QJM: An International Journal of Medicine最新文献

{"title":"Respondence of steroid predicts the long-term clinical and endoscopic prognosis in Cronkhite-Canada syndrome.","authors":"Qiushi Xu, Chengzhu Ou, Yunfei Zhi, Runfeng Zhang, Shuang Liu, Tianming Xu, Hao Tang, Gechong Ruan, Xuemin Yan, Shengyu Zhang, Jingnan Li, Dong Wu, Ji Li","doi":"10.1093/qjmed/hcaf088","DOIUrl":"https://doi.org/10.1093/qjmed/hcaf088","url":null,"abstract":"<p><strong>Background: </strong>Cronkhite-Canada syndrome (CCS) is a rare gastrointestinal polyposis syndrome characterized by hamartoma polyps and ectodermal abnormalities, with an increased risk of gastrointestinal cancers. Our previous study revealed its relapsing disease behavior and the improved long-term prognosis following the medications of steroids. However, the response of steroids varies among CCS patients, and there was no consensus about how to deal with steroid-dependent patients. This study aims to update the knowledge of long-term prognosis of CCS patients and explore the efficacy and safety of low-dose steroid as maintenance therapy.</p><p><strong>Method: </strong>CCS patients hospitalized between 1999 and 2023 in Peking Union Medical College Hospital were enrolled. All patients were followed up through telephone interviews and outpatient visits, with clinical data and endoscopic findings sequentially collected. The Cox regression model was used to identify factors associated with clinical outcomes.</p><p><strong>Outcome: </strong>A total of 64 eligible participants were included with a median (interquartile range) follow-up duration of 49.5 (22.75, 101.25) months. The cumulative probability of overall survival (OS) was 90.2% at 3 years, 87.7% at 5 years, 78.6% at 10 years and relapse-free survival (RFS) after steroid treatment was 76.3% at 1 year, 62.9% at 3 years, 54.4% at 5 years respectively. The poor response to steroids was identified as independent variable related to worse OS in multivariate model. In the subgroup analysis of relapsed patients, low-dose steroid treatment (prednisone ≤ 10 mg/day) for at least one year as maintenance therapy was in association with reduced risk of re-relapse (RFS: 72 (46.3, 78) vs 12 (9, 15.5) months; P = 0.02).</p><p><strong>Conclusion: </strong>The long-term clinical outcomes of CCS are relatively favorable in patients who responded well to steroid treatment. The low-dose steroid maintenance therapy may prevent re-relapse of disease among CCS patients.</p>","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804119","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":"Night shift work, accelerated biological aging and reduced life expectancy: a prospective cohort study.","authors":"Yangwei Cai, Jingwei Gao, Yixiu Xie, Maoxiong Wu, Guanghong Liao, Chuanrui Zeng, Jiewen Cai, Zhiteng Chen, Pinming Liu, Yangxin Chen, Jingfeng Wang, Haifeng Zhang","doi":"10.1093/qjmed/hcaf091","DOIUrl":"https://doi.org/10.1093/qjmed/hcaf091","url":null,"abstract":"<p><strong>Background: </strong>Aging is a lifelong process that initiates at birth and is associated with age-related diseases and death. Night shift work has drawn increasing attention due to its negative health effects. This study aims to explore the association between night shift work, biological aging, and life expectancy using data from the UK Biobank.</p><p><strong>Methods: </strong>A total of 192,764 participants (age : 52.69 ± 7.08 years, 51.39% male) from the UK Biobank cohort were included in the analysis. Biological aging was measured by Klemera-Doubal method biological age (KDM-BA) and PhenoAge, derived from anthropometric and blood biomarkers. Polygenic risk scores (PRS) for biological aging were calculated for participants of European descent. Multiple linear regression models were applied, and mediation analysis was used to identify potential mediators.</p><p><strong>Results: </strong>Compared to day workers, usual night shift workers showed accelerated biological aging, with β coefficients (95% CI) of 0.09 (0.05-0.13) for KDM-BA acceleration and 0.48 (0.36-0.60) for PhenoAge acceleration. At age 45, life expectancy was reduced by 0.94 years among usual night shift workers. Participants working night shifts exhibited gradually accelerated biological aging as the frequency and duration increased (P for trend <0.05). This association remained robust in a series of sensitivity analyses and across different subgroups. Further mediation analysis showed that BMI mediated 28.88%-42.76% of this association.</p><p><strong>Conclusions: </strong>Night shift work is associated with accelerated biological aging and reduced life expectancy. Minimizing night shifts and maintaining a healthy weight may help mitigate these effects.</p>","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804112","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":"Whirl sign sign of omental torsion.","authors":"A Baskar, Venkatraman Indiran","doi":"10.1093/qjmed/hcaf089","DOIUrl":"https://doi.org/10.1093/qjmed/hcaf089","url":null,"abstract":"","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781050","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":"Rosette Cataract.","authors":"Shagun Korla, Gain Chand Rajput, Shreya Narang","doi":"10.1093/qjmed/hcaf090","DOIUrl":"https://doi.org/10.1093/qjmed/hcaf090","url":null,"abstract":"","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781040","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":"Qualitative research has a place in medicine.","authors":"Sinead M Donnelly","doi":"10.1093/qjmed/hcaf087","DOIUrl":"https://doi.org/10.1093/qjmed/hcaf087","url":null,"abstract":"","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765016","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":"Blistering photosensitivity in an icteric patient-think of Variegate Porphyria.","authors":"Sukhdeep Singh, Kittu Malhi, Davinder Parsad","doi":"10.1093/qjmed/hcaf077","DOIUrl":"https://doi.org/10.1093/qjmed/hcaf077","url":null,"abstract":"","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765015","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":"Advancements in Gene Therapy for Lung Cancer: From Genetic Insights to