QJM : monthly journal of the Association of Physicians最新文献

{"title":"A unique dysregulation pattern of lipid metabolism and immune responses in patients with omicron SARS-CoV-2 recurrence.","authors":"F Liu, R Sun, J Li, W Huang, J Huang, J Bao","doi":"10.1093/qjmed/hcac177","DOIUrl":"https://doi.org/10.1093/qjmed/hcac177","url":null,"abstract":"The occurrence of re-positive Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in discharged patients infected with Omicron is common. But, the potential nature of host response in these patients remains unknown. Here,","PeriodicalId":520760,"journal":{"name":"QJM : monthly journal of the Association of Physicians","volume":" ","pages":"640-643"},"PeriodicalIF":13.3,"publicationDate":"2022-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cb/d6/hcac177.PMC9384554.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40641093","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":"A more appropriate use of antibiotics in COVID-19 infection.","authors":"O M P Jolobe","doi":"10.1093/qjmed/hcab233","DOIUrl":"https://doi.org/10.1093/qjmed/hcab233","url":null,"abstract":"In the COVID-19 context, the inappropriate use of antibiotics, to which the authors alluded, is compounded by the fact that ‘Signs, symptoms and laboratory abnormalities (including radiographic abnormalities) in patients with SARS-Co-V-2 pneumonia are (in some cases) identical to those of bacterial community-acquired pneumonia’ (parenthesis mine). In one example, a 60-year-old man had a chest X-ray which demonstrated bilateral patchy infiltration. On that basis, although he had a history of close contact with a COVID-19 patient, he was prescribed antibiotics immediately after admission. In another example, a 51-year-old man presented with cough, dyspnoea and fever. Auscultation of the chest revealed bilateral wheezing and rhonchi. According to the authors, ‘since pneumonia was suspected’ the patient was started on treatment that included ceftriaxone and vancomycin. These are examples of radiographicand clinical mimicry of bacterial pneumonia by COVID-19. These examples also illustrate how easy it can be to fall into the trap of antibiotic misuse during the course of the COVID-19 infection. Chong et al. documented the incidence of COVID-19-related secondary pulmonary infection from a literature search comprising 49 studies. Twenty-eight studies were observational ones done on hospitalized patients. Secondary bacterial infection was defined as new micro-organisms identified 48 h after admission using respiratory tract specimens with corresponding blood cultures for similar micro-organisms thought to be respiratory in origin. Respiratory tract cultures were defined as cultures obtained from sputum, endotracheal aspirates and bronchoalveolar lavage. In that review, 78.6% of the 28 studies were retrospective studies, and 21.4% were prospective. The incidence of secondary bacterial infection varied from 7.7% to 42.8%. Keeping the above observations in mind, the following are the recommendations for antibiotic use: World Health Organisation recommendations for clinical management of severe acute respiratory infection when novel coronavirus (nCoV) is suspected include the recommendation to ‘Give empiric antimicrobials to treat likely pathogens causing SARI’ and to give antimicrobials within one hour of critical patient assessment for patients with sepsis. Blood cultures should be collected for bacteria that cause pneumonia, ideally before antibiotics but antibiotics should not be delayed to collect blood cultures. The Dutch Working Party on Antibiotic Policy recommended a restrictive use of antibacterial drugs in patients with proven or a high likelihood of COVID-19. ‘This especially applies for patients upon admission who are mild to moderately ill’. As with the WHO working party advice, they recommended maximum efforts to obtain, not only blood for culture, but also pneumococcal urinary antigens, before starting antibiotic therapy. In case of suspected bacterial co-infection, empirical treatment against atypical pathogens should be avoided. Legionella ","PeriodicalId":520760,"journal":{"name":"QJM : monthly journal of the Association of Physicians","volume":" ","pages":"635-636"},"PeriodicalIF":13.3,"publicationDate":"2022-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8499968/pdf/hcab233.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39388222","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":"Factors associated with depression in residents in the post-epidemic era.","authors":"S Li,&nbsp;B Guo,&nbsp;Q Yang,&nbsp;J Yin,&nbsp;Y Jiang,&nbsp;L Tian,&nbsp;Y Ji,&nbsp;H Zhu","doi":"10.1093/qjmed/hcac181","DOIUrl":"https://doi.org/10.1093/qjmed/hcac181","url":null,"abstract":"<p><strong>Objective: </strong>To explore the factors associated with depression in residents in the post-epidemic era of COVID-19.</p><p><strong>Methods: </strong>A multi-stage stratified random sampling method was used to conduct a questionnaire survey among community residents through self-designed questionnaires and self-rating depression scale (SDS). Multivariate logistic regression analysis was performed on the influencing factors of depressive symptoms.