The Journal Of International Medical Research[JOURNAL]
Sun
200 papers
Platelet-to-albumin ratio and postoperative bleeding after endovascular treatment of intracranial aneurysms: A retrospective cohort study.
Liu H, Wu Z
J Int Med Res · 2026 Jul · PMID 42399610 · Full text
BackgroundPostoperative bleeding in patients with intracranial aneurysms remains a serious complication associated with high mortality. The platelet-to-albumin ratio, reflecting thrombotic potential and endothelial healt...
BackgroundPostoperative bleeding in patients with intracranial aneurysms remains a serious complication associated with high mortality. The platelet-to-albumin ratio, reflecting thrombotic potential and endothelial health, has demonstrated prognostic value in various clinical settings. However, its association with postoperative bleeding following endovascular treatment of intracranial aneurysms has not yet been investigated.MethodsThis retrospective cohort study (January 2021 to January 2025) included 219 participants undergoing endovascular treatment. Multivariable logistic regression, smooth curve fitting, and piecewise linear regression were used to assess the association between the platelet-to-albumin ratio and bleeding risk, adjusting for potential confounders. Predictive performance was evaluated using receiver operating characteristic curves and decision curve analysis.ResultsBleeding occurred in 58 participants (26.5%). A significant nonlinear inverse L-shaped relationship was observed between the platelet-to-albumin ratio and bleeding risk (nonlinearity p = 0.010), with an inflection point at the platelet-to-albumin ratio of 5.05. Below this threshold, a higher ratio was associated with reduced risk (odds ratio: 0.607, 95% confidence interval: 0.445-0.829, p = 0.0017); whereas above this value, the association was neutral. The incidence of bleeding decreased significantly across increasing platelet-to-albumin ratio quartiles (Q1: 45.5% vs. Q4: 14.3%, p < 0.001). Multivariable analysis confirmed platelet-to-albumin ratio as an independent predictor (continuous: odds ratio: 0.73, 95% confidence interval: 0.59-0.90, p = 0.004; Q4 vs. Q1: odds ratio: 0.05, 95% confidence interval: 0.01-0.21, p < 0.001). The platelet-to-albumin ratio demonstrated superior discriminative capacity (area under the curve, 0.670) compared with platelet count (area under the curve, 0.624) or albumin alone (area under the curve, 0.607). Decision curve analysis confirmed clinical application.ConclusionThe platelet-to-albumin ratio independently predicts postoperative bleeding with a nonlinear relationship. It should be considered an adjunctive marker within a multimodal framework to help balance bleeding and ischemic risks.
Determinants of cleft lip and cleft palate in Ethiopian children: Insights from a hospital-based study using Bayesian modeling.
Eniyew AY, Diriba TA, Tereda AB … +1 more , Debusho LK
J Int Med Res · 2026 Jul · PMID 42396633 · Full text
ObjectiveCleft lip and cleft palate are common congenital anomalies that occur when facial structures fail to completely close during early development. This study aimed to identify determinants of cleft lip and cleft pa...
ObjectiveCleft lip and cleft palate are common congenital anomalies that occur when facial structures fail to completely close during early development. This study aimed to identify determinants of cleft lip and cleft palate and assess the relationship between the two outcomes among children admitted to CURE Ethiopia Children's Hospital.MethodThis hospital-based cross-sectional study involved 544 children with congenital birth defects and their parents. A bivariate multinomial regression model was applied to identify the determinants of cleft lip and cleft palate and to account for the correlation between the two outcomes. Bayesian methods were used to estimate model parameters.ResultsMaternal factors, including inadequate prenatal nutrition, lack of multivitamin supplementation, alcohol consumption, passive smoking, cigarette smoking, folic acid deficiency, residence in rural area, parental history of birth defects, and certain medical conditions during pregnancy, were associated with the occurrence of cleft lip and cleft palate. The findings also demonstrated a strong correlation between cleft lip and cleft palate through shared latent effects.ConclusionsMaternal nutrition and exposure to harmful substances during pregnancy are important risk factors influencing the occurrence of cleft lip and cleft palate. Strengthening maternal health education, improving nutrition, and reducing exposure to harmful substances may help reduce the burden of these conditions.
Etiology, surgical management, and outcomes of patients with scleral thinning.
Sun N, Yuan H, Zhang H
J Int Med Res · 2026 Jul · PMID 42396624 · Full text
This study aimed to analyze the etiological spectrum, surgical management strategies, and clinical outcomes of patients with scleral thinning and summarize individualized treatment principles based on lesion characterist...
