Colorectal cancer (CRC) is often diagnosed at advanced stages due to the lack of early symptoms. Conventional screening methods have limitations in sensitivity and patient compliance. Tumor biomarkers may provide a less invasive and more accurate diagnostic approach.
Methods
This retrospective study analyzed serum levels of serum amyloid A (SAA), macrophage inhibitory cytokine-1 (MIC-1), carcinoembryonic antigen (CEA), and carbohydrate antigen 125 (CA125) in 186 patients with CRC and 180 healthy controls recruited between December 2022 and June 2024. Differences in biomarker levels between groups were assessed using the Mann–Whitney U test. Associations with TNM stage, pathological grade, and lymph node metastasis were evaluated using Spearman’s correlation analysis. Diagnostic performance was determined by constructing receiver operating characteristic (ROC) curves.
Results
CRC patients showed significantly higher serum levels of SAA, MIC-1, CEA, and CA125 compared with controls (all p < 0.001). Biomarker levels were positively correlated with each other and significantly associated with TNM stage, pathological grade, and lymph node metastasis. ROC analysis revealed AUC values of 0.76 (SAA), 0.74 (MIC-1), 0.81 (CEA), and 0.78 (CA125). The combined biomarker panel achieved an AUC of 0.96 (95% CI: 0.94–0.98; p < 0.001), with 90.9% sensitivity and 90.6% specificity, significantly outperforming individual markers.
Conclusion
Serum SAA, MIC-1, CEA, and CA125 are significantly elevated in CRC and correlate with tumor stage and metastasis. Their combined assessment provides superior diagnostic accuracy and may serve as a valuable noninvasive tool for CRC screening.
{"title":"The Diagnostic Value of Colorectal Cancer Using SAA, MIC-1, CEA, and CA125","authors":"Keming Zhang, Zengyao Li, Ye Zhang, Mengchen Xing","doi":"10.1155/ijcp/7007528","DOIUrl":"https://doi.org/10.1155/ijcp/7007528","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Colorectal cancer (CRC) is often diagnosed at advanced stages due to the lack of early symptoms. Conventional screening methods have limitations in sensitivity and patient compliance. Tumor biomarkers may provide a less invasive and more accurate diagnostic approach.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study analyzed serum levels of serum amyloid A (SAA), macrophage inhibitory cytokine-1 (MIC-1), carcinoembryonic antigen (CEA), and carbohydrate antigen 125 (CA125) in 186 patients with CRC and 180 healthy controls recruited between December 2022 and June 2024. Differences in biomarker levels between groups were assessed using the Mann–Whitney <i>U</i> test. Associations with TNM stage, pathological grade, and lymph node metastasis were evaluated using Spearman’s correlation analysis. Diagnostic performance was determined by constructing receiver operating characteristic (ROC) curves.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>CRC patients showed significantly higher serum levels of SAA, MIC-1, CEA, and CA125 compared with controls (all <i>p</i> < 0.001). Biomarker levels were positively correlated with each other and significantly associated with TNM stage, pathological grade, and lymph node metastasis. ROC analysis revealed AUC values of 0.76 (SAA), 0.74 (MIC-1), 0.81 (CEA), and 0.78 (CA125). The combined biomarker panel achieved an AUC of 0.96 (95% CI: 0.94–0.98; <i>p</i> < 0.001), with 90.9% sensitivity and 90.6% specificity, significantly outperforming individual markers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Serum SAA, MIC-1, CEA, and CA125 are significantly elevated in CRC and correlate with tumor stage and metastasis. Their combined assessment provides superior diagnostic accuracy and may serve as a valuable noninvasive tool for CRC screening.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2026 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/7007528","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145963806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Like Zheng, Shumin Yu, Cong Liao, Gang Xiao, Qiaoyan Dai, Qidong Ye
Background
Mycoplasma pneumoniae pneumonia, primarily caused by Mycoplasma pneumoniae, poses a significant burden on pediatric respiratory health, with macrolide-resistant strains complicating treatment. With macrolide resistance on the rise, alternative treatment options are imperative. Doxycycline has emerged as a promising alternative due to its broad-spectrum efficacy and favorable safety profile. However, the clinical scenarios for its administration, particularly in macrolide-resistant Mycoplasma pneumoniae pneumonia in children, have not been extensively explored.