Clinical Applications.","authors":"Mohammad Doroudian, Elham Abbasgholinejad, Mahdieh Soezi","doi":"10.1093/qjmed/hcaf075","DOIUrl":"https://doi.org/10.1093/qjmed/hcaf075","url":null,"abstract":"<p><p>Gene therapy represents a transformative approach in lung cancer treatment, leveraging strategies such as gene replacement, editing, and silencing to target oncogenes and restore tumor suppressor functions. Techniques like CRISPR/Cas9, RNA interference (RNAi), and viral vectors, including adenoviruses and AAVs, have shown promise in overcoming drug resistance and enhancing immune responses. Nanoparticle-based delivery systems, such as exosomes and liposomes, further improve precision and efficacy in gene delivery. Despite advancements, challenges like off-target effects, immune responses, and tumor heterogeneity persist. Clinical trials, including CAR T-cell therapies and oncolytic viruses, highlight the potential of gene therapy, yet optimizing delivery and minimizing side effects remain critical for future progress. This review underscores the evolving landscape of gene therapy in lung cancer, emphasizing its potential to revolutionize treatment paradigms.</p>","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765013","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":"Sex- and age-specific differences in the associations between comorbidity and incident heart failure.","authors":"Weida Qiu, Anping Cai, Shiping Wu, Yanchen Zhu, He Zheng, Yingqing Feng","doi":"10.1093/qjmed/hcaf080","DOIUrl":"https://doi.org/10.1093/qjmed/hcaf080","url":null,"abstract":"<p><strong>Background: </strong>Little evidence exists regarding the sex- and age-specific differences in the associations of comorbidities and incident heart failure (HF).</p><p><strong>Aims: </strong>This study aims to evaluate the sex- and age-specific associations of comorbidities and incident HF, and further calculate the population attributable fractions (PAFs) of comorbid diseases for HF by sex and age.</p><p><strong>Methods: </strong>Data were from a sub-cohort of the Patient-Centered Evaluative Assessment of Cardiac Events Million Persons Project from Southern China. Participants were stratified by sex and by age (<60 or ≥ 60). The seven comorbidities were collected at baseline, and the study outcome was HF-related hospitalization identified from the Inpatients Registry.</p><p><strong>Results: </strong>A total of 102,278 participants (mean age: 54.3 years, 60.5% were women) without prevalent HF were included. After a median follow-up of 3.5 years, 1,588 participants had incident HF. Men, older age (≥60 years), and most comorbidities were significantly associated with a higher risk of HF. The associations between several comorbidities with incident HF were more prominent in women and young participants aged <60 than in men and seniors. The seven comorbidities collectively explained a significant proportion of population attributable fraction (PAF) for HF (47.1%, 95% confidence interval: 41.4, 52.2), and several sex- and age-specific differences in PAFs of comorbidities for incident HF were also observed.</p><p><strong>Interpretation: </strong>In this large, prospective cohort study, several sex- and age-specific differences in the associations between common comorbidities and incident HF were found among Chinese general adults, highlighting the importance of sex- and age-specific preventive strategies for HF.</p>","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743491","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":"Bilateral retinochoroidopathy in malignant hypertension.","authors":"Bangtao Yao, Jianhui Zhao, Bei Wang, Bin Pang","doi":"10.1093/qjmed/hcaf085","DOIUrl":"https://doi.org/10.1093/qjmed/hcaf085","url":null,"abstract":"","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731411","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":"Progesterone and suicidality in male combat veterans.","authors":"Leo Sher, Linda M Bierer, Iouri Makotkine, Rachel Yehuda","doi":"10.1093/qjmed/hcaf082","DOIUrl":"https://doi.org/10.1093/qjmed/hcaf082","url":null,"abstract":"<p><strong>Objective: </strong>Studies suggest that progesterone may influence mood and behavior in men. We hypothesized that progesterone is associated with suicidal ideation and attempts in men. We examined morning baseline progesterone levels and the effect of dexamethasone administration on progesterone levels in male combat veterans with or without a history of suicide attempt.</p><p><strong>Methods: </strong>Demographic and clinical parameters of the study participants were assessed and recorded. Study participants were interviewed by a trained clinician using the Mini-International Neuropsychiatric Interview, the Montgomery-Åsberg Depression Rating Scale, the Scale for Suicidal Ideation, the Brown-Goodwin Aggression Scale, and the Reasons for Living Inventory. Blood samples to determine progesterone levels were collected in the morning on the day prior to and following dexamethasone ingestion.</p><p><strong>Results: </strong>Baseline progesterone levels were higher in suicide non-attempters in comparison to attempters. In the whole sample, higher baseline progesterone levels were associated with lower suicidal ideation, lower depression, and more reasons not to die by suicide. Progesterone levels decreased after dexamethasone administration among non-attempters but not among attempters. Progesterone levels before and after dexamethasone administration positively correlated with aggression among non-attempters but not among suicide attempters.</p><p><strong>Conclusion: </strong>Our study is the first demonstration of progesterone non-suppression by dexamethasone in suicide attempters. The results of our study underline the significant role of neurobiological mechanisms in the pathophysiology of suicidal behavior in combat veterans. Studies of the relation between neurosteroid function and suicidal behavior may lead to the development of biomarkers for suicidality and facilitate identification of individuals at high suicide risk.</p>","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701038","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}