This study aimed to analyze the etiological spectrum, surgical management strategies, and clinical outcomes of patients with scleral thinning and summarize individualized treatment principles based on lesion characteristics and systemic conditions. In this retrospective observational case series of 14 patients (16 eyes) diagnosed with scleral thinning, patient data on demographics, etiology, clinical presentation, surgical details, and outcomes were collected. Treatment strategies were individualized based on lesion location, extent, corneal involvement, and conjunctival status. Etiologies were congenital (18.75%), surgery/trauma-related (43.75%), immune-mediated (18.75%), inflammatory (12.5%), and idiopathic (6.25%), with four cases involving multiple factors. Surgical repair was performed in 11 eyes using scleral patch grafts (18.2%), anterior lamellar corneal grafts (45.4%), or double lamellar keratoplasty (36.4%), with adjunctive procedures (conjunctival flap or amniotic membrane transplantation) performed in 6 cases. Globe integrity was successfully restored in all surgical cases with normal intraocular pressure. Final best-corrected visual acuity improved or remained stable in 9 of the 11 cases. Four cases developed postoperative graft rejection or melting, which was associated with systemic autoimmune activity or poor medication adherence, with two requiring surgical reintervention. Management of scleral thinning requires a comprehensive etiological assessment and an individualized surgical plan based on lesion characteristics. Postoperative outcomes appear to be influenced by systemic immune status and patient compliance.
Hemichorea associated with nonketotic hyperglycemia: A case report with unremarkable neuroimaging at presentation.
Chen P, Wang L
J Int Med Res · 2026 Jul · PMID 42396620 · Full text
Nonketotic hyperglycemic hemichorea is a rare neurological disorder. Neuroimaging may provide supportive evidence, typically demonstrating contralateral basal ganglia abnormalities corresponding to the side of involuntar...
Nonketotic hyperglycemic hemichorea is a rare neurological disorder. Neuroimaging may provide supportive evidence, typically demonstrating contralateral basal ganglia abnormalities corresponding to the side of involuntary movements. However, characteristic findings may be absent or highly subtle in some patients, which can complicate recognition and delay diagnosis. Herein, we report the case of a 76-year-old woman without a known history of diabetes mellitus who presented with a 7-day history of involuntary choreiform movements of the right hand. On admission, initial brain computed tomography was interpreted as unremarkable; however, retrospective review revealed a subtle, faint hyperdensity in the left striatum. Magnetic resonance imaging, including diffusion-weighted imaging, showed no obvious characteristic signal changes in the basal ganglia. Laboratory testing demonstrated marked hyperglycemia without ketosis. After alternative etiologies were excluded, the presentation was considered most consistent with nonketotic hyperglycemic hemichorea based on the clinical syndrome and metabolic profile. The patient's symptoms improved markedly after intensive glycemic control with insulin therapy. This case highlights that nonketotic hyperglycemic hemichorea should be considered in patients with acute hemichorea and hyperglycemia, even when neuroimaging initially appears unremarkable, and that prompt glycemic management remains the cornerstone of treatment.
Diagnostic performance of machine learning-based radiomics models for predicting epidermal growth factor receptor mutation status in lung adenocarcinoma in Chinese patients: A systematic review and meta-analysis.
Yang J, Jiang J, Peng J … +3 more , Li J, Mi P, Chen G
J Int Med Res · 2026 Jul · PMID 42396618 · Full text
ObjectiveThis systematic review and meta-analysis evaluates the diagnostic performance of machine learning-based radiomics models for predicting epidermal growth factor receptor mutation status in Chinese patients with l...
ObjectiveThis systematic review and meta-analysis evaluates the diagnostic performance of machine learning-based radiomics models for predicting epidermal growth factor receptor mutation status in Chinese patients with lung adenocarcinoma.MethodsFollowing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines and prospectively registered in the International Prospective Register of Systematic Reviews (CRD420251273027), a systematic search of PubMed, Embase, Web of Science, the Cochrane Library, Scopus, China National Knowledge Infrastructure, Wanfang, VIP, and Chinese Biomedical Literature Database was conducted from inception to 31 October 2025. Two reviewers independently screened studies, extracted data, and assessed bias using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. A bivariate random-effects model was used to synthesize the data. Subgroup analyses were conducted for three factors: (a) imaging modality (computed tomography vs. positron emission tomography-computed tomography); (b) algorithm type (deep learning vs. conventional machine learning); and (3) validation strategy (external vs. internal).ResultsThirteen studies encompassing 6628 patients were included. The pooled sensitivity was 71% (95% confidence interval: 68-74), the pooled specificity was 81% (95% confidence interval: 78-84), and the summary area under the curve was 0.85 (95% confidence interval: 0.82-0.88). Deep learning models significantly outperformed conventional machine learning models (area under the curve: 0.871 vs. 0.798; P = 0.012). Computed tomography-based models yielded higher accuracy than positron emission tomography-computed tomography-based models (area under the curve: 0.879 vs. 0.828; P = 0.038). Models validated on independent external cohorts demonstrated superior performance compared with those relying solely on internal validation (area under the curve: 0.922 vs. 0.841; P = 0.006). Imaging modality was a significant source of heterogeneity (P < 0.05). No threshold effect or publication bias was detected.ConclusionMachine learning-based radiomics models exhibit promising diagnostic accuracy for the noninvasive prediction of epidermal growth factor receptor mutations in Chinese patients with lung adenocarcinoma. Computed tomography-based deep learning models subjected to independent external validation represent the current optimal approach. However, the retrospective nature and substantial heterogeneity of the included studies necessitate large-scale, prospective, multicenter trials with standardized workflows before clinical translation.
