Journal of clinical medicine research最新文献

{"title":"Prognostic Significance of Serum Sodium in Patients With Acute Pulmonary Embolism.","authors":"Patchara Kochaiyapatana, Sukrisd Koowattanatianchai, Jayanton Patumanond, Arwarit Pocathikorn, Sopida Thammongkolchai","doi":"10.14740/jocmr6664","DOIUrl":"https://doi.org/10.14740/jocmr6664","url":null,"abstract":"<p><strong>Background: </strong>Hyponatremia has been associated with adverse outcomes in several cardiovascular diseases; however, its independent prognostic value in patients with acute pulmonary embolism (APE) remains uncertain.</p><p><strong>Methods: </strong>We conducted a single-center retrospective observational study of 105 hospitalized patients with confirmed APE between January 2020 and June 2025. Baseline clinical characteristics were compared between 1-year survivors and non-survivors. Serum sodium levels at the time of APE diagnosis were assessed, and hyponatremia was defined as a serum sodium level < 135 mmol/L. Univariable and multivariable Cox proportional hazards regression analyses were performed to evaluate the association of serum sodium and other potential prognostic factors with 1-year mortality.</p><p><strong>Results: </strong>Among 105 hospitalized patients with confirmed APE, 41 (39.0%) died within 1 year. Non-survivors had a higher prevalence of active cancer (61.0% vs. 15.6%, P < 0.001) and chronic obstructive pulmonary disease (COPD) (21.9% vs. 1.6%, P = 0.001), lower systolic blood pressure (108.9 ± 25.9 vs. 130.8 ± 21.6 mm Hg, P<0.001), and higher Pulmonary Embolism Severity Index (PESI) scores (157.3 ± 56.0 vs. 91.0 ± 32.7, P < 0.001) than survivors. Serum sodium at diagnosis was significantly lower in non-survivors than in survivors (130.6 ± 5.9 vs. 136.4 ± 4.4 mmol/L, P < 0.001), and hyponatremia was more frequent among non-survivors (78.1% vs. 35.9%, P < 0.001). In univariable Cox regression, hyponatremia was associated with increased 1-year mortality (univariable hazard ratio (uHR), 4.20; 95% confidence interval (CI), 2.00-8.81; P < 0.001). After adjustment for disease severity and relevant clinical risk factors, serum sodium at diagnosis remained independently associated with 1-year mortality (multivariable hazard ratio (mHR) per 1-mmol/L increase, 0.92; 95% CI, 0.86-0.99; P = 0.043).</p><p><strong>Conclusions: </strong>Lower serum sodium at diagnosis was independently associated with increased 1-year mortality in hospitalized patients with APE. Hyponatremia may represent a simple and readily available prognostic marker for early risk stratification in APE. Larger prospective studies are needed to confirm these findings.</p>","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"18 9","pages":"661-670"},"PeriodicalIF":2.2,"publicationDate":"2026-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187139","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":"From Discovery to Verification: A Thirty-Three-Year Analysis of Research Design in Three Leading General Medical Journals, 1992-2024.","authors":"Zhe Chen, Rei Gou","doi":"10.14740/jocmr6706","DOIUrl":"https://doi.org/10.14740/jocmr6706","url":null,"abstract":"<p><strong>Background: </strong>Evidence-based medicine (EBM) has reorganized clinical research around a hierarchy favoring confirmatory designs over hypothesis-generating ones. Earlier analyses rested on single-year snapshots ending in 2008, so whether the shift continued, and at what rate, across the EBM era is unknown. We characterized 33-year trends in design profile and collaboration scale in three leading general medical journals.</p><p><strong>Methods: </strong>We conducted a repeated cross-sectional analysis of PubMed publication-type indexing for the New England Journal of Medicine (NEJM), The Lancet, and JAMA, 1992 to 2024, with numerator and denominator both restricted to the Journal Article publication type. We measured the annual proportion of journal articles tagged as Phase III trials (from 1993, when that tag was introduced), multicenter studies, randomized controlled trials and case reports, and authors per randomized trial. Trends were estimated by binomial generalized linear models (odds ratio (OR) per decade). The Phase III tag was validated against 132 articles.