Archives of internal medicine research最新文献

{"title":"Outcomes of Diabetes Management with Continuous Glucose Monitoring Technology.","authors":"Daniel Vayser, Phoebe Wang, Nolan Dafesh, Devendra K Agrawal","doi":"10.26502/aimr.0243","DOIUrl":"10.26502/aimr.0243","url":null,"abstract":"<p><p>Diabetes mellitus is a chronic metabolic disorder that imposes a global economic burden. Type 1 diabetes mellitus (T1DM) results from autoimmune destruction of pancreatic β-cells, while type 2 diabetes mellitus (T2DM) is characterized primarily by peripheral insulin resistance with progressive β-cell dysfunction. Despite advances in pharmacologic and self-monitoring therapies, many patients fail to achieve recommended glycemic targets. Continuous glucose monitoring (CGM) has emerged as a transformative technology with the potential to address persistent gaps in diabetes management. This review critically synthesizes the current literature on CGM-associated clinical outcomes, cost implications, and technological limitations across major commercial platforms-Dexcom, Medtronic, and FreeStyle Libre-and examines future directions in CGM innovation. A comprehensive review of randomized controlled trials, prospective cohort studies, real-world registries, and meta-analyses was performed to evaluate CGM use in T1DM and T2DM populations across pediatric, adult, and older adult cohorts. Outcomes assessed included HbA1c, time in range (TIR), hypoglycemic events, healthcare utilization, cost, patient-reported outcomes, and adverse effects. CGM use was consistently associated with improvements in glycemic control, with HbA1c reductions ranging from approximately 0.4% to 1.5% across studies, and the greatest benefits observed in patients with higher baseline HbA1c. Hypoglycemic events were substantially reduced, including a 72% reduction reported in the HypoDE trial and reductions of up to 79% in the DIAMOND trial. CGM use was also associated with increased TIR, decreased glycemic variability, and reduced rates of diabetic ketoacidosis hospitalizations and emergency department visits, yielding meaningful cost offsets despite higher upfront device costs. Patient-reported outcomes-including treatment satisfaction, self-efficacy, and quality of life-improved consistently across studies. Among the major platforms, Dexcom systems demonstrated robust evidence in both T1DM and T2DM populations; Medtronic's MiniMed 780G achieved mean TIR values approaching 78.8% with optimal settings through automated insulin delivery; and FreeStyle Libre demonstrated particular value in T2DM populations on basal insulin or non-insulin therapy. Limitations included dermatologic complications, sensor lag during rapid glycemic change, alarm fatigue, accuracy variability across the hypoglycemic range, and procedural and mechanical issues. CGM technology has fundamentally reshaped contemporary diabetes care, with consistent and reproducible benefits across glycemic, economic, and patient-centered domains in both T1DM and T2DM populations. While important device-related and patient-centered limitations persist, the cumulative evidence support broader integration of CGM into routine diabetes management. Continued innovation in sensor accuracy, automated insulin delivery, and data anal","PeriodicalId":519871,"journal":{"name":"Archives of internal medicine research","volume":"9 2","pages":"119-135"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13268403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148267715","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":"Limitations of Current Therapies and Barriers in Alzheimer's Disease.","authors":"Ayeshah Hussain, Iffat Alam, Devendra K Agrawal","doi":"10.26502/aimr.0244","DOIUrl":"10.26502/aimr.0244","url":null,"abstract":"<p><p>Alzheimer's disease (AD) remains a major global health crisis due to its complex pathophysiology and limited therapeutic effectiveness. Despite advances in understanding key mechanisms such as amyloid-beta accumulation, tau pathology and neuroinflammation, current therapies provide limited clinical benefit. Multiple factors contribute to limitations and highlight the difficulty of translating scientific advancements into meaningful improvement in patient outcomes. This article provides a comprehensive and critical review of therapeutic, biological, clinical, and systemic barriers to effective Alzheimer's disease management as well as showcasing emerging strategies aimed to improve early detection, treatment approaches, and overall disease prevention.