Clinics (Sao Paulo, Brazil)最新文献

{"title":"Machine learning identification of biomarkers for vascular endothelial damage in obstructive sleep apnea.","authors":"Tiantian Su, Song Shi","doi":"10.1016/j.clinsp.2026.101165","DOIUrl":"10.1016/j.clinsp.2026.101165","url":null,"abstract":"<p><strong>Background: </strong>Obstructive Sleep Apnea (OSA) is a common sleep disorder that, if left untreated, may lead to chronic damage to multiple organs. The purpose of this study is to use machine learning methods to identify biomarkers associated with Vascular Endothelial Damage (VED), providing insights for early diagnosis and targeted therapy of OSA.</p><p><strong>Methods: </strong>The authors conducted a differential expression analysis on the dataset GSE75097 to obtain Differentially Expressed Genes (DEGs), and obtained 1577 VED-Related Genes (VEDRGs) from the GeneCards database. The intersection genes of the two were defined as the differentially expressed VED-Related Genes (DE-VEDRGs). Functional and pathway enrichment analyses were conducted on them. Then, the authors adopted a combination of three machine learning algorithms to screen the Feature DE-VEDRGs (FDE-VEDRGs) of OSA. Furthermore, the authors conducted differential, correlation, and ROC curve analyses on FDE-VEDRGs, and performed Gene Set Enrichment Analysis (GSEA) and Gene Set Variation Analysis (GSVA) on these genes. Ultimately, an immune cell infiltration analysis was conducted between OSA and Primarily Snore (PS) samples, and the relationship between the expressions of FDE-VEDRGs and the levels of immune cell infiltrations was evaluated.</p><p><strong>Results: </strong>A total of 40 DE-VEDRGs were identified. These genes were involved in biological functions such as wound healing, small GTPase-mediated signal transduction, collagen-containing extracellular matrix, apical part of the cell, enzyme inhibitor activity, and growth factor receptor binding. The main pathways included Proteoglycans in cancer, Lipid and atherosclerosis, MicroRNAs in cancer, AGE-RAGE and PI3K-Akt signaling pathways, Apoptosis, etc. Six FDE-VEDRGs of OSA, namely F2RL2, SLC12A1, TGFB2, SPP1, PLAUR and MMP3, were identified, and their expression differences and correlations were explained. Furthermore, GSEA and GSVA analyses revealed significant differences in function and pathway enrichment between the high- and low- expression groups of MMP3, PLAUR, and SPP1. Finally, the analysis of immune cell infiltration indicated that compared with the PS group, the proportion of NK cell activation and macrophage M2 in the OSA group was significantly decreased, while the proportion of neutrophils was significantly increased. The correlation matrix shows the correlation between each FDE-VEDRG and each type of immune-infiltrating cells. The six-gene logistic model showed moderate discriminative ability in the discovery dataset (AUC = 0.78) and consistent performance in two external datasets (AUC = 0.75 and 0.72), suggesting potential predictive value that warrants further validation.</p><p><strong>Conclusions: </strong>This study identified several candidate vascular endothelial damage-related genes in OSA using integrative bioinformatics and machine learning analyses. These findings may provide potential bi","PeriodicalId":520594,"journal":{"name":"Clinics (Sao Paulo, Brazil)","volume":"81 ","pages":"101165"},"PeriodicalIF":2.4,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13634724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149043354","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":"Lipids, lipid-modifying drug targets with venous thromboembolism: a mendelian randomization study.","authors":"Liuyan Nie, Yongmei Han, Fenping Zheng","doi":"10.1016/j.clinsp.2026.101163","DOIUrl":"10.1016/j.clinsp.2026.101163","url":null,"abstract":"<p><strong>Background: </strong>The role of lipid-lowering therapies (e.g., statins) during anticoagulation for Venous Thromboembolism (VTE) remains unclear. This study investigated the causal role of lipid traits in VTE and evaluated lipid-lowering drug targets using a Mendelian Randomization (MR) approach.