</p><p><strong>Results: </strong>The pooled share of Phase III trials rose from 0.15% in 1993 to 5.67% in 2024 (OR 2.79 per decade, 95% confidence interval (CI) 2.59 to 3.00; P < 0.001), and multicenter studies from 4.3% to 12.6% (OR 1.25; P < 0.001). The randomized-trial share rose more modestly, from 11.4% to 13.8% (OR 1.10; P < 0.001). Case reports fell in The Lancet (7.3% to 3.8%; OR 0.78) and JAMA (7.3% to 1.3%; OR 0.63), but not in NEJM (23.0% to 25.7%; OR 0.97; P = 0.08), where stability is accounted for by two standing features, the weekly Case Records and a single-page clinical image series begun in 1993. Case reports of three or more pages fell from 11.3% to 4.2% in NEJM (OR 0.71). Median authors per randomized trial rose from 5 to 10 in 1994-1998 to 19 to 23 in 2020-2024.</p><p><strong>Conclusions: </strong>The leading general medical journals increasingly published large, multi-author, late-phase trials, while the substantive case report contracted in all three. The case report changed in kind, from a vehicle for novel observation to short pedagogical content carrying the same index tag. These trends are consistent with a structural shift from discovery toward verification, with implications for how new hypotheses enter the evidence base.</p>","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"18 9","pages":"671-678"},"PeriodicalIF":2.2,"publicationDate":"2026-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187412","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":"Nutritional Status in Multiple Sclerosis, Neuromyelitis Optica Spectrum Disorder, and Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease.","authors":"Ekdanai Uawithya, Teerawat Koosirirat, Natnasak Apiraksattayakul, Punchika Kosiyakul, Sasitorn Siritho, Tatchaporn Ongphichetmetha, Kusuma Chaiyasoot, Jerawat Uthankul, Natthapon Rattanathamsakul, Jiraporn Jitprapaikulsan","doi":"10.14740/jocmr6676","DOIUrl":"https://doi.org/10.14740/jocmr6676","url":null,"abstract":"<p><strong>Background: </strong>The study aimed to assess the frequency of malnutrition and its associated factors among patients with central nervous system inflammatory demyelinating diseases (CNSIDDs) and to explore their relationship with quality of life (QoL).</p><p><strong>Methods: </strong>A cross-sectional study at Siriraj Hospital included patients with CNSIDD aged > 18 years and matched healthy controls (HCs). Nutritional status and QoL were evaluated using the Mini Nutritional Assessment (MNA) and the 36-Item Short-Form Survey (SF-36), respectively. Spearman's rank correlation was used to identify correlations between factors and SF-36 scores. Multivariate Poisson regression analyses utilized a combined \"abnormal nutritional status\" outcome (pooling \"at-risk\" and \"malnourished\" patients) to identify significant associated factors.</p><p><strong>Results: </strong>The study included 222 patients (100 multiple sclerosis (MS), 105 neuromyelitis optica spectrum disorder (NMOSD), and 17 myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD)) with a mean age of 46.2 years (standard deviation (SD) 15.2). Overall, 102/222 (45.9%) CNSIDD patients were at risk of or actively experiencing malnutrition. Mean MNA scores were 23.25 (SD 3.76) for MS, 22.84 (SD 3.50) for NMOSD, and 22.03 (SD 3.03) for MOGAD, compared to 26.07 (SD 1.88) for HC (P < 0.001). Malnutrition was found in 7.0% of MS and 8.6% of NMOSD patients, but 0% of MOGAD patients. However, the proportion of patients at risk of malnutrition was highest in the MOGAD group (70.6%), compared to MS (35.0%) and NMOSD (37.1%). SF-36 scores showed a significant positive correlation with MNA scores (r = 0.463, P < 0.001). Initial regression analysis indicated that a MOGAD diagnosis, high Expanded Disability Status Scale (EDSS) scores, and low body mass index were associated with abnormal nutritional status, although these associations remain subject to unmeasured treatment and comorbidity confounders.</p><p><strong>Conclusion: </strong>A significant proportion of CNSIDD patients face malnutrition or are at high risk, which correlates with poorer QoL and greater disease disability. Routine nutritional screening is an essential component of standard care for this population.</p>","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"18 9","pages":"679-686"},"PeriodicalIF":2.2,"publicationDate":"2026-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186769","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":"Significant Associations of Achilles Tendon Thickness With Atherosclerotic Diseases and Atherosclerotic Risk Factors in Non-Familial Hypercholesterolemia Patients: A Cross-Sectional Study.","authors":"Mariko Hakoshima, Hidekatsu Yanai, Tatsuki Onomura, Hirohumi Sugimoto, Hisayuki Katsuyama","doi":"10.14740/jocmr6614","DOIUrl":"https://doi.org/10.14740/jocmr6614","url":null,"abstract":"<p><strong>Background: </strong>Achilles tendon thickness (ATT) is an important diagnostic tool for familial hypercholesterolemia (FH), a highly atherogenic genetic disorder. Although the available evidence remains limited, recent studies have reported associations between ATT and atherosclerotic diseases and their risk factors among non-FH patients. We investigated the relationships among ATT, carotid intima-media thickness (IMT), a marker of systemic atherosclerosis, and atherosclerotic risk factors, including diabetes, dyslipidemia, and atherosclerotic diseases, in non-FH patients.</p><p><strong>Methods: </strong>This cross-sectional survey was conducted at the National Kohnodai Medical Center, Japan. Patients who underwent ultrasonographic measurements of both ATT and carotid IMT were included. Clinical data were obtained using medical records and included demographic characteristics, anthropometric measurements, blood pressure, comorbidities, and biochemical parameters.</p><p><strong>Results: </strong>A total of 1,000 patients (512 males, 488 females) were enrolled. The mean age was 65 ± 14 years, the mean body mass index (BMI) was 24.6 ± 4.9 kg/m², and the mean ATT was 4.6 ± 0.8 mm. ATT was positively correlated with maximal carotid IMT (r = 0.088, P = 0.005), body weight (r = 0.279, P < 0.001), and BMI (r = 0.183, P < 0.001), and inversely correlated with serum levels of high-density lipoprotein-cholesterol (HDL-C) (r = -0.182, P < 0.001). In the multiple regression model that included maximal carotid IMT, BMI, HDL-C, and low-density lipoprotein-cholesterol, the correlations of ATT with maximal carotid IMT, BMI, and HDL-C remained significant; however, the correlation between ATT and maximal carotid IMT was no longer significant in the model added with age. Patients with CAD and carotid artery stenosis had significantly greater ATT than those without such diseases. Similarly, ATT values were higher in patients with diabetes, and those with diabetes and CAD had the highest ATT values.</p><p><strong>Conclusion: </strong>ATT levels were significantly associated with BMI and dyslipidemia, and were significantly higher in non-FH patients with CAD, carotid artery stenosis, and diabetes than in non-FH patients without such diseases.</p>","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"18 9","pages":"632-642"},"PeriodicalIF":2.2,"publicationDate":"2026-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187202","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":"Cytochrome P450 2D6 Metabolizer Phenotype Is Associated With Metoprolol Pharmacodynamics But Not With Metoprolol Discontinuation: A Retrospective Cohort Study in the All of Us Research Program.","authors":"Meet Popatbhai Kachhadia, Piyush Puri, Nachiketa Buha, Jay Vadodariya, Shashi Kant, Harrison Giknavorian, Amrit Gautam, Jimik Patel, Lakshya Kumar, Juber D Shaikh, Gurnoor Gill, Deep Prajapati, Quacian Dennis, Harshal A Sanghvi","doi":"10.14740/jocmr6673","DOIUrl":"https://doi.org/10.14740/jocmr6673","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The 2024 Clinical Pharmacogenetics Implementation Consortium (CPIC) guideline assigns a high level of evidence to the association between cytochrome P450 2D6 (CYP2D6) metabolizer status and both metoprolol exposure and heart-rate response and recommends genotype-informed dosing for poor metabolizers. Whether this well-characterized pharmacodynamic effect translates into a patient-level tolerability consequence, differential discontinuation has not been established at population scale in a diverse cohort. The aims of this study were to estimate the association between CYP2D6 metabolizer phenotype and metoprolol discontinuation, and to test whether metabolizer status was associated with the intermediate pharmacodynamic phenotypes (attained heart rate, bradycardia, and attained dose) through which such an effect would plausibly act. Discontinuation is treated throughout as a composite behavioral and clinical endpoint and not as a direct measure of drug tolerability.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This was a retrospective cohort study that used whole-genome sequencing linked to electronic health records (EHRs) in the All of Us Research Program (Controlled Tier, Curated Data Repository v9). Adult metoprolol users who had a CYP2D6 diplotype call and at least two metoprolol dispensings were included, so that the target population is patients who continued beyond a first fill. CYP2D6 metabolizer phenotype (normal (NM, reference), intermediate (IM), poor (PM), and ultrarapid (UM)) was derived from Cyrius diplotype calls using the CPIC and Dutch Pharmacogenetics Working Group consensus activity-score system, and a collapsed reduced-metabolizer contrast (PM plus IM vs NM) was prespecified. The primary outcome, time to metoprolol discontinuation, was modeled with cause-specific Cox regression that treated death as a competing event and adjusted for age, sex, 10 genetic-ancestry principal components, indication, comorbidity, atrioventricular-nodal cotherapy, CYP2D6 inhibitor exposure, calendar year, and EHR density. The secondary pharmacodynamic outcomes were attained on-treatment heart rate, bradycardia, and attained maximum daily dose. Sensitivity analyses addressed the discontinuation definition, phenoconversion by CYP2D6 inhibitors, and heterogeneity across genetic-ancestry strata.