Postlumbar puncture spinal intradural hematoma: A case report and literature review.
Park W, Jung JH, Han MS … +2 more , Lee JK, Hong JH
J Int Med Res · 2026 Jul · PMID 42392990 · Full text
Spinal intradural hemorrhage/hematoma is an uncommon but clinically significant complication of lumbar puncture. We report a previously healthy man in his mid-30s who developed severe low-back pain with bilateral radicul...
Spinal intradural hemorrhage/hematoma is an uncommon but clinically significant complication of lumbar puncture. We report a previously healthy man in his mid-30s who developed severe low-back pain with bilateral radiculopathy and dysesthesia later the same day followi lumbar puncture performed for headache and fever. He represented 5 days later; coagulation test results were normal. Contrast-enhanced lumbar magnetic resonance imaging demonstrated a ventral mass-like intrathecal lesion extending from L4 to S1 with minimal enhancement, compatible with an early subacute intradural hematoma. He improved with conservative management and close observation without neurologic deficits. To contextualize this case, we performed a targeted PubMed/MEDLINE search through November 2025 and a narrative review of postlumbar puncture spinal intradural hemorrhage/hematoma reports published over the past 10 years. Thirty publications describing 37 patients with spinal intradural hemorrhage/hematoma were identified: symptom onset occurred within 24 h in 54.0% and beyond 48 h in 13.5%; thoracic/thoracolumbar involvement slightly exceeded lumbar/lumbosacral involvement (54.1% vs. 45.9%); and the subarachnoid (45.9%) and subdural (37.8%) compartments predominated. Spinal intradural hemorrhage/hematoma may occur despite normal coagulation findings and can mimic an intradural mass on early magnetic resonance imaging; prompt spinal magnetic resonance imaging and early specialist input are warranted when severe or progressive postlumbar puncture symptoms develop.
Clinical management and genetic variation analysis of patients with 17β-hydroxysteroid dehydrogenase deficiency.
Tao L, Huang E, Wang C … +7 more , Wang T, Wang X, Xie R, Wu H, Yan X, Zhou Y, Zhang T
J Int Med Res · 2026 Jul · PMID 42390145 · Full text
ContextDeficiency of 17β-hydroxysteroid dehydrogenase type 3 (17β-HSD3) is a rare autosomal recessive disorder of sex development affecting individuals with a 46, XY karyotype. It is caused by pathogenic variants in the...
ContextDeficiency of 17β-hydroxysteroid dehydrogenase type 3 (17β-HSD3) is a rare autosomal recessive disorder of sex development affecting individuals with a 46, XY karyotype. It is caused by pathogenic variants in the HSD17B3 gene that impair the conversion of Δ4-androstenedione to testosterone.ObjectiveTo evaluate the clinical presentation and management of a female patient who exhibited masculinization during puberty and assess her long-term life satisfaction during follow-up.MethodsA female patient who exhibited masculinization during puberty underwent comprehensive endocrinological and genetic assessments. Subsequently, she underwent sex reassignment surgery and follow-up investigation.ResultsHormonal findings showed a baseline testosterone/androstenedione ratio of 1.77, which decreased to 1.32 after human chorionic gonadotropin stimulation; these findings are atypical for the diagnosis. Subsequently, compound heterozygous mutation p.I60 T(c.179T > C) and exon 1 deletion were identified. After extensive counseling, the patient's parents decided to reverse the patient's sex to male. Orchidopexy and two-stage urethroplasty were performed; histological evaluation demonstrated no malignancies of the testicular tissue. Follow-up after 1 year indicated that the patient was satisfied with their sex assignment.ConclusionsThe management of pediatric patients with rare 17β-HSD3 deficiency remains challenging. For patients diagnosed early, premature removal of the gonads is not recommended as the risk of malignancy is very low. Any decision must be carefully discussed within a multidisciplinary disorders of sex development team, together with the patient and their parents. Long-term follow-up is required to assess the impact of the chosen option on future quality of life.
Totally implantable venous access port implantation in a breast cancer patient with situs inversus totalis: A case report.
Shao X, Xu D, Chen W … +2 more , Pang L, Huang J
J Int Med Res · 2026 Jul · PMID 42390137 · Full text
Situs inversus totalis, a rare congenital condition characterized by complete mirror-image transposition of the thoracic and abdominal organs, has not previously been reported in patients with breast cancer. A 60-year-ol...