Methods
Clinical data of 129 pediatric patients with macrolide-resistant Mycoplasma pneumoniae pneumonia were retrospectively analyzed. Drug sensitivity testing was performed for one group to confirm the absence of doxycycline resistance, while the other group switched to doxycycline after unsatisfactory effects of macrolide therapy. Clinical response, laboratory parameters, treatment-emergent adverse events, and cytokine levels were compared between the groups.
Results
The group that switched to doxycycline after drug sensitivity testing had notably shorter fever resolution time (3.65 ± 1.24 vs. 3.06 ± 1.15 days), cough relief time (4.82 ± 1.45 vs. 4.13 ± 1.36 days), and a higher chest X-ray improvement percentage (80.15 ± 5.48% vs. 81.95 ± 4.52%) compared to the unsatisfactory curative effect group. Baseline laboratory parameters, treatment-emergent adverse events, and baseline cytokine levels showed no significant differences. However, posttreatment, significant differences were observed in IL-8 (42.16 ± 7.89 vs. 38.83 ± 7.61 pg/mL), IL-10 (19.35 ± 3.21 vs. 18.14 ± 3.37 pg/mL), and SAA (31.14 ± 5.67 vs. 29.26 ± 3.22 mg/L) between the two groups.
Conclusion
Early doxycycline use, particularly after drug sensitivity testing, demonstrated potential clinical efficacy in the treatment of macrolide-resistant Mycoplasma pneumoniae pneumonia in children.
肺炎支原体肺炎主要由肺炎支原体引起，对儿童呼吸道健康造成重大负担，大环内酯耐药菌株使治疗复杂化。随着大环内酯类药物耐药性的上升，替代治疗方案势在必行。强力霉素由于其广谱疗效和良好的安全性，已成为一种有前途的替代品。然而，其给药的临床情况，特别是在儿童大环内酯耐药肺炎支原体肺炎中，尚未得到广泛的探讨。方法回顾性分析129例小儿大环内酯耐药肺炎支原体肺炎的临床资料。其中一组进行药敏试验，确认无强力霉素耐药，另一组在大环内酯类药物治疗效果不理想后改用强力霉素。比较两组之间的临床反应、实验室参数、治疗后出现的不良事件和细胞因子水平。结果药敏试验后改用多西环素组发热消退时间（3.65±1.24∶3.06±1.15）、止咳时间（4.82±1.45∶4.13±1.36）明显短于疗效不佳组，胸片改善率（80.15±5.48%∶81.95±4.52%）明显高于疗效不佳组。基线实验室参数、治疗出现的不良事件和基线细胞因子水平没有显着差异。治疗后，两组患者IL-8（42.16±7.89 vs. 38.83±7.61 pg/mL）、IL-10（19.35±3.21 vs. 18.14±3.37 pg/mL）、SAA（31.14±5.67 vs. 29.26±3.22 mg/L）差异有统计学意义。结论早期应用强力霉素，特别是在药敏试验后，对儿童大环内酯耐药肺炎支原体肺炎具有潜在的临床疗效。
{"title":"Effectiveness of Early Doxycycline Intervention in Treating Macrolide-Resistant Mycoplasma pneumoniae Pneumonia in Pediatric Patients","authors":"Like Zheng, Shumin Yu, Cong Liao, Gang Xiao, Qiaoyan Dai, Qidong Ye","doi":"10.1155/ijcp/6990995","DOIUrl":"https://doi.org/10.1155/ijcp/6990995","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p><i>Mycoplasma pneumoniae</i> pneumonia, primarily caused by <i>Mycoplasma pneumoniae</i>, poses a significant burden on pediatric respiratory health, with macrolide-resistant strains complicating treatment. With macrolide resistance on the rise, alternative treatment options are imperative. Doxycycline has emerged as a promising alternative due to its broad-spectrum efficacy and favorable safety profile. However, the clinical scenarios for its administration, particularly in macrolide-resistant <i>Mycoplasma pneumoniae</i> pneumonia in children, have not been extensively explored.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Clinical data of 129 pediatric patients with macrolide-resistant <i>Mycoplasma pneumoniae</i> pneumonia were retrospectively analyzed. Drug sensitivity testing was performed for one group to confirm the absence of doxycycline resistance, while the other group switched to doxycycline after unsatisfactory effects of macrolide therapy. Clinical response, laboratory parameters, treatment-emergent adverse events, and cytokine levels were compared between the groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The group that switched to doxycycline after drug sensitivity testing had notably shorter fever resolution time (3.65 ± 1.24 vs. 3.06 ± 1.15 days), cough relief time (4.82 ± 1.45 vs. 4.13 ± 1.36 days), and a higher chest X-ray improvement percentage (80.15 ± 5.48% vs. 81.95 ± 4.52%) compared to the unsatisfactory curative effect group. Baseline laboratory parameters, treatment-emergent adverse events, and baseline cytokine levels showed no significant differences. However, posttreatment, significant differences were observed in IL-8 (42.16 ± 7.89 vs. 38.83 ± 7.61 pg/mL), IL-10 (19.35 ± 3.21 vs. 18.14 ± 3.37 pg/mL), and SAA (31.14 ± 5.67 vs. 29.26 ± 3.22 mg/L) between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Early doxycycline use, particularly after drug sensitivity testing, demonstrated potential clinical efficacy in the treatment of macrolide-resistant <i>Mycoplasma pneumoniae</i> pneumonia in children.