Journal of clinical medicine research最新文献

{"title":"Higher Processed Blood Volume of Granulocyte and Monocyte Adsorption Apheresis Ameliorates Long-Term Disease Activity in Ulcerative Colitis Patients.","authors":"Yoshifumi Hamasaki, Ryo Matsuura, Takahide Shinagawa, Soichiro Ishihara, Sozaburo Ihara, Mitsuhiro Fujishiro, Kent Doi, Masaomi Nangaku","doi":"10.14740/jocmr6071","DOIUrl":"https://doi.org/10.14740/jocmr6071","url":null,"abstract":"<p><strong>Background: </strong>Granulocyte and monocyte adsorption apheresis (GMA) is a therapeutic option for remission induction in the active ulcerative colitis (UC) patients. Effects of high processed blood volume of GMA as remission induction therapy on the long-term prognosis of UC patients have remained unclear. For this study, we investigated the relation between re-exacerbation of UC and the processed blood volume of GMA performed as induction therapy.</p><p><strong>Methods: </strong>Data from UC patients treated using a total of 10 GMA sessions as remission induction therapy during 2012 - 2022 were retrospectively collected and analyzed. The relation between the GMA dose, processed blood volume of GMA divided by body weight, and UC re-exacerbation requiring inpatient treatment within 1 year was evaluated.</p><p><strong>Results: </strong>This study examined data of 72 active UC patients, with median age of 44.4 years (65% male) and median GMA dose of 34.2 mL/kg/session. Kaplan-Meier analysis showed the 1-year exacerbation-free rate was significantly higher in the higher GMA dose group than in the lower GMA dose group (P = 0.008). Cox proportional hazards regression analyses revealed a higher GMA dose as inversely associated with the re-exacerbation of UC within 1 year (hazard ratio: 0.36, 95% confidence interval: 0.17 - 0.78). Extended treatment time of GMA session beyond 60 min contributed to achieving the higher GMA dose and did not increase unexpected treatment termination because of clotting.</p><p><strong>Conclusion: </strong>Greater processed blood volume of GMA per patient body weight may be associated with a lower 1-year exacerbation rate in UC patients.</p>","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"16 12","pages":"625-634"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142934342","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":"Simple Subjective Sleep Quality and Blood Pressure in Individuals With Optimal Sleep Duration: A Cross-Sectional Study.","authors":"Kenshu Taira, Yumeno Fukumine, Koshi Nakamura","doi":"10.14740/jocmr6136","DOIUrl":"https://doi.org/10.14740/jocmr6136","url":null,"abstract":"<p><strong>Background: </strong>An individual's simple subjective feeling of having poor sleep quality usually occurs in combination with short sleep duration. Previous studies have mainly investigated the association between simple subjective sleep quality and blood pressure in a general population without considering the complicated issue regarding poor sleep quality and short sleep duration. The aim of this study was therefore to investigate whether poor sleep quality was associated with increased blood pressure in individuals with optimal sleep duration.</p><p><strong>Methods: </strong>A cross-sectional study was conducted on 169 residents aged ≥ 18 years who lived in a remote island of Okinawa, Japan. The participants had a sleep duration of 6 - 7.9 h/day on weekdays and were not taking either sleep medication or antihypertensive medication. Analysis of covariance was used to compare systolic and diastolic blood pressures in the participants grouped according to simple subjective sleep quality.</p><p><strong>Results: </strong>Of the 169 participants, 51 (30.2%) reported that their sleep quality was poor. After adjustment for age, sex, and other potential confounders including sleep duration within optimal levels, the participants aged ≤ 49 years had mean (95% confidence interval) systolic and diastolic blood pressures (mm Hg) of 121.0 (114.7 - 127.3) and 68.7 (63.8 - 73.6) in the good sleep quality group, and 127.8 (120.7 - 134.9) and 71.8 (66.2 - 77.3) in the poor sleep quality group (P = 0.01 and P = 0.14, respectively). However, in those aged ≥ 50 years, the corresponding means were 130.6 (121.3 - 139.8) and 79.1 (73.5 - 84.7) in the good-quality group and 126.9 (114.6 - 139.2) and 78.0 (70.5 - 85.4) in the poor-quality group (P = 0.43 and P = 0.68, respectively). There was a statistically significant interaction between simple subjective sleep quality and age for systolic blood pressure (P value for interaction = 0.04).