Clinical Medicine & Research最新文献

{"title":"Longevity.","authors":"Shereif H Rezkalla, Robert A Kloner","doi":"10.3121/cmr.2026.2111","DOIUrl":"10.3121/cmr.2026.2111","url":null,"abstract":"<p><p>Longevity is defined as living a longer and healthier life. Longevity contributes to the vitality of a community, which is crucial for improving societal well-being and healthcare outcomes. In this narrative review, we report on the accepted guidelines for preventive medical management, adopting general measures of a healthy lifestyle, and discussing suggested potential therapy for improving a long healthy life. Many studies on aging revealed that longevity is multifactorial and includes telomere attrition, mitochondrial dysfunction, and loss of intercellular communication. The first steps to achieving a long and healthy life include lifestyle modification and appropriate medical care and follow up to achieve a lifelong normal blood pressure, low low-density lipoprotein, avoid smoking, manage diabetes, and follow up of all accepted medical guidelines. This should include maintaining good physical activity, appropriate nutrition, healthy sleep patterns, and managing various life stressors. There is a suggestion that intermittent fasting in humans may reduce the risk of some age-related diseases and improve longevity. In this report we will discuss these factors as well as some medications that are linked to longevity, such as metformin, rapamycin, lithium, and certain vitamins. In the absence of clear guidelines for longevity, and in the current environment of primary care shortage, we hope this report will assist primary care providers in focusing on this challenge.</p>","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":"24 2","pages":"80-86"},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13343780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Daily Doses of Gabapentinoids for Pain Management Among Opioid Users Aged Below and Above 65 years.","authors":"Che Suraya Zin, Nor Elina Alias, Nabil Husaini Abrar, Naeem Mubarak, Mazlila Meor Ahmad Shah","doi":"10.3121/cmr.2026.2028","DOIUrl":"10.3121/cmr.2026.2028","url":null,"abstract":"<p><p><b>Objective:</b> Gabapentinoids (gabapentin and pregabalin) are increasingly prescribed for neuropathic pain, often as adjuncts to opioid therapy. However, limited evidence exists regarding their dosing patterns and duration of use across different age groups, particularly in older adults. To examine trends in daily doses and duration of gabapentinoid use among opioid users aged below and above 65 years.<b>Methods:</b> We conducted a retrospective cross-sectional study using prescription data from a tertiary hospital in Malaysia between 2010 and 2020. The analysis included all gabapentin and pregabalin prescriptions for patients aged ≥18 years with concurrent opioid use for pain management. Daily dose and days of supply were analyzed at the individual prescription level and stratified by age group (<65 and ≥65 years). Descriptive statistics and linear trend analyses were performed using Stata version 15.<b>Results:</b> The study included 6,734 prescriptions from 2,338 patients (mean age: 56.6 years; 54.3% female). Gabapentin comprised 91.3% of prescriptions. Among patients aged ≥65-years, mean daily gabapentin dose increased by 237.96% (<i>P</i><0.001), compared to a 110.96% increase in younger patients (<i>P</i><0.001). Pregabalin showed smaller, non-significant increases in dose across both groups. The duration of supply for gabapentin increased by 54.1% (<i>P</i><0.001) in older adults and 76.8% (<i>P</i><0.001) in younger adults. Pregabalin supply days increased by 171.7% (<i>P</i>=0.003) and 116.4% (<i>P</i>=0.002), respectively.<b>Conclusion:</b> Gabapentinoid use has risen in both dose and duration over time, particularly among older adults. These findings underscore the importance of age-informed prescribing and monitoring practices in opioid-treated populations.