Situs inversus totalis, a rare congenital condition characterized by complete mirror-image transposition of the thoracic and abdominal organs, has not previously been reported in patients with breast cancer. A 60-year-old woman with a 5-year history of left breast nodules was admitted. Contrast-enhanced breast magnetic resonance imaging and abdominal ultrasound revealed mirror-image transposition of the thoracic and abdominal organs. The patient was diagnosed with left breast cancer concomitant with situs inversus totalis. Preimplantation computed tomography revealed that the left internal jugular vein followed a straighter course to the right atrium than the right internal jugular vein. Under ultrasound guidance, a totally implantable venous access port was successfully placed via the left internal jugular vein. Neoadjuvant taxotere adriblastina cyclophosphamide chemotherapy was subsequently administered through the totally implantable venous access port before the patient underwent modified radical mastectomy for left breast cancer. Given the mirror-image anatomy, the anatomically relocated left internal jugular vein should be preferentially selected for totally implantable venous access port placement because of its more favorable anatomical course compared with the right internal jugular vein. To the best of our knowledge, this is the first reported case of totally implantable venous access port implantation in a patient with breast cancer and concurrent situs inversus totalis.
An adaptive attention U-network for recognizing ultrasound images.
Jin S, Duan J, Chen Z … +6 more , Chen F, Fang W, Zhou M, Wu Q, Lin L, Zou Z
J Int Med Res · 2026 Jul · PMID 42390122 · Full text
ObjectiveThe traditional method of intraspinal anesthesia relies on surface anatomical landmarks for positioning, which is associated with a low accuracy rate. In addition, the procedure remains challenging, and the iden...
ObjectiveThe traditional method of intraspinal anesthesia relies on surface anatomical landmarks for positioning, which is associated with a low accuracy rate. In addition, the procedure remains challenging, and the identification of anatomical structures is complex. This study aimed to develop an adaptive attention U-network to enhance the segmentation performance of spinal structures under ultrasound images.MethodsUltrasound videos of the spines were collected from 80 pregnant women, yielding a total of 1000 annotated images that were used to establish a novel database, spine ultrasound image dataset. Adaptive attention U-network uses the multidepth convolution kernel and adaptive local channel attention modules to effectively extract multiscale features. Subsequently, the global attention gate module and multiscale adaptive dynamic modulation were introduced to capture critical features and enhance image super-resolution performance. Comprehensive experiments were conducted on the spine ultrasound image dataset and public breast ultrasound images dataset, in which adaptive attention U-network was juxtaposed with other current medical image segmentation models using metrics including dice similarity coefficient.ResultsOn the spine ultrasound image dataset, adaptive attention U-network achieved a mean dice similarity coefficient of 0.905. In external validation using the breast ultrasound images dataset, the network's segmentation of benign tumor structures reached a dice similarity coefficient of 0.857, demonstrating superior generalization capabilities. Adaptive attention U-network demonstrated consistent segmentation stability across all tested structures.ConclusionsThe proposed adaptive attention U-network significantly enhances the segmentation accuracy for spinal anatomical structures in ultrasound images, demonstrating superior precision compared with existing methods.
Examining the state of telehealth for mental health and substance use care after the coronavirus disease 2019 pandemic: An integrative review.
Marie SE
J Int Med Res · 2026 Jul · PMID 42390108 · Full text
ObjectiveThe objective of this integrative review was to synthesize literature and provide implications for clinical practice on telehealth use among patients with serious mental illness and substance use disorders follo...
ObjectiveThe objective of this integrative review was to synthesize literature and provide implications for clinical practice on telehealth use among patients with serious mental illness and substance use disorders following the coronavirus disease 2019 pandemic.MethodsAn integrative review guided by Socio-Technical Systems Theory was applied. The PubMed, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Medline, Academic Search Complete, and Gale Health and Wellness databases were searched for publications from 1 January 2019 to 1 December 2024. Articles selected according to the established inclusion and exclusion criteria were evaluated using a rapid critical appraisal checklist developed by Fineout-Overholt and Melnyk.ResultsAmong the 172 articles reviewed, 16 peer-reviewed and 2 government publications were included. Four themes were identified: (a) treatment adherence; (b) satisfaction reported by patients and providers; (c) telehealth policy developments; and (d) access to services. Telehealth supported continuity of care, improved satisfaction, and improved access. Technological and financial barriers restricted equitable access. Policy changes enabled broader adoption; however, regulatory approaches varied across jurisdictions.ConclusionTelehealth remains an integral method for delivering mental health and substance use care following the coronavirus disease 2019 pandemic. Greater focus is needed on long-term effectiveness and limitations of telehealth.
Effects of adrenal ablation on blood pressure and target organ damage in deoxycorticosterone acetate-salt hypertensive rats.
Wan J, Luo T, Duan R … +8 more , Wang X, Yang Q, Hou J, Wang Y, Lv Y, Ran Q, Liu S, Wang P
J Int Med Res · 2026 Jul · PMID 42387328 · Full text
BackgroundPrimary aldosteronism is a common and underdiagnosed form of secondary hypertension. However, preclinical investigations of adrenal ablation as a potential therapeutic approach for primary aldosteronism treatme...
