Archives of Medical Science最新文献

{"title":"Cognitive screening for cardiovascular risk stratification in stable coronary artery disease: a prospective cohort study.","authors":"Zehao Zhao, Yaodong Ding, Yong Zeng","doi":"10.5114/aoms/219383","DOIUrl":"10.5114/aoms/219383","url":null,"abstract":"<p><strong>Introduction: </strong>While cognitive impairment is prevalent in patients with coronary artery disease (CAD), its prognostic significance in stable CAD patients remains unclear.</p><p><strong>Material and methods: </strong>In this prospective cohort study of 6,130 stable CAD patients, baseline cognitive function was assessed using Montreal Cognitive Assessment (MoCA). The primary outcome was major adverse cardiovascular events (MACE), including all-cause death, nonfatal myocardial infarction, and nonfatal stroke. Unplanned revascularization was specified as a secondary outcome. Kaplan-Meier survival analysis and Cox regression were used to assess the prognostic impact of cognitive impairment. The robustness of the findings was tested via subgroup analyses and sensitivity analyses.</p><p><strong>Results: </strong>Over a median follow-up of 549 days, 123 (2.0%) patients experienced a MACE, and 315 (5.1%) underwent unplanned revascularization. Patients in the MACE group had significantly lower baseline cognitive function. Worse cognitive function was observed in older adults, females, individuals with lower educational attainment, and those with cardiometabolic risk factors. Patients with cognitive impairment had a significantly higher incidence of MACE (log-rank <i>p</i> = 0.001). In contrast, no significant difference was observed in the incidence of unplanned revascularization (log-rank <i>p</i> = 0.791). After multivariable adjustment, cognitive impairment remained an independent predictor of MACE (HR = 1.58, 95% CI: 1.06-2.37, <i>p</i> = 0.026). Sensitivity analyses confirmed the robustness of primary findings. In subgroup analyses, cognitive impairment showed a consistent trend toward increased MACE risk across all strata, with the notable exception of the subgroup with low-density lipoprotein cholesterol < 1.8 mmol/l.</p><p><strong>Conclusions: </strong>Baseline cognitive impairment is an independent predictor of MACE in stable CAD patients.</p>","PeriodicalId":8278,"journal":{"name":"Archives of Medical Science","volume":"22 3","pages":"1359-1371"},"PeriodicalIF":3.6,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13426167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148652929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients at high risk of postoperative complications in Crohn's disease: a meta-analysis and systematic review.","authors":"Joanna Łosińska, Miłosz Lewandowski, Adam J Dziki, Michał Mik","doi":"10.5114/aoms/218059","DOIUrl":"https://doi.org/10.5114/aoms/218059","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study was to identify patient-related factors influencing the risk of early postoperative complications in Crohn's disease (CD).</p><p><strong>Methods: </strong>A meta-analysis was conducted based on articles addressing early complications after abdominal surgery for CD. The analysis included the following risk factors: age, sex, hypoalbuminemia, serum C-reactive protein (CRP) levels, anemia, blood leukocyte levels, body mass index (BMI), smoking, diabetes mellitus, and hypertension. A systematic review was performed between 21 November 2021 and 4 December 2021 and repeated after three and a half years. Outcomes were reported as two effect sizes: odds ratio (OR) and response ratio (R), both with 95% CI, <i>p</i>-value < 0.05, and visualization in a forest plot. The strength of evidence was determined based on Egger's test <i>p</i>-value, sample size, and <i>I</i> ² statistic.</p><p><strong>Results: </strong>The following significant risk factors of early postoperative complications in CD were identified with Level I strength of evidence: hypoalbuminemia (OR = 1.82; 95% CI: 1.62-2.06), anemia (OR = 1.77; 95% CI: 1.47-2.15), age ≥ 40 years (OR = 1.44; 95% CI: 1.18-1.77), diabetes (OR = 1.28; 95% CI: 1.04-1.57), hypertension (OR = 1.27; 95% CI: 1.06-1.51), and smoking (OR = 1.23; 95% CI: 1.14-1.33). At Level II, the identified factors included CRP levels (<i>R</i> = 1.58; 95% CI: 1.32-1.89), male sex (OR = 1.23; 95% CI: 1.11-1.37), and blood leukocyte levels (<i>R</i> = 1.11; 95% CI: 1.07-1.15).</p><p><strong>Conclusions: </strong>These findings suggest that nutritional status, age, comorbidities, and parameters of blood morphology and biochemistry should be carefully considered when assessing the risk of postoperative complications in patients with CD.</p>","PeriodicalId":8278,"journal":{"name":"Archives of Medical Science","volume":"22 4","pages":"2006-2024"},"PeriodicalIF":3.6,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149190989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of ChatGPT and Claude in managing real-life difficult nephrology cases.","authors":"Seyda Gul Ozcan, Mevlut Tamer Dincer, Aydan Mutis Alan, Ali Osman Polat, Ahmet Murt, Zeynep Atli, Sinan Trabulus, Nurhan Seyahi","doi":"10.5114/aoms/217515","DOIUrl":"https://doi.org/10.5114/aoms/217515","url":null,"abstract":"<p><strong>Introduction: </strong>Artificial intelligence (AI)-based large language models (LLMs) are promising tools for clinical decision support, but their clinical performance in specialized fields such as nephrology is still uncertain. ChatGPT and Claude represent distinct AI architectures with potentially different clinical utilities. We aimed to compare the diagnostic accuracy, treatment recommendations, and overall clinical utility of these two AI models in managing real-life difficult nephrology cases.