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2026 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/6990995","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145963805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lumbar disc herniation (LDH) is a prevalent degenerative condition of the spine. This study aimed to explore the relationship between LDH and circadian rhythm (CR) disorders.
Materials and Methods
This single-center retrospective study included all patients presenting with LDH between April 2023 and April 2025. CR disorders were evaluated using the Chinese version of the Biological Rhythms Interview of Assessment in Neuropsychiatry (C-BRIAN) scale. The severity of intervertebral disc degeneration was graded according to the Pfirrmann classification system based on magnetic resonance imaging. Serum concentrations of interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hs-CRP) were quantified as inflammatory biomarkers. Low back pain intensity was assessed with the Visual Analog Scale (VAS), while the resultant functional disability was determined using the Oswestry Disability Index (ODI).
Results
A total of 140 patients were included in the final analysis. The analysis revealed that higher Pfirrmann grades were strongly associated with elevated C-BRIAN scores (p < 0.001), indicating concurrent disruptions across sleep, activity, social, and dietary domains. This relationship was quantified by a significant positive correlation (r = 0.663, p < 0.01), and linear regression confirmed Pfirrmann grade as a significant predictor of C-BRIAN scores (b = 4.120, p < 0.01). Furthermore, C-BRIAN scores showed significant positive correlations with serum levels of IL-6 (r = 0.593, p < 0.01) and hs-CRP (r = 0.631, p < 0.01).
Conclusion
CR disorders are prevalent among patients with LDH and are positively correlated with the severity of disc degeneration. CR disorders are linked to elevated levels of the inflammatory markers IL-6 and hs-CRP.
目的腰椎间盘突出症是一种常见的脊柱退行性疾病。本研究旨在探讨LDH与昼夜节律（CR）障碍的关系。材料和方法本单中心回顾性研究纳入了2023年4月至2025年4月期间出现LDH的所有患者。采用中文版神经精神病学生物节律访谈量表（C-BRIAN）对CR障碍进行评估。根据磁共振成像的Pfirrmann分级系统对椎间盘退变的严重程度进行分级。血清白细胞介素-6 （IL-6）和高敏c反应蛋白（hs-CRP）浓度被量化为炎症生物标志物。采用视觉模拟评分法（VAS）评估腰痛强度，采用Oswestry残疾指数（ODI）评估功能性残疾。结果共纳入140例患者。分析显示，较高的Pfirrmann评分与较高的C-BRIAN评分密切相关（p < 0.001），表明睡眠、活动、社交和饮食领域同时存在干扰。这种关系被量化为显著的正相关（r = 0.663, p < 0.01），线性回归证实Pfirrmann等级是C-BRIAN评分的显著预测因子（b = 4.120, p < 0.01）。C-BRIAN评分与血清IL-6 （r = 0.593, p < 0.01）、hs-CRP （r = 0.631, p < 0.01）水平呈显著正相关。结论LDH患者中CR障碍普遍存在，且与椎间盘退变严重程度呈正相关。CR疾病与炎症标志物IL-6和hs-CRP水平升高有关。
{"title":"Circadian Rhythm Disorders in Elderly Patients With Lumbar Disc Herniation and Their Association With Serum Inflammatory Factors: A Retrospective Study","authors":"Ruya Li, Zhengbo Wang, Tianyou Zhang, Yongxin Ren","doi":"10.1155/ijcp/8737409","DOIUrl":"https://doi.org/10.1155/ijcp/8737409","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Lumbar disc herniation (LDH) is a prevalent degenerative condition of the spine. This study aimed to explore the relationship between LDH and circadian rhythm (CR) disorders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This single-center retrospective study included all patients presenting with LDH between April 2023 and April 2025. CR disorders were evaluated using the Chinese version of the Biological Rhythms Interview of Assessment in Neuropsychiatry (C-BRIAN) scale. The severity of intervertebral disc degeneration was graded according to the Pfirrmann classification system based on magnetic resonance imaging. Serum concentrations of interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hs-CRP) were quantified as inflammatory biomarkers. Low back pain intensity