</p>","PeriodicalId":519871,"journal":{"name":"Archives of internal medicine research","volume":"9 2","pages":"136-144"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13322340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148371151","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":"Acute Allergic Reactions and Severe Anaphylaxis: Underlying Causes, Management Strategies, and Future Directions.","authors":"Aris Ellorin, Devendra K Agrawal","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Anaphylaxis represents the most severe and potentially fatal manifestation of allergic disease, characterized by sudden multi-system involvement and rapid hemodynamic compromise. While management protocols have improved, global incidence continues to rise and preventable deaths persist - driven largely by delayed epinephrine administration and inadequate long-term follow-up. This narrative review synthesizes current evidence on the immunological and non-immunological mechanisms underlying anaphylaxis, evaluates diagnostic criteria from major allergy societies, and appraises both immediate and long-term treatment strategies. Contributing factors to persistent morbidity - including epinephrine underuse, barriers to autoinjector access, and the emergence of biphasic and refractory phenotypes - are examined in depth. Advances in novel epinephrine delivery platforms, biologic therapies targeting the IgE and cytokine axes, and immunomodulatory strategies including oral and venom immunotherapy are highlighted as promising avenues for improving outcomes. This review also underscores the need for validated predictive biomarkers, equitable device access, and prospective trials to close the gaps that continue to drive preventable mortality.</p>","PeriodicalId":519871,"journal":{"name":"Archives of internal medicine research","volume":"9 2","pages":"64-72"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13120779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794058","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":"Neuroinflammation and Mental Health in Multiple Sclerosis and Autoimmune Encephalitis: Bridging Biological Mechanisms and Psychosocial Factors.","authors":"Rojawn Khoshnam, Nika Khosravi Kia, Devendra K Agrawal","doi":"10.26502/aimr.0240","DOIUrl":"10.26502/aimr.0240","url":null,"abstract":"<p><p>Autoimmune neuroinflammatory diseases, including multiple sclerosis (MS) and autoimmune encephalitis (AE), are characterized by dysregulated immune activity within the central nervous system that leads to both neurological and psychiatric symptoms. While MS is typically a chronic condition indicated by demyelination and progressive neurodegeneration, AE often presents more acutely through antibody-mediated disruption of synaptic function. Despite differences in disease course and mechanisms, both conditions highlight the significant impact of immune-mediated processes on cognition, mood, and behavior. Current treatment options primarily focus on reducing inflammation and controlling disease activity through immunomodulatory or immunosuppressive therapies. Although these approaches have improved neurological outcomes, many patients continue to experience persistent cognitive impairment and psychiatric symptoms, including depression, anxiety, and executive dysfunction. These symptoms are increasingly recognized as core features of disease rather than secondary symptoms. New research suggests that immune system activity works together with brain network changes and chronic stress to shape mental and neurological symptoms. However, these areas are often overlooked in clinical care and understudied in research. Future directions should prioritize integrating cognitive and psychiatric outcomes into clinical trials, developing biomarkers that link immune activity to neuropsychiatric symptoms, and implementing multidisciplinary treatment approaches. A more comprehensive understanding of both biological and psychosocial contributors is essential for improving long-term patient outcomes and quality of life.</p>","PeriodicalId":519871,"journal":{"name":"Archives of internal medicine research","volume":"9 2","pages":"79-93"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13170372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944155","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":"Convergent Regenerative Strategies in PM&R for Musculoskeletal and Hair Restoration: Integration of PRP, Exosomes, and Physical Modalities.","authors":"Andre Aabedi, Devendra K Agrawal","doi":"10.26502/aimr.0234","DOIUrl":"10.26502/aimr.0234","url":null,"abstract":"<p><p>Regenerative medicine has emerged as a transformative approach for both musculoskeletal disorders and hair follicle dysfunction by targeting