</p><p><strong>Material and methods: </strong>Twenty-two real nephrology cases from a tertiary care university hospital were presented to both models, covering disorders such as glomerulonephritis, acute kidney injury, vasculitis, and transplant complications. Each model's output was assessed for diagnostic accuracy, risk evaluation, test recommendations, and treatment planning. Three independent nephrologists evaluated the responses using the Quality Assessment of Medical Information (QAMAI) and Global Quality Score (GQS) tools. Statistical comparisons were performed using the Wilcoxon signed-rank test, with <i>p</i> < 0.05 considered significant.</p><p><strong>Results: </strong>Claude achieved higher diagnostic accuracy than ChatGPT (4.59 ±0.41 vs. 4.36 ±0.48; <i>p</i> = 0.048), whereas ChatGPT scored better in clarity (4.63 ±0.30 vs. 4.32 ±0.29; <i>p</i> = 0.002). No significant differences were found in relevance, completeness, usefulness, or source citation. Overall QAMAI scores were comparable between the two models (ChatGPT: 23.72 ±1.46; Claude: 23.39 ±1.43; <i>p</i> = 0.371). Inter-rater reliability ranged from moderate to good, with the highest agreement observed for ChatGPT's GQS.</p><p><strong>Conclusions: </strong>Both ChatGPT and Claude demonstrate notable potential as decision-support tools in nephrology. Claude provided slightly higher diagnostic accuracy, while ChatGPT offered greater clarity. Despite these promising results, clinical judgment remains essential when interpreting LLM-generated suggestions.</p>","PeriodicalId":8278,"journal":{"name":"Archives of Medical Science","volume":"22 4","pages":"2053-2057"},"PeriodicalIF":3.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149190887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atherogenic lipid ratios and insulin resistance primarily reflect adiposity rather than androgen status in adolescents with polycystic ovary syndrome: evidence from a large case-control cohort.","authors":"Karolina M Jakubowska-Kowal, Karolina Skrzyńska, Kamila M Szeliga, Karolina Kowalczyk, Aneta Gawlik-Starzyk","doi":"10.5114/aoms/221186","DOIUrl":"10.5114/aoms/221186","url":null,"abstract":"","PeriodicalId":8278,"journal":{"name":"Archives of Medical Science","volume":"22 2","pages":"1206-1211"},"PeriodicalIF":3.6,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13266725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148263062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Smoking as a determinant of rheumatoid arthritis: integrated evidence from epidemiological patterns, genetic signals, and mechanistic insights.","authors":"Dahui Wang, Runhua Li, Baiqi Li, Wei Xiao, Jiehua Deng","doi":"10.5114/aoms/221185","DOIUrl":"10.5114/aoms/221185","url":null,"abstract":"","PeriodicalId":8278,"journal":{"name":"Archives of Medical Science","volume":"22 2","pages":"1234-1238"},"PeriodicalIF":3.6,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13266735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148263025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular disease in cancer patients: a neglected dimension of modern oncology.","authors":"Seyed Saeed Tamehri Zadeh, Maciej Banach","doi":"10.5114/aoms/221422","DOIUrl":"10.5114/aoms/221422","url":null,"abstract":"","PeriodicalId":8278,"journal":{"name":"Archives of Medical Science","volume":"22 2","pages":"782-784"},"PeriodicalIF":3.6,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13266534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148263092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A real-world pharmacovigilance analysis of cardiac, endocrine, and neurological adverse events associated with cabergoline: a disproportionality study.","authors":"Yu-Zhen Wang, Qing-Qing Hu, Lu-Yao Xu, Liu-Cheng Li, Jun-Jie Xu, Kai-Li Mao","doi":"10.5114/aoms/221117","DOIUrl":"10.5114/aoms/221117","url":null,"abstract":"","PeriodicalId":8278,"journal":{"name":"Archives of Medical Science","volume":"22 2","pages":"1224-1233"},"PeriodicalIF":3.6,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13266738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148263107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating measures of remnant cholesterol and inflammation: risky business?","authors":"Josiah Bennett, Jose R Medina-Inojosa, Laurence S Sperling","doi":"10.5114/aoms/221520","DOIUrl":"10.5114/aoms/221520","url":null,"abstract":"","PeriodicalId":8278,"journal":{"name":"Archives of Medical Science","volume":"22 2","pages":"684-686"},"PeriodicalIF":3.6,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13266731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148262926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Communicating for optimal cardiovascular prevention: understanding the clinician's role.","authors":"Nader Silver, Michael J Blaha","doi":"10.5114/aoms/221406","DOIUrl":"10.5114/aoms/221406","url":null,"abstract":"","PeriodicalId":8278,"journal":{"name":"Archives of Medical Science","volume":"22 2","pages":"652-654"},"PeriodicalIF":3.6,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13266519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148263139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nonlinear association between muscle quality index and stroke risk in American adults: a national cross-sectional study.","authors":"Xiaoming Qin, Huili Yue, Yuanxing Zhang, Linyi Li, Zhixia Ren","doi":"10.5114/aoms/220750","DOIUrl":"10.5114/aoms/220750","url":null,"abstract":"","PeriodicalId":8278,"journal":{"name":"Archives of Medical Science","volume":"22 2","pages":"1212-1217"},"PeriodicalIF":3.6,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13266523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148262957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}