was assessed with the Visual Analog Scale (VAS), while the resultant functional disability was determined using the Oswestry Disability Index (ODI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 140 patients were included in the final analysis. The analysis revealed that higher Pfirrmann grades were strongly associated with elevated C-BRIAN scores (<i>p</i> < 0.001), indicating concurrent disruptions across sleep, activity, social, and dietary domains. This relationship was quantified by a significant positive correlation (<i>r</i> = 0.663, <i>p</i> < 0.01), and linear regression confirmed Pfirrmann grade as a significant predictor of C-BRIAN scores (<i>b</i> = 4.120, <i>p</i> < 0.01). Furthermore, C-BRIAN scores showed significant positive correlations with serum levels of IL-6 (<i>r</i> = 0.593, <i>p</i> < 0.01) and hs-CRP (<i>r</i> = 0.631, <i>p</i> < 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>CR disorders are prevalent among patients with LDH and are positively correlated with the severity of disc degeneration. CR disorders are linked to elevated levels of the inflammatory markers IL-6 and hs-CRP.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2026 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/8737409","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145983444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xingyu Fang, Haonan Bai, Zhanhong Cao, Dianyu Li, Yu An, Xiaohui Zhao, Nan Chen
Pulmonary fibrosis is a significant lung injury caused by multiple factors that profoundly affect the human quality of life. Currently, various animal models are used to understand the aetiology of pulmonary fibrosis and develop treatments. However, only pharmacogenetic models of pulmonary fibrosis have been discussed, and there have been no reviews of drug treatments. This study reviewed research articles as of August 2023 in major literature databases outlining different techniques for animal modelling of pulmonary fibrosis, including pharmacogenetic and nonpharmacogenetic approaches. Additionally, treatment approaches from both Western and traditional Chinese medicine are discussed. Study results show that along with commonly recognised medications such as pirfenidone and nintedanib, many traditional Chinese remedies and natural products, such as resveratrol and Qingfei Paidu, also offer preventative and therapeutic effects against pulmonary fibrosis.
{"title":"Animal Models and Treatment of Pulmonary Fibrosis: Pharmacogenetic and Nonpharmacogenetic","authors":"Xingyu Fang, Haonan Bai, Zhanhong Cao, Dianyu Li, Yu An, Xiaohui Zhao, Nan Chen","doi":"10.1155/ijcp/4075978","DOIUrl":"https://doi.org/10.1155/ijcp/4075978","url":null,"abstract":"<p>Pulmonary fibrosis is a significant lung injury caused by multiple factors that profoundly affect the human quality of life. Currently, various animal models are used to understand the aetiology of pulmonary fibrosis and develop treatments. However, only pharmacogenetic models of pulmonary fibrosis have been discussed, and there have been no reviews of drug treatments. This study reviewed research articles as of August 2023 in major literature databases outlining different techniques for animal modelling of pulmonary fibrosis, including pharmacogenetic and nonpharmacogenetic approaches. Additionally, treatment approaches from both Western and traditional Chinese medicine are discussed. Study results show that along with commonly recognised medications such as pirfenidone and nintedanib, many traditional Chinese remedies and natural products, such as resveratrol and Qingfei Paidu, also offer preventative and therapeutic effects against pulmonary fibrosis.</p>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2026 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/4075978","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145963867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
More evidence is required to determine the physical therapists’ perception and knowledge about clinical practice guidelines (CPGs).