BackgroundPrimary aldosteronism is a common and underdiagnosed form of secondary hypertension. However, preclinical investigations of adrenal ablation as a potential therapeutic approach for primary aldosteronism treatment are limited.MethodsA deoxycorticosterone acetate-salt hypertensive rat model was established, and the animals were treated with either unilateral adrenal ablation or oral spironolactone for 12 weeks. Blood pressure was continuously monitored throughout the study period. The key endpoints included blood pressure regulation, circulating hormone levels, and target organ damage.ResultsAdrenal ablation markedly reduced blood pressure in deoxycorticosterone acetate-salt hypertensive rats. During the first 8 weeks of treatment, the antihypertensive effect exerted by adrenal ablation was significantly greater than that achieved using oral spironolactone. After 8 weeks, the blood pressure-lowering effects of both interventions were comparable, although each effect remained significantly lower than that in the untreated controls. Moreover, adrenal ablation was more effective than spironolactone in attenuating the target organ damage associated with deoxycorticosterone acetate-salt hypertension.ConclusionsCompared with oral spironolactone, adrenal ablation significantly lowered blood pressure and more effectively attenuated target organ damage in deoxycorticosterone acetate-salt hypertensive rats.
Regional citrate versus systemic heparin anticoagulation in continuous renal replacement therapy for sepsis-associated acute kidney injury: A retrospective cohort study of short-term outcomes.
Lan J, Mao Y, Shi C … +4 more , Chen Q, Cai S, Zhang X, Zheng C
J Int Med Res · 2026 Jun · PMID 42383899 · Full text
ObjectiveTo compare the clinical outcomes and prognosis of regional citrate anticoagulation and systemic heparin anticoagulation in patients with sepsis-associated acute kidney injury undergoing continuous renal replacem...
ObjectiveTo compare the clinical outcomes and prognosis of regional citrate anticoagulation and systemic heparin anticoagulation in patients with sepsis-associated acute kidney injury undergoing continuous renal replacement therapy.MethodsThis retrospective cohort study (2020-2024) included 168 adults with sepsis-associated acute kidney injury who received continuous renal replacement therapy at the intensive care unit of Taizhou Municipal Hospital. Kaplan-Meier curves and multivariable Cox regression were used to evaluate 14- and 28-day mortality, with subgroup analyses performed to assess effect modification.ResultsAmong 168 eligible patients, 1:1 propensity score matching yielded 42 well-balanced pairs (regional citrate anticoagulation, n = 42; systemic heparin anticoagulation, n = 42) with comparable baseline characteristics. Hospital mortality was lower with regional citrate anticoagulation (59.5%) than with systemic heparin anticoagulation (71.4%); however, the difference did not reach statistical significance ( = 0.251). The 14-day comparison demonstrated a higher survival probability with regional citrate anticoagulation (log-rank = 0.043; hazard ratio, 2.10; 95% confidence interval: 1.01-4.39), and a similar benefit persisted at 28 days (log-rank = 0.042; hazard ratio, 1.76; 95% confidence interval: 1.01-3.05). Subgroup analysis further indicated that the survival benefit of regional citrate anticoagulation on 28-day mortality was most pronounced among patients with pre-existing hypertension (hazard ratio, 2.75; 95% confidence interval: 1.32-5.71; = 0.007; interaction = 0.028).ConclusionsIn patients with sepsis-associated acute kidney injury requiring continuous renal replacement therapy, regional citrate anticoagulation may confer better short-term (14- and 28-day) survival than systemic heparin anticoagulation; however, no clear difference in overall hospital mortality was observed. This potential benefit may be more pronounced among patients with hypertension, meriting further evaluation of tailored anticoagulation approaches.
Analgesic efficacy of ilioinguinal/iliohypogastric, transversus abdominis plane, and quadratus lumborum blocks in inguinal hernia surgery: A prospective randomized controlled trial.
Savaş Özdemir M, Gültekin A, Şahin A … +1 more , Arar C
J Int Med Res · 2026 Jul · PMID 42383898 · Full text
ObjectiveThis study compared the efficacy of ilioinguinal/iliohypogastric, transversus abdominis plane, and quadratus lumborum blocks as adjuncts to spinal anesthesia for postoperative pain management in unilateral ingui...
ObjectiveThis study compared the efficacy of ilioinguinal/iliohypogastric, transversus abdominis plane, and quadratus lumborum blocks as adjuncts to spinal anesthesia for postoperative pain management in unilateral inguinal hernia repair.MethodsThis study was a prospective, randomized, controlled, single-blind study. Eighty patients were randomized into four groups: (a) ilioinguinal/iliohypogastric block group; (b) transversus abdominis plane block group; (c) quadratus lumborum block; and (d) control group. Postoperative pain was assessed using the visual analog scale at rest and during movement over 24 h. Total tramadol consumption via patient-controlled analgesia, supplemental paracetamol use, and opioid-related adverse effects were recorded.ResultsNo statistically significant differences were found in visual analog scale scores among the groups at any time point ( > 0.05). Opioid consumption ranged from 60 to 300 mg, with a mean value of 226.79 ± 49.94 mg. There was no statistically significant difference in opioid use among the groups ( = 0.930; > 0.05). The requirement for additional analgesics did not differ significantly among the groups ( = 0.389; > 0.05). The overall incidence of adverse effects (postoperative nausea and vomiting, and respiratory depression) was 11.2% ( = 9). No statistically significant differences were observed in the rate of adverse effects between the groups ( = 0.069; > 0.05).ConclusionNo statistically significant differences were observed in pain scores, opioid consumption, or adverse effects between the three block groups and the control group. There was a nonsignificant trend toward lower visual analog scale scores in the ilioinguinal/iliohypogastric group compared with the transversus abdominis plane and quadratus lumborum groups during the postoperative period. Although the total number of patients requiring additional analgesics was lower in all three block groups compared with the control group, these findings were not statistically significant.Clinical Trial NumberThis trial was retrospectively registered at clinicaltrials.gov with trial number NCT06997536.
