QJM: An International Journal of Medicine最新文献

{"title":"Birds in a tree appearance in Chronic Central Serous Chorioretinopathy (CSCR).","authors":"Manu Sharma, Sushil Bhatt, Deeksha Katoch","doi":"10.1093/qjmed/hcag203","DOIUrl":"https://doi.org/10.1093/qjmed/hcag203","url":null,"abstract":"","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888446","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":"Bubble-Wrapped: An Unusual Developmental Cataract.","authors":"Akanksha Sharma, Parul Chawla Gupta, Ranjan Kumar Behera","doi":"10.1093/qjmed/hcag224","DOIUrl":"https://doi.org/10.1093/qjmed/hcag224","url":null,"abstract":"<p><p>An 11-year-old girl presented with progressive visual diminution in the right eye, with previous left cataract surgery. Slit-lamp examination revealed multiple discrete, circular lenticular opacities with central dark zones and dense white peripheral halos, producing a distinctive \"bubble-wrap\" appearance. The lesions were predominantly nuclear and varied in size. Although bubble-like cataract morphologies have been described following ocular trauma and in retinitis pigmentosa, this appearance has not, to our knowledge, been reported in a developmental cataract. This may represent a novel morphological variant, expanding the phenotypic spectrum of pediatric cataracts.</p>","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881527","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":"Targeting the Nrf2-SLC7A11/GPX4 Pathway to Inhibit Ferroptosis: Mechanism of Yiqi Fumai Formula in Acute Decompensated Heart Failure.","authors":"Lu Fan, Yunfeng Jia, Yanyang Li, Zhihan Yang, Yiming Zuo, Haomin Zhang, Xuezheng Liu, Shichao Lv","doi":"10.1093/qjmed/hcag220","DOIUrl":"https://doi.org/10.1093/qjmed/hcag220","url":null,"abstract":"<p><strong>Objective: </strong>To elucidate the mechanism of Yiqi Fumai Formula (YQFM) in acute decompensated heart failure (ADHF) via the Nrf2/SLC7A11/GPX4 pathway in regulating ferroptosis.</p><p><strong>Methods: </strong>Network pharmacology was employed to predict the underlying mechanisms of YQFM in ADHF. Rat models of ADHF were established, incorporating agonists or inhibitors of key ferroptosis pathways. The therapeutic mechanism of Yiqifumai Formula was investigated by assessing cardiac structure/function, myocardial injury biomarkers, lipid peroxidation, iron metabolism, ultrastructural changes, and key ferroptosis pathways.</p><p><strong>Results: </strong>Network pharmacology analysis suggested that YQFM might intervene in ADHF by modulating key processes of ferroptosis, including lipid metabolism, inflammatory response, and cell survival. Experimental validation confirmed that YQFM improved cardiac function, reduced myocardial lipid peroxidation, and inhibited cardiomyocyte ferroptosis in rat models. This cardioprotective effect is likely associated with the regulation of the Nrf2/SLC7A11/GPX4 signaling pathway.</p><p><strong>Conclusion: </strong>YQFM exerts the cardioprotective effect in ADHF by suppressing ferroptosis through the modulation of the Nrf2-SLC7A11/GPX4 pathway.</p>","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876013","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":"Interferon Gamma Release Assay testing and TNF antagonists; mind the window period.","authors":"Ammar Janjua, Brian Keane, Lorraine Dolan, Annemarie McLaughlin, Joseph Keane","doi":"10.1093/qjmed/hcag223","DOIUrl":"https://doi.org/10.1093/qjmed/hcag223","url":null,"abstract":"","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881550","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":"Lytic bone lesions in a patient diagnosed with breast cancer - Sarcoidosis.","authors":"Ami Schattner, Ina Dubin, Yair Glick, Vladimir Kravtsov","doi":"10.1093/qjmed/hcag221","DOIUrl":"https://doi.org/10.1093/qjmed/hcag221","url":null,"abstract":"<p><p>Sarcoidosis is an inflammatory disease of unknown cause with protean manifestations and presentations which may affect almost any organ. Involvement of intra-thoracic organs (lungs, lymph nodes), reticuloendothelial system, skin, and eyes is predominant. The histological hallmark is non-necrotizing (noncaseating) granulomas. Bone involvement in sarcoidosis is noteworthy. We report a woman who developed crescendo back pain, with multiple lytic bone lesions. Since she had been recently diagnosed with locally-invasive breast cancer, metastatic spread was strongly suspected, but prudently, bone biopsy was considered essential. The biopsy was typical of sarcoidosis, later also identified in the lungs/lymph nodes, and successfully treated. Sarcoidosis is a notorious imitator which may pose a substantial diagnostic challenge, especially when presenting as seemingly isolated destructive bone lesions. Its development shortly after breast cancer may be coincidental, but anecdotal data and an observational study suggest that stressful life events affecting the immune system may precede its appearance in some cases.