Objectives
The main purpose of this study is to explore the physical therapists’ knowledge, attitude, and practice toward CPGs in Saudi Arabia.
Methods
A cross-sectional study was conducted among 115 physical therapists in Saudi Arabia. Data were collected through a self-administered electronic survey to assess the association between participants’ demographic and work data with CPG familiarity and evidence-based practice (EBP) understanding. Data were analyzed using descriptive statistics and multivariable ordinal logistic regression.
Results
The study revealed that 81.7% of the participants indicated familiarity with CPG, with 94% having received prior education on the topic, mostly through 29% of postgraduate studies. About 50% of the participants reported that they always use CPGs when relevant. Participants who had a higher educational level showed more positive attitudes and greater levels of familiarity with CPG and EBP. Regarding the barriers of applying CPG recommendations, the highest two barriers were lack of time (63.5%) and work-limited resources (57.5%).
Conclusion
Despite familiarity and positive attitudes toward CPGs, adherence among physical therapists in Saudi Arabia was limited due to barriers such as lack of time, resources, and insufficient training.
{"title":"Knowledge, Attitude, and Practice Related to Clinical Practice Guidelines Among Physical Therapists","authors":"Muataz Almaddah, Afnan Gmmash, Samiah Alqabbani, Mashael Alsobhi","doi":"10.1155/ijcp/4032737","DOIUrl":"https://doi.org/10.1155/ijcp/4032737","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>More evidence is required to determine the physical therapists’ perception and knowledge about clinical practice guidelines (CPGs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The main purpose of this study is to explore the physical therapists’ knowledge, attitude, and practice toward CPGs in Saudi Arabia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional study was conducted among 115 physical therapists in Saudi Arabia. Data were collected through a self-administered electronic survey to assess the association between participants’ demographic and work data with CPG familiarity and evidence-based practice (EBP) understanding. Data were analyzed using descriptive statistics and multivariable ordinal logistic regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study revealed that 81.7% of the participants indicated familiarity with CPG, with 94% having received prior education on the topic, mostly through 29% of postgraduate studies. About 50% of the participants reported that they always use CPGs when relevant. Participants who had a higher educational level showed more positive attitudes and greater levels of familiarity with CPG and EBP. Regarding the barriers of applying CPG recommendations, the highest two barriers were lack of time (63.5%) and work-limited resources (57.5%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Despite familiarity and positive attitudes toward CPGs, adherence among physical therapists in Saudi Arabia was limited due to barriers such as lack of time, resources, and insufficient training.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2026 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/4032737","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Although several algorithms have been proposed to predict individual warfarin doses, the relationships between the international normalized ratio (INR) and cumulative warfarin dose remain to be determined.
Objectives
The aim of this study was to explore the correlation between the INR and the cumulative dosage of warfarin within a week in patients who have undergone mechanical heart valve replacement.
Methods
A retrospective study was conducted at the First Affiliated Hospital of Shantou University Medical College in southern China. Fifty-two patients who underwent mechanical heart valve replacement between January 2016 and December 2022 were included. The daily warfarin dose, cumulative dosage of warfarin within a week, and INR value were recorded. A simple linear regression model was used to analyze the correlation between the INR and cumulative warfarin dosage within a week.
Results
Of the 52 patients who underwent mechanical heart valve replacement, 19 were male, and 33 were female. Twenty-three and 18 patients had undergone mitral valve replacement and aortic valve replacement, respectively. Eleven patients underwent both mitral and aortic valve replacement. There was a strong linear correlation in 35 patients (67.31%), with a correlation coefficient (adjusted R2 ≥ 0.7) identified between the INR and the cumulative dosage of warfarin within a week. The patients with weak correlations (adjusted R2 < 0.7) were more likely to be female and have lower left ventricular ejection fractions, fewer days and lower cumulative warfarin doses at the first time of therapeutic INR. Multivariate logistic regression analysis revealed that none of these factors significantly affected the relationship between the INR and cumulative warfarin dose.
Conclusion
Our study revealed a strong linear correlation between the INR and the cumulative dosage of warfarin within a week in most patients with mechanical prosthetic heart valves.
