Journal of General and Family Medicine最新文献

{"title":"Personal, health system, and geosocial disparities in appointment nonadherence at family medicine clinics in southcentral Pennsylvania, United States","authors":"Wen-Jan Tuan DHA, MS, MPH,&nbsp;Ashley Weems,&nbsp;Shou Ling Leong MD","doi":"10.1002/jgf2.698","DOIUrl":"10.1002/jgf2.698","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>To assess the relationship between patients' demographic, health system-related, and geosocial characteristics and the risk of missed appointments among patients in family medicine practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study was based on a retrospective cross-sectional design using electronic health records and neighborhood-level social determents of health metrics linked by geocoded patients' home address. The study population consisted of patients who had a primary care provider and at least one appointment at 14 family medicine clinics in rural and suburban areas in January–December 2022. Negative binomial regression was utilized to examine the impact of personal, health system, and geosocial effects on the risk of no-shows and same-day cancellations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 258,614 appointments were made from 75,182 patients during the study period, including 7.8% no-show appointments from 20,256 patients. The analysis revealed that individuals in the ethnic minority groups were 1.24–1.65 times more likely to miss their appointments than their White counterpart. Females and English speakers had 14% lower risk for no-show. A significant increase (32%–64%) in the odds of no-shows was found among individuals on Medicaid and uninsured. Persons with prior history of no-shows or same day cancellations were 6%–27% more likely to miss their appointments. The no-show risk was also higher among people living in areas experiencing socioeconomic disadvantage.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The risk of missed appointments is affected by personal, health system, and geosocial contexts. Future efforts aiming to reduce no-shows could develop personalized interventions targeting the at-risk populations identified in the analysis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.698","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141009165","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":"Scalp vein sign caused by intracranial dural arteriovenous fistula","authors":"Munenori Iwamoto MD,&nbsp;Yoshihisa Otsuka MD, PhD,&nbsp;Tsuneaki Kenzaka MD, PhD,&nbsp;Masaaki Kohta MD, PhD,&nbsp;Yusuke Okamura MD, PhD","doi":"10.1002/jgf2.701","DOIUrl":"10.1002/jgf2.701","url":null,"abstract":"<p>A 68-year-old man presented with a headache that had started 1 month earlier. The scalp vein dilatation was observed at presentation. The findings of computed tomography and magnetic resonance imaging raised suspicion of a dural arteriovenous fistula, leading to the definitive diagnosis by digital subtraction angiography. Scalp vein signs can be a useful clue to suspect intracranial abnormalities, including dural arteriovenous fistula.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.701","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141015883","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":"Japanese primary care physicians' postpartum mental health care: A cross-sectional study","authors":"Keiichiro Narumoto MD, MPH, PhD,&nbsp;Miho Endo MD,&nbsp;Makoto Kaneko MD, MClSc, PhD,&nbsp;Tomoko Iwata MD,&nbsp;Machiko Inoue MD, MPH, PhD","doi":"10.1002/jgf2.700","DOIUrl":"10.1002/jgf2.700","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Postpartum mental health care is a public health priority requiring interprofessional and interorganizational collaboration. Primary care physicians (PCPs) have the potential to play an essential role in facilitating access to health care and providing comprehensive and coordinated care for postpartum mental health problems. In Japan, however, there are no previous studies on the extent to which PCPs are involved in postpartum mental health care. Therefore, this study aimed to investigate the practices and experiences of Japanese PCPs in providing such care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study presents a subset of the findings from a cross-sectional study using an online questionnaire on postpartum care among Japanese PCPs. We employed descriptive analysis to examine their practices and experiences in providing general and postpartum mental health care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We received 339 valid responses from 5811 PCPs. The median proportion of the outpatients with mental health problems that PCPs regularly saw was 15%. Approximately two out of three PCPs (68.7%) reported routinely performing screening for depression and anxiety. Seventy-six percent of PCPs had the opportunity to provide care for postpartum women. Approximately one in two PCPs (47.8%) had managed cases of postpartum mental health problems and collaborated with various professionals and resources to provide care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The majority of Japanese PCP participants in the study provide mental health care and have managed cases of postpartum mental health problems, collaborating with various health professionals.