International Journal Of General Medicine[JOURNAL]
Sun
200 papers
Postoperative Neutrophil-to-Albumin Ratio as a Prognostic Marker for Patients with Bladder Cancer Undergoing Radical Cystectomy: A Retrospective Observational Cohort Study.
Li W, Xiang C, Xie G … +1 more , Zhang Y
Int J Gen Med · 2026 · PMID 41947978 · Full text
OBJECTIVE: This study aimed to investigate the prognostic value of the postoperative neutrophil-to-albumin ratio (NAR) in patients with bladder cancer undergoing radical cystectomy. PATIENTS AND METHODS: A total of 368 p...
OBJECTIVE: This study aimed to investigate the prognostic value of the postoperative neutrophil-to-albumin ratio (NAR) in patients with bladder cancer undergoing radical cystectomy. PATIENTS AND METHODS: A total of 368 patients with histologically confirmed bladder cancer who underwent radical cystectomy between January 2018 and December 2021 were retrospectively analyzed. Postoperative NAR was calculated using neutrophil count (%) and serum albumin concentration (g/L) measured approximately three months after surgery. Receiver operating characteristic analysis identified the optimal NAR cutoff value for predicting 5-year overall survival. Kaplan-Meier and Cox regression models were used to assess associations between NAR and overall survival or recurrence-free survival. RESULTS: The optimal NAR cutoff value was 2.6 with an AUC value of 0.76. Elevated NAR was significantly correlated with bladder cancer of invasive pathological types (p = 0.005), advanced tumor stage (p 0.0001), lymph-node metastasis (p = 0.002), and receipt of neoadjuvant chemotherapy (p = 0.014). Patients with elevated NAR had significantly shorter overall survival (HR=3.14; 95% CI, 1.27-6.24; p = 0.002) and recurrence-free survival (HR=3.27; 95% CI, 1.52-5.87; p = 0.001) compared with those with low NAR. In multivariate analysis, postoperative NAR (p = 0.001), tumor stage (p = 0.002), and pathological type (p = 0.013) were independent predictors of overall survival, while NAR (p = 0.002), tumor stage (p = 0.003), and lymph-node metastasis (p = 0.014) independently predicted recurrence-free survival. CONCLUSION: An increased postoperative NAR independently predicts poorer overall and recurrence-free survival of bladder cancer patients following radical cystectomy. As an inexpensive and readily available biomarker reflecting systemic inflammation and nutritional status, NAR may serve as a practical tool for postoperative risk stratification and individualized patient management.
Clinical Diagnosis and Treatment of 31 Children with Necrotizing Pneumonia.
Wang Z, Zhao Y, Liu H
Int J Gen Med · 2026 · PMID 41947977 · Full text
OBJECTIVE: This study aimed to summarize the clinical characteristics and outcomes of necrotizing pneumonia caused by in children. METHODS: The clinical features, accessory examinations, treatments, and prognoses of 31...
OBJECTIVE: This study aimed to summarize the clinical characteristics and outcomes of necrotizing pneumonia caused by in children. METHODS: The clinical features, accessory examinations, treatments, and prognoses of 31 children with M. pneumoniae necrotizing pneumonia admitted to our hospital between January 2020 and June 2023 were retrospectively analyzed. RESULTS: There were 31 patients, including 14 males and 17 females, with an average age of (6.77 ± 0.98) years. The length of hospitalization was 23.38 ± 5.56 days, with an average length of fever (22.10 ± 5.64) days. At the beginning of the disease, all patients had high fever and cough. Respiratory sounds were reduced in 29 cases, rales were audible in 13 cases, and wheezing sounds were audible in 4 cases. Pulmonary imaging revealed multiple alveolar or cavity formations in the lung consolidation areas and pleural effusion in 29 cases. The peak value of WBC in peripheral blood was (17.84 ± 3.72) × 10/L, and the proportion of neutrophils was (80.83 ± 4.19) %. C-reactive protein peak was (131.68 ± 36.47) mg/L, and D-dimer peak value was (6.79 ± 2.22) mg/L; The course of pulmonary necrosis was (11.61 ± 3.48) days. Bronchoscopy and lavage were performed on 30 patients. Two patients underwent closed thoracic drainage, and one patient underwent pulmonary lobectomy. After comprehensive treatment with macrolide antibiotics and glucocorticoids, the patient's prognosis improved. CONCLUSION: Mycoplasma pneumoniae necrotizing pneumonia is more common in preschool and school-aged children with a long heat course and hospital stay. When WBC, neutrophil ratio, D-dimer, and C-reactive protein levels increase significantly, combined with pleural effusion, CT examination of the lungs should be performed to identify M. pneumoniae necrotizing pneumonia at an early stage. Despite a long disease course, most patients have a good prognosis after active treatment.
Prognostic Nutritional Index as a Predictor of Mortality in Hospitalized Geriatric Patients with Chronic Atrial Fibrillation.
Türker F, Kula AC, Yamak M … +4 more , Karayiğit VS, Oral A, Doğan P, Türker BÇ
Int J Gen Med · 2026 · PMID 41938367 · Full text
PURPOSE: Internal medicine departments manage a broad spectrum of chronic diseases, which are frequently associated with higher mortality rates. In this context, we evaluated the relationship between the Prognostic Nutri...
