Postgraduate medicine最新文献

{"title":"Readmission and mortality outcomes with subsequent follow-up hemoglobin checks in general medical patients with hospital-acquired anemia.","authors":"Brianna L Konwinski, Ananya Vinay, Christopher L Boswell, Brad A Bohn, Donna M Miller, Alyssa Wallace, Gregory M Garrison, Nathaniel E Miller","doi":"10.1080/00325481.2026.2670028","DOIUrl":"https://doi.org/10.1080/00325481.2026.2670028","url":null,"abstract":"<p><strong>Introduction: </strong>Hospital-acquired anemia is associated with increased readmissions and 30-day mortality. We evaluated whether anemia severity is associated with readmission and mortality 1-year post-hospitalization, and whether a recheck of hemoglobin and/or hematocrit level within 30 days of discharge is associated with reduced readmission and mortality rates.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted on 1734 patients at the Mayo Clinic Hospital Inpatient services from 2020 to 2023. The association between readmission and death within 1 year, and hemoglobin recheck within 30 days, or anemic category, was assessed using multivariable Cox regression while controlling for patient characteristics.</p><p><strong>Results: </strong>There were 1734 patients meeting inclusion criteria (mean age 61.5 years). Prior to discharge, 89.4% of the patients remained anemic, categorized as mild (53%), moderate (39.1%), or severe (7.8%) anemia. Only 526 (30.3%) had a hemoglobin recheck within 30 days of discharge. Anemia severity at discharge was not associated with readmission or mortality. Age, length of stay, and a higher hemoglobin level prior to discharge were significantly associated with readmission and mortality risk. A hemoglobin recheck within 30 days post-discharge was associated with a higher risk of 30-day readmission and subsequent mortality (HR = 5.97, <i>p</i> < 0.001; HR = 1.69, <i>p</i> = 0.006).</p><p><strong>Conclusion: </strong>Patients with more severe hospital-acquired anemia did not have increased readmission and mortality during 1-year post-hospitalization. Anemia rechecking was associated with increased mortality but likely confounded by underlying co-morbidities and other clinical factors. Future studies could compare readmission and mortality in different discharge destinations.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"1-7"},"PeriodicalIF":2.8,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848063","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":"Comment on 'Extracorporeal shock wave lithotripsy with pancreatic stent prevents spontaneous clearance of stone'.","authors":"İbrahim Ethem Güven","doi":"10.1080/00325481.2026.2664926","DOIUrl":"https://doi.org/10.1080/00325481.2026.2664926","url":null,"abstract":"","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"1-2"},"PeriodicalIF":2.8,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793454","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":"Autonomic modulation following fecal microbiota transplantation in chronic insomnia.","authors":"Teng Gao, Mingming Zheng, Feng Geng, Yixiao Fu, Yongfeng Yang, Xinrong Li, Yongxiang Wang, Daomin Zhu, Zhe Wang, Lin Lu","doi":"10.1080/00325481.2026.2664261","DOIUrl":"https://doi.org/10.1080/00325481.2026.2664261","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether fecal microbiota transplantation (FMT) modulates autonomic function in chronic insomnia disorder and whether autonomic rebalancing mediates sleep improvement.</p><p><strong>Methods: </strong>This prespecified exploratory analysis was embedded within a multicenter, double-blind, randomized, placebo-controlled trial of FMT for chronic insomnia. The original trial was designed to evaluate the efficacy and safety of the FMT-based treatment protocol, with polysomnography-measured sleep efficiency at 1 month as the primary endpoint. Eighty adults were randomly assigned to receive either FMT (<i>n</i> = 40) or placebo capsules (<i>n</i> = 40). Overnight polysomnography was conducted at baseline and 1 month, and heart rate variability indices were derived to quantify autonomic regulation. Sleep outcomes included PSG-derived metrics and validated subjective questionnaires. Associations between changes in autonomic parameters and sleep outcomes were examined using correlation analyses. Mediation analysis was performed to evaluate whether autonomic changes statistically mediated FMT-associated improvements in sleep. Gut microbiota composition was profiled using 16S rRNA gene sequencing.