Clinical Medicine & Research最新文献

Eosinophilic Fasciitis after Covid Infection: A Case Report and Review of Literature. 新冠病毒感染后嗜酸性筋膜炎1例报告及文献复习。

IF 1.4

Clinical Medicine & Research Pub Date : 2025-08-01 DOI: 10.3121/cmr.2025.1907

Sweta Boban, Hiral Patel, Jonathan Cutlan, Boban Mathew, Lisa Francis

{"title":"Eosinophilic Fasciitis after Covid Infection: A Case Report and Review of Literature.","authors":"Sweta Boban, Hiral Patel, Jonathan Cutlan, Boban Mathew, Lisa Francis","doi":"10.3121/cmr.2025.1907","DOIUrl":"10.3121/cmr.2025.1907","url":null,"abstract":"Eosinophilic fasciitis (EF) is a rare fibrosing disorder caused by an autoimmune response to an unknown trigger. Many possible triggers have been suggested including strenuous exercise, drug or chemical exposure, and preceding infection. We present a case of a female patient, age 69 years, who developed EF following SARS-CoV-2 infection. There have been several advances in the diagnosis and management of EF since it was first described 50 years ago. EF is a mimic of scleroderma, but key clinical features can be used to differentiate between the two diagnoses. Laboratory abnormalities include eosinophilia, elevated inflammatory markers, and hypergammaglobulinemia. A full thickness biopsy of the skin including muscle and fascia is recommended to confirm the diagnosis. Imaging modalities such as ultrasound and magnetic resonance imaging have been increasingly used in the diagnosis and follow-up of EF. Corticosteroids remain the first line in treatment of EF. Combination of steroids and methotrexate have shown the best possible outcome. Early diagnosis is important for better treatment response.","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":"23 2","pages":"67-71"},"PeriodicalIF":1.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12352912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856751","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}

引用次数: 0

Impaired Sustained Attention in Patients with Subclinical Hypothyroidism. 亚临床甲状腺功能减退患者持续注意力受损。

IF 1.4

Clinical Medicine & Research Pub Date : 2025-08-01 DOI: 10.3121/cmr.2025.1925

Satkarjit Kaur Jhandi, Shweta Shenoy, Ajaypal Singh Randhawa, A P Singh

{"title":"Impaired Sustained Attention in Patients with Subclinical Hypothyroidism.","authors":"Satkarjit Kaur Jhandi, Shweta Shenoy, Ajaypal Singh Randhawa, A P Singh","doi":"10.3121/cmr.2025.1925","DOIUrl":"10.3121/cmr.2025.1925","url":null,"abstract":"Background: Subclinical hypothyroidism (SCH) is of particular importance due to its high prevalence and its association with cognitive deficits. Patients often express complaints of neuropsychological symptoms and cognitive impairments including lack of attention. Also, patients treated with levothyroxine (LT-4) often report persistent complaints related to mental slowing or lack of attention despite normal TSH levels.Purpose: To investigate the effects of different ranges of TSH on sustained attention in SCH.Methods: Included in the study were 136 participants that were divided into four groups: Group 1, 35 healthy individuals; Group 2, 33 newly diagnosed patients with SCH; Group 3, 36 patients on LT-4 with uncontrolled or elevated TSH; Group 4, 32 euthyroid patients (ongoing LT-4). Laboratory measurements and clinical assessment were done. Rapid visual processing (RVP) task was performed on standardized battery (Cambridge Automated Neuropsychological Test Battery).Results: There was significant impairment in sustained attention (P=<0.05) in Group 2 patients who had neuropsychological symptoms and SCH diagnosed with a TSH range of ≥2.5mIU/L.Conclusion: Our findings encourage screening for sustained attention along with thyroid profile in those who report neuropsychological symptoms. TSH mean range of ≥2.5 mIU/L was established as a more reasonable threshold for evaluating sustained attention and initiating LT-4 in SCH.","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":"23 2","pages":"45-52"},"PeriodicalIF":1.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12352913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856752","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}