PURPOSE: Internal medicine departments manage a broad spectrum of chronic diseases, which are frequently associated with higher mortality rates. In this context, we evaluated the relationship between the Prognostic Nutritional Index (PNI) and mortality in elderly inpatients with chronic atrial fibrillation (AF) admitted to an internal medicine department. PATIENTS AND METHODS: This study included 158 hospitalized patients who were followed for five years post-discharge. We compared the following variables between the survival and non-survival groups: age, sex, presence of diabetes mellitus, hypertension, coronary artery disease, anticoagulant use, Prognostic Nutritional Index (PNI) score, CHADS-VASc score, HAS-BLED score, ejection fraction (EF%), and laboratory parameters including neutrophil count, lymphocyte count, glucose, urea, alanine aminotransferase (ALT), hemoglobin, C-reactive protein (CRP), albumin, total cholesterol, thyroid-stimulating hormone (TSH), free T3, and ferritin levels. RESULTS: When compared to the surviving patients, the patients who died were older ( = 0.001) and had a lower PNI scores ( = 0.011) Moreover the patients who died also had significantly higher total cholesterol and urea, levels and significantly lower Free T3 and albumin levels. The multivariate analysis revealed that the PNI score and urea level were significant independent factors in differentiating deceased patients from survivors (p < 0.05). The PNI score demonstrated a significant effect in distinguishing between non-survivors and survivors (Area under the curve (AUC)= 0.662). CONCLUSION: The PNI score have indicated the clinical importance of as a novel marker for predicting mortality in geriatric chronic AF patients.
Factors Associated and Survival Outcomes Among Japanese Patients with Solid Cancer Who Developed Deep Vein Thrombosis (DVT).
Masuda Y, Yakushijin Y, Yamanaka S … +4 more , Hasebe S, Fujii T, Yamanouchi J, Takenaka K
Int J Gen Med · 2026 · PMID 41938366 · Full text
OBJECTIVE: Deep vein thrombosis (DVT) is a common and serious complication in patients with cancer. We retrospectively analyzed patients newly diagnosed with solid cancers in a Japanese cohort. PATIENTS OR MATERIALS: We...
OBJECTIVE: Deep vein thrombosis (DVT) is a common and serious complication in patients with cancer. We retrospectively analyzed patients newly diagnosed with solid cancers in a Japanese cohort. PATIENTS OR MATERIALS: We retrospectively reviewed the medical records (2013-2020) of Japanese patients with solid cancers who were suspected of having DVT and were diagnosed and treated at Ehime University Hospital. Controls were patients with solid cancers in whom DVT was suspected on physical examination and/or laboratory testing but subsequently ruled out by definitive imaging. Candidate risk and prognostic variables were extracted from electronic medical records. This was a single-center cohort study. RESULTS: Among the initial 1399 patients, 224 with DVT and 560 without DVT (as controls) were included in the final analysis after excluding those with incomplete medical records, missing diagnostic tests, or unclear medical histories. The median overall survival (OS) period was 5.87 years for patients with DVT and 6.81 years for patients without DVT (p=0.0014). Anemia (Hb <11 g/dl) and thrombocytopenia (Plt <15 x 104 / μL) were found to be strong risk factors related to an increased incidence of DVT. Female cancer patients with DVT had a significantly worse outcome than those without DVT (p=0.028). Analysis of OS in patients with DVT associated with gynecological cancers following treatment with three different direct oral anticoagulants (DOACs; edoxaban, rivaroxaban, and apixaban) indicated that those treated with apixaban had a significantly worse outcome than those treated with the others (p=0.019) in this Japanese cohort. CONCLUSION: Japanese patients with solid cancers, particularly those with gynecologic cancers, tend to have poorer outcomes when DVT co-occurs with anemia and low platelet counts. In addition, the choice of DOAC for DVT treatment may be associated with differences in prognosis. These exploratory findings require more detailed, adjusted analyses and confirmation using other datasets or populations.
Integrated Multi-Omics Analysis Constructs an Intratumoral Heterogeneity-Corrected Prognostic Signature for Cervical Cancer.
Tang X, Zheng Q, Li X … +1 more , Wang K
Int J Gen Med · 2026 · PMID 41938365 · Full text
INTRODUCTION: Tumor heterogeneity challenges the accuracy of existing prognostic models for cervical squamous cell carcinoma and endocervical adenocarcinoma (CESC). Prognostic models that correct for tumor heterogeneity...