</p><p><strong>Results: </strong>In the original trial, the FMT-based treatment met its prespecified primary endpoint, with significantly improved polysomnography-measured sleep efficiency at 1 month. In this exploratory analysis, FMT significantly reduced the LF/HF ratio (-0.10; 95% CI, -0.18 to -0.02; <i>p</i> = 0.010). A reduction in LF/HF was associated with longer TST (β = -0.41; <i>p</i> = 0.004). Mediation analysis showed that LF/HF accounted for 49.7% of the FMT effect on TST (ACME = 19.44 min; <i>p</i> = 0.018). FMT induced microbial compositional remodeling associated with the nocturnal LF/HF ratio, including enrichment of Lachnospira eligens, Christensenellaceae R-7 group, Ruminococcaceae, and Coprococcus, and depletion of Prevotella copri, Streptococcus, and Faecalibacterium.</p><p><strong>Conclusions: </strong>These findings provide clinical exploratory evidence for autonomic system as a potential pathway through which microbiota-targeted interventions may alleviate insomnia. Further studies are needed to determine the durability and clinical significance of these findings.</p><p><strong>Clinical trial registration: </strong>ClinicalTrials.gov: NCT05917379 (June 23, 2023).</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"1-13"},"PeriodicalIF":2.8,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793412","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":"Safeguarding Quality in Health and Medical Science Information Today.","authors":"Scott C Ratzan, Rebecca K Ivic, Kenneth H Rabin, Ruth M Parker, Sara Rubinelli, Rafael Obregon, Lawrence O Gostin, Michael G Baker, Samantha Thomas, Don Nutbeam, Ilona Kickbusch, J Gregory Payne, Vivianne Ihekweazu, Kirsten J McCaffery, Richard L Street, Sir Cary Cooper","doi":"10.1080/00325481.2026.2655398","DOIUrl":"https://doi.org/10.1080/00325481.2026.2655398","url":null,"abstract":"","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"1-3"},"PeriodicalIF":2.8,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147648068","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":"Acute kidney injury in heart failure hospitalization: a national study of outcomes and healthcare utilization.","authors":"Brent Tai, Chijioke Okonkwo","doi":"10.1080/00325481.2026.2658370","DOIUrl":"10.1080/00325481.2026.2658370","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) is a common complication among patients hospitalized with acute heart failure and is associated with worse clinical outcomes. However, contemporary national data examining its epidemiology and association with outcomes across heart failure phenotypes and chronic kidney disease (CKD) stages remain limited. We evaluated the prevalence of AKI and its association with mortality, critical care interventions, and healthcare utilization in a nationally representative cohort.</p><p><strong>Methods: </strong>We conducted a retrospective study using the 2022 Healthcare Cost and Utilization Project National Inpatient Sample. Adult hospitalizations for acute heart failure were identified using ICD-10-CM codes, and AKI was defined using diagnosis codes. Survey-weighted multivariable logistic regression models were used to identify factors associated with AKI and evaluate its association with in-hospital outcomes. Multicollinearity was assessed using variance inflation factors.</p><p><strong>Results: </strong>Among 1,126,036 hospitalizations, AKI occurred in 35.2%. AKI was associated with higher in-hospital mortality (adjusted odds ratio [aOR] 3.69; 95% CI 3.60-3.77), corresponding to adjusted mortality of 10.2% vs 3.4% (absolute difference 6.8% points). AKI was also associated with higher odds of mechanical ventilation (aOR 3.86), vasopressor use (aOR 3.66), and acute kidney replacement therapy (aOR 16.17) (all <i>p</i> < 0.001). In addition, AKI was associated with greater healthcare utilization, including prolonged length of stay (aOR 1.77; 40.0% vs 22.1%) and increased likelihood of discharge to skilled nursing or rehabilitation facilities (aOR 1.43).