引用次数: 0

Low HDL-The Challenge. 低高密度脂蛋白-挑战。

IF 1.4

Clinical Medicine & Research Pub Date : 2025-08-01 DOI: 10.3121/cmr.2025.1970

Shereif H Rezkalla, Robert A Kloner

{"title":"Low HDL-The Challenge.","authors":"Shereif H Rezkalla, Robert A Kloner","doi":"10.3121/cmr.2025.1970","DOIUrl":"10.3121/cmr.2025.1970","url":null,"abstract":"The main function of high-density lipoprotein (HDL) is to remove low-density lipoprotein (LDL) from blood vessels through reverse cholesterol transport. In addition, HDL has anti-inflammatory and antioxidant properties. Low HDL level is an independent risk factor for development of coronary artery disease. To manage patients with low HDL levels, general measures such as lifestyle modification, controlling acute metabolic syndrome, and participating in regular endurance exercise are essential. Smoking cessation is a must, and it will often improve HDL levels by 5% to 10%. While statin therapy is the backbone therapy for controlling LDL levels, it also results in elevation of HDL levels by at least 5%. Specific pharmacologic interventions to improve HDL level and function have been disappointing. Cholesteryl ester transfer protein (CETP) is the key metabolic pathway to transfer HDL to LDL; thus, CETP inhibitors result in elevation of HDL levels. Several products were tested in large controlled studies, such as dalcetrapib and evacetrapib; neither resulted in any clinical benefit. Anacetrapib only resulted in very limited benefit and is no longer under active development. The most recent study utilized apolipoprotein A1 infusion in high-risk patients shortly after acute myocardial infarction. There was no benefit in the primary end point of myocardial infarction, stroke, or death. In patients with low HDL, a strategy of having LDL as low as can be possibly achieved may be the most appropriate approach.","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":"23 2","pages":"60-66"},"PeriodicalIF":1.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12352915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856753","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}

引用次数: 0

Non-equivalence of Standard and Unified Criteria for Gestational Diabetes Mellitus. 妊娠期糖尿病标准与统一标准的不等同性。

IF 1.4

Clinical Medicine & Research Pub Date : 2025-08-01 DOI: 10.3121/cmr.2025.1974

Ahmad Hamdan, Amna Zar, Fatima R Alsharif, Mohannad N AbuHaweeleh, Nouran Alwisi, Hanan Khudadad, Khalid Bashir, Stephen Beer, Mohammed Bashir, Abdul-Badi Abou-Samra, Suhail A R Doi

{"title":"Non-equivalence of Standard and Unified Criteria for Gestational Diabetes Mellitus.","authors":"Ahmad Hamdan, Amna Zar, Fatima R Alsharif, Mohannad N AbuHaweeleh, Nouran Alwisi, Hanan Khudadad, Khalid Bashir, Stephen Beer, Mohammed Bashir, Abdul-Badi Abou-Samra, Suhail A R Doi","doi":"10.3121/cmr.2025.1974","DOIUrl":"10.3121/cmr.2025.1974","url":null,"abstract":"Objective: There are two types of criteria for diagnosing gestational diabetes mellitus (GDM). The first is based on measurement of three values on the glucose tolerance test (GTT) and making a diagnosis when any value is abnormal (individual time-point criterion). The second is based on creating a weighted average of the three values and using the average to split glycemic status into normal gestational glycemia (NGG), impaired gestational glycemia (IGG), gestational diabetes (GDM), or high-risk gestational diabetes (hGDM) (unified criterion). There is no information currently regarding how these two criteria relate to each other in the diagnosis of GDM. This study aimed to make this comparison.Design: Cross-sectional study.Setting: Publicly available data on a cohort of women in pregnancy.Participants: Pregnant women from the cohort.Methods: The cross-classification of diagnosis by two criteria was evaluated. The individual time-point criterion had a binary outcome (GDM yes/no), while the unified criterion had the four aforementioned outcomes.Results: Within the low risk (non-GDM) category by the individual time-point criterion, 1 in 85 women would have been deemed at high risk by the unified criterion. More importantly, within the high risk (GDM) category by the individual time-point criterion, 1 in 2 women would have been deemed at low risk by the unified criterion.Conclusion: The standard criterion is not equivalent to the unified criterion in terms of risk estimation. This is important as the unified criterion correlates with area under the GTT curve known to be associated with glucose excursion and is predictive of the net effect of insulin resistance and beta-cell function.","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":"23 2","pages":"53-59"},"PeriodicalIF":1.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12352914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856754","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}

引用次数: 0

Complex Separation Humeral Head Fracture in a Young Patient: Operative and Postoperative Challenges. 一例年轻患者复杂分离肱骨头骨折：手术和术后的挑战。

IF 1.4

Clinical Medicine & Research Pub Date : 2025-08-01 DOI: 10.3121/cmr.2025.1987

Evangelos Sakellariou, Athanasios Galanis, Evangelia Argyropoulou, Michail Vavourakis, Panagiotis Karampinas, Dimitrios Zachariou, Vasilios Marougklianis, Iordanis Varsamos, Dimitrios Kalavrytinos, Eftychios Papagrigorakis

{"title":"Complex Separation Humeral Head Fracture in a Young Patient: Operative and Postoperative Challenges.","authors":"Evangelos Sakellariou, Athanasios Galanis, Evangelia Argyropoulou, Michail Vavourakis, Panagiotis Karampinas, Dimitrios Zachariou, Vasilios Marougklianis, Iordanis Varsamos, Dimitrios Kalavrytinos, Eftychios Papagrigorakis","doi":"10.3121/cmr.2025.1987","DOIUrl":"10.3121/cmr.2025.1987","url":null,"abstract":"Management of humeral head fractures presents numerous challenges, particularly in cases of separation fractures, which are relatively rare and often caused by high-energy trauma. Due to the complexity of these fractures and the absence of a standardized treatment algorithm, surgical intervention can be technically intricate and fraught with postoperative complications. In young patients, the decision to pursue open reduction and internal fixation must be meticulously made to achieve optimal outcomes while minimizing long-term sequelae. We present a rare case of a man, age 25 years, sustaining a complex proximal humerus fracture. The patient presented with a proximal humerus fracture involving a head-splitting pattern comprising five fragmented pieces, necessitating careful anatomical reduction and fixation. Despite the technical challenges encountered during surgery, including the meticulous reconstruction of the humeral head \"puzzle\" using headless screws, the postoperative recovery was relatively uneventful. While some restrictions in range of motion were noted postoperatively, the absence of early complications like osteonecrosis bodes well for the patient's long-term functional prognosis. This is a thought-provoking case accentuating that by apposite surgical techniques and tailored treatment strategy to individual young patients, successful management of humeral head fractures can be achieved while minimizing potential complications and optimizing functional recovery in this challenging patient population.","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":"23 2","pages":"72-78"},"PeriodicalIF":1.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12352911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856750","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}

