Postgraduate medicine最新文献

{"title":"Significance of relative fat mass to estimate prevalent prehypertension and hypertension in the general population.","authors":"Shan Li, Zhi Du, Heng Chen, Liding Zhao, Pei Zhou, Xuan Zhang, Safraz Anwar, Jialan Lv, Zhicheng Pan, Xiaogang Guo","doi":"10.1080/00325481.2025.2502317","DOIUrl":"https://doi.org/10.1080/00325481.2025.2502317","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the relationship between relative fat mass (RFM) with prehypertension and hypertension in general population.</p><p><strong>Methods: </strong>This investigation was a cross-sectional study that recruited 4,885 community-dwelling residents from Zhejiang Province in September 2023 to November 2023. The logistic regression and penalized spline method were applicated to determine the correlation between RFM with prehypertension and hypertension. The interaction effects and subgroups analyses were further conducted to estimate the stability of the aforesaid findings. Besides, the category-free analysis was performed to demonstrate whether the addition of the RFM levels to the traditional model could improve the risk classification of prehypertension and hypertension.</p><p><strong>Results: </strong>The prevalence of prehypertension and hypertension were, respectively, 64.8%. Multivariable logistic regression indicated that the risk of prehypertension (hazard ratio, 1.99; 95% confidence interval, 1.63-2.44) and hypertension (3.41; 2.81-4.14), respectively, increased by 99% and 241% per standard deviation increase in RFM after adjusting for established risk factors. Taking the participants in the lowest RFM quartile as the reference, and those with the highest quartile had a significantly increased risk of prehypertension (5.26; 3.03-9.12) and hypertension (20.42; 11.84-35.22). The restricted cubic splines demonstrated aforesaid associations were linear, and interaction and subgroup analysis observed the stability of these findings. The category-free analysis suggested that the addition of RFM to the traditional model eventuated an improvement in predictive ability of prehypertension and hypertension.</p><p><strong>Conclusions: </strong>Our results corroborated the positive association between RFM with prehypertension and hypertension. Clinically, the calculation of RFM should be emphasized in the risk assessment of hypertension and prehypertension.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047636","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 methotrexate monotherapy in patients with idiopathic granulomatous mastitis.","authors":"Mehmet Nur Kaya, Emre Tekgöz, Seda Çolak, Özlem Kılıç, Muhammet Çınar, Sedat Yılmaz","doi":"10.1080/00325481.2025.2502322","DOIUrl":"https://doi.org/10.1080/00325481.2025.2502322","url":null,"abstract":"<p><strong>Objectives: </strong>Idiopathic granulomatous mastitis (IGM) is a rare benign inflammatory disease of the breast. It is characterized by chronic inflammation and granuloma formation. We designed this study to assess the compliance and remission status of patients with IGM on methotrexate treatment.</p><p><strong>Methods: </strong>The study included 114 patients who were treated with methotrexate for at least 1 year after a biopsy-proven diagnosis of IGM at a tertiary rheumatology center between January 2017 and February 2024. Demographic characteristics, clinical findings, laboratory parameters, treatment options and patient compliance with treatment were obtained from patient files.</p><p><strong>Results: </strong>The mean age of patients diagnosed with IGM was 32.3 ± 6.3 years. Patients were treated with a combination of methotrexate, and complete remission was achieved in 97 patients (85.1%) after an average of one year. When Kaplan-Meier analysis was performed for the average annual methotrexate use, the average duration of drug use in patients with IGM was found to be 11.24 (10.88-11.49) months.</p><p><strong>Conclusion: </strong>The use of methotrexate treatment in IGM patients has been shown to be both successful and well tolerated when evaluated according to the duration of drug administration.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039318","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":"Investigating the 'Diabetes Paradox' in Takotsubo Cardiomyopathy.","authors":"Song Peng Ang, Jia Ee Chia, Kwan Lee, Madhan Shanmugasundaram, Abhishek J Deshmukh, Chayakrit Krittanawong, Jose Iglesias, Debabrata Mukherjee, Carl J Lavie","doi":"10.1080/00325481.2025.2502315","DOIUrl":"https://doi.org/10.1080/00325481.2025.2502315","url":null,"abstract":"<p><strong>Background: </strong>The impact of diabetes mellitus (DM) on outcomes of Takotsubo cardiomyopathy (TC) remains unclear, with conflicting evidence suggesting either protective or harmful effects. This study evaluates the association between DM and in-hospital outcomes in TC patients.