</p>","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":"24 2","pages":"60-69"},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13343746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revisiting Career Sabotaging in Academic Medicine.","authors":"Delete Ebere-Bank, Rosibel Arcia-Diaz, Kenneth Soyemi","doi":"10.3121/cmr.2026.2134","DOIUrl":"10.3121/cmr.2026.2134","url":null,"abstract":"","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":"24 2","pages":"46-47"},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13343745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dysautonomia in Long COVID: Why Sex Differences Matter in Cardiovascular Risk Assessment.","authors":"Anna Vittoria Mattioli","doi":"10.3121/cmr.2026.2127","DOIUrl":"10.3121/cmr.2026.2127","url":null,"abstract":"","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":"24 2","pages":"49-50"},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13343743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Author Response to \"Revisiting Career Sabotaging in Academic Medicine\".","authors":"Jamiu O Busari","doi":"10.3121/cmr.2026.2137","DOIUrl":"10.3121/cmr.2026.2137","url":null,"abstract":"","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":"24 2","pages":"47-48"},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13343753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Parakinesia Brachialis Oscitans: An Intriguing Post-Stroke Phenomenon.","authors":"Danah AlJaafari, Erum Shariff","doi":"10.3121/cmr.2026.2067","DOIUrl":"10.3121/cmr.2026.2067","url":null,"abstract":"<p><p>Parakinesia Brachialis Oscitans (PBO) is a rare post-stroke phenomenon characterized by abnormal, involuntary movement in a paralyzed limb triggered by yawning. We present the case of a male patient, age 57 years, who was admitted with right hemiparesis, dysarthria, and facial weakness. Brain magnetic resonance imaging revealed an infarction in the left pons. One week following the stroke, the patient began to experience involuntary elevation of his paretic arm and, to a lesser extent, his leg, triggered specifically by yawning. Based on these observations, he was diagnosed with PBO. The characteristic movement pattern of elevation of the upper limb during yawning was consistent with the typical presentation of PBO. The patient was reassured about the benign nature of his condition and continued his rehabilitation program. This phenomenon occurs due to a dissociation between autonomic and voluntary motor control, reflecting a disruption of cortical inhibition of the cerebellum, while sparing functional spinocerebellar pathways. Given the potential for confusion with focal seizure activity, especially during the acute phase of a stroke, a high index of suspicion is necessary to distinguish PBO from other neurologic disorders. Correctly identifying PBO can guide accurate diagnosis and appropriate management preventing unnecessary investigations and facilitating better outcomes in post-stroke care.</p>","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":"24 2","pages":"87-90"},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13343783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elderly at a Crossroads: Rehabilitation and Hospice Outcomes in Small Traumatic Brain Injuries.","authors":"Heather Rhodes-Lyons, Adel Elkbuli, David L McClure, Lucy Martinek, Antonio Pepe","doi":"10.3121/cmr.2026.2025","DOIUrl":"10.3121/cmr.2026.2025","url":null,"abstract":"<p><p><b>Background:</b> Traumatic brain injury (TBI) in older adults is a growing public health concern, yet outcome research has primarily focused on moderate-to-severe injuries or aggregated severity groups. Small-volume intracranial lesions, subdural hematomas (SDH ≤ 8mm), epidural hematomas (EDH ≤ 8mm), and cerebral contusions (≤ 2cm), are often classified as mild, but this may underestimate the functional burden in aging populations. Evidence is lacking on discharge outcomes in patients with isolated small-volume TBIs, particularly across age strata.<b>Objective:</b> To evaluate age-related differences in hospital discharge disposition, specifically to rehabilitation or hospice care, among adults aged ≥40 years with isolated, small-volume blunt TBIs, stratified by TBI type and age group.<b>Methods:</b> A retrospective cohort study was conducted using American College of Surgeons-Trauma Quality Programs-Participant Use Files (ACS-TQIP-PUF) data (2017-2022). Adults ≥40 years with isolated blunt TBIs, without skull fractures or polytrauma, were included. Lesion size was defined radiographically via abbreviated injury scale codes. Logistic regression models assessed associations between age group (middle-aged [40-64] vs. elderly [≥65]) and discharge disposition, adjusting for TBI subtype, comorbidities, injury severity, and facility factors.<b>Results:</b> Among 135,343 patients with isolated small-volume TBIs, elderly individuals were more likely to be discharged to rehabilitation (EDH: OR 1.601, 95% CI 1.234-2.076, <i>P</i> <0.001) and hospice care (SDH: OR 2.184, 95% CI 1.630-2.927, <i>P</i> <0.001) compared to middle-aged patients. These age-based differences persisted across TBI subtypes.