shared biological mechanisms underlying tissue repair and renewal. Conditions such as tendinopathies, osteoarthritis, and alopecia contribute substantially to physical morbidity and psychosocial burden, while conventional therapies often provide limited or symptomatic relief. This Physical Medicine and Rehabilitation-centered review synthesized evidence on convergent regenerative pathways involved in musculoskeletal healing and hair follicle restoration, with a focused analysis of platelet-rich plasma, exosomes and cell-free biologics, and physical modalities, including low-level laser therapy and mechanotransduction. Across both tissue systems, these modalities modulate stem cell activity, angiogenesis, inflammatory signaling, and extracellular matrix remodeling through shared molecular pathways, including Wnt/β-catenin, TGF-β, IGF-1, PDGF, and VEGF signaling. Despite tissue-specific differences in cellular architecture and repair demands, overlapping regenerative mechanisms enable translational application of biologic, photo-biomodulatory, and mechanical therapies across orthopedic and dermatologic contexts. This review highlights clinical evidence, practical considerations, and regulatory challenges, while identifying gaps in standardization, dosing, and outcome measures. By framing hair follicle restoration and musculoskeletal healing within a unified regenerative paradigm, physical medicine and rehabilitation is positioned to bridge these traditionally distinct domains and advance biologically driven, minimally invasive therapies aimed at true tissue regeneration rather than symptom modulation alone.</p>","PeriodicalId":519871,"journal":{"name":"Archives of internal medicine research","volume":"9 1","pages":"26-33"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12995375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147482951","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":"Dermatomyositis: Prevalence, Clinical Spectrum, Diagnostic Approach, and Management Strategies.","authors":"Amrita Sandhu, Devendra K Agrawal","doi":"10.26502/aimr.0233","DOIUrl":"10.26502/aimr.0233","url":null,"abstract":"<p><p>Dermatomyositis is a rare, inflammatory myopathy with signature cutaneous manifestation and variable degrees of muscular and systemic involvement. Clinical phenotypes range from muscle-predominant disease to amyopathic presentations, leading to diagnostic complexity and heterogeneity in disease trajectory. Immunologic testing reveals myositis-specific autoantibodies that associate with characteristic clinical patterns, pattern of organ involvement, and prognostic implications, including interstitial lung disease and malignancy. The absence of definitive serologic markers in all cases of dermatomyositis requires a comprehensive diagnostic approach integrating clinical features, supportive testing, and histopathologic evaluation in dermatomyositis. Current management approaches include systemic glucocorticoids, conventional and emerging immunosuppressive therapies, and intravenous immunoglobulin. Moving forward, improved understanding of disease heterogeneity and immune pathways is expected to influence personalized approaches to diagnosis and treatment in dermatomyositis. This critical review article integrates current evidence on the epidemiology, clinical presentation, diagnostic framework, systemic association, and management of dermatomyositis, highlighting ongoing challenges and future directions in the care of this intricate autoimmune disorder.</p>","PeriodicalId":519871,"journal":{"name":"Archives of internal medicine research","volume":"9 1","pages":"14-25"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12948254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147328891","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":"Immunopathogenesis, Diagnosis, and Treatment of Hashimoto's Thyroiditis.","authors":"Felicia Delgadillo, Devendra K Agrawal","doi":"10.26502/aimr.0232","DOIUrl":"10.26502/aimr.0232","url":null,"abstract":"<p><p>This comprehensive literature review examines the immunopathogenesis of Hashimoto's thyroiditis, a prevalent autoimmune thyroid disorder. Hashimoto's thyroiditis results from a complex interplay of genetic predisposition and environmental triggers, leading to loss of immune tolerance to thyroid antigens. Hashimoto's thyroiditis involves both cellular (T cells) and humoral (B cells, autoantibodies) responses. Key players include Th1, Th17, and regulatory T cells, with an imbalance in the Th17/Treg ratio implicated. The diagnosis of Hashimoto's thyroiditis relies on clinical presentation, thyroid function tests, detection of