INTRODUCTION: Tumor heterogeneity challenges the accuracy of existing prognostic models for cervical squamous cell carcinoma and endocervical adenocarcinoma (CESC). Prognostic models that correct for tumor heterogeneity remain unexplored. METHODS: Based on the GSE5787 dataset comprising 33 multiregional samples from 11 patients with CESC, we calculated both interpatient heterogeneity (IPH) and intratumoral heterogeneity (ITH) scores. Genes with low heterogeneity were selected to construct a prognostic model using the CESC cohort from The Cancer Genome Atlas (TCGA). Key gene expression was validated in HeLa and SiHa cell lines. The functional consequences of gene knockout were assessed through Cell Counting Kit-8 (CCK-8) proliferation assays, wound healing migration assays, and Transwell assays. RESULTS: Genes exhibiting low heterogeneity were predominantly associated with energy metabolism pathways, whereas those displaying high heterogeneity were enriched in immune-related signaling pathways. The risk score based on Armadillo Repeat Containing X-Linked 1 (ARMCX1) and Signal Transducing Adaptor Family Member 2 (STAP2) achieved area under the curve (AUC) values of 0.74, 0.68, and 0.74 for predicting 1-year, 3-year, and 5-year overall survival, respectively. Importantly, this signature demonstrated robust performance with a risk classification inconsistency rate of merely 18%, outperforming 10 previously published CESC prognostic models. The integrative nomogram incorporating both the risk score and clinical staging demonstrated enhanced prognostic accuracy. Although patients in the high-risk group exhibited diminished immunotherapy efficacy, drug sensitivity screening identified seven potentially effective therapeutic agents as alternative treatment options. In vitro experiments demonstrated that STAP2 knockdown suppressed HeLa cell proliferation, migration, and invasive capacity. CONCLUSION: This study establishes a robust gene signature through ITH correction, which may mitigate single-region sampling bias and offers a promising tool for prognostic stratification in CESC.
Analysis of Platelet Membrane Glycoproteins and The Specific Antibodies in MYH9-Related Diseases.
Wang L, Cao K, Chen S … +3 more , Fu X, Chen Y, Luo X
Int J Gen Med · 2026 · PMID 41938364 · Full text
OBJECTIVE: To comparatively analyze platelet membrane glycoprotein expression profiles and antiplatelet-specific antibody levels in patients with MYH9-related disorders (MYH9-RD) versus immune thrombocytopenia (ITP), and...
OBJECTIVE: To comparatively analyze platelet membrane glycoprotein expression profiles and antiplatelet-specific antibody levels in patients with MYH9-related disorders (MYH9-RD) versus immune thrombocytopenia (ITP), and to evaluate their potential clinical significance. METHODS: From July 2017 to June 2025, a total of 20 patients with MYH9-RD, 20 patients with ITP, and 20 healthy controls were enrolled. Platelet membrane glycoprotein expression of CD41 (GPIIb), CD42a (GPIX), CD42b (GPIb), CD61 (GPIIIa), and CD62P (GMP140), platelet-leukocyte aggregation ratios, and antiplatelet-specific antibody levels were analyzed using flow cytometry. Inter-group differences in platelet membrane glycoprotein expression were compared using the Kruskal-Wallis test. RESULTS: The MYH9-RD cohort demonstrated significantly higher median fluorescence intensity of platelet membrane glycoproteins (CD41, CD42a, CD42b, CD61, and CD62P) compared to ITP and healthy control groups ( < 0.05). Compared to ITP patients, the MYH9-RD group demonstrated significantly higher platelet-leukocyte ( = 0.020) and platelet-granulocyte aggregation ratios ( = 0.004), as quantified by flow cytometry. The identified MYH9-RD mutations were localized to both N-terminal and C-terminal regions of the NMMHC-IIA protein domain. However, no statistically significant differences in platelet membrane glycoprotein expression profiles were observed between the two groups ( > 0.05). Significant intergroup differences ( < 0.05) were observed in the detection rates of antiplatelet antibodies targeting GPIX, GPIb, GPIIb, GPIIIa, and P-selectin (GMP140) among MYH9-RD, ITP, and healthy control groups. The total antibody positivity rate in MYH9-RD patients was intermediate-significantly higher than in healthy controls ( = 0.0317) but lower than in ITP patients ( = 0.0017). CONCLUSION: Significant differences in platelet membrane glycoprotein expression profiles and antiplatelet-specific antibody levels distinguish MYH9-related disorders (MYH9-RD) from immune thrombocytopenia (ITP). These findings have important clinical implications, providing potential biomarkers for the differential diagnosis of MYH9-RD.
Predictive Value of the Combination of Lactate and qSOFA Score for Clinical Outcomes in Cirrhotic Patients with Esophagogastric Variceal Bleeding.
Li M, Geng N, Liu Z … +9 more , Pan W, Lai C, Cui Y, Miao Y, Zhu Y, Yan B, Li H, Wang J, Liu B
Int J Gen Med · 2026 · PMID 41938363 · Full text
PURPOSE: The objective of our research was to examine the predictive power of the combination of lactate and the quick Sepsis-Related Organ Failure Assessment (qSOFA) score on clinical outcomes in cirrhotic patients with...
PURPOSE: The objective of our research was to examine the predictive power of the combination of lactate and the quick Sepsis-Related Organ Failure Assessment (qSOFA) score on clinical outcomes in cirrhotic patients with EGVB. PATIENTS AND METHODS: This single-center retrospective study consecutively enrolled 547 eligible cirrhotic patients with EGVB admitted to the Emergency Department of Beijing You'an Hospital between July 2022 and November 2022. Data collected included Lactate levels, qSOFA, pre-endoscopic Rockall score (pRS), Glasgow-Blatchford score (GBS), albumin, international normalized ratio (INR), altered mental status, systolic blood pressure, age older than 65 years score (AIMS65), and age, blood tests, comorbidities scores (ABC). These variables were used to predict rebleeding, ICU-admission, and 6-week mortality. Receiver operating characteristic (ROC) curves and logistic regression analysis were used to assess the prognostic value of the scoring systems. RESULTS: Lactate and qSOFA independently predicted ICU admission and 6-week mortality (P<0.05). qSOFA alone was an independent predictor of rebleeding, but lactate was not. For rebleeding prediction, the AUC values were: pRS 0.540, GBS 0.582, AIMS65 0.519, ABC 0.510, and Lac+qSOFA 0.564. For ICU-admission, the AUC values were: pRS 0.723, GBS 0.623, AIMS65 0.787, ABC 0.760, and Lac+qSOFA 0.808. For 6-week mortality, the AUC values were: pRS 0.759, GBS 0.715, AIMS65 0.817, ABC 0.834, and Lac+qSOFA 0.818. The combination of lactate and qSOFA showed better predictive performance for ICU admission and 6-week mortality than for rebleeding. CONCLUSION: Although the combination of lactate and qSOFA offers limited utility for predicting rebleeding, it is a robust predictor of ICU admission and 6-week mortality in cirrhotic patients with EGVB. Its simplicity and rapid availability make it a highly practical tool for emergency triage in this high-risk population.
