explore their relationship with pain.</p><p><strong>Results: </strong>In the final risk factor model, young age (P = .031; odds ratio [OR] = 0.986 [0.973, 0.999]), prolonged disease duration (P < .001; OR = 1.307 [1.127, 1.516]), heavy smoking (P = .014; OR = 1.331 [1.060, 1.617]), alcohol consumption (P = .003; OR = 1.419 [1.127, 1.788]), low body mass index (P < .001; OR = 0.786 [0.703, 0.879]), pancreatic exocrine insufficiency (P = .040; OR = 1.683 [1.024, 2.767]), acute pancreatitis attacks (P = .027; OR = 1.759 [1.067, 2.902]), anxiety, and depression (P = .016; OR = 1.047 [1.009, 1.088]; P = .014; OR = 1.068 [1.013, 1.126]) were associated with CP pain. Reducing tobacco and alcohol intake (P = .001; OR = 2.367 [1.525, 4.637]; P = .024; OR = 2.011 [1.085, 3.199]), increasing the body mass index (P = .005; OR = 1.968 [1.265, 3.805]), and improving anxiety (P = .001; OR = 1.164 [1.081, 1.340]) were identified to be beneficial for pain relief. Compared to the effects on persistent pain, pancreatic enzyme supplementation (P = .004; OR = 1.794 [1.186, 2.502]) had a clear effect on intermittent pain in patients with CP.</p><p><strong>Conclusion: </strong>We identified a multifactorial model of pain risk factors for CP and confirmed that modifying these risk factors could influence patient pain symptoms.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"545-552"},"PeriodicalIF":3.6,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010304","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":"Strategic tips to successfully undertake research: a comprehensive roadmap for medical trainees.","authors":"Isaac Oluwatobi Akefe, Victoria Aderonke Adegoke, Elijah Akefe","doi":"10.1093/postmj/qgaf001","DOIUrl":"10.1093/postmj/qgaf001","url":null,"abstract":"<p><p>Engaging in research during medical training is crucial for fostering critical thinking, enhancing clinical skills, and deepening understanding of medical science. Despite its importance, the shortage of physician-scientists lingers with many trainees and junior doctors encountering challenges navigating the research process. Drawing on current literature, this article provides a comprehensive roadmap, categorising 12 actionable strategies into five themes, to help medical trainees overcome common obstacles and optimise their research experience. The strategies include early planning, research conduct and integrity, productivity and time management, collaboration and dissemination, and personal growth and development. By implementing these evidence-based recommendations, derived from current literature and expert insights, medical trainees can refine their research skills, produce high-quality outputs, and contribute meaningfully to the scientific community, ultimately enriching their medical training and future careers.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"574-582"},"PeriodicalIF":3.6,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010307","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":"Refining mortality prediction in earthquake-induced rhabdomyolysis: evaluating the McMahon score.","authors":"John Patrick C Toledo","doi":"10.1093/postmj/qgae123","DOIUrl":"10.1093/postmj/qgae123","url":null,"abstract":"","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"585"},"PeriodicalIF":3.6,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142293740","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":"Exploring multiple ways for a successful COVID-19 vaccination program in the Philippines.","authors":"Dalmacito A Cordero","doi":"10.1093/postmj/qgae151","DOIUrl":"10.1093/postmj/qgae151","url":null,"abstract":"","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"586-587"},"PeriodicalIF":3.6,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546916","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 causal relationship between negative emotions and inflammatory dermatoses: a bidirectional Mendelian randomization study.","authors":"Keyi Zhang, Mingwei Zeng, Li Lei, Chuhan Fu, Jiangfeng Huang, Shu Zhou, Yaqing Wen, Jinhua Huang, Jing Chen, Qinghai Zeng","doi":"10.1093/postmj/qgae173","DOIUrl":"10.1093/postmj/qgae173","url":null,"abstract":"<p><strong>Purpose: </strong>Observational studies have suggested a potential link between emotions and inflammatory dermatoses. However, research on the causal relationship between different types of emotions and inflammatory dermatoses is lacking. This study is aimed to investigate the causal relationship between negative emotions and inflammatory dermatoses through Mendelian randomization (MR) analysis.</p><p><strong>Methods: </strong>Summary data of seven negative emotions were obtained from a genome-wide association study (GWAS) conducted by the MRC-IEU consortium. Seven inflammatory dermatoses including vitiligo, psoriasis, systemic lupus erythematosus, eczema, atopic dermatitis, acne, and rosacea were obtained from published GWAS. The MR analysis primarily employed the Inverse variance weighted (IVW) method, and supplemented by MR-Egger and other three MR methods.</p><p><strong>Results: </strong>The IVW method revealed that guilty feelings have potential to increase the risk of psoriasis (OR = 1.02, 95% CI: 1.00-1.05, P = 0.019), while worrier/anxious feelings have a potential risk effect on eczema (OR = 1.07, 95% CI: 1.00-1.13, P = 0.042). Psoriasis could increase the occurrence of miserableness (OR = 1.41, 95% CI: 1.18-1.68, P = 0.0001), worrier/anxious feelings (OR = 1.26, 95% CI: 1.02-1.57, P = 0.033), nervous feelings (OR = 1.25, 95% CI: 1.05-1.49, P = 0.012), and loneliness/isolation (OR = 1.19, 95% CI: 1.04-1.36, P = 0.009). Eczema might cause an increased incidence of worrier/anxious feelings (OR = 1.038, 95% CI: 1.007-1.070, P = 0.014).