</p><p><strong>Methods: </strong>A retrospective analysis of the National Inpatient Sample database (2016-2019) was conducted to compare in-hospital outcomes in TC patients with and without DM. The primary outcome was in-hospital mortality, while secondary outcomes included cardiac arrest, cardiogenic shock, and acute kidney injury (AKI). Propensity-score matching (PSM) was applied to balance covariates, and multivariable logistic regression was used to evaluate DM as an independent predictor of mortality, with results reported as adjusted odds ratios (ORs) and 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Of 63,155 TC hospitalizations 13,380 (21.2%) involved patients with DM, who were older and had higher rates of comorbidities. PSM analysis revealed a higher risk of AKI in DM patients (20.13% vs. 15.91%; OR, 1.33; 95% CI, 1.16-1.54; <i>p</i> < 0.001), with no significant differences in mortality, cardiogenic shock, or cardiac arrest. Patients with diabetic neuropathy showed a non-significant trend toward increased AKI risk (27.04% vs. 20.44%; OR, 1.44; 95% CI, 1.00-2.09; <i>p</i> = 0.053). Multivariable analysis identified comorbidities like CKD, liver disease, and coagulopathy as mortality predictors, but not DM.</p><p><strong>Conclusion: </strong>DM was associated with a higher risk of AKI but did not affect in-hospital mortality or major cardiac events in TC patients. These findings suggest that DM has a neutral impact on TC outcomes, highlighting the need for further investigation.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060628","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":"Abstracts from the 19th Annual Cardiometabolic Health Congress.","authors":"","doi":"10.1080/00325481.2025.2476828","DOIUrl":"10.1080/00325481.2025.2476828","url":null,"abstract":"","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756970","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":"Treating obesity in patients with depression: a narrative review and treatment recommendation.","authors":"Pamela Kushner, Scott Kahan, Roger S McIntyre","doi":"10.1080/00325481.2025.2478812","DOIUrl":"10.1080/00325481.2025.2478812","url":null,"abstract":"<p><p>The high morbidity of obesity and depression pose significant public health concerns, with the prevalence of obesity doubling in the US between 1990 and 2022 and patients frequently presenting with both. Untreated obesity and depression can greatly impact patient health and well-being, as both obesity and depression are associated with a number of comorbidities including sleep apnea, type 2 diabetes mellitus, metabolic syndrome, metabolic dysfunction-associated steatotic liver disease, and cardiovascular disease. This narrative review aims to provide a comprehensive and current overview of the overlapping etiologies between obesity and depression as well as the available treatment options that may be recommended by primary care professionals to treat these patients with concomitant obesity and depression. With the considerable overlap in the population of patients with obesity and depression, as well as the overlap in the neurobiological, hormonal, and inflammatory pathways underlying both diseases, primary care professionals should consider screening patients presenting with obesity for depression. Holistic treatment options, including lifestyle and behavioral modifications, and pharmacotherapy for both depression and obesity and bariatric surgery for obesity are critical to manage both conditions simultaneously. Therefore, due to the overlapping neurobiological pathways and mechanisms responsible for the incidence and progression of both obesity and depression, a holistic treatment plan including strategies with efficacy for both conditions and any additional comorbidities may improve the clinical approach for patients with concomitant obesity and depression.