{"title":"Association Between the INR and Warfarin Dose in Patients With Mechanical Prosthetic Heart Valves","authors":"Jing Cao, Shan Zou, Xiaoqing Dai, Wan Lin, Zhengyu Lin, Xinyin Xie, Hui Zeng, Xuanyan Zhong, Hongjuan Chen, Xiaoli Ou, Min Yu","doi":"10.1155/ijcp/5428329","DOIUrl":"https://doi.org/10.1155/ijcp/5428329","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Although several algorithms have been proposed to predict individual warfarin doses, the relationships between the international normalized ratio (INR) and cumulative warfarin dose remain to be determined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The aim of this study was to explore the correlation between the INR and the cumulative dosage of warfarin within a week in patients who have undergone mechanical heart valve replacement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective study was conducted at the First Affiliated Hospital of Shantou University Medical College in southern China. Fifty-two patients who underwent mechanical heart valve replacement between January 2016 and December 2022 were included. The daily warfarin dose, cumulative dosage of warfarin within a week, and INR value were recorded. A simple linear regression model was used to analyze the correlation between the INR and cumulative warfarin dosage within a week.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 52 patients who underwent mechanical heart valve replacement, 19 were male, and 33 were female. Twenty-three and 18 patients had undergone mitral valve replacement and aortic valve replacement, respectively. Eleven patients underwent both mitral and aortic valve replacement. There was a strong linear correlation in 35 patients (67.31%), with a correlation coefficient (adjusted <i>R</i><sup>2</sup> ≥ 0.7) identified between the INR and the cumulative dosage of warfarin within a week. The patients with weak correlations (adjusted <i>R</i><sup>2</sup> < 0.7) were more likely to be female and have lower left ventricular ejection fractions, fewer days and lower cumulative warfarin doses at the first time of therapeutic INR. Multivariate logistic regression analysis revealed that none of these factors significantly affected the relationship between the INR and cumulative warfarin dose.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our study revealed a strong linear correlation between the INR and the cumulative dosage of warfarin within a week in most patients with mechanical prosthetic heart valves.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/5428329","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145905172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chronic kidney disease (CKD) affects approximately 850 million people worldwide, with limited therapeutic options. Plasma proteins, as major sources of therapeutic targets, may play a significant role in the pathophysiology of CKD.
Objective
This study aims to evaluate the causal relationship between 4907 plasma proteins and CKD using bidirectional Mendelian randomization (MR) to identify potential therapeutic targets.
Methods
The bidirectional MR study utilized genetic data from a genome-wide association study (GWAS) involving 10,039 CKD cases and 396,706 controls from the Finnish database. Plasma protein data were obtained from a GWAS summary of 35,559 healthy participants. The causal relationship was primarily investigated using the inverse-variance weighted method, supplemented by MR-Egger, weighted median, and weighted mode analyses. Heterogeneity of the results was assessed using Cochran’s Q test. Horizontal pleiotropy was evaluated by the MR-Egger intercept test and the MR Pleiotropy RESidual Sum and Outlier (MR-PRESSO) test. Sensitivity analysis was performed using leave-one-out analysis.
Results
MR analysis revealed that several plasma proteins are directly causally related to CKD. Increased levels of nine plasma proteins, including CHCHD10, NBR1, SLC5A5, TOM1L1, PSME1, IL23R, CRYZL1, HERC5, and RARRES1, were associated with increased CKD risk. Conversely, elevated levels of three proteins, UCMA, FTMT, and H6PD, were associated with reduced CKD risk, with FTMT and H6PD showing particularly strong associations. Reverse MR analysis demonstrated that CKD itself does not exert a direct causal effect on the levels of these proteins. Functional enrichment and gene interaction network analyses further revealed the potential roles of these proteins in the pathophysiological processes.
Conclusion
These findings confirmed the causal relationships between specific plasma proteins and CKD and excluded a causal effect of CKD on the levels of these proteins, providing new targets for early prevention and treatment of the disease.