</p>","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841142","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":"Lung cancer disparities: infrastructure, not just eligibility, drives the global gap.","authors":"Esteban Cardenas-Duran, Hefziba Lorences-Noguera, Carlos Alejandro Gomez-Anguiano","doi":"10.1093/qjmed/hcag222","DOIUrl":"https://doi.org/10.1093/qjmed/hcag222","url":null,"abstract":"","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148832069","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":"Translating evolutionary history and protein-focused machine learning supports increased prevalence of hereditary haemorrhagic telangiectasia, one of the most common inherited disorders.","authors":"Adriana Macko, Jill Pecon-Slattery, Claire L Shovlin","doi":"10.1093/qjmed/hcag209","DOIUrl":"https://doi.org/10.1093/qjmed/hcag209","url":null,"abstract":"<p><strong>Background: </strong>Recent genetic data suggest hereditary haemorrhagic telangiectasia (HHT) is 2-12 times more common than the clinically-ascertained prevalence, potentially above the 'rare disease' designation threshold, and undermining clinical predictions for asymptomatic individuals diagnosed by genetic testing.</p><p><strong>Aim: </strong>To test, we examined if missense variants in HHT disease-causing genes may have been misclassified as pathogenic (LP/P) or benign (B/LB).</p><p><strong>Design: </strong>Evaluation of ClinVar-annotated missense variants in ENG, ACVRL1 and SMAD4.</p><p><strong>Methods: </strong>Human-independent methods using CodeXome for pan-primate evolutionary history, and AlphaMissense which incorporates AlphaFold predictions for protein misfolding were used to validate/reclassify pathogenic and benign missense variants.</p><p><strong>Results: </strong>ClinVar annotations were commonly conservative with 35-90% of rare missense substitutions in ENG, ACVRL1 and SMAD4 classified as variants of uncertain significance (VUS). CodeXome identified 92% of ClinVar-annotated B/LB variants were shared with other primate species, supporting their benign classification. AlphaMissense metrics strongly correlated with CodeXome, and 380/403 (94.3%) variants matched ClinVar benign-pathogenic annotations. However, a small number of variants showed conflicting classifications with ClinVar: 19/293 (6.5%) appeared to be over-called as LP/P by ClinVar representing 15/408 (3.7%) of genotyped families at Imperial, while 4/110 (3.6%) were apparently under-called as B/LB, and not accessible through clinical gene test reports. Newer pathobiological understanding of variants, and recognition of shared familial tendencies reflecting non-HHT heritable burdens were identified as possible explanations of over-calls.</p><p><strong>Conclusions: </strong>Our findings suggest tools to simplify variant pathogenicity predictions; molecular diagnoses to revisit for HHT families, but do not materially influence prevalence estimates for 'genetic' HHT, challenging current clinical policies, training and standards.</p>","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819392","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":"Schaumann Bodies : A Histopathological Clue To Sarcoidosis.","authors":"Bodhibrata Banerjee, Akash Sengupta, Uma Nahar Saikia, Sanjay Jain, Shefali Khanna Sharma","doi":"10.1093/qjmed/hcag219","DOIUrl":"https://doi.org/10.1093/qjmed/hcag219","url":null,"abstract":"","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797200","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":"Comparative Risk of Respiratory Virus Infections Among Patients with Asthma Treated with Biologic Therapies.","authors":"Kuang-Ming Liao, Sheng Chi Huang, I-Ha Lao, Chia-Yu Kuo, Wan-Hsuan Hsu, Jheng-Yan Wu, Chih-Cheng Lai","doi":"10.1093/qjmed/hcag218","DOIUrl":"https://doi.org/10.1093/qjmed/hcag218","url":null,"abstract":"<p><strong>Background: </strong>Respiratory virus infections are a major cause of morbidity in asthma. Although biologic therapies targeting type 2 inflammation are widely used for severe asthma, their comparative effects on respiratory virus infection risk remain unclear.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using the TriNetX US Collaborative Network, including adults with asthma who newly initiated benralizumab, omalizumab, dupilumab, or mepolizumab. Using an active comparator, new-user design with 1:1 propensity score matching, we compared benralizumab with each biologic. The primary outcome was a composite of respiratory virus infections (COVID-19, influenza, RSV infection, and viral pneumonia) over three years. Hazard ratios (HRs) were estimated using Cox proportional hazards models.</p><p><strong>Results: </strong>After matching, 5,663 benralizumab-omalizumab pairs, 7,075 benralizumab-dupilumab pairs, and 6,492 benralizumab-mepolizumab pairs were included. Benralizumab was associated with a higher risk of composite respiratory virus infection than omalizumab (HR 1.49, 95% CI 1.33-1.66), dupilumab (HR 1.24, 95% CI 1.11-1.39), and mepolizumab (HR 1.24, 95% CI 1.12-1.38; all p < 0.001). Risks of COVID-19 and influenza were consistently higher with benralizumab across all comparisons. Viral pneumonia risk was higher versus dupilumab (HR 1.59, 95% CI 1.18-2.14) but not versus omalizumab or mepolizumab. RSV infection risk did not differ significantly.</p><p><strong>Conclusions: </strong>Benralizumab was associated with a higher risk of respiratory virus infections than omalizumab, dupilumab, and mepolizumab. These findings suggest that profound eosinophil depletion may impair antiviral host defense and should be considered when selecting biologic therapy for patients at increased risk of respiratory viral infections.</p>","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797210","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 Capsular Sunburst: Late Anterior Capsular Phimosis in Fuchs Uveitis Syndrome.","authors":"Anchal Gera, Avishi Agrawal, Sonam Yangzes","doi":"10.1093/qjmed/hcag216","DOIUrl":"https://doi.org/10.1093/qjmed/hcag216","url":null,"abstract":"","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797223","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}