引用次数: 0

PRN Antihypertensives in Hospitals: A Crisis of Precision or Pragmatism? 医院PRN降压药：精准还是实用的危机？

IF 1.2

Clinical Medicine & Research Pub Date : 2025-03-01 DOI: 10.3121/cmr.2025.2002

Apurva Popat

引用次数: 0

Weil's Disease with Multi-Organ Dysfunction: A Diagnostic Challenge. 伴有多器官功能障碍的韦尔氏病：一个诊断挑战。

IF 1.2

Clinical Medicine & Research Pub Date : 2025-03-01 DOI: 10.3121/cmr.2025.1963

David Vivero-Tellez, Joshua Antonio Contreras-Ortíz, Emmanuel Flores-Martínez, Abraham Edgar Gracia-Ramos

引用次数: 0

False Positive Supraventricular Tachycardia During Exercise Stress Test. 运动负荷试验中假阳性室上性心动过速。

IF 1.2

Clinical Medicine & Research Pub Date : 2025-03-01 DOI: 10.3121/cmr.2025.201

Apurva Popat, Sweta Yadav, Deepa Soodi, Param P Sharma

引用次数: 0

A Case of Methemoglobinemia and Hemolysis from Sodium Chlorite Ingestion. 食入亚氯酸钠致高铁血红蛋白血症及溶血1例。

IF 1.2

Clinical Medicine & Research Pub Date : 2025-03-01 DOI: 10.3121/cmr.2025.1954

Jessica Liu, Matthew Patel, Marisa Vigna, Mark Keith Hewitt, Wendy Lim

引用次数: 0

Evaluation of CRH, ACTH, Cortisol, and Chromogranin Levels in the Acute Stage of Schizophrenia. 精神分裂症急性期CRH、ACTH、皮质醇和嗜铬粒蛋白水平的评估。

IF 1.2

Clinical Medicine & Research Pub Date : 2025-03-01 DOI: 10.3121/cmr.2025.1930

Esra Yazici, Yavuz Selim Ogur, Derya Guzel Erdogan, Betul Aslan Turkmen, Ahmet Bulent Yazici

{"title":"Evaluation of CRH, ACTH, Cortisol, and Chromogranin Levels in the Acute Stage of Schizophrenia.","authors":"Esra Yazici, Yavuz Selim Ogur, Derya Guzel Erdogan, Betul Aslan Turkmen, Ahmet Bulent Yazici","doi":"10.3121/cmr.2025.1930","DOIUrl":"10.3121/cmr.2025.1930","url":null,"abstract":"Objective: This study investigated the relationship between corticotropin-releasing hormone (CRH) related hypothalamic-pituitary-adrenal (HPA) axis hormones, chromogranin (CgA), and the acute stage of schizophrenia.Methods: Thirty-eight patients diagnosed with schizophrenia according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM 5) were included in the study. Brief Psychiatric Rating Scale (BPRS), Positive and Negative Syndrome Scale (PANSS), Stroop Test, Clinical Global Impression Scale (CGI), Global Assessment of Functioning Scale (GAF), and Wechsler Memory Scale III Visual Reproduction Subtest (WMS III-VRS) were implemented to the patient on the days 1 and 20 of their hospitalization. Blood samples were taken on days 1 and 20 from each patient at 8 AM. Adrenocorticotropic hormone (ACTH), cortisol, CRH, and CgA serum levels were measured.Results: The CRH levels were significantly higher on day 20 than day 1 (P=0.007, t=-2.8). A positive correlation was found between cortisol level and PANSS General (r=0.325; P=0.046) and immediate WMS III- VRS (r=0.424; P=0.008). CgA change between the day 1 and day 20 negatively correlated with the sum of previous psychiatric hospitalization days (r=-0.344, P=0.034). Day 1 ACTH levels were negatively correlated with the sum of previous psychiatric hospitalization days (r=-0.365, P=0.024) and the hospitalization number (r=-0.415, P=0.01).Conclusion: HPA axis hormones measured in the acute phase of schizophrenia can give an idea about the severity of the disease and visual memory functions. However, studies with more subjects and controlling confounders are needed.","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":"23 1","pages":"11-20"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12172663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318327","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}

引用次数: 0