The inflammation-nutrition axis and survival outcomes: Role of the neutrophil percentage-to-albumin ratio in patients with sleep disorders.
Wu L, Zhang X, Zhang L … +1 more , Chen S
J Int Med Res · 2026 Jun · PMID 42383754 · Full text
BackgroundThe neutrophil percentage-to-albumin ratio has shown prognostic significance across several chronic diseases; however, its relevance within the context of sleep disorders has not been investigated.MethodsThis s...
BackgroundThe neutrophil percentage-to-albumin ratio has shown prognostic significance across several chronic diseases; however, its relevance within the context of sleep disorders has not been investigated.MethodsThis study utilized data from the National Health and Nutrition Examination Survey for the years 2005-2014 to explore the connection between the neutrophil percentage-to-albumin ratio and all-cause mortality in people with sleep disorders. Mortality risk was assessed using Cox regression, and the analyses included restricted cubic spline, Kaplan-Meier survival, subgroup, and time-dependent receiver operating characteristic curve analyses.ResultsA positive correlation was identified between the neutrophil percentage-to-albumin ratio and mortality risk among individuals with sleep disorders (hazard ratio = 1.09, 95% confidence interval: 1.05, 1.14). A comparison between the highest (Q4) and lowest (Q1) quartiles revealed that patients in Q4 had an 86% higher mortality risk (hazard ratio = 1.86, 95% confidence interval: 1.31, 2.65). Subgroup analysis further confirmed consistency across different demographic and clinical strata (all for interaction > 0.05). Furthermore, the neutrophil percentage-to-albumin ratio demonstrated strong predictive performance for early mortality risk in patients with sleep disorders (1-year area under the curve = 0.751, 95% confidence interval: 0.693, 0.808).ConclusionsAmong patients diagnosed with sleep disorders, higher levels of NPAR are independently linked to an elevated risk of all-cause mortality.
Variation in the diagnosis and management of functional hypothalamic amenorrhea across clinical specialties: A nationwide cross-sectional survey in China.
Zhang Y, Guo Y, Wan C … +7 more , Liu Y, Deng Y, Xue W, Sun X, Liang W, Wang Y, Sun A
J Int Med Res · 2026 Jul · PMID 42383749 · Full text
ObjectiveTo characterize interspecialty variation and areas of consensus in the understanding and clinical management of functional hypothalamic amenorrhea among physicians from different clinical specialties in China.Me...
ObjectiveTo characterize interspecialty variation and areas of consensus in the understanding and clinical management of functional hypothalamic amenorrhea among physicians from different clinical specialties in China.MethodsWe conducted a nationwide, cross-sectional questionnaire survey of licensed physicians practicing in reproductive endocrinology, obstetrics and gynecology, and related specialties involved in functional hypothalamic amenorrhea care. The survey was administered anonymously via a national continuing medical education platform affiliated with the Peking Union Medical College Hospital Alliance between 1 November and 30 November 2025.ResultsA total of 2026 questionnaires were included in the final analysis, comprising 112 reproductive endocrinologists (5.5%), 1516 obstetricians-gynecologists (74.8%), and 398 physicians from other specialties (19.6%). Overall, only 62.7% of respondents recognized genetic susceptibility as a contributing factor to functional hypothalamic amenorrhea, and only 43.9% of respondents perceived that functional hypothalamic amenorrhea was generally diagnosed appropriately. Compared with physicians from other specialties, reproductive endocrinologists and obstetricians-gynecologists were significantly more likely to prioritize sex hormone evaluation, pelvic ultrasonography, and assessment of the thyroid and adrenal axes (all p < 0.01), whereas physicians from other specialties more frequently reported emphasizing assessments of energy metabolism (p < 0.01). Among women without fertility intentions, reproductive endocrinologists were more likely to report prioritizing elimination of precipitating factors (p < 0.05) and recommending hormone replacement and bone-targeted therapies (both p < 0.01). For women desiring pregnancy, reproductive endocrinologists were more likely to report recommending ovulation induction (p < 0.01), whereas physicians from other specialties reported greater support for the use of pulsatile gonadotropin-releasing hormone pumps (p < 0.01).ConclusionsVariations were observed in physicians' self-reported diagnostic and management approaches to functional hypothalamic amenorrhea across clinical specialties in China. These findings suggest the importance of promoting multidisciplinary consensus, developing standardized clinical pathways, and strengthening interdisciplinary collaboration to improve the quality of care for women with functional hypothalamic amenorrhea.
