Clinics (Sao Paulo, Brazil)最新文献

{"title":"Analysis of the relationship between antidepressants and seizures based on the food and drug administration's adverse event reporting system database.","authors":"Dan Zou, Qiaozhi Hu, Lei Yu, Bin Wu","doi":"10.1016/j.clinsp.2025.100727","DOIUrl":"10.1016/j.clinsp.2025.100727","url":null,"abstract":"<p><strong>Background: </strong>Antidepressants, a cornerstone of depression treatment, are increasingly scrutinized for their safety concerns. The seizure risk of antidepressants has garnered attention. However, the current research on the relationship between antidepressant use and seizures remains unclear, prompting this study to investigate potential associations using data from the FAERS database.</p><p><strong>Aim: </strong>This study sought to assess the correlation between seizures and different antidepressants in individuals without pre-existing epilepsy or neurological comorbidities, as well as to explore potential variations in the occurrence of adverse events linked to each specific antidepressant drug.</p><p><strong>Methods: </strong>A disproportionality analysis was conducted to identify potential risk indicators within the FAERS database. Signals were detected using both the Reporting Odds Ratio (ROR) via the frequency approach and the Information Component (IC) through the Bayesian approach.</p><p><strong>Results: </strong>A total of 15,940,383 FAERS reports from January 1, 2004, to December 31, 2023, were analyzed. 14 antidepressant drugs were associated with seizures, as defined by 41 preferred terms.</p><p><strong>Conclusion: </strong>This study identified 14 antidepressant drugs that showed significant associations with seizures. Bupropion had the highest seizure ROR among the antidepressant drugs evaluated in this study.</p>","PeriodicalId":520594,"journal":{"name":"Clinics (Sao Paulo, Brazil)","volume":"80 ","pages":"100727"},"PeriodicalIF":0.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12281246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144652029","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":"New evidence for the effect of type 2 diabetes and glycemic traits on lung function: a Mendelian randomization and mediation analysis.","authors":"Shuo Xie, Liping Yu, Lulu Song, Fei Chen, Wanlu Ma, Yifan He, Xiaoping Chen, Ying Yang, Bo Zhang","doi":"10.1016/j.clinsp.2025.100693","DOIUrl":"10.1016/j.clinsp.2025.100693","url":null,"abstract":"<p><strong>Background: </strong>Type 2 Diabetes Mellitus (T2DM) is common worldwide. Patients with T2DM often experience reduced lung function, but the relationship between the two conditions remains uncertain. This study employed Mendelian Randomization (MR) to explore the causal link between T2DM and lung function, and to identify the factors that mediate this relationship.</p><p><strong>Methods: </strong>Genome-wide association study data were obtained from public databases. Four glycemic traits were considered exposures, whereas lung function was considered an outcome. Inverse Variance Weighting (IVW) was used to investigate causality, supplemented by MR-Egger and weighted medians methods. Multivariable MR (MVMR) analysis investigated whether T2DM had an independent impact on lung function. Mediation analysis was employed to examine potential mediating impacts.</p><p><strong>Results: </strong>IVW revealed that T2DM was associated with decreased forced expiratory volume in 1s (FEV1) (p = 0.012) and Forced Vital Capacity (FVC) (p = 0.004). After adjusting for potential confounders, the effects of T2DM on FEV1 and FVC remained significant. Mediation analysis demonstrated that smoking and Systolic Blood Pressure (SBP) partially mediated the causal relationship between T2DM, and FEV1 and FVC. The proportions mediated by smoking, SBP, and both factors on FEV1 were 0.302, 0.412, and 0.418, respectively, while the proportion mediated by SBP on FVC was 0.594.</p><p><strong>Conclusions: </strong>This study validated the causal relationship between T2DM and decreased lung function, with smoking and SBP acting as mediators. This study provides a novel perspective on the occurrence and development mechanisms of reduced lung function as well as potential new targets for metabolic intervention in treatment.</p>","PeriodicalId":520594,"journal":{"name":"Clinics (Sao Paulo, Brazil)","volume":"80 ","pages":"100693"},"PeriodicalIF":0.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12281521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144652030","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":"Comment on \"Role of meditation on the essence of self in the psychological profile, quality of life and lifestyle - a comparative study\".","authors":"Zeeshan Solangi, Rachana Mehta, Ranjana Sah","doi":"10.1016/j.clinsp.2025.100719","DOIUrl":"10.1016/j.clinsp.2025.100719","url":null,"abstract":"","PeriodicalId":520594,"journal":{"name":"Clinics (Sao Paulo, Brazil)","volume":"80 ","pages":"100719"},"PeriodicalIF":0.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12281517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144645182","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":"Commentary on \"Agreement analysis and associated factors of SARC-F and SARCCalf in screening risk sarcopenia in people living with human immunodeficiency virus\".","authors":"Shubham Kumar, Ranjana Sah","doi":"10.1016/j.clinsp.2025.100709","DOIUrl":"10.1016/j.clinsp.2025.100709","url":null,"abstract":"","PeriodicalId":520594,"journal":{"name":"Clinics (Sao Paulo, Brazil)","volume":"80 ","pages":"100709"},"PeriodicalIF":0.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621696","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":"Neurological adverse events of PD-1/PD-L1 immune checkpoint inhibitors in clinical trials: A meta-analysis.","authors":"Yanting Zhou, Hansong Yu, Hongyan Li","doi":"10.1016/j.clinsp.2025.100698","DOIUrl":"10.1016/j.clinsp.2025.100698","url":null,"abstract":"<p><strong>Objective: </strong>Based on the data in clinical studies, the authors explored the potential link between cancer immunotherapy and Neurological Adverse Events (NAEs), and established a clinical picture.</p><p><strong>Methods: </strong>The authors searched PubMed, Embase, Cochrane Library, Web of Science databases, and ClinicalTrials.gov for Randomized Controlled Trials (RCTs) using PD-1/PD-L1 inhibitors for cancer until November 2023. A total of 141 articles were included, covering 12 PD-1/PD-L1 inhibitors and 18 cancer types.</p><p><strong>Results: </strong>Finally, 90,079 patients of 141 RCTs met the eligibility criteria. Data showed no significant difference in the incidence of NAEs in patients receiving PD-1/PD-L1 inhibitors compared to the control group (OR = 1.07; 95 % CI 0.95, 1.21; p = 0.25). However, the authors surprisingly found that the incidence of serious NAEs in the PD-1/PD-L1 group was higher than the control group (OR = 1.34; 95 % CI 1.24, 1.44; p < 0.00001), the same with NAEs in atezolizumab subgroup (OR = 1.66; 95 % CI 1.08, 2.56; p = 0.02). It is worth noting that the intra-group heterogeneity of the serious NAEs subgroup was relatively small (I² = 16 %, p = 0.06).</p><p><strong>Conclusion: </strong>The authors first proposed the opinion that the incidence of serious NAEs in immunotherapy patients was significantly higher than in other groups, providing a novel direction for research.</p>","PeriodicalId":520594,"journal":{"name":"Clinics (Sao Paulo, Brazil)","volume":"80 ","pages":"100698"},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621699","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":"Expression and clinical significance of MCF2L-AS1 in stomach adenocarcinoma.","authors":"Chaowen Sun, Jun Guo, Bixia Chen, Xiayang Lu, Huihui Jiang","doi":"10.1016/j.clinsp.2025.100701","DOIUrl":"10.1016/j.clinsp.2025.100701","url":null,"abstract":"<p><strong>Background: </strong>Stomach Adenocarcinoma (STAD) poses a significant burden due to its high prevalence and costly, painful treatments, exerting considerable pressure on individuals.</p><p><strong>Objectives: </strong>This study intends to explore novel therapeutic targets to enhance prognosis and alleviate patient stress.</p><p><strong>Materials and methods: </strong>Quantitative Real-time Polymerase Chain Reaction was employed to detect MCF2L-AS1 expression in STAD tissues and cell lines. The correlation between this expression and patients' clinical conditions and prognosis was analyzed utilizing the Chi-squared test and Kaplan-Meier method. To investigate the regulatory mechanism of MCF2L-AS1, the Luciferase reporter gene system and transfection experiments were implemented. Cellular behaviors were analyzed through CCK8 and Transwell assays.</p><p><strong>Results: </strong>MCF2L-AS1 expression was upregulated in STAD tissues and cells, strongly correlating with TNM stage and lymph node metastases. High MCF2L-AS1 levels were associated with reduced 5-year survival rates compared to the low-expression groups. miR-503-5p, a downstream miRNA, was downregulated in STAD and inversely correlated with MCF2L-AS1. Knockdown of MCF2L-AS1 suppressed miR-503-5p expression, indicating its role as a competitive endogenous RNA. Low miR-503-5p expression reversed the inhibitory effects of MCF2L-AS1 knockdown on STAD cell behaviors.</p><p><strong>Conclusions: </strong>The oncogene role of MCF2L-AS1 in STAD is mediated through the negative regulation of miR-503-5p, highlighting its potential as a prognostic marker and therapeutic target.</p>","PeriodicalId":520594,"journal":{"name":"Clinics (Sao Paulo, Brazil)","volume":"80 ","pages":"100701"},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621698","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":"Postpartum indicators of stress injury and inflammatory factors in high-risk pregnancies by oxytocin combined with cervical balloon dilators.","authors":"Ruihong Lan, Mengdi Xue, Yihong Yu, Xiaoqing Huang, Humin Gong","doi":"10.1016/j.clinsp.2025.100668","DOIUrl":"10.1016/j.clinsp.2025.100668","url":null,"abstract":"<p><strong>Objective: </strong>This work analyzes the effect of the combination of Oxytocin (OXT) combined with cervical balloon dilators on stress injury indicators and inflammatory factors in pregnant women with high-risk pregnancies.</p><p><strong>Methods: </strong>Ninety-three pregnant women with high-risk pregnancies from June 2021 to November 2023 were collected and analyzed retrospectively, of which 43 cases were induced by OXT (control group), and 50 cases were induced by OXT combined with cervical balloon dilators (observation group). The differences in blood pressure and Heart Rate (HR) between the two groups were compared, and the pre-and post-treatment oxidative stress indicators Norepinephrine (NE), Adrenaline (AD), and Cortisol (Cor) and the inflammatory factors Tumor Necrosis Factor-α (TNF-α), Interleukin-1β (IL-1β), Interleukin-6 (IL-6), and Prostaglandin E2 (PGE2). In addition, postpartum complications were counted in both groups.</p><p><strong>Results: </strong>The observation group had higher BP and lower HR than the control group (p < 0.05). After treatment, NE, AD, Cor, TNF-α, IL-1β, IL-6, and PGE2 increased in both groups, but the observation group was lower than the control group (p < 0.05). In addition, there was no difference in the incidence of postpartum complications between the observation group and the control group (p > 0.05).</p><p><strong>Conclusion: </strong>OXT combined with cervical balloon dilators can effectively ameliorate oxidative stress injury and reduce inflammatory response in high-risk pregnancy women.</p>","PeriodicalId":520594,"journal":{"name":"Clinics (Sao Paulo, Brazil)","volume":"80 ","pages":"100668"},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621700","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":"Construction and validation of a predictive model for the efficacy of valproic acid monotherapy in epilepsy based on Lasso-logistic regression.","authors":"Qichang Xing, Zheng Liu, Haibo Lei, Renzhu Liu, Xiang Liu, Jia Chen","doi":"10.1016/j.clinsp.2025.100684","DOIUrl":"https://doi.org/10.1016/j.clinsp.2025.100684","url":null,"abstract":"<p><strong>Introduction: </strong>Valproic acid (VPA) is a broad-spectrum antiepileptic drug; but its therapeutic efficacy varies significantly among individuals. The objective of this study is to identify the specific biomarkers that can predict the efficacy of VPA.</p><p><strong>Methods: </strong>The GSE143272 dataset from the Gene Expression Omnibus (GEO) was utilized to identify Differentially Expressed Genes (DEGs) between responders and non-responders to VPA. Weighted Gene Co-expression Network Analysis (WGCNA) was employed to identify genes related to the non-responder phenotype. Intersection genes were selected to obtain the core genes affecting VPA tolerance. Lasso regression was applied to determine the core genes that influence the VPA effect. Lasso regression was applied to screen these core genes, using their expression values as independent variables and VPA response as the dependent variable in constructing a univariate logistic regression model. Peripheral blood samples from epileptic patients treated solely with VPA were collected according to nano-discharge standard. The expression levels of target genes were determined by qPCR to validate the accuracy of the model.</p><p><strong>Results: </strong>86 genes were closely related to the response phenotype through WGCNA. 13 intersection genes were obtained by intersection with 97 DEGs, which mainly involve mRNA splicing function and transport pathway. Ultimately, 3 genes-NELL2, SNORD3A and mir-1974 were included in the final model. The Area Under Curve (AUC) for this predictive model was found to be 0.70 (95 % CI: 0.70). qPCR analysis revealed a significant difference in the relative expression of the SNORD3A gene between the responder and non-responder groups.</p><p><strong>Conclusion: </strong>Epilepsy patients are at an increased risk of developing drug resistance when undergoing VPA monotherapy. The risk prediction model based on Lasso-Logistic regression demonstrates strong predictive capabilities. The SNORD3A gene may serve as a valuable biomarker for predicting the likelihood of VPA resistance.</p>","PeriodicalId":520594,"journal":{"name":"Clinics (Sao Paulo, Brazil)","volume":"80 ","pages":"100684"},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between Tic disorders and 41 inflammatory factors in circulating blood: a two-sample Mendelian randomization study.","authors":"Ciai Lai, Guolin Huang, Xi Chen, Xionghan Lian, Xin Li, Wei He, Guangliang Luo, Aiyuan Cai","doi":"10.1016/j.clinsp.2025.100649","DOIUrl":"10.1016/j.clinsp.2025.100649","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the causal associations between 41 circulating inflammatory factors and Tic Disorders (TD) via the Mendelian Randomization (MR) approach.</p><p><strong>Methods: </strong>Single-Nucleotide Polymorphisms (SNPs) related to 41 circulating inflammatory factors were obtained from published Genome-Wide Association Studies (GWASs). The outcome event, TD, was sourced from the FinnGen Biobank database. MR was employed to explore the causal relationship between these inflammatory factors and TD. Causal inference was performed via Inverse Variance Weighted (IVW), MR-Egger, and Weighted Median (WM) methods. Heterogeneity was assessed by Cochran's Q statistic and the leave-one-out method. Horizontal pleiotropy was examined with MR-Egger regression and MR-PRESSO. SNPs with horizontal pleiotropy were removed via the PhenoScanner database to ensure result reliability.</p><p><strong>Results: </strong>MR analysis revealed significant causal associations between three circulating inflammatory factors and TD. Increased levels of Interleukin-17 (IL-17) and macrophage Migration Inhibitory Factor (MIF) were associated with an increased risk of TD (OR = 2.329, 95 % CI [1.069-5.078], p = 0.033; OR = 2.267, 95 % CI [1.097-4.686], p = 0.027), whereas increased levels of Platelet-Derived Growth Factor BB (PDGF-BB) were linked to a reduced incidence of TD (OR = 0.750, 95 % CI [0.387-1.453], p = 0.023). No causal relationships were found for other inflammatory factors. No heterogeneity or horizontal pleiotropy was detected during the study, and the MR statistical power (power > 80 %) confirmed the reliability of these three findings.</p><p><strong>Conclusion: </strong>MR analysis revealed causal links between IL-17, MIF, PDGF-BB and TD, suggesting important clinical implications for the development of targeted prevention and treatment strategies for TD.</p>","PeriodicalId":520594,"journal":{"name":"Clinics (Sao Paulo, Brazil)","volume":"80 ","pages":"100649"},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621701","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":"Association between fibrinogen-to-albumin ratio and carotid intraplaque neovascularization on AngioPLUS in patients with asymptomatic carotid stenosis.","authors":"Jun He, Jimei Xu, Shugang Cao, Yuan Feng, Jian Wang, Yan Yan, Fang Ma, Mingwu Xia, Qingsong Wang","doi":"10.1016/j.clinsp.2025.100710","DOIUrl":"https://doi.org/10.1016/j.clinsp.2025.100710","url":null,"abstract":"<p><strong>Introduction: </strong>The importance of the Fibrinogen-to-Albumin Ratio (FAR) as a novel inflammatory and thrombotic biomarker in the development of carotid Intraplaque Neovascularization (IPN) is not well understood. This study aims to investigate the relationship between FAR and carotid IPN characteristics in patients with asymptomatic carotid stenosis.</p><p><strong>Methods: </strong>We enrolled patients with carotid plaques for the AngioPLUS examination, and clinical and laboratory indicators were collected. Carotid IPN was evaluated by semi-quantitative visual grading of IPN and Intraplaque Microvascular Flow (IMVF). Binary logistic regression models were performed to determine potential associations between various variables and the presence of high IPN and IMVF.</p><p><strong>Results: </strong>In the study, a total of 187 patients were included, with 73 in the high IPN group and 98 in the high IMVF group. The IPN score was positively correlated with the IMVF grade, as indicated by a correlation coefficient of 0.815 (p < 0.001). A FAR value of 7.578 was the optimal cutoff value to differentiate high and low IPN as well as high and low IMVF. After adjusting for various factors, multivariate logistic regression models demonstrated that FAR was a strong predictor of the presence of high IPN and IMVF. Furthermore, a high FAR level was also significantly correlated with the presence of high IPN (OR = 2.81, 95 % CI 1.49‒3.30, p = 0.001) and high IMVF (OR = 2.55, 95 % CI 1.39‒4.68, p = 0.002) when the variable FAR grouping was included in the above models.</p><p><strong>Conclusion: </strong>Elevated FAR is closely correlated with the presence of high IPN and IMVF on AngioPLUS and may facilitate plaque vulnerability.</p>","PeriodicalId":520594,"journal":{"name":"Clinics (Sao Paulo, Brazil)","volume":"80 ","pages":"100710"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}