</p><p><strong>Conclusion: </strong>This MR study revealed bidirectional causality between worrier/anxious feelings and eczema. It also found that guilty feelings may elevate the risk of psoriasis, and individuals with psoriasis may experience increased rates of miserableness, worrier/anxious feelings, nervous feelings, and loneliness/isolation.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"511-516"},"PeriodicalIF":3.6,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807767","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":"Integrating bioinformatics and machine learning to unravel shared mechanisms and biomarkers in chronic obstructive pulmonary disease and type 2 diabetes.","authors":"Shen Jiran, Wang Jiling, Zhou Sijing, Zhang Binbin, Li Pulin, Han Rui, Fei Guanghe, Cao Chao, Wang Ran","doi":"10.1093/postmj/qgae186","DOIUrl":"10.1093/postmj/qgae186","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) and type 2 diabetes mellitus (T2DM) are on the rise. While there is evidence of a link between the two diseases, the pathophysiological mechanisms they share are not fully understood.</p><p><strong>Methods: </strong>In this study, the co-expressed genes of COPD and T2DM in Gene Expression Omnibus database were identified by bioinformatics method, and the functional enrichment analysis was performed. Machine learning algorithms were used to identify biomarkers. The diagnostic value of these biomarkers was assessed by receiver operating characteristic analysis, and their relationship to immune cells was investigated by immunoinfiltration analysis. Finally, real-time quantitative polymerase chain reaction was performed.</p><p><strong>Results: </strong>A total of five overlapping genes were obtained, focusing on pathways associated with insulin resistance and inflammatory mediators. The machine learning method identified three biomarkers: matrix metalloproteinase 9, laminin α4, and differentially expressed in normal cells and neoplasia domain containing 4 C, all of which were shown to have high diagnostic values by receiver operating characteristic analysis. Immunoinfiltration analysis showed that it was associated with a variety of immune cells. In addition, the real-time quantitative polymerase chain reaction results confirmed agreement with our bioinformatics analysis.</p><p><strong>Conclusions: </strong>Our study sheds light on the common pathogenesis and biomarkers of both diseases, and these findings have potential implications for the development of new diagnostic and treatment strategies for COPD and T2DM. Key message What is already known on this topic?  Chronic obstructive pulmonary disease (COPD) and type 2 diabetes mellitus (T2DM) often coexist as comorbidities. However, the exact mechanistic link between the two diseases remains complex, multifactorial, and not fully understood. What this study adds?  Three biomarkers, including matrix metalloproteinase, laminin α4, and differentially expressed in normal cells and neoplasia domain containing 4 C, were identified as key co-expression hub genes in COPD and T2DM. How this study might affect research, practice or policy?  Future studies may benefit from incorporating a larger sample set to further explore and validate the diagnostic and therapeutic effects of these core genes.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"535-544"},"PeriodicalIF":3.6,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847205","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":"AI-enhanced telemedicine for personalized antiretroviral therapy in HIV patients with neurological comorbidities: a narrative review.","authors":"Nadine Mugisha, Olivier Uwishema, Boluwatife Samuel Fatokun, Rawan Noureddine, Lolita Fawaz, Jack Wellington","doi":"10.1093/postmj/qgaf069","DOIUrl":"https://doi.org/10.1093/postmj/qgaf069","url":null,"abstract":"<p><strong>Background: </strong>Human immunodeficiency virus (HIV), while now manageable as a chronic health condition with highly active antiretroviral therapy (HAART), often precipitates the onset of neurological comorbidities such as HIV-associated neurocognitive disorders (HAND) and a number of neuropathies. ART, though effective, may lead to neurotoxic adverse drug reactions, impacting patient adherence and clinical outcomes. Innovative approaches are warranted to balance ART efficacy with minimized neurological risk.</p><p><strong>Objective: </strong>This paper investigates how artificial intelligence (AI) may improve telemedicine for individualized ART management to reduce neurotoxicity and raise patient adherence to medication regimes.</p><p><strong>Methods: </strong>A comprehensive literature review was conducted using PubMed/MEDLINE, and Google Scholar, among other electronic search databases, with keywords comprising \"Artificial Intelligence,\" \"Telemedicine,\" \"HIV,\" and \"Neurological Comorbidities.\" Studies were selected based on relevance to AI applications in personalized HIV care. Inclusion criteria included peer-reviewed articles, systematic reviews, and clinical trials on AI in HIV care. Exclusion criteria omitted non-peer-reviewed articles and studies lacking direct AI relevance. Titles and abstracts were screened before full-text review.