Inhibitory Mechanism of Buyang Huanwu Decoction on AGE/RAGE Pathway in Membranous Nephropathy: Integration of Network Pharmacology and Cell Model Validation.
Fu L, Zhang N, Chen X … +2 more , Xu X, Shen Y
Int J Gen Med · 2026 · PMID 41926526 · Full text
PURPOSE: The Buyang Huanwu Decoction (BYHWD) has demonstrated therapeutic potential in renal-related disorders; however, its pharmacological mechanisms are still poorly understood. Therefore, the aim of this study was to...
PURPOSE: The Buyang Huanwu Decoction (BYHWD) has demonstrated therapeutic potential in renal-related disorders; however, its pharmacological mechanisms are still poorly understood. Therefore, the aim of this study was to elucidate the regulatory mechanisms of BYHWD in membranous nephropathy (MN). METHODS: Network pharmacology was used to identify BYHWD-related target genes for MN. Enrichment analyses were conducted to determine the relevant biological functions and signaling pathways. An integrated "compound-target-pathway" interaction network was established. The binding affinities between the active compounds and target proteins were determined via molecular docking. Two podocyte injury models were established using zymosan-activated serum (ZAS)-induced MPC-5 cells and Angiotensin II (Ang II)-induced AB8/13 cells. Cell viability was assessed using the Cell Counting Kit-8 (CCK-8) assay. ELISA was used to quantify the levels of pro-inflammatory cytokines, membrane attack complexes (MAC, C5b-9), and advanced glycation end products (AGE), while Western blotting was performed to determine receptor for advanced glycation end products (RAGE) protein expression. RESULTS: BYHWD shared 230 genes with the MN-related targets. GO analysis indicated its involvement in regulating cell proliferation, apoptosis, and inflammation. KEGG analysis highlighted the modulation of the AGE-RAGE signaling pathway. IL-1β showed the highest diagnostic value in the machine learning analysis. Molecular docking revealed stable interactions between key compounds (myristic acid, stigmasterol, quercetin, and β-sitosterol) and target proteins. Both ZAS and Ang II inhibited podocyte proliferation and increased the levels of pro-inflammatory cytokines and C5b-9, whereas BYHWD reversed these effects. It also suppressed AGE and RAGE expression, and these effects were counteracted by pathway agonists. CONCLUSION: BYHWD may improve podocyte injury by inhibiting AGE/RAGE and suppressing inflammatory responses and complement activation, providing a preliminary basis for its clinical application.
Refractive Errors and Ocular Biometric Parameters in Children with Autism Spectrum Disorder in Handan: A Cross-Sectional Study.
Cheng Y, Wang J, Liu M … +9 more , Guo D, Yan J, Bai L, Guo K, Wei J, Zhang Y, Yang K, Guo Y, Zhang W
Int J Gen Med · 2026 · PMID 41924538 · Full text
PURPOSE: To investigate the differences in refractive status between children with autism spectrum disorders (ASD) and normal children, as well as the differences in the development of ocular characteristic parameters su...
PURPOSE: To investigate the differences in refractive status between children with autism spectrum disorders (ASD) and normal children, as well as the differences in the development of ocular characteristic parameters such as axial length(AL), in order to provide some help for eye care and subsequent rehabilitation in this group. PATIENTS AND METHODS: This cross-sectional study enrolled 95 children aged 4-12 years with ASD from the Handan region of China, along with 96 matched control children. All participants underwent non-cycloplegic ocular refraction and ocular biometric parameter measurements, aiming to explore the association between ASD and ocular refractive errors as well as ocular biometric parameters. RESULTS: Children with ASD exhibited significantly higher hyperopia, Spherical equivalent (SE: ASD 0.00 ±1.30 DS vs control -0.50 ±1.80 DS, p < 0.01), Cylinder (CYL: ASD -0.75 ±1.50DC vs control -0.50 ±0.50 DC, p < 0.01), shallower Anterior Chamber Depth (ACD) (ASD 2.93 ±0.26 vs control 3.03 ±0.34, p < 0.05) compared to controls. SE was negatively correlated with AL. The axial length-to-crane ratio (AL/CR), ACD, and vitreous thickness (VT) were positively correlated with lens thickness (LT) (p <0.05). Logistic regression analysis demonstrated that SE, CYL, AL/CR, and ACD were associated with ASD (all p-values <0.05). The random forest model indicated that SE (25.5%) and ACD (25.3%) were the primary predictors of ASD. CONCLUSION: The detection of ocular biological characteristic parameters has significant guiding significance for correcting refractive errors in children with ASD. Moreover, the combined diagnosis of SE, CYL, AL/CR, and may help identify children who may benefit from further ASD assessment. However, the predictive utility of these parameters requires validation in prospective, larger-scale studies.
