QJM: An International Journal of Medicine最新文献

{"title":"Dual-pattern direct immunofluorescence in bullous systemic lupus erythematosus.","authors":"Yanyan Zhu, Yanting Liu, Songmei Geng, Bin Peng","doi":"10.1093/qjmed/hcag215","DOIUrl":"https://doi.org/10.1093/qjmed/hcag215","url":null,"abstract":"","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797170","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":"Photopenic PET in toxoplasmosis.","authors":"Nitin Gupta, Sumeet Suresh Malapure, Muralidhar Varma, Praveen Kumar Tirlangi","doi":"10.1093/qjmed/hcag214","DOIUrl":"https://doi.org/10.1093/qjmed/hcag214","url":null,"abstract":"","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797167","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":"Associations Between Glucagon-like Peptide-1 Receptor Agonists and Respiratory Outcomes in Chronic Obstructive pulmonary disease and Diabetes.","authors":"Kuang-Ming Liao, Ya-Wen Tsai, Konstantinos Kostikas, Gerard J Criner, Jheng-Yan Wu, Chih-Cheng Lai","doi":"10.1093/qjmed/hcag217","DOIUrl":"https://doi.org/10.1093/qjmed/hcag217","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) is frequently complicated by acute respiratory failure, pneumonia, exacerbations, and premature mortality, particularly in patients with comorbid type 2 diabetes (T2D). Glucagon-like peptide-1 receptor agonists (GLP-1RAs) possess anti-inflammatory and metabolic properties that may confer protective effects against COPD-related respiratory complications, but comparative evidence remains limited.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using data from the TriNetX global federated health research network. Adults aged 40 years or older with both COPD and T2D who newly initiated GLP-1RAs, dipeptidyl peptidase-4 inhibitors (DPP-4is), sulfonylureas (SUs), or metformin between January 1, 2017, and May 31, 2025, were identified. An active-comparator, new-user design with 1:1 propensity score matching was applied. The primary outcome was incident acute respiratory failure. Secondary outcomes included all-cause mortality, all-cause hospitalization, acute exacerbation of COPD, and pneumonia, assessed over one year of follow-up.</p><p><strong>Results: </strong>After propensity score matching, GLP-1RA use was associated with significantly lower risk of acute respiratory failure compared with DPP-4is (HR, 0.77; 95% CI, 0.73-0.81), SUs (HR, 0.80; 95% CI, 0.76-0.84), and metformin (HR, 0.91; 95% CI, 0.85-0.98). GLP-1RA use was also consistently associated with reduced risks of all-cause mortality, all-cause hospitalization, acute exacerbation of COPD, and pneumonia across all three comparator groups. Subgroup analyses demonstrated consistent protective trends across sex, age, exacerbation history, and inhaled bronchodilator regimen.</p><p><strong>Conclusions: </strong>In patients with COPD and T2D, initiation of GLP-1RAs was associated with significantly lower risks of acute respiratory failure, pneumonia, acute exacerbation, hospitalization, and all-cause mortality compared with DPP-4is, SUs, and metformin. These findings suggest that GLP-1RA therapy may offer meaningful respiratory and survival benefits in this high-risk population.</p>","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797446","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":"Heat-safe shelters after the 2026 Kumamoto earthquake.","authors":"Yudai Kaneda","doi":"10.1093/qjmed/hcag213","DOIUrl":"10.1093/qjmed/hcag213","url":null,"abstract":"","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148724779","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":"Erythrocyte sickling in sickle cell disease using an anaerobic bottle.","authors":"Yuji Okazaki, Toshihisa Ichiba","doi":"10.1093/qjmed/hcag211","DOIUrl":"10.1093/qjmed/hcag211","url":null,"abstract":"","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148723776","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 eye-of-the-tiger sign in pantothenate kinase-associated neurodegeneration.","authors":"Binglin Lai","doi":"10.1093/qjmed/hcag212","DOIUrl":"10.1093/qjmed/hcag212","url":null,"abstract":"","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148727781","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 hummingbird sign in progressive supranuclear palsy.","authors":"Shuyun Wang, Binglin Lai","doi":"10.1093/qjmed/hcag210","DOIUrl":"https://doi.org/10.1093/qjmed/hcag210","url":null,"abstract":"","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148679368","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":"Scrub