anti-thyroid peroxidase and anti-thyroglobulin antibodies, and ultrasound imaging. Current treatment of Hashimoto's thyroiditis primarily involves levothyroxine replacement therapy. Emerging adjunctive approaches include vitamin D and selenium supplementation. Some potential challenges of Hashimoto's thyroiditis include understanding precise disease triggers, developing predictive biomarkers, and addressing persistent symptoms despite biochemical euthyroid. This article highlights recent advances in understanding the pathogenesis of Hashimoto's thyroiditis, particularly the roles of Th17 cells and oxidative stress. It also discusses controversies and knowledge gaps, such as the exact mechanisms that initiate autoimmunity and the factors that influence disease progression. There is a need for personalized treatment strategies and therapies targeting the underlying autoimmune process for better treatment of patients with Hashimoto's Thyroiditis.</p>","PeriodicalId":519871,"journal":{"name":"Archives of internal medicine research","volume":"9 1","pages":"1-13"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12915989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146230411","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":"Overview of Primary Angiitis of the Central Nervous System: Current Insights.","authors":"Amy Phu, Devendra K Agrawal","doi":"10.26502/aimr.0236","DOIUrl":"10.26502/aimr.0236","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Primary angiitis of the central nervous system (PACNS), also known as primary central nervous system vasculitis, is a rare autoimmune condition characterized by exclusive involvement of the brain, spinal cord, and leptomeninges. With an estimated prevalence of 2.4 cases per million person-years in North America, PACNS represents one of the rarest vasculitides and continues to pose significant diagnostic and therapeutic challenges due to its heterogeneous clinical manifestations and lack of specific biomarkers. This critical review article provides a comprehensive overview of PACNS with emphasis on: (i) current understanding of pathophysiology and unique variations of clinical presentation, (ii) challenges and strategies in reaching a definitive diagnosis, and (iii) evaluation and comparison of pharmacological and neuromodulatory therapies currently available. Recent advances in understanding pathophysiology have identified elevated interleukin-17 in cerebrospinal fluid, distinct gene expression profiles including upregulation of TBC1D3C and TBC1D3L genes, and immune cell profiling showing increased intrathecal NK-cell and B-cell frequencies. Three histopathological subtypes have been characterized: granulomatous vasculitis (32-61%), lymphocytic vasculitis (24-79%), and necrotizing vasculitis (14-42%). Emerging biomarkers including neurofilament light chain, circulating endothelial cells, and soluble triggering receptor expressed on myeloid cells 2 (sTREM2) show promise for diagnosis and disease monitoring. Advanced neuroimaging modalities, particularly high-resolution vessel wall magnetic resonance imaging and positron emission tomography, demonstrate utility in detecting vessel wall inflammation and guiding biopsy site selection. Treatment approaches include glucocorticoids combined with cyclophosphamide for induction therapy, with mycophenolate mofetil, rituximab, azathioprine, and methotrexate used for maintenance. TNF-α inhibitors have shown efficacy in refractory cases. Despite treatment, mortality ranges from 8-23%, and approximately 25% of patients experience severe disability. PACNS remains a diagnostically challenging condition requiring high clinical suspicion and comprehensive workup. Recent advances in understanding immunopathological mechanisms, identification of novel biomarkers, and development of advanced neuroimaging techniques offer promise for earlier diagnosis and more targeted therapeutic interventions. Brain biopsy remains the gold standard for diagnosis, though emerging non-invasive diagnostic modalities may reduce reliance on invasive procedures. Treatment strategies continue to evolve beyond traditional glucocorticoid and cyclophosphamide regimens, with biologics including rituximab and TNF-α inhibitors showing efficacy in refractory disease. Future multicenter collaborative studies are essential to validate emerging biomarkers, refine diagnostic criteria, establish evidence-based treatment protocols, and improve ou","PeriodicalId":519871,"journal":{"name":"Archives of internal medicine research","volume":"9 