</p><p><strong>Results: </strong>There is potential for individualized ART management with AI-integrated telemedicine. By anticipating clinical concerns pertaining to ART-associated neurotoxicity, machine learning systems allow for preemptive therapeutic modifications. Wearable technology and AI-powered mHealth apps enable real-time adherence and symptom monitoring, facilitating the prompt adjustments to therapy if necessitated whilst lowering neurotoxic adverse drug reactions.</p><p><strong>Conclusions: </strong>AI-enhanced telemedicine promotes customized ART regimens that bolster clinical outcomes and individual quality of life, providing a revolutionary approach to HIV management in populations affected by neurological sequalae. In order to provide fully personalized HIV care, future research should concentrate on improving AI model accuracy across a range of demographics while tackling moral issues pertaining to patient confidentiality and data privacy.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079329","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 optimal slice to quantify the volumes of subcutaneous adipose tissue and skeletal muscle on chest computed tomography as imaging marker for body composition estimation.","authors":"Linlin Lang, Liping Zuo, Kai Dou, Jinlei Fan, Donglai Li, Yuqing Tang, Weiwei Ji, Dexin Yu","doi":"10.1093/postmj/qgaf076","DOIUrl":"https://doi.org/10.1093/postmj/qgaf076","url":null,"abstract":"<p><strong>Background/objectives: </strong>This study aims to identify the optimal anatomical site that best predicts the total thoracic subcutaneous adipose tissue (SAT) and skeletal muscle (SM) volumes on chest computed tomography (CT), and to evaluate the relationships between SAT and SM areas at optimal slice and lung function.</p><p><strong>Subjects/methods: </strong>Healthy participants and chronic obstructive pulmonary disease (COPD) patients undergoing chest CT between January 2022 and April 2023 were retrospectively included. On chest CT, cross-sectional areas of SAT and SM at 14 specific anatomical levels, and thoracic SAT and SM volumes were measured using 3D Slicer software. Correlations were calculated by Spearman's correlation coefficients.</p><p><strong>Results: </strong>About 58 healthy participants and 68 COPD patients were included. In healthy participants, the T4 SAT area correlated most strongly with thoracic SAT volume (r = 0.888, P < 0.01), and the aortic arch SM area with SM volume (r = 0.941, P < 0.01). The combined Spearman's correlation coefficients reached their highest sum (1.816) at the aortic arch level. In COPD patients, correlations were identified between SAT area at the aortic arch slice with forced expiratory volume in the first second (FEV1)/forced vital capacity (FVC) (r = 0.472, P < 0.001), while SM area with both FEV1(r = 0.431, P < 0.001) and FVC (r = 0.522, P < 0.001).</p><p><strong>Conclusion: </strong>Considering measurement simplicity and accuracy, the aortic arch slice was identified as the optimal single slice for predicting total thoracic SAT and SM volumes. Additionally, the clinical significance of SAT and SM area at this slice was verified with lung function in COPD patients. Key messages What is already known on this topic: Specific abdominal slices have been shown to estimate abdominal volumes accurately, while the optimal slice to predict thoracic volumes is uncertain. What this study adds: To identify the optimal slice for simultaneously predicting both thoracic SAT and SM volumes. How this study might affect research, practice or policy: The optimal slice in the chest for measurement is crucial for advancing research on thoracic SAT and SM.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079518","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":"Nephrotoxicity of direct factor Xa inhibitors: a pharmacovigilance study using real-world data from the Federal Adverse Event Reporting System database.","authors":"Xitong Zhang, Bing Lv, Bin Liu, Faping Li","doi":"10.1093/postmj/qgaf067","DOIUrl":"https://doi.org/10.1093/postmj/qgaf067","url":null,"abstract":"<p><strong>Background: </strong>Factor Xa inhibitors (FXaIs) may induce nephrotoxicity despite their FDA approval for thrombotic diseases, which has raised concerns due to its severe consequences. This study utilizes the FAERS database to assess the potential link between direct FXaIs and nephrotoxicity.</p><p><strong>Methods: </strong>Data from the FAERS database, spanning from the third quarter of 2011 to the fourth quarter of 2023, were used to perform a disproportionality analysis on Apixaban, Edoxaban, and Rivaroxaban. Disproportionality analysis and statistical processing were conducted using R software.</p><p><strong>Results: </strong>Descriptive analysis revealed that males and individuals aged 65-85 are more susceptible to nephrotoxic adverse events. The disproportionality analysis indicated that all three drugs are associated with acute renal failure and renovascular disorders, with Edoxaban showing the strongest correlation.</p><p><strong>Conclusions: </strong>This study quantitatively analysed the relative risk of nephrotoxic adverse reactions associated with direct FXaIs, emphasizing the importance of renal function monitoring for these medications. The results indicate that Edoxaban has a significant association with nephrotoxicity, necessitating closer attention to its use and recommending additional renal function tests and drug concentration testing for high-risk patients.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989900","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}