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.700","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141018740","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":"Successful treatment of a Morbihan's disease patient after a therapeutic challenge: A case report and comprehensive literature review","authors":"Afsaneh Sadeghzadeh Bazargan MD,&nbsp;Ali Zare Dehnavi MD,&nbsp;Abbas Dehghani MD,&nbsp;Kambiz Kamyab Hesari MD,&nbsp;Paria Jafari MD,&nbsp;Azadeh Goodarzi MD","doi":"10.1002/jgf2.690","DOIUrl":"10.1002/jgf2.690","url":null,"abstract":"<p>Morbihan's disease is a rare condition characterized by chronic facial edema. While its exact cause is unknown, it is thought to involve local cutaneous vascularization and lymphatic drainage imbalance. Traditional treatment options are often ineffective, and no established efficient treatment exists. We present a case study of a 17-year-old male with Morbihan's syndrome who showed resistance to traditional treatments but responded well to a combination of cromolyn sodium nasal spray and oral montelukast after histopathology revealed hyperplasia of plasma cells and mast cells. This combination has not been used before for Morbihan's syndrome. Our review of the literature also provides insight for clinicians seeking to manage this condition.</p>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.690","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141021354","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":"Timing and prediction of secondary bacteremia in patients with COVID-19: A retrospective cohort study","authors":"Aoi Yogo,&nbsp;Shungo Yamamoto MD, DTM&H, DrPH,&nbsp;Kentaro Tochitani","doi":"10.1002/jgf2.697","DOIUrl":"10.1002/jgf2.697","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>We aimed to aid the appropriate use of antimicrobial agents by determining the timing of secondary bacteremia and validating and updating clinical prediction models for bacteremia in patients with COVID-19.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a retrospective cohort study on all hospitalized patients diagnosed with COVID-19 who underwent blood culture tests from January 1, 2020, and September 30, 2021, at an urban teaching hospital in Japan. The primary outcome measure was secondary bacteremia in patients with COVID-19.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 507 patients hospitalized with COVID-19, 169 underwent blood culture tests. Eleven of them had secondary bacteremia. The majority of secondary bacteremia occurred on or later than the 9th day after symptom onset. Positive blood culture samples collected on day 9 or later after disease onset had an odds ratio of 22.4 (95% CI 2.76–181.2, <i>p</i> &lt; 0.001) compared with those collected less than 9 days after onset. The area under the receiver operating characteristic curve of the modified Shapiro rule combined with blood culture collection on or after the 9th day from onset was 0.919 (95% CI, 0.843–0.995), and the net benefit was high according to the decision curve analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The timings of symptom onset and hospital admission may be valuable indicators for making a clinical decision to perform blood cultures in patients hospitalized with COVID-19.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11221055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141535891","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":"Lack of women physician representation in the Japanese Society of Hospital General Medicine","authors":"Seiji Shiota MD, PhD,&nbsp;Rie Utsunomiya-Nishimizu MD,&nbsp;Ryo Goto MD,&nbsp;Ayana Hirabayashi MD,&nbsp;Noboru Horinouchi MD, MPH,&nbsp;Eri Doi MD,&nbsp;Katsuhiko Yoshimura MD,&nbsp;Kyoko Yamamoto MD, PhD,&nbsp;Aoi Yoshiiwa MD, PhD,&nbsp;Eishi Miyazaki MD, PhD","doi":"10.1002/jgf2.693","DOIUrl":"10.1002/jgf2.693","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The increasing number of women physicians is in contrast to their underrepresentation in academic positions and professional associations. This study aimed to evaluate the status of women physicians in the Japanese Society of Hospital General Medicine (JHGM) based on society membership, board membership, and annual meeting authorship.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional analysis was conducted. Information on women physicians, society and board membership, and annual meeting authorship was collected. Data from the Japanese Primary Care Association (JPCA) served as the control. The gender of authors with accepted abstracts in the JHGM and JPCA annual meetings was determined by name or Internet search.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the JHGM, 14.2% of members were women physicians, compared to 19.1% in the JPCA (<i>p</i> &lt; 0.001). None of the 21 JHGM board members were women, compared to 20.5% in the JPCA (<i>p</i> &lt; 0.001). The average number of years of experience was significantly higher for the JHGM board members than for the JPCA board members (37.0 vs. 28.1 years, <i>p</i> &lt; 0.001). Women first authors in the 2022–2023 JHGM meeting comprised 17.9%, significantly lower than the 28.4% in the 2023 JPCA meeting (<i>p</i> = 0.002). Similar patterns were seen for women last authors (6.0% in the JHGM vs. 18.8% in the JPCA, <i>p</i> &lt; 0.001) and women chairpersons (17.9% in the JHGM vs. 40.3% in the JPCA, <i>p</i> = 0.036).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The JHGM has low women representation in society and board membership, and annual meeting authorship. Strategies are needed to enhance diversity and inclusion by increasing women's participation and leadership in the JHGM.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11221056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141535947","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":"Strict association between development of psychological conditions and hypertension incidence: A cross-sectional study","authors":"Hossein Namdar MD,&nbsp;Fatemeh Jamshidi PhD,&nbsp;Aysa Rezabakhsh PhD,&nbsp;Davoud Ezzati PhD,&nbsp;Raana Zakeri MD,&nbsp;Seyyed-Reza Sadat-Ebrahimi MD","doi":"10.1002/jgf2.696","DOIUrl":"10.1002/jgf2.696","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background/Aims</h3>\u0000 \u0000 <p>Previous studies indicated a significant association between mental disorders and cardiovascular diseases, including heart failure (HF) and coronary artery disease (CAD) with comorbidity hypertension (HTN), and vice versa, leading to a challenge in the final decision. To resolve this issue, we aimed to exclude comorbidities and further assessed to better find any association between mental disorders and cardiovascular diseases (CVD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The cross-sectional study involved 300 participants: 100 with HTN (without HF or CAD), 100 with HF (without HTN or CAD), 100 with CAD (without HTN or HF), and 100 healthy individuals as a control group. To evaluate depression, anxiety, and stress levels, the Depression, Anxiety, and Stress Scale – 21 (DASS-21) was applied. For further analysis, the SPSS <i>ver.</i>20 was used.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The analysis showed that the score of depression, anxiety, and stress was higher in the HTN patients compared to the control (<i>p</i> &lt; 0.001), CAD (<i>p</i> &lt; 0.001), and HF (<i>p</i> &lt; 0.001) groups, respectively. However, no significant differences were observed between the other study groups. Notably, patients with HF and CAD without concurrent HTN had similar psychological distress levels to healthy participants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The present study emphasized the higher prevalence of psychological distress in HTN patients and suggests a requirement for further research regarding the etiology involved in this association.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.696","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140656540","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":"The correlation between smoking cumulative dose based on Brinkman Index with peak expiratory flow rate","authors":"Erwin Mulyawan MD, Sp.An, KMN, FIPM, PhD,&nbsp;Jessica Anastasia Setiawan MD","doi":"10.1002/jgf2.694","DOIUrl":"10.1002/jgf2.694","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Indonesia is the country with the highest prevalence of smokers above 15 years old according to WHO, with a percentage of 76.2%. Smoking-induced lung damage is characterized by inflammation, leading to the destruction of lung parenchyma and airway obstruction, ultimately worsening lung function parameters. This study aims to find correlation between cumulative dose of smoking based on Brinkman index (BI) with Peak Expiratory Flow Rate (PEFR).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a cross-sectional correlative study conducted on January–March 2020. Data were collected through history taking and PEFR measured with a peak flowmeter by taking the average of three peak flowmeter measurements, each separated by a 2-min interval. Inclusion criteria include male active smokers, aged 30 to 40 years, who have had a smoking history for at least 1 year. Exclusion criteria are as follows: uses e-cigarretes for smoking, has a history of chronic lung diseases such as tuberculosis, pneumonia, post-COVID-19 syndrome, asthma, and has not smoked in the last 28 days.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 48 male smokers are included in this study. The mean age of participants was 35.91 years, with a history of smoking of 18.12 years, and 12.5 cigarettes smoked daily. Patients included in this study had BI classified as mild (47.91%), moderate (47.91%), and severe (4.16%). PEFR in patients was classified into green (10.41%), yellow (83.33%), and red (6.25%). Analysis showed significant negative correlation between BI and PEFR (<i>r</i> = −0.721; <i>p</i> &lt; 0.001) suggesting that increasing Brinkman Index may lead to a decrease in PEFR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Higher BI correlates with a decrease in PEFR. PEFR may prove to be useful in early detection of reduced pulmonary function. Further trials conducted on larger sample sizes and evaluating other lung function parameters are recommended.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.694","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140673629","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":"Medical students' impression of a generalist in Japan: A cross-sectional study","authors":"Kai Kinoshita MD,&nbsp;Makoto Kaneko MD, PhD","doi":"10.1002/jgf2.692","DOIUrl":"10.1002/jgf2.692","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Despite the increasing global demand, few medical students aspire to become generalists. To address this shortage, we investigated medical students' impressions of generalists in Japan.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional study used a web-based questionnaire from a previous study. The participants chose the impression of a generalist from four categories based on the previous report: family physician, hospital family physician, hospitalist, and general internal medicine.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Medical students' impressions were as follows: family physicians (32%), hospitalists (28%), general internal medicine staff (20%), and hospital family physicians (18%). Students considered reasonable working hours, research opportunities, a clinical clerkship in generalist medicine, and information from university faculty as essential for making career choices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The study demonstrated that the number of Japanese medical students who considered generalists to be family physicians/hospital family physicians and the number of those who considered generalists to be hospitalists/general internal medicine were almost equal. To increase the number of medical students who consider and choose to become generalists, understanding their impressions of generalist practice and their needs regarding work settings in that role is crucial.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.692","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140711910","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":"SARS-CoV-2 PCR cycle threshold value at admission might not be a good predictor of in-hospital COVID-19-associated AKI","authors":"Shiva Rahimipour Anaraki MD,&nbsp;Ali Mohammadian MD,&nbsp;Talieh Mostaghimi MSc,&nbsp;Farzin Sadeghi PhD,&nbsp;Roghayeh Akbari MD","doi":"10.1002/jgf2.682","DOIUrl":"10.1002/jgf2.682","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Acute kidney injury (AKI) is a prevalent complication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and a predictor of disease severity and mortality; furthermore, a prompt diagnosis and treatment of this complication may enhance COVID-19 prognosis. Therefore, we aim to investigate potential risk factors for SARS-CoV-2-associated AKI, including SARS-CoV-2 PCR cycle threshold value (CT value), which correlation with AKI is conflicting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This case–control study included 110 hospitalized patients with SARS-CoV-2-associated AKI as cases and 110 random SARS-CoV-2 hospitalized patients as controls. Reverse transcription real-time PCR of admission nasopharyngeal swabs evaluated E gene cycle thresholds. Additional clinical and paraclinical information extracted from medical records. The patient's status at discharge, and 14 and 30 days after discharge. Therefore, after adjusting for age and gender, the correlation between variables was assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>SARS-CoV-2 AKI is significantly associated with age above 60, hypertension, diabetes mellitus, ischemic heart disease, and underlying kidney diseases. Abnormal admission hemoglobin or alkaline phosphatase, proteinuria or hematuria in urine sediment, and abnormal creatinine during hospitalization were the paraclinical features correlated to SARS-CoV-2 AKI. AKI group demonstrated greater in-hospital, 14- and 30-day mortality. Nevertheless, this study did not evidence a correlation between the admission CT value and mortality or AKI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Admission CT values provide limited information regarding the dynamic viral load and varying hospitalization time points; thus, they may not be reliable for predicting the prognosis and complications of COVID-19 in all populations. Further studies with serial CT measurements or symptom onset time adjustment are recommended.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.682","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140739156","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}