1","pages":"40-52"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13052826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147635452","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":"Neuroprotective Role of DING Protein in Normal Aging and Alzheimer's Disease.","authors":"Nune Darbinian, Armine Darbinyan, Paul Pozniak, Shohreh Amini, Michael E Selzer","doi":"10.26502/aimr.0237","DOIUrl":"10.26502/aimr.0237","url":null,"abstract":"<p><strong>Introduction: </strong>Previously, we showed that the phosphatase DING extracted from St. John's wort (p38SJ) is neuroprotective against EtOH-mediated toxicity in rat and human fetal neurons in vitro. Now, we assess the role of human DING in Alzheimer's disease (AD). DING (p38SJ/p38hu), a member of the DING family of proteins, has been shown to be neuroprotective against cellular stress injury induced by alcohol, HIV-1, and in cancer cells. DING has demonstrated phosphatase activity on MAPK substrates, but its effect on Tau phosphorylation, which is involved in AD, has not yet been explored.</p><p><strong>Methods: </strong>Expression of DING protein levels was studied in human postmortem brain using histochemistry and quantitative western blot with ANOVA. Five patients with dementia, of whom 3 had AD neuropathology, a fourth had AD/Parkinson complex, and one had cerebrovascular dementia, were compared with 5 non-dementia controls.</p><p><strong>Results: </strong>DING was present in the neuronal cell bodies and processes of both normal and AD-affected human brain tissue. DING demonstrated phosphatase activity in PC12 cells (a cell line derived from rat pheochromocytoma) and inhibited Tau phosphorylation in these cells and in human brain tissue (both normal and AD). Increasing DING by transduction and overexpression in PC12 cells was associated with increased cell survival. In human brains (age=72-92 years), levels of endogenously expressed 38 kDa DING protein correlated positively with Tau dephosphorylation.</p><p><strong>Conclusions: </strong>Excess Tau phosphorylation leads to the formation of neurofibrillary tangles in neurons, a hallmark of neurodegeneration in Alzheimer's disease. DING inhibits Tau phosphorylation and increases cell viability in non-proliferating neuronal cells overexpressing Tau, while reducing the viability of proliferating cells. Thus, DING may be neuroprotective in AD.</p>","PeriodicalId":519871,"journal":{"name":"Archives of internal medicine research","volume":"9 1","pages":"53-63"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13095167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794143","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":"Epidemiology, Pathogenesis, Clinical Manifestations, and Management Strategies of Tuberculous Meningitis.","authors":"Nicholas Oo, Devendra K Agrawal","doi":"10.26502/aimr.0195","DOIUrl":"10.26502/aimr.0195","url":null,"abstract":"<p><p>Tuberculous meningitis (TBM), the most severe manifestation of extrapulmonary tuberculosis, poses significant global health challenges due to its high mortality rates and complex pathophysiology. This review synthesizes recent findings on TBM, covering epidemiology, pathogenesis, clinical manifestations, diagnostics, and management strategies. TBM disproportionately affects immunocompromised populations, including individuals with HIV, with the highest mortality observed in low-resource settings. Pathogenesis involves Mycobacterium tuberculosis breaching the blood-brain barrier, eliciting a granulomatous inflammatory response that contributes to neurotoxicity. Advances in diagnostics, such as next-generation sequencing and novel imaging techniques, have improved early detection and treatment guidance. Management strategies emphasize multidrug regimens, adjunctive corticosteroids, and emerging therapies like intrathecal administration and nanoparticle-based drug delivery. Host-directed therapies targeting immune modulation and oxidative stress show promise in improving outcomes, particularly for drug-resistant TBM. Despite advancements, diagnostic delays, treatment resistance, and high rates of neurological effects underscore the need for further research. Preventive strategies focusing on early diagnosis, modifiable risk factor management, and public health interventions are critical to reducing global burden of TBM. This review highlights the importance of integrating innovative diagnostics, tailored treatments, and preventive measures to address the challenges of TBM and improve patient outcomes.</p>","PeriodicalId":519871,"journal":{"name":"Archives of internal medicine research","volume":"8 1","pages":"48-58"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143589198","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}