Echocardiographic Risk Factors for Atrial Fibrillation Recurrence Following Radiofrequency Catheter Ablation: A Retrospective Analysis.
He H, Yuan S, He S
Int J Gen Med · 2026 · PMID 41924537 · Full text
OBJECTIVE: To assess the value of pre-procedural echocardiography (ECHO) parameters for predicting recurrence following radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF) and develop a predictive model....
OBJECTIVE: To assess the value of pre-procedural echocardiography (ECHO) parameters for predicting recurrence following radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF) and develop a predictive model. METHODS: In this retrospective study of 103 AF patients undergoing first-time RFCA, pre-ablation ECHO parameters were analyzed. The primary endpoint was AF recurrence after 3-month "blanking period". Independent predictors were identified employing univariate and Firth-penalized multivariate logistic regression. Model performance was evaluated via ROC curve analysis, Bootstrap validation, calibration curves, and decision curve analysis (DCA). A predictive nomogram was generated based on the final model. RESULTS: AF recurrence occurred in 32 patients (31.1%). Univariate analysis revealed that the recurrence group exhibited remarkably greater left atrial diameter (LAD), left atrial volume index (LAVI), mitral inflow early diastolic velocity (E-wave), E/A ratio, and E/e' ratio, while the average early diastolic mitral annular tissue velocity (e') was significantly lower (all < 0.05). Multivariate analysis identified LAVI and the E/e' ratio as independent risk factors (OR = 1.154, 95% CI: 1.057-1.260, = 0.001; OR = 2.545, 95% CI: 1.344-4.821, = 0.004, respectively). The AUC was 0.722 for LAVI and 0.764 for the E/e' ratio. The combined predictive model incorporating both parameters yielded an AUC of 0.809 (95% CI: 0.726-0.891), and demonstrated robust internal validation, good calibration, and positive clinical net benefit on DCA. CONCLUSION: Pre-procedural LAVI and E/e' ratio are independent predictors of AF recurrence post-RFCA. The combined model demonstrates promising predictive performance, warranting further external validation before clinical application.
Novel Clinically Validated Machine Learning Model for Early Pregnancy Loss in Recurrent Spontaneous Abortion: Integrating Serum Autoantibodies and Ultrasonic Parameters.
Li J, Yang Y, Li T … +2 more , Sun B, Zhang Y
Int J Gen Med · 2026 · PMID 41924536 · Full text
OBJECTIVE: To explore the correlation between autoantibodies, ultrasonic endometrial receptivity parameters and early miscarriage in recurrent spontaneous abortion (RSA) patients during subsequent pregnancies, and to est...
OBJECTIVE: To explore the correlation between autoantibodies, ultrasonic endometrial receptivity parameters and early miscarriage in recurrent spontaneous abortion (RSA) patients during subsequent pregnancies, and to establish and validate a predictive model for early miscarriage. METHODS: A retrospective analysis was conducted on RSA patients who visited Xi'an People's Hospital from January 2019 to December 2024. Patients were randomly divided into a training set (70%, n=412) and a validation set (30%, n=177). Baseline data, serum autoantibodies (anti-β2-glycoprotein 1 antibody [aβ2-GP1], thyroglobulin antibody [TgAb], anti-sperm antibody [AsAb], anti-cardiolipin antibody [ACA]) and ultrasonic parameters (resistance index [RI], endometrial thickness, endometrial volume, vascularization index [VI], vascularization flow index [VFI]) were collected. Multiple machine learning models (logistic regression [LR], XGBoost, random forest, etc.) were developed. Model performance was evaluated using area under the receiver operating characteristic curve (AUC), accuracy, and other metrics. A nomogram was constructed based on the optimal model. RESULTS: The abortion subgroup had significantly higher positive rates of aβ2-GP1, TgAb, ACA and RI, but lower endometrial thickness, endometrial volume, VI and VFI than the normal subgroup (all P<0.05). Eight variables (aβ2-GP1, TgAb, AsAb, RI, endometrial thickness, endometrial volume, VI, VFI) were identified as candidate predictors. The LR model was optimal, with AUC=0.94 and accuracy=0.93 in the training set, and AUC=0.92 and accuracy=0.90 in the validation set. The nomogram based on this model showed good alignment between predicted probabilities and actual outcomes. CONCLUSION: A practical and accurate LR model for predicting early miscarriage in RSA patients was established using autoantibodies and ultrasonic parameters. It can assist in clinical risk stratification and individualized intervention. Future multicenter prospective studies with larger samples and more variables are needed to optimize the model.
Prevalence of and Factors Associated with Cognitive Impairment Among Adults in Central Sudan: A Community-Based Cross-Sectional Study.
Omar SM, Alwabili AA, Alotaibi EA … +1 more , Adam I
Int J Gen Med · 2026 · PMID 41924535 · Full text
BACKGROUND: Cognitive impairment is a major global public health challenge; however, data from sub-Saharan Africa, particularly Sudan, remain scarce. This study investigated the prevalence of cognitive impairment and the...