{"title":"Exploring the Causal Relationship Between Plasma Proteins and Chronic Kidney Disease: A Bidirectional Mendelian Randomization Study","authors":"Minghui Li, Haiyan Xian, Haiming Wen, Fei Lin","doi":"10.1155/ijcp/1620972","DOIUrl":"https://doi.org/10.1155/ijcp/1620972","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Chronic kidney disease (CKD) affects approximately 850 million people worldwide, with limited therapeutic options. Plasma proteins, as major sources of therapeutic targets, may play a significant role in the pathophysiology of CKD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aims to evaluate the causal relationship between 4907 plasma proteins and CKD using bidirectional Mendelian randomization (MR) to identify potential therapeutic targets.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The bidirectional MR study utilized genetic data from a genome-wide association study (GWAS) involving 10,039 CKD cases and 396,706 controls from the Finnish database. Plasma protein data were obtained from a GWAS summary of 35,559 healthy participants. The causal relationship was primarily investigated using the inverse-variance weighted method, supplemented by MR-Egger, weighted median, and weighted mode analyses. Heterogeneity of the results was assessed using Cochran’s <i>Q</i> test. Horizontal pleiotropy was evaluated by the MR-Egger intercept test and the MR Pleiotropy RESidual Sum and Outlier (MR-PRESSO) test. Sensitivity analysis was performed using leave-one-out analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>MR analysis revealed that several plasma proteins are directly causally related to CKD. Increased levels of nine plasma proteins, including CHCHD10, NBR1, SLC5A5, TOM1L1, PSME1, IL23R, CRYZL1, HERC5, and RARRES1, were associated with increased CKD risk. Conversely, elevated levels of three proteins, UCMA, FTMT, and H6PD, were associated with reduced CKD risk, with FTMT and H6PD showing particularly strong associations. Reverse MR analysis demonstrated that CKD itself does not exert a direct causal effect on the levels of these proteins. Functional enrichment and gene interaction network analyses further revealed the potential roles of these proteins in the pathophysiological processes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These findings confirmed the causal relationships between specific plasma proteins and CKD and excluded a causal effect of CKD on the levels of these proteins, providing new targets for early prevention and treatment of the disease.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/1620972","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145905167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fabiana Nery Ribeiro Oliveira, Fernando de Aguiar Lemos, Thaís Ferreira Lopes Diniz Maia, Maria Deborah Monteiro de Albuquerque, Armèle Dornelas de Andrade, Paulo André Freire Magalhães
Objective
To examine the association between cough peak flow (CPF) and dysphagia risk in patients with acute brain injury.
Design
Observational, analytical, cross-sectional study.
Setting
A university hospital located in the northeastern region of Brazil.
Participants
A sample of 108 adult patients diagnosed with acute brain injury (stroke or traumatic brain injury) was examined. The mean age of the participants was 53.4 ± 15.2 years, with 64% of the subjects being male. The patient’s swallowing assessments and CPF measurements were obtained during the patient’s stay in the hospital.
Main Outcome Measures
The severity of dysphagia risk was evaluated through the implementation of a bedside clinical swallowing protocol. The measurement of CPF was conducted by means of a portable peak expiratory flow meter. Logistic regression and receiver operating characteristic (ROC) curve analyses with bootstrap resampling were used to analyze the relationship between CPF and dysphagia risk. Additionally, secondary associations with age and body mass index were examined using the Spearman rank correlation test.
Results
Dysphagia risk was identified in 44% of patients. A cutoff value of 202 L/min on the CPF predicted dysphagia risk with 82% sensitivity and 83% specificity. A lack of statistically significant disparities in CPF was observed across different lesion types. The present study demonstrated a strong negative correlation between CPF and dysphagia risk (ρ = −0.791, p < 0.001).
Conclusions
The CPF demonstrated high sensitivity and specificity in identifying patients at dysphagia risk following acute brain injury. Its ease of use and noninvasive nature make it a promising adjunctive screening tool for clinical swallowing evaluations.