Typhus Presenting as Fulminant Myocarditis with Cardiogenic Shock: The Diagnostic Value of an Eschar.","authors":"Atanu Chandra, Tarun Kumar Paria, Pulakesh Sinha, Rupak Chatterjee, Uddalak Chakraborty, Sugata Dasgupta","doi":"10.1093/qjmed/hcag208","DOIUrl":"https://doi.org/10.1093/qjmed/hcag208","url":null,"abstract":"","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674140","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":"Flumazenil challenge reveals a sedation-masked electrographic seizure in post resuscitation encephalopathy.","authors":"Haruka Ishibashi, Shuichiro Neshige, Hirofumi Maruyama","doi":"10.1093/qjmed/hcag180","DOIUrl":"https://doi.org/10.1093/qjmed/hcag180","url":null,"abstract":"","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664345","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":"Procalcitonin as a biomarker of bacterial infection in children and adolescents with chronic liver disease.","authors":"Amel Abd El Magied El Faramawy, Ahmed Ehab El Azab, Lamyaa Elsayed Mehriz Ali Salem, Iman Mohammed Talaat","doi":"10.1093/qjmed/hcag168.106","DOIUrl":"10.1093/qjmed/hcag168.106","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Bacterial infections significantly worsen the prognosis of children with chronic liver disease, yet traditional inflammatory markers such as C-reactive protein (CRP) and total leukocyte count (TLC) often lack the specificity needed to reliably distinguish bacterial sepsis from non-infectious inflammation. Procalcitonin (PCT) has emerged as a promising biomarker because its synthesis is selectively upregulated in bacterial infections, providing an early and reliable indicator in this vulnerable population.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aims: &lt;/strong&gt;This study aims to evaluate the diagnostic accuracy of serum procalcitonin in differentiating bacterial infections from non-infectious inflammatory states among pediatric patients with chronic liver disease. Also, it aims to compare the performance of procalcitonin with conventional parameters to establish a reliable cutoff for clinical decision making.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A prospective case-control study was conducted involving 44 children with chronic liver disease subdivided into two groups-22 patients with clinical and laboratory evidence of bacterial infection and 22 without-were recruited from hepatology clinic, Children's Hospital, Ain Shams University and 23 age- and sex-matched healthy controls. All participants underwent detailed clinical assessments including vital signs, comprehensive liver function tests, and inflammatory marker measurements. Serum procalcitonin levels were determined using an enzyme-linked immunosorbent assay (ELISA). Receiver operating characteristic (ROC) curve analysis was performed to determine the optimal procalcitonin cutoff, with its sensitivity, specificity, and predictive values assessed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Procalcitonin levels were found to be significantly higher in the bacterial infection group (median: 0.95 ng/mL; interquartile range [IQR]: 0.70-1.90) compared to both the non-infected chronic liver disease group (median: 0.04 ng/mL; IQR: 0.02-0.06) and the control group (median: 0.05 ng/mL; IQR: 0.02-0.07) (p &lt; 0.001). At a cutoff value of 0.07 ng/mL, procalcitonin achieved a sensitivity of 95.5% and a specificity of 77.3% (area under the curve [AUC]: 0.901, 95% confidence interval: 0.773-0.970, p &lt; 0.001) for detecting bacterial infection in these patients. Moreover, statistically significant positive correlations were observed between procalcitonin levels and both CRP and INR as a marker of liver dysfunction, while an inverse correlation was noted with platelet count.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Serum procalcitonin is a highly sensitive and specific biomarker for detection of bacterial infections in children and adolescents with chronic liver disease with a lower cut off value compared to normal population. Despite specificity to bacterial infection, still its value is comparable to conventional inflammatory markers. Future larger studies are warranted to validate these findings and optimize clinical protocol","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":"119 Supplement_1","pages":""},"PeriodicalIF":8.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881499","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}