BACKGROUND: Cognitive impairment is a major global public health challenge; however, data from sub-Saharan Africa, particularly Sudan, remain scarce. This study investigated the prevalence of cognitive impairment and the factors associated with it among adults in East Gezira, central Sudan. METHODS: This community-based cross-sectional study was conducted from April to June 2025. Using multistage stratified random sampling, 336 adults aged ≥18 years were recruited. Cognitive status was assessed using the Montreal Cognitive Assessment (MoCA), with a score of <26 indicating cognitive impairment. Depression and anxiety were assessed using the Patient Health Questionnaire (PHQ-9) and the General Anxiety Disorder (GAD-7) scales, respectively. Multivariable binary logistic regression was used to identify independent factors associated with cognitive impairment. RESULTS: Of the 336 adults, 227 (67.6%) were men and 109 (32.4%) were women. Their median (interquartile range) age and body mass index were 42.0 (30.0‒55.0) years and 22.6 (19.3‒27.0) kg/m, respectively. The overall prevalence of cognitive impairment (MoCA score <26) was 73.5%. The prevalence of mild, moderate, and severe cognitive impairment was 51.5%, 21.7%, and 0.3%, respectively. In multivariate binary analysis, factors independently associated with cognitive impairment were older age (adjusted odds ratio [AOR], 1.02; 95% confidence interval [CI]: 1.004-1.05), low education level (AOR: 5.22; 95% CI: 2.70-10.09), unemployment (AOR: 2.46; 95% CI: 1.03-5.91), and depression (AOR: 2.98; 95% CI: 1.30-6.83). CONCLUSION: The prevalence of cognitive impairment in this central Sudan community is remarkably high. Age, low education, unemployment, and depression are significant risk factors. These findings underscore the urgent need for public health interventions to detect and manage cognitive impairment early in this population.
Digital Geriatric Medical Care in the Era of Big Data: A Narrative Review and Case Study of a Chinese Aged Care Facility.
Zhao R, Zhang Q, Sun H … +4 more , Zhang Y, Mao Y, An Z, Zhu K
Int J Gen Med · 2026 · PMID 41924534 · Full text
OBJECTIVE: This study aims to explore the development prospects and trends of digital geriatric medical care in the era of big data. By taking the Longhu Ecological Senior Apartment in Bengbu City as a case example, the...
OBJECTIVE: This study aims to explore the development prospects and trends of digital geriatric medical care in the era of big data. By taking the Longhu Ecological Senior Apartment in Bengbu City as a case example, the study examines the integration of intelligent healthcare systems for elderly populations and proposes solutions to bridge the digital divide, ensuring accessible healthcare for seniors in the context of rapid technological advancements. METHODS: This study employed a mixed-methods approach, combining a review of national policies and global practices with an in-depth case study at the Longhu Ecological Senior Apartment in Bengbu City. Quantitative data on residents' demographics, health status, and technology adoption were collected from institutional records. Qualitative insights were obtained through semi-structured interviews with administrative staff and caregivers. Data were analyzed using descriptive statistics and thematic analysis. RESULTS: More than 95% of the residents suffered from chronic illnesses, and 73.30% were aged 80 years or above. Despite the availability of smart medical devices, 48.80% of residents reported difficulty in using digital tools due to insufficient technological literacy, and 46.30% were unaware of product functions. Economic burden and safety concerns further hindered acceptance. The gap between the rapid growth of digital health services and seniors' limited ability to engage created a pronounced digital divide. CONCLUSION: To cope with the growing elderly population, digital healthcare must be further developed and tailored to meet the specific needs of the elderly. Bridging the digital divide through user-friendly technologies and policy support is crucial. The integration of 5G, telemedicine, and virtual reality holds great potential for improving elderly healthcare services, but a coordinated effort from the government, healthcare providers, and technology developers is necessary for sustainable and effective implementation.
Public Knowledge and Acceptance of Artificial Intelligence-Assisted Physicians in Saudi Arabia: A Cross-Sectional Study.
Alhindi Y, Almoqati H, Alsaadi R … +12 more , Alabbas LM, Alhuzali M, Alamoudi R, Khawaji H, Alharbi AA, Fallatah A, Muharrij A, Alluhaybi MB, Alotaibi WS, Alahmadi B, Alqurashi N, Fairaq A
Int J Gen Med · 2026 · PMID 41919063 · Full text
BACKGROUND: Artificial intelligence (AI) technologies are increasingly integrated into healthcare systems worldwide. However, successful implementation depends largely on public trust and acceptance. Limited evidence is...