</p><p><strong>Methods: </strong>Genetic variants associated with lipid traits and lipid-lowering drug targets were extracted from the Global Lipids Genetics Consortium GWAS. Summary statistics for VTE, Deep Vein Thrombosis (DVT), and Pulmonary Embolism (PE) were obtained from UK Biobank. For associated targets, expression quantitative trait loci data were analyzed using summary-data-based MR. Colocalization analysis assessed shared genetic signals, and molecular docking explored plausible ligand-target binding poses.</p><p><strong>Results: </strong>Higher triglyceride levels were associated with lower VTE (OR = 0.998, 95% CI: 0.996‒1.000, p = 0.035) and DVT risks (OR = 0.998, 95% CI: 0.997‒1.000, p = 0.012). Genetic mimicry of Lipoprotein Lipase (LPL) enhancement was nominally associated with lower VTE odds (OR = 0.997, 95% CI: 0.995‒1.000, p = 0.02) and with lower PE odds after Bonferroni correction (OR = 0.996, 95% CI: 0.994‒0.998, p = 5.29E-06), but not DVT. LPL expression in whole blood showed a significant MR association with PE (OR = 1.001, 95% CI: 1.000‒1.002, p = 0.039) and moderate colocalization (PP.H4 = 0.68). Molecular docking predicted plausible active-site or allosteric binding poses for three LPL agonists (binding energies ≤ -6.8 kcal/mol).</p><p><strong>Conclusions: </strong>Genetically proxied LPL enhancement was nominally associated with modestly lower composite VTE risk and was associated with lower PE risk after multiple-testing correction, although no association was observed for DVT. These findings support a potential role for LPL-related pathways in VTE biology and warrant independent genetic and functional validation before clinical translation.</p>","PeriodicalId":520594,"journal":{"name":"Clinics (Sao Paulo, Brazil)","volume":"81 ","pages":"101163"},"PeriodicalIF":2.4,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13691490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208397","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":"Inspiratory muscle strength and post-liver transplantation outcomes: safety of measurement in the ICU ‒ an observational study.","authors":"Rayssa Pistilli Duarte, Rodrigo Marques Tonella, Ligia Dos Santos Roceto Ratti, Lilian Elisabete Bernardes Delazari, Gabriela Maria de Oliveira, Leticia de Souza Campos Assis, Mariana Bueno da Rosa, Edmilson Florêncio Pinto Junior, Enrico de Francisco Magnani, Ilka de Fátima Santana Ferreira Boin","doi":"10.1016/j.clinsp.2026.101079","DOIUrl":"10.1016/j.clinsp.2026.101079","url":null,"abstract":"<p><strong>Objective: </strong>Assess respiratory muscle strength and hemodynamic responses in the early postoperative period after Liver Transplantation (LT) and to analyze their associations with clinical outcomes.</p><p><strong>Patients and methods: </strong>A prospective and observational study included adult LT recipients admitted to the Intensive Care Unit (ICU) of the Clinical Hospital of the University of Campinas. Inspiratory muscle strength was assessed during the first three postoperative days using a digital Manovacuometer and POWERbreathe® device. Hemodynamic and respiratory parameters were continuously monitored. Statistical analyses included repeated-measures ANOVA, Wilcoxon tests, correlation analyses (p < 0.05), linear mixed models for respiratory variables, and multiple linear regression to examine the directionality of associations.</p><p><strong>Results: </strong>Sample consisted of 35 patients, with a median age of 59-years [IQR: 52.0-68.0] and a predominance of males (n = 26; 74.3%). The MELD mean was 18.1±7.6, SAPS3 score of 44.7±11.2, and SOFA score of 9.2±3.1, MIP increased significantly between postoperative days 1 and 3 (37.5 [32.8-53.8] vs. 49.0 [40.0-72.0] cmH₂O, p = 0.035). The S-Index showed significant negative correlations with both surgery duration (r_s = -0.52, p = 0.009) and ICU length of stay (r = -0.42, p = 0.015). No clinically relevant hemodynamic changes occurred during tests; however, there was a main effect of Time for MAP (4.079, 204.0) = 6.765, p < 0.0001) and RR (2.030, 101.5) = 3.628, p = 0.0295).</p><p><strong>Conclusions: </strong>LT patients exhibit early postoperative improvement in inspiratory muscle strength, with both assessment methods proving safe. Higher dynamic inspiratory strength is associated with shorter ICU stay and surgical duration, supporting the inclusion of routine respiratory muscle monitoring in postoperative physiotherapy protocols.</p>","PeriodicalId":520594,"journal":{"name":"Clinics (Sao Paulo, Brazil)","volume":"81 ","pages":"101079"},"PeriodicalIF":2.4,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149027406","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":"Mendelian randomization analysis reveals causal links between specific immune cell phenotypes and Parkinson's disease.","authors":"Yan Su, Sheng Cai, Yang Xu, QiQi Xu, Qi Wang, XianWen Chen","doi":"10.1016/j.clinsp.2026.101164","DOIUrl":"10.1016/j.clinsp.2026.101164","url":null,"abstract":"<p><strong>Objective: </strong>Immunity and neuroinflammation are key factors in Parkinson's Disease (PD); however, detailed studies on how they are causally related to each other are lacking. This study aimed to explore the potential causal relationship between immune cells and PD.</p><p><strong>Methods: </strong>A comprehensive two-sample Mendelian Randomization (MR) analysis was conducted based on publicly available genetic data to explore the causal relationship between 731 immune cells and PD risk. Inverse Variance Weighted (IVW) served as the main technique to explore the causal relationship, along with methods such as weighted median, MR-Egger regression, simple mode, and weighted mode. Sensitivity analysis was performed to evaluate the reliability, heterogeneity, and horizontal pleiotropy of the study results.</p><p><strong>Results: </strong>A total of 18 immune cell phenotypes related to PD were identified in MR analysis, with 8 associated with risk, including 3 from the T-cells, B-cells, and Natural Killer cells (TBNK) group, 3 from the regulatory T-cell (Treg) group, and 2 from the myeloid group. There were 10 factors conferring protection against PD, with 3 associated with monocytes, 3 associated with T-cell maturation, 2 associated with Tregs, and 1 associated with myeloid cells. PD altered the phenotypic levels of two immune cell types, one from the TBNK group and one from the B-cell group.</p><p><strong>Conclusions: </strong>This study suggests a potential causal link between immune cells and PD, pinpointing specific immune cell features related to PD.</p>","PeriodicalId":520594,"journal":{"name":"Clinics (Sao Paulo, Brazil)","volume":"81 ","pages":"101164"},"PeriodicalIF":2.4,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13636344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070750","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":"Predictive value of stress-induced hyperglycemia for 28-day all-cause mortality in ICU patients with sepsis: a MIMIC-IV-based retrospective cohort study.","authors":"Jiahui Ma, Xu Wang, Yan Zhang, Chunyan Ge","doi":"10.1016/j.clinsp.2026.101123","DOIUrl":"10.1016/j.clinsp.2026.101123","url":null,"abstract":"<p><strong>Background: </strong>This study explored the link between Stress-Induced Hyperglycemia (SIH) and 28-Day All-Cause Mortality (28D-ACM) in patients with sepsis, focusing on the predictive values of stress hyperglycemia ratios 1 and 2 (SHR1 and SHR2) and Glucose Gap (GG).</p><p><strong>Methods: </strong>This retrospective cohort study included ICU patients with sepsis from the MIMIC-IV database. The relationships between the three SIH metrics and 28D-ACM risk were analyzed using multivariate Cox proportional hazards models, Kaplan-Meier curves, and restricted cubic spline analysis. The predictive performances of these metrics within a basic model were assessed using the Receiver Operating Characteristic (ROC) curve and Integrated Discrimination Improvement (IDI) index.</p><p><strong>Results: </strong>The study included 12,582 ICU patients with sepsis, with a 28D-ACM rate of 13.63%. In the fully adjusted model, SHR1, SHR2, and GG were independently associated with 28D-ACM risk, with Hazard Ratios (HR) and 95% Confidence Intervals (95% CIs) of 1.158 (1.029, 1.304), 1.18 (1.046, 1.332), and 1.133 (1.008, 1.275), respectively. Increased SIH metrics correlated positively with higher mortality risk (p_trend< 0.05). The Kaplan-Meier curve indicated that higher tertiles of SHR1, SHR2, and GG resulted in increased cumulative incidence of 28D-ACM (p < 0.05). Additionally, integrating SHR1 and SHR2 enhanced the model's predictive accuracy for 28D-ACM (p < 0.05).</p><p><strong>Conclusions: </strong>SHR1, SHR2, and GG are significantly associated with 28D-ACM risk in ICU patients with sepsis. SHR1 showed statistical association with mortality and modest incremental value, but clinical utility for risk stratification is limited and needs external validation.</p>","PeriodicalId":520594,"journal":{"name":"Clinics (Sao Paulo, Brazil)","volume":"81 ","pages":"101123"},"PeriodicalIF":2.4,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13628219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009696","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":"Trimester-specific reference interval for glycated hemoglobin in non-diabetic pregnant women: A cross-sectional study.","authors":"Kassahun Takiso, Aster Tsegaye, Mekoya Dabulo, Abenet Woldesenbet, Abebaye Leminie","doi":"10.1016/j.clinsp.2026.101160","DOIUrl":"10.1016/j.clinsp.2026.101160","url":null,"abstract":"<p><strong>Background: </strong>Gestational Diabetes Mellitus (GDM) is a growing public health concern in Ethiopia. HbA1c is useful for assessing glycemia but is influenced by physiological changes in pregnancy. To our knowledge, no published trimester-specific HbA1c reference intervals exist for Ethiopian non-diabetic pregnant women. This limits population-specific clinical interpretation.</p><p><strong>Methods: </strong>A facility-based cross-sectional study was conducted from February to July 2025 among 424 non-diabetic pregnant women across all trimesters. Normality of HbA1c distribution was assessed using the Shapiro-Wilk and Kolmogorov-Smirnov tests; outliers were identified using Tukey's fences method. Reference intervals were determined parametrically (mean ±2SD). Differences across trimesters were tested using one-way ANOVA. Because Levene's test indicated a violation of the homogeneity of variances (p < 0.001) and group sizes were unequal, pairwise comparisons were performed using the Games-Howell post hoc test. A p-value < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>HbA1c showed a normal distribution across all trimesters. Reference intervals were 4.8-5.9% in the first, 4.2-5.8% in the second, and 4.5-5.9% in the third trimester. Mean HbA1c levels differed significantly between trimesters (p < 0.05). Lowest in the second trimester 5.00% (95% CI 4.93-5.07) and highest in the first trimester 5.35% (95% CI: 5.31-5.39). Games-Howell post hoc tests confirmed that all pairwise comparisons were significant (p < 0.05).</p><p><strong>Conclusion: </strong>Trimester-specific HbA1c reference intervals were defined for non-diabetic pregnant women, demonstrating measurable physiological variation across gestation. The use of locally derived thresholds could improve the accuracy of GDM screening and support more appropriate clinical interpretation.</p>","PeriodicalId":520594,"journal":{"name":"Clinics (Sao Paulo, Brazil)","volume":"81 ","pages":"101160"},"PeriodicalIF":2.4,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13628227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009686","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":"Advanced lung cancer inflammation index is associated with mortality in critically ill patients with acute kidney injury.","authors":"Qingquan Liu, Yuncheng Zhang, Yuan Xia, Binfeng Li","doi":"10.1016/j.clinsp.2026.101156","DOIUrl":"10.1016/j.clinsp.2026.101156","url":null,"abstract":"<p><strong>Background: </strong>Nutritional and inflammatory status are closely associated with outcomes in Acute Kidney Injury (AKI). This study investigated the association between the Advanced Lung cancer Inflammation index (ALI), a composite nutrition-inflammation marker, and short-term mortality in critically ill patients with AKI.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using the MIMIC-IV database. A total of 1887 adult ICU patients with AKI were included. ALI was calculated as body mass index × serum albumin / neutrophil-to-lymphocyte ratio. The primary outcome was all-cause in-hospital mortality, and the secondary outcome was 90-day mortality. Kaplan-Meier curves, Cox proportional hazards models, restricted cubic spline analysis, and subgroup analyses were performed.</p><p><strong>Results: </strong>The median age was 68.0-years, and 62.4% of patients were male. In-hospital and 90-day mortality rates were 25.2% and 33.9%, respectively. Patients in the lowest ALI tertile had significantly higher cumulative mortality than those with higher ALI. After full adjustment, higher ln(ALI) was independently associated with lower in-hospital mortality (HR = 0.86; 95% CI 0.79-0.93; p < 0.001) and lower 90-day mortality (HR = 0.81; 95% CI 0.75-0.87; p < 0.001). Restricted cubic spline analysis showed an approximately linear inverse association between ALI and in-hospital mortality.</p><p><strong>Conclusions: </strong>Lower ALI was associated with higher short-term mortality in critically ill patients with AKI, but this association was substantially attenuated after full adjustment and was largely confined to non-septic AKI. This retrospective single-center analysis supports an association but does not establish clinical utility; prospective multicenter external validation is needed before ALI can be recommended for risk stratification.</p>","PeriodicalId":520594,"journal":{"name":"Clinics (Sao Paulo, Brazil)","volume":"81 ","pages":"101156"},"PeriodicalIF":2.4,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13628232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009657","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":"Steatosis worsens ischemia-reperfusion injury post hepatectomy with intermittent inflow occlusion.","authors":"Hui Chen, Biao Duan, Shiyu Yang, Nuo Pan, Kun Tao, Xiaohui Liu, Bing Hu, Jun Chen, Weifeng Tan","doi":"10.1016/j.clinsp.2026.101151","DOIUrl":"10.1016/j.clinsp.2026.101151","url":null,"abstract":"<p><strong>Purpose: </strong>Intermittent Vascular Inflow Occlusion (VIO) is widely used during hepatectomy, but its impact on Liver Ischemia-Reperfusion Injury (LIRI) - especially in steatotic livers - remains debated. This study aims to evaluate the effects of VIO and hepatic steatosis on LIRI severity and postoperative recovery after hepatectomy.</p><p><strong>Methods: </strong>A retrospective cohort study analyzed 200 patients undergoing hepatectomy. Patients were divided into three groups according to the number of hepatic inflow occlusion episodes: N-VIO (no occlusion, n = 136), F-VIO (few-VIO, 1-2 occlusions, n = 35), and M-VIO (multiple-VIO, ≥ 3 occlusions, n = 29). After 1:1:1 Propensity Score Matching (PSM) based on surgical approach and tumor characteristics, 23 matched triplets were generated among the three groups. Liver function (ALT, AST) was assessed preoperatively and on Postoperative Days-3 (POD3) and 7 (POD7). Steatosis effects were evaluated.</p><p><strong>Results: </strong>At POD3, the three groups exhibited a trending overall difference in ALT levels before PSM (p = 0.009). Following PSM, no significant intergroup differences were observed at either POD3 (p = 0.422) or POD7 (p = 0.156). Collectively, these results suggest that, within the confines of the present study, variations in the number of hepatic inflow occlusions do not translate into significant differences in early postoperative ALT recovery. Steatosis significantly exacerbated IRI, with higher ALT in steatosis patients at POD3 (p = 0.026) and POD7 (p = 0.006).</p><p><strong>Conclusions: </strong>Appropriate VIO does not exacerbate LIRI. Steatosis heightens LIRI susceptibility. Patients with liver steatosis should pay more attention to controlling the number of VIO during the operation.</p>","PeriodicalId":520594,"journal":{"name":"Clinics (Sao Paulo, Brazil)","volume":"81 ","pages":"101151"},"PeriodicalIF":2.4,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009688","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":"Predictive factors for running economy in female recreational runners.","authors":"Fabio de Paula Domingos, Vinícius Ribeiro Dos Anjos Souza, Lavínia Vivan, Claudio Andre Barbosa de Lira, Rodrigo Luiz Vancini, Katja Weiss, Beat Knechtle, Marilia Santos Andrade","doi":"10.1016/j.clinsp.2026.101158","DOIUrl":"10.1016/j.clinsp.2026.101158","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the predictive value of age, sport experience, lower-limb flexibility, lean mass, Fat percentage (%FAT), Maximal Oxygen consumption (V̇O₂max), knee extensor muscle Peak Torque (PT), and Maximal Aerobic Speed (MAS) on Running Economy (RE) in female long-distance recreational runners.</p><p><strong>Methods: </strong>A total of 61 female recreational runners aged 20-60 yr participated in this study. RE was evaluated based on the Energy Cost of running (EC). Additional parameters measured included V̇O₂max, flexibility, lean mass, %FAT, MAS, sport experience, age, and PT.</p><p><strong>Results: </strong>EC was significantly associated with %FAT (r = 0.629, p < 0.001), flexibility (r = -0.388, p = 0.002), lean mass (r = -0.330, p = 0.009), and MAS (r = -0.516, p < 0.001). No significant correlations were observed between RE and age (r = 0.017, p = 0.896), sport experience (r = -0.119, p = 0.360), V̇O₂max (r = -0.200, p = 0.121), or PT (r = -0.026, p = 0.841). Regression analysis revealed that %FAT (β = 0.017, t = 4.168, p < 0.001) and MAS (β = -0.039, t = -1.987, p = 0.052) accounted for 43.5% of the variation in EC.</p><p><strong>Conclusion: </strong>These findings indicate that %FAT and MAS were the key predictors of RE in female recreational runners, with higher %FAT associated with poorer RE and greater MAS correlating with improved RE. However, MAS showed a borderline association with EC (p = 0.052), suggesting a potential but cautious interpretation as a predictor. These insights underscore the importance of training strategies that optimize body composition and aerobic performance to enhance RE in female recreational runners.</p>","PeriodicalId":520594,"journal":{"name":"Clinics (Sao Paulo, Brazil)","volume":"81 ","pages":"101158"},"PeriodicalIF":2.4,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009670","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":"Comparison of the short-term and long-term effects of AngioJet and AcoStream mechanical catheter thrombolysis on acute iliofemoral vein thrombosis.","authors":"Yaobo Yang, Xuan Dong, Yilin Zhao, Sipan Chen","doi":"10.1016/j.clinsp.2026.101097","DOIUrl":"10.1016/j.clinsp.2026.101097","url":null,"abstract":"<p><strong>Objective: </strong>To compare the short-term and long-term clinical efficacy and safety of AngioJet and AcoStream thrombectomy devices in the treatment of acute iliofemoral venous thrombosis.</p><p><strong>Methods: </strong>We conducted a 4-year retrospective case ‒ control study. A total of 243 patients with acute iliofemoral deep vein thrombosis underwent endovascular interventional therapy in our hospital. According to different operation methods, patients were divided into two groups: Group A (AngioJet mechanical thrombectomy system) and Group B (AcoStream mechanical thrombectomy system). The clinical basic data and short-term postoperative efficacy of the two groups were compared. After 36-months of follow-up, the recurrence rate and long-term efficacy of post-thrombotic syndrome were compared between the two groups. The Kaplan-Meier survival method was used to analyze the proportion of Post-Thrombotic Syndrome (PTS).</p><p><strong>Results: </strong>The thrombus aspiration time in the AngioJet group (4.62 ± 0.12 min) was shorter than that in the AcoStream group (5.87 ± 0.09 min) (p = 0.001); the intraoperative blood loss (264.12 ± 5.46 mL) was less than that in the AcoStream group (307.62 ± 4.52 mL) (p < 0.001); the hemoglobin difference (15.57 ± 0.72 g/L) was less than that in the AcoStream group (24.58 ± 0.86 g/L) (p < 0.001); the D - D decrease rate (0.85 ± 0.03 mg/L/D) was faster than that in the AcoStream group (0.75 ± 0.03 mg/L/D) (p = 0.03); the dosage of urokinase (147.39 ± 0.71) million units was more than that in the AcoStream group (125.33 ± 1.01) million. Units (p < 0.001). The swelling reduction rates of the thigh and calf at 24-hours after surgery were (0.61 ± 0.01%) vs. (0.56 ± 0.01%) and (0.63 ± 0.01%) vs. (0.66 ± 0.01%), respectively, with statistically significant differences between the two groups (p < 0.05). The incidence of postoperative hematuria in the AngioJet group (91.9%) was higher than that in the AcoStream group (0.0%) (p < 0.001). After 36-months of follow-up, the thrombus recurrence rate in the AngioJet group (8.9%) was compared with that in the AcoStream group (2.5%) (p < 0.05), and the incidence of postoperative PTS in the two groups was (34.95%) vs. (21.67%) (p = 0.016).</p><p><strong>Conclusion: </strong>Compared with the AcoStream system, the AngioJet system has a higher efficiency of thrombus clearance, but the incidence of hematuria and the recurrence rate are slightly higher. Of course, both have their advantages and disadvantages, and the appropriate surgical method should be selected according to the individual conditions of patients.</p>","PeriodicalId":520594,"journal":{"name":"Clinics (Sao Paulo, Brazil)","volume":"81 ","pages":"101097"},"PeriodicalIF":2.4,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13613512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149003103","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}