<b>Conclusion:</b> Despite being classified as \"mild\" by volume, small TBIs are associated with significant discharge care needs among older adults. Elderly patients face markedly higher odds of requiring rehabilitation or end-of-life care. These findings challenge traditional severity frameworks and highlight the need for age-adapted discharge planning in the context of small-volume intracranial injuries.</p>","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":"24 2","pages":"52-59"},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13343744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Author Response to \"Dysautonomia in Long COVID: Why Sex Differences Matter in Cardiovascular Risk Assessment\".","authors":"Leonardo Tamariz, Ana Palacio","doi":"10.3121/cmr.2026.2146","DOIUrl":"10.3121/cmr.2026.2146","url":null,"abstract":"","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":"24 2","pages":"50-51"},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13343767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age Matters: Unveiling the Impact of Traumatic Brain Injury Size and Type on Outcomes in Middle-Aged and Elderly Patients.","authors":"Heather Rhodes-Lyons, Adel Elkbuli, David L McClure, Lucy Martinek, Antonio Pepe","doi":"10.3121/cmr.2026.2047","DOIUrl":"10.3121/cmr.2026.2047","url":null,"abstract":"<p><p><b>Background:</b> Traumatic brain injury (TBI) is a major cause of morbidity and mortality in older adults. While age and severity are known predictors of outcomes, limited research exists on how specific TBI types and sizes affect prognosis in older age groups.<b>Methods:</b> A retrospective cohort study analyzed data from the American College of Surgeons Trauma Quality Programs Participant Use File (ACS-TQIP-PUF) (2017-2022) including 182,661 adults ≥40 years with isolated blunt TBI (subdural hematoma >8mm, epidural hematoma >8mm, contusion >2cm, subarachnoid hemorrhage, or diffuse axonal injury [DAI]) and no skull fractures. Polytrauma cases were excluded. Outcomes included in-hospital mortality, intensive care unit (ICU) length of stay (LOS), and ventilator days. Multivariable logistic and linear regression models were used, adjusting for demographic, clinical, and injury characteristics.<b>Results:</b> Elderly patients (≥65 years) showed significantly higher mortality across all TBI types, most notably with contusions >2cm (OR 4.85, 95% CI 3.46-6.80, <i>P</i><.01). DAI in elderly patients was associated with the longest ICU LOS (+2.63 days, 95% CI 1.76-3.49, <i>P</i><.01) and ventilator duration (+4.29 days, 95% CI 1.90-6.67, <i>P</i><.01). Factors such as anticoagulation use, low Glasgow Coma Scores, and specific comorbidities further increased risk.<b>Conclusions:</b> Older adults with larger, isolated TBIs, especially contusions and DAI, experience worse clinical outcomes. These findings underscore the critical need for age-tailored trauma management protocols and early intervention strategies to reduce mortality and improve recovery in this vulnerable population.</p>","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":"24 2","pages":"70-79"},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13343765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-Hodgkin Lymphoma Presenting as Peritoneal Lymphomatosis: A Case Report.","authors":"Abraham Edgar Gracia-Ramos, Martín Galván-Rodríguez, Edith Aurora Escobar-Cázares, Martin Jacobo Pacheco, Erika Yazmín López-Flores, Erick Villa-Mejía","doi":"10.3121/cmr.2026.2055","DOIUrl":"10.3121/cmr.2026.2055","url":null,"abstract":"<p><p>Peritoneal lymphomatosis (PL) is an uncommon form of extranodal non-Hodgkin lymphoma (NHL), characterized by the spread of lymphoma cells within the peritoneum. We present a case involving a woman, age 43 years, diagnosed with diffuse large B-cell lymphoma that infiltrated the peritoneum and omentum and was accompanied by ascites and pleural effusion. Imaging revealed diffuse thickening of the peritoneum and omentum, mesenteric lymphadenopathy, and thickening of the jejunum wall. Cytology from the ascites and pleural fluid did not show malignant cells. The diagnosis was confirmed through histological and immunohistochemical analysis of tissue obtained via surgical laparoscopy. PL generally appears as an aggressive, high-grade subtype of NHL. Awareness of this rare condition is crucial for clinicians to facilitate early diagnosis and effective treatment, ultimately improving patient outcomes.</p>","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":"24 2","pages":"91-96"},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13343766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}