</p><p><strong>Results: </strong>A total of 1993 residues completed the survey of depression status. The incidence of depressive symptoms was 27.04%. The multivariate logistic regression analysis showed that female (odds ratio (OR): 6.239, 95% confidence interval (CI): 2.743-10.698), body mass index (BMI) > 24 (OR: 2.684, 95% CI: 1.059-3.759) and drinking (OR: 1.730, 95% CI: 1.480-3.153) were the risk factors for developing depressive symptoms. Married (OR: 0.417, 95% CI: 0.240-0.652), monthly income (3001-5000 yuan, OR: 0.624, 95% CI: 0.280-0.756; >5000 yuan, OR: 0.348, 95% CI: 0.117-0.625), ordinary residents (OR: 0.722, 95% CI: 0.248-0.924) and urban residents (OR: 0.655, 95% CI: 0.394-0.829) were the protective factors of depressive symptoms.</p><p><strong>Conclusions: </strong>Under the post-epidemic era of COVID-19, depressive symptoms are still common among community residents in China. Gender, BMI, drinking, marriage, monthly income and nature of personnel and residential area are associated with the incidence of depressive symptoms.</p>","PeriodicalId":520760,"journal":{"name":"QJM : monthly journal of the Association of Physicians","volume":" ","pages":"605-609"},"PeriodicalIF":13.3,"publicationDate":"2022-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9384610/pdf/hcac181.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40664550","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":"Predicting survival and immune microenvironment in colorectal cancer: a STAT signaling-related signature.","authors":"R Zeng,&nbsp;H Wu,&nbsp;X Qiu,&nbsp;Z Zhuo,&nbsp;W Sha,&nbsp;H Chen","doi":"10.1093/qjmed/hcab334","DOIUrl":"https://doi.org/10.1093/qjmed/hcab334","url":null,"abstract":"<p><strong>Background: </strong>Despite research advances, studies on predictive models of colorectal cancer (CRC) remain scarce and none have evaluated signal transducer and activator of transcription (STAT) signaling.</p><p><strong>Aim: </strong>To develop an effective prognostic signature for and evaluate its association with immune microenvironment.</p><p><strong>Design: </strong>Comprehensive analysis based on The Cancer Genome Atlas and Gene Expression Omnibus databases with experimental validation.</p><p><strong>Methods: </strong>Gene expression and clinical profiles of CRC patients were extracted from the databases. Differentially expressed genes with prognostic values were used to construct a signature. Immune cell infiltration and composition were further evaluated by TIMER, single-sample gene set enrichment and CIBERSORT analyses. The impact of the hub gene Caveolin-1 (CAV1) on cell proliferation, apoptosis, senescence and tumor angiogenesis was experimentally validated.</p><p><strong>Results: </strong>The five-gene-based STAT signaling-related prognostic signature was significantly associated with CRC survival, and the nomogram was with improved prognostic efficacy than the conventional TNM stage. The STAT signaling-related signature was correlated with tumor immune microenvironment. CAV1 was further identified as the hub gene within the signature. CAV1 inhibits the proliferation and induces the apoptosis as well as senescence of CRC cells. In addition, the tumor angiogenesis of CRC can be suppressed by CAV1 overexpression.</p><p><strong>Conclusions: </strong>The STAT signaling-related signature effectively predicts the prognosis and regulates tumor immune microenvironment in CRC. Our study underscores the role of STAT regulator, CAV1, as an important tumor suppressor in CRC carcinogenesis. Modulating STAT and its regulators could be a promising strategy for CRC in clinical practice.</p>","PeriodicalId":520760,"journal":{"name":"QJM : monthly journal of the Association of Physicians","volume":" ","pages":"596-604"},"PeriodicalIF":13.3,"publicationDate":"2022-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39780859","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":"Risk of stroke with antivenom usage after venomous snakebite in Taiwan: a population-based cohort study.","authors":"W-H Hung,&nbsp;J Sung,&nbsp;W-Y Chen,&nbsp;L-T Chiu,&nbsp;H-T Yip,&nbsp;J C-C Wei,&nbsp;Y-M Hung,&nbsp;R Chang","doi":"10.1093/qjmed/hcab259","DOIUrl":"https://doi.org/10.1093/qjmed/hcab259","url":null,"abstract":"<p><strong>Background and purpose: </strong>Stroke is a rare complication of snakebites, but may lead to serious sequelae. We aimed to explore the relationship between venomous snakebite and the risk for acute stroke, in a nationwide population-based cohort study.</p><p><strong>Methods: </strong>This retrospective cohort study used claims data between 1 January 2000 and 31 December 2012, from the Taiwan National Health Insurance Research Database. The study included data of patients aged 18 years or older with venomous snakebite (n = 535), matched for propensity score with controls without venomous snakebite (n = 2140). The follow-up period was the duration from the initial diagnosis of venomous snakebite and administration of antivenom to the date of an acute stroke, or until 31 December 2013. The competing risk model was used to estimate the hazard ratio (HR) and 95% confidence intervals (CIs) of stroke, ischemic stroke and hemorrhagic stroke, after adjusting for demographic and other possible stroke risk factors.</p><p><strong>Results: </strong>The adjusted HR for the venomous snakebite group compared with the control group was 2.68 for hemorrhagic stroke (95% CI = 1.35-5.33). Stratified analysis showed that the older age group (>65 years old) had a higher risk of hemorrhagic stroke. A 2.72-fold significant increase in the risk for hemorrhagic stroke was observed following venomous snakebite with antivenom usage (95% CI = 1.41-5.26).</p><p><strong>Conclusion: </strong>Venomous snakebite is associated with an increased risk of hemorrhagic stroke after the use of antivenom. Further study of the underlying mechanism is warranted.</p>","PeriodicalId":520760,"journal":{"name":"QJM : monthly journal of the Association of Physicians","volume":" ","pages":"587-595"},"PeriodicalIF":13.3,"publicationDate":"2022-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39488783","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":"Pachydermoperiostosis.","authors":"K Ikeda,&nbsp;D Miyamori,&nbsp;R Hirabayashi,&nbsp;M Ito","doi":"10.1093/qjmed/hcac147","DOIUrl":"https://doi.org/10.1093/qjmed/hcac147","url":null,"abstract":"","PeriodicalId":520760,"journal":{"name":"QJM : monthly journal of the Association of Physicians","volume":" ","pages":"611-612"},"PeriodicalIF":13.3,"publicationDate":"2022-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40178238","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":"Calcinosis cutis with amyopathic dermatomyositis.","authors":"J Samanta,&nbsp;G S R S N K Naidu,&nbsp;R Sood,&nbsp;R Nada,&nbsp;A Sharma,&nbsp;S Jain","doi":"10.1093/qjmed/hcac148","DOIUrl":"https://doi.org/10.1093/qjmed/hcac148","url":null,"abstract":"","PeriodicalId":520760,"journal":{"name":"QJM : monthly journal of the Association of Physicians","volume":" ","pages":"613-614"},"PeriodicalIF":13.3,"publicationDate":"2022-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40178239","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":"Response to: A more appropriate use of antibiotics in COVID-19 infection.","authors":"C M H Pinxt,&nbsp;R M M Bogie,&nbsp;N M J Hanssen,&nbsp;B Spaetgens","doi":"10.1093/qjmed/hcab234","DOIUrl":"https://doi.org/10.1093/qjmed/hcab234","url":null,"abstract":"","PeriodicalId":520760,"journal":{"name":"QJM : monthly journal of the Association of Physicians","volume":" ","pages":"637"},"PeriodicalIF":13.3,"publicationDate":"2022-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c3/db/hcab234.PMC8499869.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39389293","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":"Splenomegaly in silent endocarditis.","authors":"T Ishida,&nbsp;H Hagiya,&nbsp;Y Yamamoto,&nbsp;K Oguni,&nbsp;F Otsuka","doi":"10.1093/qjmed/hcac150","DOIUrl":"https://doi.org/10.1093/qjmed/hcac150","url":null,"abstract":"","PeriodicalId":520760,"journal":{"name":"QJM : monthly journal of the Association of Physicians","volume":" ","pages":"615-616"},"PeriodicalIF":13.3,"publicationDate":"2022-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40071525","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":"Giant cell arteritis presenting with chronic cough and headache after BNT162b2 mRNA COVID-19 vaccination.","authors":"Drs K Ishizuka,&nbsp;K Katayama,&nbsp;Y Ohira","doi":"10.1093/qjmed/hcac171","DOIUrl":"https://doi.org/10.1093/qjmed/hcac171","url":null,"abstract":"A 74-year-old Japanese man presented with cough and headache following the Coronavirus disease 2019 (COVID-19) vaccination. Two months before, the day after the third dose of BNT162b2 mRNA COVID-19 vaccination, he presented with a left temporal headache. One month ago, he developed a right temporal headache and cough. His medical history revealed hypertension, for which he was prescribed amlodipine (2.5mg/ day). Physical examination was unremarkable. Auscultation and chest radiograph were normal. His C-reactive protein (6.32mg/dl) levels and erythrocyte sedimentation rate (79mm/ h) were elevated. Neck and chest contrast-enhanced computed tomography (CT) showed no abnormalities of the lung, thoracic aorta, its branches or pulmonary arteries. Positron emission tomography/CT (PET/CT) showed hyperaccumulation in the thoracic aorta, subclavian, axillary, brachial and temporal arteries (Figure 1a and b). Giant cell arteritis (GCA) was diag-nosed. Symptoms improved with oral administration of pred-nisolone (30mg/day). GCA is the most common form of vasculitis in older adults, affecting people > 50years of age. 1 Common symptoms of GCA include headache, scalp tenderness, jaw claudi-cation, ocular ischemic manifestations and inflammatory arthralgia. 1 Cough is a rare initial manifestation of GCA and is often overlooked. 2 The mechanism of cough formation is unclear; however, inflammation of the artery adjacent to the cough reflex pathway is thought to cause cough. 3 GCA patho-physiology is not fully understood but environmental factors and infections are likely to play a role. 4 Additionally, it has been reported that GCA can occur after influenza vaccination and COVID-19 vaccination, which could act as an inflammatory trigger. 5 With advances in","PeriodicalId":520760,"journal":{"name":"QJM : monthly journal of the Association of Physicians","volume":" ","pages":"621-622"},"PeriodicalIF":13.3,"publicationDate":"2022-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9384497/pdf/hcac171.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40585297","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}