First population-based national eHealth system study on the prevalence of nonmalignant thyroid disorders in North Macedonia: A cross-sectional analysis.
Talevska A, Smokovski I, Chagoroska Z … +5 more , Antova E, Zottarelli L, Daniels C, Ozeryansky L, Sunil T
J Int Med Res · 2026 Jun · PMID 42383745 · Full text
ObjectiveThyroid disorders are among the most common endocrine conditions worldwide. However, in the Republic of North Macedonia, national level data on their prevalence and demographic distribution are lacking. This stu...
ObjectiveThyroid disorders are among the most common endocrine conditions worldwide. However, in the Republic of North Macedonia, national level data on their prevalence and demographic distribution are lacking. This study aimed to determine the prevalence and demographic patterns of nonmalignant thyroid disorders using data from the National eHealth System.MethodsThis retrospective, population-based cross-sectional study analyzed 269,690 anonymized records of patients diagnosed with nonmalignant thyroid disorders, derived from the National eHealth System as of 31 October 2024. Diagnoses were identified using the International Classification of Diseases, 10th Revision codes E00-E07.ResultsThe overall national prevalence of nonmalignant thyroid disorders was 14.68%. Prevalence was higher in women (24.36%) than in men (4.85%) and increased with age, with the highest prevalence of 21.9% among those aged 60-79 years. Women had significantly higher odds of thyroid disorders than men (odds ratio: 6.32; 95% confidence interval: 6.25-6.38; < 0.0001). Prevalence was higher in urban than in rural areas (17.1% vs. 10.9%). Hypothyroidism (E03) was the most common disorder, affecting 9.7% of the population.ConclusionThis is the first national level study to examine the epidemiology of nonmalignant thyroid disorders in the Republic of North Macedonia. The findings reveal marked variations in prevalence by sex, age, and place of residence, underscoring the need for targeted public health strategies and further investigation.
Nationwide trends and forecasts in Alzheimer's and cerebrovascular disease-related mortality in the United States, 1999-2023: A CDC WONDER analysis.
Hafeez AS, Mumtaz S, Kumar L … +10 more , Amir M, Maity R, Ashraf S, Khan A, Hassan M, Zaman A, Asad M, Singh P, Faisal AR, Dhali A
J Int Med Res · 2026 Jun · PMID 42378334 · Full text
ObjectiveTo describe nationwide mortality patterns related to Alzheimer's disease and cerebrovascular disease in United States adults aged ≥65 years and explore future trend projections.MethodsIn this retrospective study...
ObjectiveTo describe nationwide mortality patterns related to Alzheimer's disease and cerebrovascular disease in United States adults aged ≥65 years and explore future trend projections.MethodsIn this retrospective study, we utilized the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research database (ICD-10 G30, I60-I69) to calculate crude and age-adjusted mortality rates per 100,000 population. Temporal trends were modeled using Joinpoint regression, and 10-year forecasts were obtained using autoregressive integrated moving average models. Subgroup analyses were performed by sex, race/ethnicity, census region, urbanization, and place of death.ResultsWe identified 199,606 Alzheimer's disease-cardiovascular disease-related deaths. Overall, age-adjusted mortality rates peaked at 24.8 in 2002, reduced to 14.2 in 2013, and then rose to 18.7 in 2020 before dropping to 16.6 in 2023. Women exhibited higher age-adjusted mortality rates than men (20.1 vs. 16.0). Individuals of White and Black ethnicity bore the greatest burden, and the South and West recorded the highest regional age-adjusted mortality rates. These rates were consistently higher in non-metropolitan areas than in metropolitan areas. Exploratory projections estimate an overall age-adjusted mortality rate of 16.6 by 2033, with persistently higher rates in women, non-Hispanic Black populations, and among those residing in the West and non-metropolitan areas.ConclusionsDespite substantial decline since the early 2000s, Alzheimer's disease-cardiovascular disease mortality remains high and unevenly distributed. Exploratory projections suggest that the burden will remain substantial, underscoring the need for targeted prevention, vascular risk reduction, and equity-focused dementia care.
Feasibility and optimal imaging time window for intraperitoneal versus intravenous injection of a macrocyclic gadolinium-based contrast agent in mice.
He M, Qi H, Wang P … +4 more , Liu X, Lian J, Liu P, Shi Y
J Int Med Res · 2026 Jun · PMID 42372112 · Full text
ObjectiveThis study aimed to evaluate the feasibility of intraperitoneal injection as an alternative to the technically challenging intravenous route for contrast agent administration in murine brain magnetic resonance i...
