QJM: An International Journal of Medicine最新文献

{"title":"Integrative genetic analysis to decode the causal effect of air pollution on accelerated aging.","authors":"Pei Xiao, Yinkun Yan, Jingfan Xiong, Jie Mi","doi":"10.1093/qjmed/hcaf093","DOIUrl":"https://doi.org/10.1093/qjmed/hcaf093","url":null,"abstract":"<p><strong>Background: </strong>The relationships between air pollutants and aging remain poorly understood due to the limitations of observational studies.</p><p><strong>Aim: </strong>Herein, we aimed to infer the causality between air pollutants (PM2.5, NO2, NOx, PM2.5 ∼ 10, and PM10) and a comprehensive set of aging phenotypes (frailty index, face aging, GrimAge, HannumAge, PhenoAge, granulocyte proportions, intrinsic epigenetic age acceleration, longevity, healthspan, parental lifespan, and telomere length) using integrative genetic analysis framework.</p><p><strong>Methods: </strong>A three-phase study design was used: phase one involved univariable and multivariable Mendelian randomization (MR) analyses; phase two used two-step MR to identify potential mediators among 4,596 candidate multi-omics traits; phase three performed transcriptome-wide association studies (TWAS) followed by biological pathway enrichment and Bayesian colocalization analyses to explore the underlying mechanisms.</p><p><strong>Results: </strong>A robust causal association between PM2.5 exposure and frailty was found across all univariable MR analyses, which remained robust even after controlling for lifestyle factors or air pollutants in the multivariable MR analyses. The causal effect remained significant in multivariable MR analyses after adjusting for other air pollutants or potential lifestyle factors. We identified several common mediators that potentially mediate the effect, with the B cell lymphoma-2 protein 1 being the most prominent mediator. Our TWAS identified 98 genes associated with both PM2.5 and frailty, with the MMAB gene showing the most significant association.</p><p><strong>Conclusions: </strong>This study provides robust genetic evidence supporting a causal link between PM2.5 exposure and frailty, highlighting the detrimental effects of air pollution on aging.</p>","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021535","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":"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":"A review of falls and injuries of nursing home residents presenting to the emergency department.","authors":"Aoife O'Connor, Claire Noonan, Aoife Fallon, Sean Kennelly","doi":"10.1093/qjmed/hcaf008","DOIUrl":"10.1093/qjmed/hcaf008","url":null,"abstract":"<p><strong>Background: </strong>Falls are frequently reported within the HSE. The Irish Longitudinal Study on Ageing (TILDA) found that 40% of over 50 s experience a fall in a two-year period, with 20% requiring hospital attendance. It has been estimated that the cost of injuries related to falls in older people will increase exponentially over the coming years. There is no national database in Ireland with statistics for nursing home (NH) residents presenting with falls to our Emergency Departments (EDs).</p><p><strong>Aim: </strong>To review the prevalence and risk factors for nursing home patients presenting to the ED with falls.</p><p><strong>Design: </strong>Retrospective chart review.</p><p><strong>Method: </strong>Retrospective review of all NH presentations to the ED of a university hospital over one year.</p><p><strong>Results: </strong>There were 519 ED presentations by NH residents over one year. 48.17% (n = 250) presented with a fall. One-third of ED visits presented during conventional working hours. Falls patients were more likely to be admitted when not reviewed by a GP prior to presentation. The average length of stay for falls admissions was 10.77 days (n = 132), versus 9.56 (n = 153) for admissions with no documented fall. There was no statistical difference in the falls risk medications between the groups. Patients presenting with falls were more likely to have bone protection reviewed during their stay (P = 0.011). Patients with falls were also more likely to use mobility aids (P < 0.001).</p><p><strong>Conclusion: </strong>Rapid referral to falls prevention programmes and the use of standardized care pathways for high falls risk patients are essential for future prevention and management.</p>","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":"273-277"},"PeriodicalIF":7.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12151533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The chameleon of diseases: IgG4-RD in unforeseen clinical presentations.","authors":"Yi-Chin Chang, Wei-Hsin Chiang, Fu-Zong Wu","doi":"10.1093/qjmed/hcae246","DOIUrl":"10.1093/qjmed/hcae246","url":null,"abstract":"","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":"289-290"},"PeriodicalIF":7.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142897051","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":"Improving suicidal ideation assessment and prevention in healthcare workers.","authors":"Qianling Huang, Deyang Liu","doi":"10.1093/qjmed/hcaf018","DOIUrl":"10.1093/qjmed/hcaf018","url":null,"abstract":"","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":"311"},"PeriodicalIF":7.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143060610","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}