BACKGROUND: Artificial intelligence (AI) technologies are increasingly integrated into healthcare systems worldwide. However, successful implementation depends largely on public trust and acceptance. Limited evidence is available regarding public perceptions of AI-based medical consultation in Saudi Arabia. OBJECTIVE: This study aimed to assess public knowledge and acceptance of artificial intelligence doctors as a partial alternative to human physicians in Saudi Arabia and identify demographic factors influencing these perceptions. METHODS: A cross-sectional online survey was conducted among members of the general public in Saudi Arabia. The questionnaire assessed demographic characteristics, awareness of AI technologies, knowledge of AI healthcare applications, perceptions of AI doctors, and willingness to use AI-assisted medical consultation. Descriptive statistics were used to summarize responses, and Chi-square tests were performed to examine associations between demographic factors and participants' acceptance levels. RESULTS: A total of 303 participants completed the survey. Most respondents reported prior awareness of artificial intelligence applications in healthcare. However, acceptance of AI as a partial substitute for human physicians remained cautious. Participants acknowledged potential benefits such as efficiency and diagnostic support but expressed concerns regarding trust, reliability, and ethical considerations. CONCLUSION: While awareness of AI technologies in healthcare appears relatively widespread among the Saudi public, acceptance of AI-based medical consultation remains moderate. Educational initiatives and transparent regulatory frameworks may enhance public trust and facilitate responsible integration of AI technologies into healthcare systems.
Correlation Between T1 Rho Value of Magnetic Resonance and Clinical Characteristics of Patients with Knee Osteoarthritis and Analysis of Related Factors of T1 Rho Value [Letter].
Kocak S
Int J Gen Med · 2026 · PMID 41919062 · Full text
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Pathophysiology of Cerebral Microbleeds in Patients with Severe Respiratory Failure and Acute Respiratory Distress Syndrome: A Scoping Review.
Ziaka M, Zagalioti SC, Zgouridou A … +2 more , Fyntanidou B, Exadaktylos A
Int J Gen Med · 2026 · PMID 41919061 · Full text
Cerebral microbleeds (CMBs) are increasingly identified in critically ill patients with severe respiratory failure and acute respiratory distress syndrome (ARDS). This scoping review aims to systematically examine the ex...
Cerebral microbleeds (CMBs) are increasingly identified in critically ill patients with severe respiratory failure and acute respiratory distress syndrome (ARDS). This scoping review aims to systematically examine the existing literature to explore the mechanisms contributing to the development of CMBs in ARDS and to summarize current evidence on CMBs associated with severe respiratory failure. We conducted a comprehensive search across two databases, PubMed and CENTRAL, and relevant study registries (PROSPERO and Clinicaltrials.gov), between February 1 and March 3, 2025. Eligible studies included those reporting on the presence of CMBs in adult patients with severe respiratory failure or ARDS, regardless of whether mechanical ventilation (MV) was used. Eighteen observational studies involving critically ill patients with respiratory failure or ARDS were included, with sample sizes ranging from 9 to 214 patients. The proposed pathophysiological mechanisms for the development of CMBs include hypoxaemia and inflammation leading to endothelial injury and blood-brain barrier (BBB) dysfunction, cerebral hypoperfusion facilitating interaction between coronavirus disease 2019 (COVID-19) and angiotensin-converting enzyme 2 (ACE2) receptors, microangiopathy with the formation of diffuse microthrombi, and renal failure contributing to uraemia-associated BBB disruption. CMBs were predominantly localized in the corpus callosum and juxtacortical white matter. The majority of patients with CMBs were mechanically ventilated and experienced a prolonged duration of ventilation. Identified risk factors for CMBs development included greater disease severity, coagulation abnormalities, and renal dysfunction. In conclusion, CMBs are increasingly recognized in critically ill patients with ARDS, particularly in the corpus callosum and juxtacortical white matter, but current evidence is associative rather than causal. Their pathophysiology likely involves compromised small vessel integrity due to hypoxia-induced endothelial injury, inflammation, and possible direct viral effects on cerebral microvasculature. These mechanisms are further exacerbated by coagulation abnormalities and disruption of the BBB.
Interleukin-Mediated Inflammatory Pathways and Nerve Injury in Lumbar Disc Herniation: A Narrative Review.
Wang D, Zhao D, Li X
Int J Gen Med · 2026 · PMID 41919060 · Full text
OBJECTIVE: This is a narrative review aimed to explore the molecular biosciences mechanisms by which interleukin (IL) networks and inflammatory pathways mediate nerve injury in lumbar disc herniation (LDH), providing tra...
OBJECTIVE: This is a narrative review aimed to explore the molecular biosciences mechanisms by which interleukin (IL) networks and inflammatory pathways mediate nerve injury in lumbar disc herniation (LDH), providing translational insights for therapy. METHODS: We screened PubMed and Embase databases from January 2010 to January 2026 to search for published studies. The search keywords used are as follows: ["lumbar disc herniation" or "LDH"], [" interleukin" or "IL" or "Interleukin Network"], ["Nerve Injury"], ["Inflammatory"]. A total of 196 peer-reviewed studies were included, comprising 152 experimental studies (128 animal models, 24 in vitro cell experiments) and 44 human clinical studies, with a human-to-animal study ratio of approximately 1:2.9. RESULTS: Preclinical mechanistic studies indicate that pro-inflammatory interleukins such as IL-1β, IL-6 and IL-17 lead to nerve root demyelination, axonal degeneration and neuropathic pain by activating NLRP3, JAK-STAT3 and p38MAPK pathways. Anti-inflammatory interleukins including IL-4 and IL-10 produce neuroprotective effects through inducing M2 macrophage polarization. Clinical evidence shows that interleukin levels are related to the severity of radicular pain and neurological deficits. Targeted biologics, TCM and acupuncture can regulate interleukin signaling to relieve symptoms. This review is structured with a three-part framework that includes interleukin characteristics and inflammatory signaling in LDH, interleukin-mediated mechanisms of nerve injury and translational interventions as well as clinical challenges. CONCLUSION: In the future, it can be transformed into clinical practice of LDH through the development of targeted biologics, the combination of standardized traditional Chinese and Western medicine protocols, and the evaluation of biomarkers based on interleukin.