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"221-234"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664893","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":"Junctional ectopic tachycardia revisited.","authors":"Raimundo Carmona-Puerta, Elibet Chávez-González, Elizabeth Lorenzo-Martínez","doi":"10.1080/00325481.2025.2485672","DOIUrl":"10.1080/00325481.2025.2485672","url":null,"abstract":"<p><p>Junctional ectopic tachycardia (JET) is an uncommon arrhythmia, but it can have devastating consequences when it occurs. Most physicians are not familiar with its diagnosis, which can seriously compromise management in emergency rooms. Many cases arise in the postoperative period following cardiovascular surgery. In this context, the arrhythmia significantly worsens the prognosis of patients. A particularly severe form of JET is congenital, which has a mortality rate of up to 35%. The diagnosis can be made from the fetal period to six months of age. JET is infrequently diagnosed in otherwise healthy adults. Some medical conditions have been associated with the occurrence of JET. In the electrocardiogram, the most prominent characteristics of the arrhythmia are atrioventricular dissociation, narrow QRS complexes, and R-R interval irregularity due to intermittent ventricular captures. A notable feature of JET is the lack of response to treatment in many patients. Management options are divided into general and specific measures. General measures include avoiding hyperthermia, pain control, and minimizing the use of exogenous catecholamines. Specific treatment involves antiarrhythmic drugs, temporary atrial pacing, and ablation.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"243-250"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143723055","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":"Semaglutide 2.4 mg long-term clinical outcomes in patients with obesity or overweight: a real-world retrospective cohort study in the United States (SCOPE 12 months).","authors":"Aleksandrina Ruseva, Firas Dabbous, Nina Ding, Anthony Fabricatore, Samuel Huse, Wojciech Michalak, Beth Nordstrom, Bríain Ó Hartaigh, Zhenxiang Zhao, Devika Umashanker","doi":"10.1080/00325481.2025.2482274","DOIUrl":"10.1080/00325481.2025.2482274","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the effectiveness of semaglutide 2.4 mg for weight reduction and improvement in cardiometabolic biomarkers at 52 and 68 weeks in a real-world setting in the United States.</p><p><strong>Methods: </strong>This noninterventional, retrospective cohort study used the Komodo Health database and included adults with obesity or overweight with ≥1 weight-related condition who initiated treatment with semaglutide 2.4 mg between June 2021 and August 2022 and remained on treatment for 1 year. A paired t-test was used to assess changes in weight, body mass index (BMI), and cardiometabolic biomarkers (systolic blood pressure [SBP], diastolic blood pressure [DBP], glycated hemoglobin [HbA1c], HDL [high-density lipoprotein] cholesterol, LDL [low-density lipoprotein] cholesterol, and triglycerides) from baseline to 52-week and 68-week follow-up.</p><p><strong>Results: </strong>Among 4,424 eligible patients, 77% were women and the mean (SD) age was 46.7 (10.0) years and BMI was 36.6 (3.6) kg/m². Dyslipidemia and hypertension were the most common obesity-related comorbidities at baseline. The mean (%) change in weight from baseline was -15.5 kg (-14.5%; <i>p</i> < 0.001; <i>n</i> = 594) at 52 weeks and -15.9 kg (-14.8%; <i>p</i> < 0.001; <i>n</i> = 391) at 68 weeks. The mean change in BMI from baseline was - 4.8 kg/m² (<i>n</i> = 1124) at 52 weeks and - 4.9 kg/m² (<i>n</i> = 700) at 68 weeks. At 52weeks, statistically significant improvements in mean values were observed for SBP (-6.3 mmHg), DBP (-3.1 mmHg), HbA1c (-0.4%), LDL cholesterol (-8.1 mg/dL), and triglycerides (-38.4 mg/dL) (all <i>p</i> < 0.001). Mean change at 52 weeks for HDL cholesterol was 1.0 mg/dL; <i>p</i> = 0.109. Results at 68 weeks were similar.</p><p><strong>Conclusions: </strong>In this retrospective cohort study, the real-world effectiveness of semaglutide 2.4 mg was demonstrated by reductions in weight and BMI along with improvements in BP, HbA1c, and lipid panel among patients with obesity or overweight.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"251-260"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143695019","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":"Unveiling the effectiveness and safety spectrum of biologic therapies in psoriasis: a three-year real-world analysis.","authors":"Abdullah Demirbas, Esin Diremsizoglu, Mustafa Esen, Gozde Ulutas Demirbas","doi":"10.1080/00325481.2025.2493042","DOIUrl":"10.1080/00325481.2025.2493042","url":null,"abstract":"<p><strong>Background: </strong>Psoriasis vulgaris is a chronic immune-mediated inflammatory disease that significantly affects quality of life, particularly in severe cases and anatomically challenging areas. Biologic therapies targeting immune pathways have improved clinical outcomes; however, variability in effectiveness, safety, and drug survival necessitates further investigation.</p><p><strong>Objectives: </strong>This study aimed to evaluate the effectiveness, safety, and drug survival of biologic therapies in patients with moderate-to-severe psoriasis vulgaris.