</p><p><strong>Conclusions: </strong>AKI is common among acute heart failure hospitalizations and is associated with higher mortality, greater use of critical care interventions, and increased healthcare utilization. These findings reinforce prior evidence that AKI identifies a high-risk population. Given the observational design, results should be interpreted as associations rather than causal effects. Further studies using laboratory-based definitions and longitudinal outcomes are needed to better characterize the long-term implications of AKI.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"283-292"},"PeriodicalIF":2.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147701390","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":"Clinicopathological characteristics of pure red cell aplasia induced by immune checkpoint inhibitors in cancer patients.","authors":"Jian Xiao, Licheng Li, Yuxiang Luo, Zhi Xia, Min Fang","doi":"10.1080/00325481.2026.2662039","DOIUrl":"10.1080/00325481.2026.2662039","url":null,"abstract":"<p><strong>Background: </strong>This study aims to elucidate the clinical features of pure red cell aplasia (PRCA) induced by immune checkpoint inhibitors (ICIs), with the goal of providing guidance for the prevention, diagnosis, and clinical management of this complication.</p><p><strong>Methods: </strong>We systematically searched multiple databases, including PubMed, Embase, EBSCO, Scopus, Web of Science, and Google Scholar, and integrated case reports related to ICI-induced PRCA for retrospective analysis. The search period spanned from the initiation of relevant research up to 11 July 2025.</p><p><strong>Results: </strong>This study included 32 patients with PRCA induced by ICIs, with a median age of 57.5 years (25-84 years). The median time to PRCA onset was 3 months (0.7-36 months) after ICI initiation, and the median treatment duration was 4 cycles (1-52 cycles). The main clinical manifestations were anemia and fatigue, with diagnosis confirmed by hematologic laboratory tests and bone marrow biopsy. Upon discontinuation of ICIs, along with transfusion support, systemic glucocorticoid therapy, and, when necessary, intravenous immunoglobulin or other immunosuppressants, the condition of ICI-associated PRCA patients showed significant improvement.</p><p><strong>Conclusion: </strong>PRCA induced by ICIs is a rare immune-related adverse event that typically occurs around 3 months after treatment. Early identification and appropriate intervention can lead to favorable outcomes.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"370-376"},"PeriodicalIF":2.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147731110","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 role of social determinants of health in predicting pediatric anemia in primary care clinics.","authors":"Julia Hoffman, Molly Posa, Jaclyn Otero, Xiaofei Chi, Cynthia Garvan, Colton Kelly, John Jones, Maria Kelly","doi":"10.1080/00325481.2026.2661421","DOIUrl":"10.1080/00325481.2026.2661421","url":null,"abstract":"<p><strong>Background: </strong>Social determinants of health (SDOH) influence access to nutrition, healthcare, and living conditions and may contribute to pediatric anemia. Anemia in children is particularly concerning because delayed identification can lead to developmental and long-term health consequences. Despite their potential impact, SDOH are not explicitly recognized as risk factors in current AAP anemia screening guidelines. Identifying whether SDOH predict anemia risk may facilitate earlier detection and treatment.</p><p><strong>Objective: </strong>To determine whether specific SDOH domains predict an increased risk of anemia in pediatric patients in primary care settings.</p><p><strong>Methods: </strong>Pediatric patients (<18 years) presenting for routine or acute primary care visits and their caregivers were recruited. Caregivers completed a validated SDOH screener, and tcHgb measurements were obtained. A retrospective chart review provided demographic and clinical data. Associations between tcHgb and numeric variables were assessed using Spearman correlations; categorical variables were analyzed with Kruskal-Wallis or Wilcoxon rank sum tests. Regression analysis evaluated tcHgb as the outcome with SDOH risk as the predictor, adjusting for age, sex, race, and insurance type. Analyses were conducted using SAS v9.4.</p><p><strong>Results: </strong>Among 248 families, 186 children (75%) had at least one identified social need. The most common were financial strain (31.85%), food insecurity (25.00%), cognitive disabilities (21.77%), language and literacy barriers (21.05%), and mental health concerns (18.11%). Mean (SD) tcHgb was 12.7 (1.2) g/dL, with a median of 2.0 [0.5, 3.0] positive SDOH domains when present. TcHgb was not associated with age, BMI, or sex but differed by insurance type. Each additional SDOH concern was associated with a 0.29 g/dL decrease in tcHgb (<i>p</i> < .0001).</p><p><strong>Conclusion: </strong>SDOH risk factors are significantly associated with lower hemoglobin levels in pediatric patients, with cumulative social needs conferring increased anemia risk. Incorporating SDOH screening into pediatric primary care may improve early identification and outcomes for children at risk of anemia.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"309-314"},"PeriodicalIF":2.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793503","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":"Referral pathway for adults with chronic cough in Switzerland from a Delphi-based consensus study.","authors":"Martin Brutsche, Barbara Ballmer-Weber, Emanuel Burri, Christian Clarenbach, Manuela Funke Chambour, Jörg D Leuppi, Michael B Soyka, Christophe von Garnier, Andreas Zeller","doi":"10.1080/00325481.2026.2663615","DOIUrl":"10.1080/00325481.2026.2663615","url":null,"abstract":"<p><strong>Objectives: </strong>The etiology of chronic cough (CC) is varied, making it difficult to manage, particularly when the cough persists despite appropriate treatment of underlying disease (refractory CC) or when no underlying disease or cause can be identified (unexplained CC). There are currently no recommendations in Switzerland outlining how general practitioners (GPs) should approach the management of CC. The aim of this study was to establish a consensus among physicians from various specialties in Switzerland regarding the assessment, treatment, and referral of CC patients.</p><p><strong>Methods: </strong>This Delphi-based consensus study included two survey rounds (May-December 2023) evaluating 71 statements on the assessment of CC and referral pathways among a panel of GPs, pulmonologists, allergologists, gastroenterologists, and ear nose and throat (ENT) specialists with experience managing CC in Switzerland (<i>N</i> = 50). A 9-point scale was used to rate agreement with statements; consensus in agreement or disagreement was achieved when the median of responses fell within 7-9 or 1-3, respectively, less than one third voted outside these ranges, and the interquartile range (IQR) was <4. An interdisciplinary Scientific Committee with representatives from medical disciplines involved in managing CC led the study and provided the context for the referral pathways proposed.</p><p><strong>Results: </strong>Consensus was reached on 84.5% of statements. Agreement was reached on general considerations for CC, initial actions to be taken in primary care, including clinical evaluation, 'red flags' to identify, pathologies to investigate, treatments to consider, and referral route. Two schematics were produced outlining 1) how to perform a basic assessment of CC patients in primary care, and 2) how and when to refer patients to specialists if CC persists.</p><p><strong>Conclusions: </strong>This study provides valuable recommendations for management of CC, promoting standardized assessment and referral of patients, which is not currently achieved in Switzerland.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"293-308"},"PeriodicalIF":2.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848116","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":"Nonlinear relationship between the CHG index and MASLD in type 2 diabetes mellitus: mediating role of immunoinflammatory markers.","authors":"Binjing Pan, Xiaoyu Lv, Xinyuan Guo, Jingfang Liu","doi":"10.1080/00325481.2026.2661571","DOIUrl":"10.1080/00325481.2026.2661571","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the relationship between cholesterol, high-density lipoprotein, and glucose (CHG) index and metabolic dysfunction-associated steatotic liver disease (MASLD) in patients with type 2 diabetes mellitus (T2DM).