Prognosis Impact of Betel Nut on Oral Squamous Cell Carcinoma: A Population-Based Study.
Zhang T, Hu X, Zeng L … +2 more , Huang S, Su T
Int J Gen Med · 2026 · PMID 41919059 · Full text
PURPOSE: The prognostic impact of betel nut on oral squamous cell carcinoma (OSCC) remains controversial. This study aimed to determine whether betel nut chewing is an independent prognostic factor in patients treated wi...
PURPOSE: The prognostic impact of betel nut on oral squamous cell carcinoma (OSCC) remains controversial. This study aimed to determine whether betel nut chewing is an independent prognostic factor in patients treated with standardized surgery. METHODS: This retrospective population-based cohort study enrolled 1113 patients with primary OSCC, including 922 betel nut chewers and 191 non-chewers. All patients underwent standardized surgical treatment. The prognostic impact of betel nut chewing was evaluated by returning to all patients and comparing the disease-free survival times between the two groups. The Chi-square test was used to explore the clinical characteristics associated with betel nut chewing. Kaplan-Meier survival analysis, univariable Cox regression, and multivariable Cox regression analyses were used to investigate the prognostic impact of betel nut. RESULTS: No significant difference was observed in the disease-free survival time between chewers and non-chewers in either the overall group or subgroup analyses. Univariable Cox regression analysis indicated that betel nut use was not a prognostic factor. After adjusting for potential confounders, multivariable Cox regression confirmed that cervical lymph node metastasis, clinical stage, and pathological grade were independent risk factors for prognosis, whereas betel nut use had no significant impact on prognosis. CONCLUSION: These findings suggest that the prognosis of OSCC is dictated by the biological stage of the tumor rather than betel nut use. This allows clinicians to develop more objective, precise treatment plans for OSCC patients.
Gut-Brain Axis Dysregulation in Inflammatory Bowel Disease: Implications for Coagulation Abnormalities and Extraintestinal Manifestations.
Lu P, Liu M, Zhang L … +6 more , Fan JJ, Han G, Hou B, Meng Y, Wang L, Sun Y
Int J Gen Med · 2026 · PMID 41913906 · Full text
Inflammatory bowel disease (IBD) involves chronic intestinal inflammation driven by gut-brain axis imbalance, fostering complications through an "inflammation-neuro-coagulation" triad. Current staging systems inadequatel...
Inflammatory bowel disease (IBD) involves chronic intestinal inflammation driven by gut-brain axis imbalance, fostering complications through an "inflammation-neuro-coagulation" triad. Current staging systems inadequately capture the dynamics of this multidimensional network. Therefore, integrated multi-omics analyses-including metagenomics, metabolomics, and single-cell transcriptomics-are essential to construct dynamic models that monitor coagulation, microbiome, and metabolism for precise assessment of disease activity and thrombotic or bleeding risks. Interventions targeting gut-brain axis nodes, such as eliminating tissue factor-positive (TF⁺) T cells or modulating vagal activity, show potential to disrupt the inflammation-coagulation cycle, although rigorous randomized trials are still needed. Artificial intelligence (AI)-assisted systems that integrate real-time biomarker monitoring with multi-omics predictions represent a novel paradigm for managing IBD-related coagulation dysfunction. Key challenges include elucidating gut-brain-liver axis regulation of coagulation and characterizing platelet functional heterogeneity. Future efforts must prioritize ethically compliant multi-omics platforms and racially stratified risk models to advance personalized coagulation management in IBD.
The New Era of Precision Oncology. Practicing Pathology in Low Resource Countries and Settings.
Ahmad Z, Rahim S, Zubair M … +1 more , Abdul-Ghafar J
Int J Gen Med · 2026 · PMID 41913905 · Full text
Personalized or precision medicine is the future of cancer treatment modalities. It is advancing at a rapid pace and transforming the practice of oncology. Personalized oncology demands personalized (precision) pathology...
Personalized or precision medicine is the future of cancer treatment modalities. It is advancing at a rapid pace and transforming the practice of oncology. Personalized oncology demands personalized (precision) pathology. New biomarkers are continuously being discovered, and there is increasing emphasis on individualized care. The primary aim of oncology in the new era is to utilize the molecular characteristics of malignant tumors to design the best and most optimal treatment for each cancer patient. Molecular diagnostics is the cornerstone of precision oncology. Pathology always had a crucial and major role in cancer care encompassing all aspects of oncology and this role is becoming even more critical. It is expanding and transforming into an even more dynamic specialty. Pathologists in developing countries and low resource settings need to understand these changes, take up the new challenges and opportunities, and modify their practice accordingly not only in order to remain relevant, but even more importantly to embrace a more central and vital role in cancer care. They need to embrace molecular technologies like next-generation sequencing (NGS) and familiarize themselves with new and emerging molecular biomarkers, and how these help in deciding the best targeted therapy for individual cancer patients. They also need to incorporate digital pathology (DP) and artificial intelligence (AI) in their routine practice. Herein, we present our views and perspective regarding opportunities and challenges for pathologists in the era of "precision oncology".
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