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted on 400 psoriasis patients treated with IL-17, IL-12/23, and IL-23 inhibitors. Clinical outcomes were assessed using PASI, DLQI, PSSI, NAPSI, and ppPASI scores. Kaplan-Meier survival analysis and Cox regression were employed to identify predictors of drug survival.</p><p><strong>Results: </strong>Ixekizumab demonstrated superior effectiveness in achieving PASI 100 and improving scalp psoriasis, while Guselkumab provided the most sustained improvements in palmoplantar and nail involvement. Adverse events were most frequently associated with IL-17 inhibitors, particularly upper respiratory tract infections. Guselkumab and Secukinumab demonstrated the highest drug survival rates, whereas Ixekizumab had the lowest. Early improvements in PASI and DLQI scores were strong predictors of drug survival.</p><p><strong>Conclusion: </strong>Personalized treatment approaches are crucial, given the varied effectiveness, safety profiles, and drug survival among biologic therapies.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"299-308"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001085","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":"Daily solriamfetol improved performance on a memory and attention task in people with obstructive sleep apnea and excessive daytime sleepiness: a plain language summary.","authors":"Eileen B Leary, Hans P A Van Dongen, Christopher Drake, Richard Bogan, Judith Jaeger, Caroline Streicher, Herriot Tabuteau","doi":"10.1080/00325481.2025.2494499","DOIUrl":"10.1080/00325481.2025.2494499","url":null,"abstract":"","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"209-219"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055598","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":"Comparative assessment of left and right atrial deformation using 2D and 3D speckle-tracking echocardiography in healthy individuals and rheumatic mitral stenosis patients with/without atrial fibrillation.","authors":"Özden Seçkin Göbüt, Serkan Ünlü, Gülten Taçoy Aydoğdu","doi":"10.1080/00325481.2025.2478819","DOIUrl":"10.1080/00325481.2025.2478819","url":null,"abstract":"<p><strong>Background: </strong>Rheumatic mitral stenosis continues to be a significant public health issue in developing countries. Advances in echocardiography have made it possible to non-invasively assess atrial physiomechanics. In our study, we aimed to evaluate the changes in left and right atrial phasic functions in patients with have mitral stenosis and to investigate the relationship of these changes with clinical signs, symptoms, and intervention decisions.</p><p><strong>Methods: </strong>Patients with rheumatic mitral stenosis who did not have comorbidities affecting cardiac function were included in this single-center, prospective study. The study population consisted of 122 subjects: 30 healthy controls with no chronic diseases and normal cardiac function confirmed by clinical and echocardiographic evaluations, 31 patients with moderate mitral stenosis, 31 patients with severe mitral stenosis and 30 patients with severe mitral stenosis with valvular atrial fibrillation. In addition to conventional echocardiographic parameters, biventricular deformation analyses were assessed using 2D-STE. Right and left atrial phasic functions were evaluated using both 2D and 3D-STE analysis and compared with clinical findings.</p><p><strong>Results: </strong>In the patient group with severe mitral stenosis in sinus rhythm, the contractile left atrial strain values were significantly higher. The left atrial peak longitudinal (reservoir) strain values were found to be significantly lowest in the group with severe mitral stenosis accompanied by atrial fibrillation. Similarly, in the group with severe mitral stenosis accompanied by atrial fibrillation, the right atrial phasic strain values were significantly lower in both 2D and 3D measurements.</p><p><strong>Conclusion: </strong>Mitral stenosis, the increased left atrial afterload in patients with sinus rhythm is compensated by an increase in contractile function. However, this compensatory increase is insufficient to preserve left atrial reservoir function. Patients with mitral stenosis who develop atrial fibrillation lack the compensatory contractile function, and this deficiency underlies the increased clinical deterioration associated with the development of atrial fibrillation.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"309-317"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652940","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}