ObjectiveThis study aimed to evaluate the feasibility of intraperitoneal injection as an alternative to the technically challenging intravenous route for contrast agent administration in murine brain magnetic resonance imaging by comparing their enhancement effects. Specifically, it sought to determine the optimal injection dose and imaging time window for administration of gadobutrol, a macrocyclic gadolinium-based contrast agent, in orthotopic glioblastoma models.MethodsThis study used an orthotopic glioblastoma model established in BALB/c nude mice (n = 24) by intracranial implantation of LN229 cells. Mice were randomized to receive gadobutrol at doses of 1 or 2 mmol/kg via both intravenous and intraperitoneal routes on separate days. Contrast-enhanced magnetic resonance imaging was performed at multiple post-injection time points. The resulting images were evaluated qualitatively by blinded neuroradiologists and quantitatively by measuring signal-to-noise ratio and contrast-to-noise ratio, with statistical comparisons made between injection methods and dosage groups.ResultsImage quality assessments revealed no significant differences in signal-to-noise ratio, contrast-to-noise ratio, or enhancement metrics between the intravenous and intraperitoneal routes. Peak enhancement occurred at 7 min following intravenous injection and 30 min following intraperitoneal injection.ConclusionsIntraperitoneal injection is a viable alternative, with scanning at 30 min recommended for optimal contrast enhancement.
Spinal extradural meningeal cysts: Long-term outcomes of a dural defect-oriented surgical strategy.
Hong JH, Jung JH, Jung JH … +2 more , Han MS, Lee JK
J Int Med Res · 2026 Jun · PMID 42372066 · Full text
Spinal extradural meningeal cysts are rare spinal lesions, and the optimal surgical strategy remains debated, particularly regarding the relative importance of complete cyst wall excision and closure of the dural communi...
Spinal extradural meningeal cysts are rare spinal lesions, and the optimal surgical strategy remains debated, particularly regarding the relative importance of complete cyst wall excision and closure of the dural communication. We retrospectively reviewed 10 patients (5 male and 5 female; mean age, 38.5 years) who underwent surgical treatment for Nabors Type IA spinal extradural meningeal cysts at a single institution between 1987 and 2023. The median symptom duration was 5.5 months. All lesions showed cerebrospinal fluid-equivalent signal intensity on magnetic resonance imaging. Surgical approaches included total or subtotal laminectomy, hemilaminectomy, and osteoplastic laminotomy. The mean clinical follow-up period was 121.6 months. Nine patients underwent partial cyst wall resection or fenestration with primary dural defect closure; among the seven patients in this group with available postoperative radiological follow-up, no radiological recurrence was observed. The single patient in whom primary dural closure was not achieved showed a persistent residual or recurrent cystic lesion on follow-up imaging but remained clinically improved. No neurological complications were observed. These findings suggest that identifying and closing the dural communication may be an important component of durable spinal extradural meningeal cyst management, whereas complete cyst wall excision may not always be necessary. Because this was a small retrospective case series with incomplete imaging follow-up in some patients, these findings should be interpreted as supportive clinical observations rather than definitive evidence of causality.
Association between serum uric acid level and cataract Arisk: A cross-sectional study based on two databases (CHARLS and NHANES).
Lumei H, Guoqing W, Xianglong Y
J Int Med Res · 2026 Jun · PMID 42371413 · Full text
ObjectiveCataracts represent the predominant cause of global blindness. Although previous research has implicated aqueous humor uric acid in cataract pathogenesis, its invasive measurement method limits clinical utility....
ObjectiveCataracts represent the predominant cause of global blindness. Although previous research has implicated aqueous humor uric acid in cataract pathogenesis, its invasive measurement method limits clinical utility. Consequently, the association between readily accessible serum uric acid levels and cataract risk remains poorly defined. This study aimed to elucidate this relationship in two large, independent populations.MethodsThis cross-sectional analysis utilized data from 11,473 participants in the China Health and Retirement Longitudinal Study (CHARLS, 2011) and 9754 participants from the National Health and Nutrition Examination Survey (NHANES, 1999-2008). Cataract status was defined by self-reported history of cataract surgery. Multivariable logistic regression analysis was employed to calculate odds ratios, using restricted cubic splines and subgroup analyses used to assess dose-response relationships and the robustness of associations.ResultsIn both cohorts, significant crude associations between higher serum uric acid and cataract prevalence were observed (CHARLS, odds ratio: 1.14, 95% confidence interval: 1.03-1.25; NHANES, odds ratio per SD: 1.23, 95% confidence interval: 1.16-1.30). However, these associations were no longer statistically significant after full adjustment for demographic, socioeconomic, and cardiometabolic covariates (CHARLS, odds ratio: 1.09, 95% confidence interval: 0.98-1.22; NHANES, odds ratio per SD: 1.05, 95% confidence interval: 0.98-1.12). Restricted cubic spline analyses confirmed no significant linear or nonlinear dose-response relationship (all > 0.05). Subgroup analyses consistently demonstrated a null association across key demographic and clinical strata.ConclusionsThis large-scale, two-country study suggests that the apparent association between serum uric acid and cataracts is not independent; it may be largely explained by confounding factors such as age, cardiometabolic diseases, and socioeconomic factors. Serum uric acid levels may not be independently associated with self-reported cataract surgery status and may have limited utility as a marker for risk assessment in population-based settings.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe