Journal of investigative medicine : the official publication of the American Federation for Clinical Research最新文献

{"title":"EXPRESS: Impact of anesthesia precision intervention on perioperative serum myocardial injury markers and major adverse cardiac events in high-risk cardiovascular patients undergoing non-cardiac surgery.","authors":"Li Zhang, Haoyu Zhai, Heng Zeng, Liyang Qiu, Rong Huang","doi":"10.1177/10815589251388962","DOIUrl":"https://doi.org/10.1177/10815589251388962","url":null,"abstract":"<p><p>This study aims to unravel the impact of anesthesia precision intervention on perioperative serum myocardial injury markers and major adverse cardiac events in high-risk cardiovascular patients undergoing non-cardiac surgery. One hundred and sixty high-risk cardiovascular disease patients were randomly allocated into two groups. The control group received conventional empirical management, while the observation group underwent precise anesthesia interventions. We compared the general data, the levels of myocardial injury markers, including cardiac troponin (cTn), creatine kinase isoenzyme (CK-MB), and myoglobin (Mb). Furthermore, the levels of cardiac function markers, such as brain natriuretic peptide (BNP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP), as well as the levels of inflammatory factors and the incidence of adverse cardiac events were compared between the two groups. Postoperatively, the observation group exhibited significantly lower levels of cTn, CK-MB, Mb, BNP, NT-proBNP, c-reactive protein (CRP). Additionally, the total incidence of adverse cardiac events in the observation group was noticeably lower than that in the control group. The application of precise anesthetic intervention in the perioperative period of non-cardiac surgery for high-risk cardiovascular patients can further mitigate cardiac injury and reduce the incidence of adverse cardiac events, making it worthy of clinical application.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589251388962"},"PeriodicalIF":2.0,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246303","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":"Gender-specific effects of appendectomy on inflammatory bowel disease: Increased odds of Crohn's disease, and decreased odds of ulcerative colitis in women-An analysis using the National Inpatient Sample.","authors":"Giovannie Isaac-Coss, Meghana Kakarla, Zoë Post, Kanika Garg, Agnieszka Maniak, Veena Nannegari, Maham Lodhi, Joseph Frasca, Thapa Uchit, Atsushi Sakuraba","doi":"10.1177/10815589251347188","DOIUrl":"10.1177/10815589251347188","url":null,"abstract":"<p><p>This study investigates the gender-specific and demographic associations of appendectomy on the concurrent diagnosis of inflammatory bowel disease (IBD), using data from the National Inpatient Sample (2018-2021), comprising 25,950,053 hospitalized patients. Among the cohort, there were a total of 1,207,569 patients who underwent an appendectomy during the hospitalization. Similarly, there were 648,751 and 338,357 patients with a diagnosis of ulcerative colitis (UC) and Crohn's disease (CD), respectively. Multivariate logistic regression models were employed to assess the association between appendectomy and IBD diagnoses, adjusting for age, gender, race, income, and hospital division. Patients who underwent an appendectomy during hospitalization had a 68% lower odds of concurrent UC diagnosis compared to those without an appendectomy (odds ratio (OR) 0.32; 95% confidence interval (CI) 0.18-0.58; p < 0.001). Female patients showed a 10% lower odds of UC diagnosis compared to male patients (OR 0.90; 95% CI 0.87-0.93; p < 0.001). However, the interaction between appendectomy and gender was not statistically significant (OR 1.15; 95% CI 0.50-2.65; p = 0.746). For CD, patients undergoing an appendectomy during hospitalization had increased odds of CD diagnosis compared to those without an appendectomy (OR 1.42; 95% CI 1.12-1.80; p = 0.003). Female patients showed a significantly higher odds of CD diagnosis compared to males (OR 1.42; 95% CI 1.12-1.80; p = 0.003). Regional disparities and racial differences in IBD diagnosis were also observed. These findings suggest that patients with UC and CD have differential risks of appendectomy and may influence the development of UC and CD, with gender-specific variations. Further studies are needed to explore the underlying mechanisms.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"569-572"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546854","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":"Narrative review: Chronic lung allograft dysfunction with focus on short telomere syndrome, adjunctive therapies, and MRI detection.","authors":"Andrew Talon, Deepika Razia, Jayen Sum, Ramachandra Rao Sista","doi":"10.1177/10815589251355173","DOIUrl":"10.1177/10815589251355173","url":null,"abstract":"<p><p>Lung transplantation (LTx) is a vital treatment option for patients with end-stage lung diseases, significantly enhancing survival rates and quality of life. Nonetheless, chronic lung allograft dysfunction (CLAD) remains the primary cause of long-term morbidity and mortality in LTx recipients, posing substantial challenges to patient outcomes and healthcare systems. Despite progress in surgical methods and immunosuppressive treatments, CLAD management is complicated by its multifaceted, potentially irreversible nature. This review delves into critical aspects such as short telomere syndrome (STS), innovations in early detection, and adjunctive therapeutic approaches, offering insights into strategies that may extend the survival of LTx recipients. STS exacerbates CLAD by accelerating cellular aging and hindering tissue repair, necessitating a multidisciplinary approach to devise comprehensive care plans. The review emphasizes dynamic magnetic resonance imaging as a promising tool for early CLAD detection, enhancing patient monitoring capabilities. Additionally, it examines the roles of extracorporeal photopheresis, total lymphoid irradiation, and anti-thymocyte globulins as adjunctive therapies, advocating for their inclusion in standard treatment protocols. This could lead to broader adoption and insurance coverage. Furthermore, we attempt to provide a framework to help decide which adjunctive treatments should be pursued based on the available evidence. By assessing these strategies and highlighting the importance of personalized care, this review aims to guide future research and clinical practice, ultimately improving CLAD management in lung transplant recipients.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"525-532"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487726","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":"Beyond age and family history: Symptoms as predictors in colorectal cancer screening.","authors":"Majd Khader, Rimon Artoul, Jorge-Shmuel Delgado, Moshe Ben Artzi, Abu-Freha Naim","doi":"10.1177/10815589251346964","DOIUrl":"10.1177/10815589251346964","url":null,"abstract":"<p><p>Colorectal cancer (CRC) screening guidelines have prioritized age and clinically relevant family history, yet other clinically relevant parameters remain underutilized. Our study investigates the correlation between CRC-related manifestations and screening performance metrics-polyp detection rate (PDR) and adenoma detection rate (ADR). This cross-sectional retrospective study analyzed 235,781 colonoscopy procedures from eight medical centers in Israel conducted between 2016 and 2022. The dataset comprised the identification and classification of polyps, adenomas, and CRC, in conjunction with patient demographics, clinical background, and particular clinical-laboratory manifestations, including hematochezia, abdominal pain, family history of CRC, fecal occult blood results, and presence of anemia. Our study found significant variations in PDR and ADR based on symptom presence. Patients with hematochezia exhibited a PDR of 36.8% and an ADR of 12.1%, compared to 28.7% and 10.8% in those without it. Furthermore, individuals with occult blood in their feces had a PDR of 48.3% and an ADR of 21.5%, respectively, while those without had rates of 31.6% and 11.0%. In addition, having a family history of CRC is also related to a more significant increase in PDR and ADR of 37.7% and 13.8% compared to patients with no family history of CRC, who had PDR and ADR of 33.3% and 12.2%. Moreover, clinical combinations, including CRC family history with hematochezia or occult blood, had the highest PDR of 62.3% and 58.9%, and ADR of 15% and 20.6%, respectively. Incorporating hematochezia and fecal blood occult tests enhances the effectiveness of the CRC screening.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"573-579"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144145326","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":"Letter to the Editor regarding EXPRESS: Large language model content detectors: Effects of human editing and ChatGPT mimicking individual style: A preliminary study.","authors":"Amnuay Kleebayoon, Viroj Wiwanitkit","doi":"10.1177/10815589251360324","DOIUrl":"10.1177/10815589251360324","url":null,"abstract":"","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"585-586"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144586189","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":"Assessment of the bidirectional causal association between frailty and allergic diseases.","authors":"Guo Zhen Fan, Jian Xiang Gao, Li Xin Hu, Nikolaos G Papadopoulos, Zheng Hai Qu","doi":"10.1177/10815589251348911","DOIUrl":"10.1177/10815589251348911","url":null,"abstract":"<p><p>This study aimed to explore the potential causal relationship between frailty and allergic diseases through bidirectional Mendelian randomization (MR) analysis. Single-nucleotide polymorphisms (SNPs) were selected as instrumental variables from the genome-wide association studies summary data. The inverse variance weighted (IVW) method was used as the main analysis method, and the MR-Egger regression and weighted median method were employed to complement the IVW results. Verification of the reliability of results using multiple sensitivity analysis methods. The results of forward MR analysis revealed a statistically significant positive causal relationship between allergic asthma (AA) and frailty, as well as between atopic dermatitis (AD) and frailty; however, no causal effects were detected between allergic conjunctivitis (AC), allergic rhinitis (AR), and frailty. The results of reverse MR analysis indicated that frailty had a statistically significant positive causal effect on AD and AR, but no causal effect on AA or AC. The sensitivity analysis showed that the MR results were stable, with no heterogeneity and horizontal pleiotropy. This study found a bidirectional causal relationship between AD and frailty, a positive causal relationship between AA and frailty, an inverse causal relationship between AR and frailty, and no causal relationship between AC and frailty. In view of this, it may be recommended to promote routine frailty screening among patients with AD and AR to help identify high-risk individuals early. In addition, appropriate interventions for frailty are crucial to reduce the risk of AA and AD.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"533-540"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144183329","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":"The mediating role of depressive symptoms between asthma and risk of all-cause mortality.","authors":"Chenyi Zhang, Ziqing Ye","doi":"10.1177/10815589251352474","DOIUrl":"10.1177/10815589251352474","url":null,"abstract":"<p><p>This study aimed to evaluate the mediating role of depressive symptoms on asthma and the risk of mortality. We employed the distribution-of-product method to test whether depressive symptoms had a mediating effect on the association between asthma and risk of mortality. The 95% confidence interval (CI) of the distribution of the product was obtained. A weighted multivariable Cox regression model was used to analyze the correlation between asthma and all-cause mortality and verify the mediating impact of depressive symptoms on the association between asthma and risk of mortality. Odds ratio (OR), hazard ratio (HR), 95%CI, and percentage mediated were effect size. The mean follow-up time of all participants was 99.45 months. The percentage of subjects with depressive symptoms in the death group was 23.67%, and in the alive group was 16.65%. The risk of depressive symptoms was heightened in people with asthma (OR = 2.03, 95%CI: 1.82-2.27). Asthma was found to increase the risk of all-cause mortality (OR = 1.18, 95%CI: 1.06-1.31). The distribution of the product for the mediating effect of depressive symptoms on the relationship between asthma and all-cause mortality was 0.08 (95% CI: 0.01-0.16), with the 95% CI not including 0, indicating that depressive symptoms played a mediating role in this relationship. The indirect effect was 1.09(95%CI: 1.01-1.18), and the percentage of asthma's impact on all-cause mortality mediated by depressive symptoms was 11.11%. Depressive symptoms mediated the association of asthma and all-cause mortality.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"557-568"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144311218","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":"Restoring gut microbial balance: The role of <i>Collinsella</i> in tuberculosis management.","authors":"Sama Ali, Jorge Cervantes","doi":"10.1177/10815589251352523","DOIUrl":"10.1177/10815589251352523","url":null,"abstract":"","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"523-524"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144278055","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":"Impact of anxiety and depression on hospitalization outcomes and healthcare costs in ulcerative colitis and Crohn's Disease: A National Inpatient Sample analysis.","authors":"Giovannie Isaac-Coss, Meghana Kakarla, Zoe Post, Joseph Frasca, Maham Lodhi, Veena Nannegari, Atsushi Sakuraba","doi":"10.1177/10815589251346962","DOIUrl":"10.1177/10815589251346962","url":null,"abstract":"<p><p>Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn's disease (CD), is associated with high rates of anxiety and depression, which can significantly influence disease outcomes through the gut-brain axis. This study utilized the National Inpatient Sample (NIS) database (2018-2021) to assess the impact of these psychiatric comorbidities on hospitalization outcomes, including length of stay (LOS), total hospitalization costs (TOTCHG), and mortality. Among 24,584 UC hospitalizations, depression significantly increased LOS (+3.49 days, p < 0.001) and TOTCHG (+$41,480, p< 0.001), whereas anxiety was associated with lower hospitalization costs (-$14,766, p = 0.025) but had no impact on LOS. In 46,117 CD hospitalizations, moderate-to-severe depression (1.08%) led to longer hospital stays (6.92 vs 4.86 days, p < 0.001), higher costs ($68,169 vs $51,981, p = 0.001), and a fivefold increase in mortality risk (OR = 5.05, p = 0.002). Anxiety (2.08%) was associated with a slight increase in LOS (5.83 vs 4.86 days, p < 0.001) but did not significantly impact costs or mortality. In addition, racial and socioeconomic disparities were evident, with Black and Hispanic patients experiencing longer hospitalizations and higher costs, underscoring the need for equitable access to care. These findings highlight the significant burden of psychiatric comorbidities in IBD, particularly the substantial impact of depression on hospitalization outcomes and mortality risk in CD. Integrating mental health support into routine IBD care may improve patient outcomes and reduce healthcare burdens. Further research is needed to develop targeted interventions that address these disparities and optimize treatment strategies.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"580-584"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546855","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":"EXPRESS: Time To Endoscopy and its Effect on Outcomes in Acute Nonvariceal and Variceal Upper Gastrointestinal Bleeding.","authors":"Emely Eid, Alan Elliott, Don Rockey","doi":"10.1177/10815589251386727","DOIUrl":"https://doi.org/10.1177/10815589251386727","url":null,"abstract":"<p><strong>Introduction: </strong>The role of early endoscopy in patients with non-variceal upper gastrointestinal bleeding (UGIB) is controversial; additionally, the timing of endoscopy in patients with variceal hemorrhage has been poorly studied. We aimed to determine the effect of time to endoscopy on clinical outcomes in non-variceal and variceal UGIB.</p><p><strong>Materials and methods: </strong>We identified patients with acute UGIB admitted from the emergency room in an academic medical center. Patients were stratified by risk (low and high) and source of bleeding (variceal or non-variceal). We examined time to endoscopy (within 3h, >3-6h, >6-12h, and >12-24h) and assessed the following outcomes: stigmata of bleeding, transfusions, rebleeding, surgery, mortality, ICU admission, readmission (within 42 days), weekday vs weekend admission, and length of stay (LOS).</p><p><strong>Results: </strong>We identified 987 patients with non-variceal UGIB and 288 patients with variceal UGIB. Clinical outcomes including transfusions, rebleeding, surgery, mortality, ICU admission or readmission did not vary as a function of the time to endoscopy. However, a shorter time to endoscopy was an independent predictor of identifying stigmata of bleeding (p<0.001) and increases in time to endoscopy reduced the likelihood of identifying stigmata of bleeding to 66%, 35%, and 23% at 2, 6, and 12 hours, respectively (p<0.001). Endoscopy performed within 3 hours was also associated with a significantly reduced LOS in low risk patients with non-variceal UGIB (p<0.001).</p><p><strong>Discussion: </strong>The earlier endoscopy is performed, the more likely stigmata are identified and treatment is employed. Earlier endoscopy is associated with earlier discharge in low risk patients.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589251386727"},"PeriodicalIF":2.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194422","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}