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among 44,485 metoprolol users (PM, 2,470 (5.6%); IM, 16,687 (37.5%); NM, 24,123 (54.2%); UM, 1,205 (2.7%)), 29,999 (67.4%) discontinued and 629 (1.4%) died during follow-up. Metabolizer phenotype was not associated with discontinuation (PM vs NM: cause-specific hazard ratio (HR), 1.04 (95% confidence interval (CI), 0.99-1.09), P = 0.12; IM: 1.01 (0.99-1.03), P = 0.41; UM: 1.01 (0.94-1.08), P = 0.89). The reduced-metabolizer contrast was null (HR, 1.01 (0.99-1.04), P = 0.24). The PM estimate was stable across three discontinuation definitions producing event rates of 67% to 98% (HR range, 1.01-1.04). Reclassifying ","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"18 9","pages":"599-611"},"PeriodicalIF":2.2,"publicationDate":"2026-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187480","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":"Radiation-Induced Xerostomia in Patients With Head and Neck Cancer Treated With Comprehensive Salivary Gland-Sparing Helical Tomotherapy Technique Based on a Back Propagation Artificial Neural Network.","authors":"Feng Teng, Qi Teng Liu, Ling Ling Meng, Zhong Jian Ju, Xiang Kun Dai, Xin Xin Zhang, Lin Ma","doi":"10.14740/jocmr6633","DOIUrl":"https://doi.org/10.14740/jocmr6633","url":null,"abstract":"<p><strong>Background: </strong>The aim was to create a back propagation artificial neural network (BPANN) model for gauging the risk of developing xerostomia (dry mouth) due to targeted radiotherapy in patients with head and neck cancer (HNC), who underwent comprehensive salivary gland-sparing helical tomotherapy (HT).</p><p><strong>Methods: </strong>Data from 222 HNC patients treated with salivary gland-sparing HT between November 26, 2016, and December 31, 2017, were analyzed. Potential variables considered included age, gender, tumor type, radiation dose to salivary glands, and xerostomia questionnaire scores. These variables were adjusted using multivariate linear regression. The BPANN model was constructed to predict the likelihood and severity of xerostomia at both 1 and 2 years after radiotherapy. Model evaluation was based on the confusion matrix table and the area under the receiver operating characteristic curve (AUC of ROC).</p><p><strong>Results: </strong>The BPANN model revealed that the risk of radiation-induced xerostomia could be evaluated using age, gender, tumor type, and radiation dose to specific salivary glands (parotid glands, submandibular glands, oral cavity, and tongue glands). Multivariate analysis indicated that age, gender, and submandibular gland dose were the primary influencing factors for xerostomia. Both prediction models demonstrated strong performance as reflected in the confusion matrix table and the AUC of ROC curve.</p><p><strong>Conclusions: </strong>BPANN stands as a potential and recommended predictive tool for assessing the likelihood of xerostomia induced by salivary gland-sparing HT.</p>","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"18 9","pages":"623-631"},"PeriodicalIF":2.2,"publicationDate":"2026-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187183","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":"Prediction Model for Detecting Active Pulmonary Tuberculosis in Patients With Head and Neck Cancer Prior to Concurrent Chemoradiotherapy.","authors":"Chawalit Lakdee, Jayanton Patumanond, Peeraphong Thiarawat, Thanin Lokeskrawee, Suppachai Lawanaskol, Pornpit Treebupachatsakul, Wanwisa Bumrungpagdee, Suwapim Chanlaor","doi":"10.14740/jocmr6634","DOIUrl":"https://doi.org/10.14740/jocmr6634","url":null,"abstract":"<p><strong>Background: </strong>Patients with cancer, particularly those with head and neck cancer (HNC), have a higher risk of developing active pulmonary tuberculosis (PTB) than the general population. Radiotherapy or concurrent chemoradiotherapy (CCRT) is a primary treatment modality for HNC. Therefore, the detection of active PTB before treatment is important. However, routine testing in all patients is not feasible. We aimed to develop a diagnostic prediction model for active PTB using routinely available pretreatment clinical and laboratory parameters in patients with HNC prior to radiotherapy.</p><p><strong>Methods: </strong>We performed a diagnostic prediction study with a retrospective, cross-sectional design using medical record reviews of all patients diagnosed with HNC who underwent radiotherapy at the Radiation Therapy Unit, Buddhachinaraj Phitsanulok Hospital, Phitsanulok, Thailand, from October 2014 to October 2025. Active PTB was defined as the initiation of anti-tuberculosis treatment with microbiological confirmation (acid-fast bacilli smear microscopy, culture, or nucleic acid amplification testing/GeneXpert) and/or chest imaging compatible with active PTB. Multivariable logistic regression was performed to derive the models. Discrimination was measured using the area under the receiver operating characteristic curve (AuROC); calibration was assessed using calibration plots, and internal validation was performed using bootstrap resampling. Decision curve analysis was used to determine clinical utility.</p><p><strong>Results: </strong>Of the 505 patients with HNC, 30 (5.94%) had active PTB. Four predictors independently associated with active PTB were body mass index (BMI) (odds ratio (OR) 0.86; 95% confidence interval (CI) 0.75-0.99), hemoglobin (OR 0.75; 95% CI 0.58-0.95), albumin (OR 0.25; 95% CI 0.12-0.53), and cancer symptom duration (months) (OR 1.49; 95% CI 1.25-1.76). The model showed excellent discrimination (AuROC 0.882; 95% CI 0.814-0.950) and good calibration (slope 1.000). At a predicted probability cutoff (≥ 5.94%), sensitivity was 90.0% (95% CI 73.5-97.9) and specificity was 82.3% (95% CI 78.6-85.6). The model may reduce the number of patients requiring confirmatory PTB testing, missing only three of 505 patients (0.6%) overall.</p><p><strong>Conclusions: </strong>In patients with HNC undergoing pretreatment evaluation, a simple four-variable model (BMI, hemoglobin level, albumin concentration, and cancer symptom duration) can estimate the probability of active PTB.</p>","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"18 9","pages":"612-622"},"PeriodicalIF":2.2,"publicationDate":"2026-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186839","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":"Common Carotid Artery Extra-Media Thickness as a Marker of Perivascular Obesity and Cardiometabolic Risk in Individuals Without Cardiovascular Disease.","authors":"Anna Bragina, Natalia Druzhinina, Yulia Rodionova, Daria Akvitskaya, Kirill Novikov, Galina Nikiforova, Oksana Avdeenko, Natalia Vlasova, Alina Arzukanyan, Alina Kudravceva, Valery Podzolkov","doi":"10.14740/jocmr6657","DOIUrl":"https://doi.org/10.14740/jocmr6657","url":null,"abstract":"<p><strong>Background: </strong>Perivascular adipose tissue (PVAT) is increasingly recognized as a pathogenetic contributor to vascular dysfunction. Carotid extra-media thickness (EMT) measured by ultrasound is the simplest, noninvasive and clinically accessible marker of PVAT deposition. However, reference values in young individuals without cardiovascular disease (CVD) are lacking. The aim of this study was to analyze the relationship between carotid EMT and cardiovascular risk factors and to determine a tentative reference value of carotid EMT in individuals without CVD.</p><p><strong>Methods: </strong>This cross-sectional study included 373 patients with a median age of 23 (21; 32) years and without CVD. All patients underwent anthropometric examination, lipid-profile assessment using the CardioChek PA (USA, 2020), and duplex ultrasound of the brachiocephalic arteries with measurement of common carotid artery EMT and intima-media thickness (IMT). A subgroup of apparently healthy individuals without cardiovascular risk factors was selected to define a threshold. EMT above the 90th percentile of this subgroup was regarded as perivascular obesity (PVO).</p><p><strong>Results: </strong>Carotid EMT was significantly associated with age, blood pressure levels, anthropometric and laboratory metabolic markers, glycemia and smoking. On multivariable linear regression, age, obesity and smoking were independently associated with EMT. The 90th percentile threshold in the apparently healthy subgroup (n = 185) was 0.54 mm; EMT ≥ 0.54 mm (PVO) was identified in 24.2% of the sample and was most frequent in individuals aged 41-55 years. On multivariable logistic regression, age and waist circumference were independently associated with the presence of PVO.