</p><p><strong>Conclusions: </strong>This study showed that an individual's simple subjective feeling of poor sleep quality was associated with increased systolic blood pressure in participants aged ≤ 49 years with optimal sleep duration. These findings highlight the importance of easily assessing simple subjective sleep quality in clinical settings even in individuals with optimal sleep duration, in order to prevent and manage hypertension.</p>","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"16 12","pages":"600-607"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142934343","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":"The Impact on Patient Prognosis of Changes to the Method of Notifying Staff About Accepting Patients With Out-of-Hospital Cardiac Arrest.","authors":"Youichi Inoue, Keisuke Okamura, Hideaki Shimada, Shinobu Watakabe, Shiori Hirayama, Machiko Hirata, Ayaka Kusuda, Arisa Matsumoto, Miki Inoue, Emi Matsuishi, Mizuki Yamada, Sachiko Iwanaga, Shogo Narumi, Shiki Nakayama, Hideto Sako, Akihiro Udo, Kenichiro Taniguchi, Shogo Morisaki, Souichiro Ide, Yasuyuki Nomoto, Shin-Ichiro Miura, Osamu Imakyure, Ichiro Imamura","doi":"10.14740/jocmr6111","DOIUrl":"https://doi.org/10.14740/jocmr6111","url":null,"abstract":"<p><strong>Background: </strong>Our hospital is a designated emergency hospital and accepts many patients with out-of-hospital cardiac arrest (OHCA). Previously, after receiving a direct call from emergency services to request acceptance of an OHCA patient, the emergency room (ER) chief nurse notified medical staff. However, this method delayed ER preparations, so a Code Blue system (CB) was introduced in which the pending arrival of an OHCA patient was broadcast throughout the hospital.</p><p><strong>Methods: </strong>In this study, we retrospectively analyzed the impact of introducing CB at our hospital on OHCA patient prognosis to examine whether the introduction of CB is clinically meaningful. We compared consecutive cases treated before introduction of the CB (March 3, 2022, to March 22, 2023) with those treated afterwards (March 23, 2023, to July 23, 2024).</p><p><strong>Results: </strong>A total of 30 cases per group were included. The mean number of medical staff present at admissions increased significantly from 5.4 ± 0.6 to 15.0 ± 3.0 (P < 0.001). Although not statistically significant, the introduction of the CB increased the return of spontaneous circulation (ROSC) rate from 20% to 30%, survival to discharge rate from 3% to 10%, and social reintegration rate from 0% to 3%. ROSC occurred in 15 patients. Among OHCA patients with cardiac disease, the ROSC rate tended to increase from 0% to 43% (P = 0.055). In addition, in OHCA patients with cardiac disease whose electrocardiogram initially showed ventricular fibrillation or pulseless electrical activity, the ROSC rate increased from 0% to 100%. ROSC tended to be influenced by the total number of staff and physicians present and the number of staff such as medical clerks, clinical engineers, and radiology technicians (P = 0.095, 0.076, 0.088, respectively).</p><p><strong>Conclusions: </strong>Introduction of a CB may increase the ROSC rate and the number of patients surviving to discharge. It also appears to improve the quality of medical care by quickly gathering all necessary medical staff so that they can perform their predefined roles.</p>","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"16 12","pages":"578-588"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142934344","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":"Clinical Implications of Skin Cancer in Kidney Transplant Recipients in the Era of Immune Checkpoint Inhibitors.","authors":"Lakshmi Manogna Chintalacheruvu, Vamsi Krishna Chilluru","doi":"10.14740/jocmr6088","DOIUrl":"https://doi.org/10.14740/jocmr6088","url":null,"abstract":"<p><p>Long-term survival has improved in kidney transplant recipients (KTRs) due to effective surgical techniques and anti-rejection therapies. Chronic immunosuppression associated with it has led to several types of skin cancers leading to