</p><p><strong>Methods: </strong>1,789 patients with T2DM aged ≥50 years were divided into MASLD (age: 62.56 ± 7.59) and non-MASLD groups (age: 62.78 ± 7.79). Adjusted regression models, threshold analysis, mediation analysis, and receiver operating characteristic (ROC) curves were used. Based on CHG index levels and various immunoinflammatory markers, patients with T2DM were divided into different groups, and the prevalence of MASLD was compared.</p><p><strong>Results: </strong>The CHG index, neutrophil-to-albumin ratio (NAR), neutrophil-to-lymphocyte ratio (NLR,) systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and aggregate inflammation systemic index (AISI) were higher in the MASLD group than in the non-MASLD group (<i>p</i> < 0.05). Multiple logistic regression analysis showed that the CHG index, NAR, NLR, SII, SIRI, and AISI were positively correlated with MASLD risk (all <i>p</i> < 0.05). Threshold analysis showed that when the CHG index was <5.474, it was positively associated with MASLD risk (<i>p</i> < 0.05). MASLD prevalence increased with increasing levels of inflammatory markers and the CHG index (<i>p</i> < 0.05). Mediation analysis of NAR, NLR, and SII between the CHG index and MASLD showed that the total effect estimates were 0.0159, 0.0153, and 0.0157, respectively; the direct effect estimates were 0.0107, 0.0134, and 0.0120; and the mediation effect estimates were 0.0053, 0.0019 and 0.0037, with the mediated proportions accounting for 27.25%, 11.47%, and 27.25% of the total effect, respectively. ROC curve analysis showed that the CHG index combined with SIRI had improved diagnostic performance for MASLD, with an area under the curve of 0.71.</p><p><strong>Conclusion: </strong>The CHG index was positively associated with MASLD risk in patients with T2DM aged ≥50 years. NAR, NLR, and SII partially mediated this association, highlighting their potential application in MASLD diagnosis.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"345-356"},"PeriodicalIF":2.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793512","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":"An assessment of neutrophil percentage‑to‑albumin ratio in Kawasaki disease.","authors":"Yunjia Tang, Jiaying Zhang, Xuan Li, Jin Ma, Wanping Zhou, Haitao Lv","doi":"10.1080/00325481.2026.2662041","DOIUrl":"10.1080/00325481.2026.2662041","url":null,"abstract":"<p><strong>Backgrounds: </strong>Kawasaki disease (KD) is an immune vasculitis of unknown etiology. Coronary artery lesions (CALs) and intravenous immunoglobulin resistance (IVIGR) are two major clinical challenges in KD. Previous studies had pointed out that neutrophil percentage‑to‑albumin ratio (NPAR) was associated with the prognosis of cardiac diseases. However, its role in KD has not been fully explored.</p><p><strong>Methods: </strong>We enrolled patients with the main diagnosis of KD admitted to Children's Hospital of Soochow University between December 2018 and June 2024. Patients were stratified into tertiles based on NPAR, and comparisons among groups were conducted. Univariate and multivariable logistic regression were carried out. Restricted cubic splines and fitted curves were used to examine the relationships between NPAR and the presence of CALs and IVIGR. Subgroup analyses were also investigated.</p><p><strong>Results: </strong>A total of 2371 patients were included in the present study. The incidences of IVIGR and CALs were 12.9% (305/2371) and 28.3% (670/2371), respectively. Patients with higher NPAR levels exhibited higher incidences of IVIGR. In contrast, NPAR was not associated with CALs. A positive linear relationship was noted between NPAR and IVIGR (<i>p</i> < 0.001). The expected presence of IVIGR was also positively related to NPAR. However, the association was modified by age and coronary artery status.</p><p><strong>Conclusions: </strong>NPAR may serve as a prognostic indicator for IVIGR, particularly in patients younger than 48 months and those without CALs, but not for CALs.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"377-383"},"PeriodicalIF":2.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793380","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}