</p><p><strong>Conclusions: </strong>Carotid EMT, reflecting the severity of PVAT deposition, may be associated with a wide range of cardiometabolic risk factors in individuals without CVD, with a tentative threshold value of 0.54 mm.</p>","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"18 9","pages":"652-660"},"PeriodicalIF":2.2,"publicationDate":"2026-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187342","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":"Bone Morphogenetic Protein-10 as a Predictor of Atrial Fibrillation Recurrence After Catheter Ablation: A Systematic Review and Meta-Analysis.","authors":"Naveed Mohsin, Martin Eugene Matsumura, Tariq Ahmad, Kaif Ul Sahar","doi":"10.14740/jocmr6640","DOIUrl":"10.14740/jocmr6640","url":null,"abstract":"<p><strong>Background: </strong>Biomarkers of atrial cardiomyopathy may improve the prediction of recurrence of atrial fibrillation (AF) after catheter ablation. Bone morphogenetic protein-10 (BMP10) is an atrial-specific cardiomyocyte protein and a potential biomarker, but evidence is limited and not comprehensively synthesized.</p><p><strong>Methods: </strong>We performed a systematic review and meta-analysis of prospective cohort studies to evaluate the association between circulating BMP10 concentrations with AF recurrence after catheter ablation. Pooled hazard ratios (HRs) with corresponding 95% confidence intervals (CIs) were computed using a random-effects model. The primary analysis used unadjusted HRs per continuous BMP10 levels from all included studies. Secondary analyses were conducted based on the adjusted HRs of studies with continuous BMP10 and all studies, including one study that reported adjusted HRs based on quartiles.</p><p><strong>Results: </strong>Three studies were included. In the primary analysis without adjustment (n = 3), increased levels of BMP10 were significantly associated with recurrence of AF (pooled HR 1.53, 95% CI 1.13-2.07; P = 0.006), with moderate-to-high heterogeneity (I² = 69%). The association was attenuated and non-significant in the adjusted analysis of two studies with continuous BMP10 (HR 1.46, 95% CI 0.94-2.25; I² = 59%). However, after the inclusion of a third study with adjusted quartile-based HR, the statistical significance was re-demonstrated (HR 1.33, 95% CI 1.16-1.53; P < 0.001) with low heterogeneity (I² = 20%).</p><p><strong>Conclusion: </strong>Elevated BMP10 levels are correlated with higher risk of AF recurrence following catheter ablation. Although the results are consistent across analyses, they should be interpreted with caution due to the small number of studies and methodological heterogeneity. BMP10 needs to be confirmed as a clinically applicable biomarker by larger prospective studies.</p>","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"18 9","pages":"643-651"},"PeriodicalIF":2.2,"publicationDate":"2026-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187399","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":"Airway Ultrasound: Applications in Pediatric Anesthesiology and Critical Care.","authors":"Nahida Akhter, Tariq Wani, Joseph D Tobias","doi":"10.14740/jocmr6635","DOIUrl":"10.14740/jocmr6635","url":null,"abstract":"<p><p>The clinical uses and potential applications of point-of-care ultrasound (POCUS) have seen a significant increase in the practice of anesthesiology and critical care medicine. While initially used for regional anesthesia and vascular access, POCUS has since expanded to have significant applications for airway management and evaluation. Ultrasound has been effectively used to visualize the anatomical structures of the hypopharynx and anterior neck including the cricothyroid membrane, tracheal rings, esophagus, and aerated lung in a simple, rapid, and non-invasive manner. POCUS has demonstrated utility across multiple aspects of airway management including preoperative airway assessment, identification and evaluation of the difficult airway, confirmation of endotracheal intubation, verification of cuff position in relation to the cricoid ring, endotracheal tube depth, and localization of the cricothyroid membrane for emergency airway access. This educational review outlines the novel uses of POCUS in airway evaluation and management in various clinical scenarios with a focus on the pediatric-aged patient.</p>","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"18 8","pages":"497-514"},"PeriodicalIF":2.2,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13568779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148957745","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}