substantial morbidity and mortality. Structured patient education including sun protective behaviors, regular dermatological surveillance, nicotinamide, long-chain omega-3 polyunsaturated fatty acids (PUFAs), early switch to mammalian target of rapamycin inhibitors (mTORis), combining them with low-dose calcineurin inhibitors (CNIs), can decrease the cancer risk. Checkpoint inhibitors (CPIs) are the major backbone of the treatment of advanced skin cancers. Unfortunately, these agents can increase the risk of graft rejection. Prospective studies done so far looking at combining steroids with CPI in treatment of skin cancer in KTRs have shown mixed results. Adoption of the weight-based approach of CPI has shown to decrease the amount of drug exposure with acceptable outcomes in the general population, which is something that can be studied in KTRs with skin cancer. Also, it is reasonable to consider surveillance allograft biopsies in KTRs receiving CPIs to detect early subclinical rejection. More studies are needed to develop guidelines to safely treat this population with minimal graft rejection. We conducted a comprehensive literature review from PubMed on skin cancer in kidney transplant patients, focusing on incidence, risk factors, protective behaviors, financial and treatment implications, especially with regards to CPIs therapy. We also discussed potential newer treatment options that will decrease skin cancer risk, as well as graft rejection.</p>","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"16 12","pages":"571-577"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142934341","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":"Association Between Chronic Kidney Disease Risk Categories and Abdominal Aortic Calcification: Insights From the National Health and Nutrition Examination Survey.","authors":"Song Peng Ang, Jackson Rajendran, Jia Ee Chia, Pratiksha Singh, Jose Iglesias","doi":"10.14740/jocmr6101","DOIUrl":"https://doi.org/10.14740/jocmr6101","url":null,"abstract":"<p><strong>Background: </strong>Abdominal aortic calcification (AAC) is a critical indicator of cardiovascular risk, particularly in patients with chronic kidney disease (CKD). Traditional classification systems may underestimate the risk in those with moderate CKD. This study aimed to evaluate the association between CKD risk categories - defined by both estimated glomerular filtration rate (eGFR) and albuminuria - and the prevalence of severe AAC.</p><p><strong>Methods: </strong>This cross-sectional study analyzed data from the National Health and Nutrition Examination Survey (NHANES) 2013-2014. We included adults aged ≥ 40 years who underwent imaging for AAC assessment, excluding pregnant individuals and those without AAC scores. Survey-weighted and multivariate logistic regression was employed to assess the relationship between CKD risk categories and severe AAC, adjusting for age, hypertension, and smoking history. Subgroup analyses were conducted to explore variability across demographic and clinical subgroups.</p><p><strong>Results: </strong>We analyzed data from 3,140 participants in the NHANES, 423 (13.4%) of whom had severe AAC. The cohort was categorized into CKD risk categories 1 through 4, with the majority (76%) in stage 1. Severe AAC was more prevalent among older individuals and those with traditional cardiovascular risk factors. Initial unadjusted analyses revealed that CKD category 2 was associated with a nearly fourfold increase in severe AAC (odds ratio (OR): 3.93), while categories 3 and 4 showed 3.75-fold and over 10-fold increases, respectively (all P < 0.01). However, after adjusting for confounders, categories 2 and 4 showed higher risks of severe AAC compared to category 1, but these associations did not reach statistical significance (OR: 1.72, 95% confidence interval (CI): 0.90 - 1.86, P = 0.06 and OR: 5.70, 95% CI: 0.85 - 38.00, P = 0.07, respectively).</p><p><strong>Conclusion: </strong>Our study offers insights that may complement the current reliance on eGFR and albuminuria in risk stratification, highlighting that CKD category 2, defined by mildly reduced eGFR and albuminuria, may be a potential marker for severe AAC. Although statistical significance was narrowly missed after full adjustment, the clinical implications remain significant, advocating for more aggressive cardiovascular risk management in this population. This understanding may contribute to evolving approaches in CKD-related cardiovascular risk assessment and inform potential intervention strategies.</p>","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"16 12","pages":"589-599"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142934340","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":"High Blood Glucose After Starch Loading in Young Women With Small Increase in Salivary Amylase: Another Crucial Role of Postprandial Salivary Amylase.","authors":"Airi Sekine, Kei Nakajima","doi":"10.14740/jocmr6057","DOIUrl":"10.14740/jocmr6057","url":null,"abstract":"<p><strong>Background: </strong>Salivary α-amylase plays a crucial role in the glucose metabolism. However, postprandial salivary α-amylase activity (SAA) and its relationship with blood glucose (BG) are poorly understood. Therefore, we investigated SAA and BG after starch loading in healthy young women.</p><p><strong>Methods: </strong>In 60 healthy non-obese young women, we investigated SAA, BG, and blood 3-hydroxybutyrate (3HB) after the consumption of 150 g rice (starch 48.8 g). Participants were classified into two groups based on the changes (Δ) in SAA from baseline at 60 min: small- and large-increase in ΔSAA groups (SI-ΔSAA and LI-ΔSAA).</p><p><strong>Results: </strong>BG levels were significantly higher at 60, 90, and 120 min in participants with SI-ΔSAA (n = 31) than LI-ΔSAA (n = 29). Baseline 3HB concentration was also higher in participants with SI-ΔSAA. ΔSAA at 60 min was most closely and inversely correlated with BG and ΔBG at 90 min (r = -0.53 and -0.50, both P < 0.0001). Generalized linear model analysis also indicated that ΔSAA at 60 min was the most predictive of ΔBG at 90 min.</p><p><strong>Conclusions: </strong>Higher levels of BG and ΔBG were observed after starch loading in healthy young women with smaller increase in salivary amylase, suggesting another crucial role of postprandial salivary amylase for the postprandial glucose metabolism.</p>","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"16 10","pages":"465-471"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11557500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635615","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":"Elevated Serum Growth Differentiation Factor 15 Levels as a Potential Biomarker of the Efficacy of Imeglimin in Individuals With Type 2 Diabetes Mellitus: An Exploratory Study.","authors":"Naoki Wada, Takaaki Murakami, Muhammad Fauzi, Kentaro Sakaki, Shinobu Oshima, Yoshihito Shimada, Kanae Asai, Ayako Oshima, Satoko Nomura, Erina Joo, Michiko Mori, Ryoko Fujiwara, Kenichiro Shide, Keiko Wada, Daisuke Yabe, Nobuya Inagaki, Norio Harada","doi":"10.14740/jocmr6031","DOIUrl":"10.14740/jocmr6031","url":null,"abstract":"<p><strong>Background: </strong>The aim of the present study was to conduct a prospective observational study to explore the effects of imeglimin on systemic energy metabolism/body composition and to identify potential mitochondria-related biomarkers of the efficacy of the drug in clinical settings.</p><p><strong>Methods: </strong>In this prospective observational study, 16 participants with type 2 diabetes mellitus in the diabetes clinic of Kyoto University Hospital were enrolled. Individuals were started on imeglimin as monotherapy or add-on therapy.</p><p><strong>Results: </strong>After 3 months under imeglimin treatment, there was no significant change in basal metabolism or body composition. However, serum levels of growth differentiation factor 15 (GDF15) were higher while those of serum fibroblast growth factor 21 and urine 8-hydroxy-2'-deoxyguanosine were not changed. Additional <i>in vitro</i> examination revealed that imeglimin induces GDF15 protein release from human hepatocytes.</p><p><strong>Conclusions: </strong>Three-month imeglimin treatment increased serum GDF15 levels in clinical type 2 diabetes mellitus patients along with little change in basal metabolism or body composition, suggesting GDF15 as a potential marker for the efficacy of imeglimin.</p>","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"16 10","pages":"503-508"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11557504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635695","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":"Comprehensive Benefits of Sodium-Glucose Cotransporter 2 Inhibitors in Heart Failure With Reduced Ejection Fraction: A Literature Review.","authors":"Almendra Lopez-Usina, Camila Mantilla-Cisneros, Jordan Llerena-Velastegui","doi":"10.14740/jocmr6033","DOIUrl":"10.14740/jocmr6033","url":null,"abstract":"<p><p>Sodium-glucose cotransporter 2 (SGLT2) inhibitors, initially developed for type 2 diabetes, have emerged as a promising treatment for heart failure with reduced ejection fraction (HFrEF). They show significant cardiovascular benefits, including reduced cardiovascular mortality and heart failure hospitalizations. This review consolidates knowledge on the efficacy of SGLT2 inhibitors in HFrEF, focusing on their mechanisms of action, clinical benefits, and patient outcomes. To consolidate existing knowledge on the efficacy of SGLT2 inhibitors in reducing cardiovascular mortality in HFrEF, with an emphasis on pathophysiology, clinical benefits, and patient outcomes, major medical databases such as PubMed, Scopus, and Web of Science were reviewed, prioritizing research published from 2020 to 2024. Key studies and clinical trials, including DAPA-HF and EMPEROR-Reduced, were analyzed to understand the impacts of SGLT2 inhibitors on HFrEF management. The review highlights the multifaceted mechanisms by which SGLT2 inhibitors exert their cardiovascular benefits, including osmotic diuresis, natriuresis, improved myocardial energetics, and anti-inflammatory and antifibrotic effects. Clinical trials have consistently demonstrated significant reductions in cardiovascular mortality and hospitalizations among HFrEF patients treated with SGLT2 inhibitors. These benefits are observed across diverse demographic and clinical subgroups, indicating their broad applicability in clinical practice. SGLT2 inhibitors significantly advance HFrEF management, reducing cardiovascular mortality and hospitalizations. However, gaps remain in long-term outcomes, early diagnostic indicators, and mechanisms of action. Future research should address these gaps and explore personalized medicine to optimize treatment. Integrating SGLT2 inhibitors into standard HFrEF management guidelines, supported by updated policies and educational initiatives for healthcare providers, will be crucial to maximize their therapeutic potential and improve patient outcomes.</p>","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"16 10","pages":"449-464"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11557505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635694","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":"Bridging Three Years of Insights: Examining the Association Between Depression and Gallstone Disease.","authors":"Huai Zhi Wang, Saboor Saeed, Jin Yu Zhang, Shao Hua Hu","doi":"10.14740/jocmr6050","DOIUrl":"10.14740/jocmr6050","url":null,"abstract":"<p><strong>Background: </strong>Despite sharing common pathophysiological risk factors, the relationship between gallstones and depression requires further evidence for a clearer understanding. This study combines the National Health and Nutrition Examination Survey 2017 - 2020 observational data and Mendelian randomization (MR) analysis to shed light on the potential correlation between these conditions.</p><p><strong>Methods: </strong>By analyzing the National Health and Nutrition Examination Survey 2017 - 2020 data through weighted multivariable-adjusted logistic regression, we examined the association between depression and gallstone risk. MR was subsequently applied, utilizing genetic instruments from a large genome-wide association study on depression (excluding 23andMe, 500,199 participants) and gallstone data (28,627 cases, 348,373 controls), employing the main inverse variance-weighted method alongside other MR methods to explore the causal relationship. Sensitivity analyses validated the study's conclusions.</p><p><strong>Results: </strong>Among the 5,303 National Health and Nutrition Examination Survey participants, a significant association was found between depressive symptoms and increased gallstone risk (initial odds ratio (OR) = 2.001; 95% confidence interval (CI) = 1.523 - 2.598; P < 0.001), with the association persisting after comprehensive adjustments (final OR = 1.687; 95% CI = 1.261 - 2.234; P < 0.001). MR findings also indicated a causal link between genetically predicted depression and higher gallstone risk (OR = 1.164; 95% CI = 1.053 - 1.286; P = 0.003).</p><p><strong>Conclusions: </strong>Depression is significantly associated with a higher risk of gallstones, supported by genetic evidence suggesting a causal link. These findings highlight the importance of considering depression in gallstone risk assessments and management strategies.</p>","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"16 10","pages":"472-482"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11557501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635692","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":"The Effects of Preoperative Serum Carcinoembryonic Antigen, Cancer Antigen 15-3 and Cancer Antigen 125 on the Prognosis of Breast Cancer Patients With Different Molecular Subtypes.","authors":"Yipala Yilihamu, Lei Wang, Tao Ma, Ting Zhao, Yan Wang, Gang Sun","doi":"10.14740/jocmr5237","DOIUrl":"10.14740/jocmr5237","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The aim of the study was to investigate the relationship between serum carcinoembryonic antigen (CEA), cancer antigen 15-3 (CA15-3), and cancer antigen 125 (CA125) levels and traditional clinicopathological factors in patients with early invasive breast cancer in Xinjiang, and the influence of those serum markers on the prognosis of patients with different molecular subtypes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a retrospective study based on the clinical data of 2,940 invasive breast cancer patients who were diagnosed and treated at the Affiliated Cancer Hospital of Xinjiang Medical University from 2015 to 2019. Firstly, in this study, preoperative serum CEA, CA15-3, and CA125 levels were divided into elevated and normal groups based on the optimal cut-off values. Secondly, Chi-square test was used to analyze the correlation between the elevated and normal groups of CEA, CA15-3, and CA125 and traditional clinicopathological factors. Finally, Cox regression model was also used to evaluate the effect of preoperative CEA, CA15-3, and CA125 elevated groups on the prognosis of patients with different molecular subtypes compared with normal groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The optimal cut-off values for preoperative CEA, CA15-3, and CA125 were 4.32 ng/mL, 23.10 U/mL and 29.80 U/mL, respectively. The elevated group of preoperative CEA, CA15-3, and CA125 patients usually had larger tumors (tumor size: T2-4), later clinical staging (TNM stage: II-III), and higher histological grading (histological grade: II-III). Univariate analysis showed that the overall survival (OS) of preoperative CEA, CA15-3, and CA125 patients in the elevated group was lower than that in the normal group (P &lt; 0.0001), the 5-year OS was 76.63% vs. 95.35%, 74.34% vs. 95.60%, and 83.73% vs. 94.71%, respectively. Multivariate analysis revealed that for the luminal A, compared with the normal group, the hazard ratios (HRs) of preoperative CEA, CA15-3, and CA125 elevated groups were 6.475 (95% confidence interval (CI): 1.850 - 22.66), 5.192 (95% CI: 1.153 - 23.38), and 7.294 (95% CI: 1.152 - 46.18), respectively. However, for the luminal B, elevated levels of CEA, CA15-3, and CA125 were not independent prognostic factors for OS. For the human epidermal growth factor receptor-2 (HER2)-enriched, the HR of preoperative CA15-3 elevated group was 3.155 (95% CI: 1.325 - 7.509). Additionally, for the triple-negative breast cancer, the HR of preoperative CEA elevated group was 2.390 (95% CI: 1.247 - 4.583).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;High levels of CEA, CA15-3, and CA125 were positively correlated with increased tumor load. Preoperative CEA, CA15-3, and CA125 levels may have different prognostic effects on patients with different molecular subtypes. Particularly, preoperative elevated levels of CEA have a significant adverse impact on the prognosis of luminal A and triple-negative patients, while preoperative elevated levels of CA15-3 have","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"16 10","pages":"491-502"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11557502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635616","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}