目的探讨急性脑损伤患者咳嗽峰流量（CPF）与吞咽困难的关系。设计观察性、分析性、横断面研究。位于巴西东北部地区的一所大学医院。研究了108例诊断为急性脑损伤（中风或创伤性脑损伤）的成年患者。参与者的平均年龄为53.4±15.2岁，男性占64%。患者在住院期间进行吞咽评估和CPF测量。主要观察指标：通过床边临床吞咽方案的实施评估吞咽困难风险的严重程度。CPF的测定采用便携式呼气峰流量仪。采用Logistic回归和自举重采样的受试者工作特征（ROC）曲线分析CPF与吞咽困难风险的关系。此外，使用Spearman秩相关检验检验年龄和体重指数的二级关联。结果44%的患者存在吞咽困难风险。CPF的临界值为202 L/min，预测吞咽困难风险的敏感性为82%，特异性为83%。在不同的病变类型中观察到CPF缺乏统计学上的显著差异。本研究显示CPF与吞咽困难风险之间存在很强的负相关（ρ = - 0.791, p < 0.001）。结论CPF对急性脑损伤后吞咽困难患者具有较高的敏感性和特异性。它的易用性和无创性使其成为临床吞咽评估的一个很有前途的辅助筛查工具。
{"title":"Does Cough Peak Flow Hold the Key to Safer Swallowing Assessments in Acute Brain Injury?","authors":"Fabiana Nery Ribeiro Oliveira, Fernando de Aguiar Lemos, Thaís Ferreira Lopes Diniz Maia, Maria Deborah Monteiro de Albuquerque, Armèle Dornelas de Andrade, Paulo André Freire Magalhães","doi":"10.1155/ijcp/6032315","DOIUrl":"https://doi.org/10.1155/ijcp/6032315","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To examine the association between cough peak flow (CPF) and dysphagia risk in patients with acute brain injury.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Observational, analytical, cross-sectional study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>A university hospital located in the northeastern region of Brazil.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>A sample of 108 adult patients diagnosed with acute brain injury (stroke or traumatic brain injury) was examined. The mean age of the participants was 53.4 ± 15.2 years, with 64% of the subjects being male. The patient’s swallowing assessments and CPF measurements were obtained during the patient’s stay in the hospital.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>The severity of dysphagia risk was evaluated through the implementation of a bedside clinical swallowing protocol. The measurement of CPF was conducted by means of a portable peak expiratory flow meter. Logistic regression and receiver operating characteristic (ROC) curve analyses with bootstrap resampling were used to analyze the relationship between CPF and dysphagia risk. Additionally, secondary associations with age and body mass index were examined using the Spearman rank correlation test.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Dysphagia risk was identified in 44% of patients. A cutoff value of 202 L/min on the CPF predicted dysphagia risk with 82% sensitivity and 83% specificity. A lack of statistically significant disparities in CPF was observed across different lesion types. The present study demonstrated a strong negative correlation between CPF and dysphagia risk (<i>ρ</i> = −0.791, <i>p</i> < 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The CPF demonstrated high sensitivity and specificity in identifying patients at dysphagia risk following acute brain injury. Its ease of use and noninvasive nature make it a promising adjunctive screening tool for clinical swallowing evaluations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/6032315","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145887682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Silvia M. Pol, Victoria M. Link, Heidi Toivonen, Floortje E. Scheepers, Constance H. C. Drossaert
<div> <section> <h3> Objective</h3> <p>Narrative interventions show promise in reducing trauma symptoms, self-stigma, and depression. However, a systematic review of various narrative approaches for a broad range of mental health conditions is missing. This study explores the characteristics, effectiveness, and experiences of participants and counselors in existing narrative interventions for people with mental disorders, including personality disorders.</p> </section> <section> <h3> Method</h3> <p>This mixed-methods systematic review searched PsychINFO, PubMed, Scopus, Web of Science, and Ovid Embase, including forward and backward citations, for studies published up to December 22, 2023. Included were peer-reviewed, empirical research articles (quantitative and qualitative), written in English, about life stories or self-defining memories, and targeting people with psychopathology. Excluded were interventions focusing solely on mental flourishing, cognition, autobiographical memories, children, and people with dementia. Two researchers independently selected studies and assessed evidence quality using the Mixed-Methods Appraisal Tool. Metasynthesis integrated quantitative effects and qualitative evaluations by participants and counselors. This study is registered on PROSPERO (2024 CRD42024526703).</p> </section> <section> <h3> Results</h3> <p>Of 1451 records identified, 36 studies met the inclusion criteria, all with low to moderate overall bias. Most studies were published between 2004 and 2024, mainly in the last decade, and focused on various mental disorders. Interventions were categorized into four types: Narrative Exposure Therapy (14 studies), Narrative Enhancement and Cognitive Therapy (5 studies), Reminiscence therapies (8 studies), and other narrative interventions (9 studies). Interventions targeted individuals and groups, consisting of 1–20 sessions. Symptoms related to trauma, depression, anxiety, and self-stigma were consistently reduced, while positive mental health aspects were less frequently assessed. Qualitative synthesis revealed three themes: appreciation of interventions, changes in identity, and changes in recovery. There was minimal overlap between quantitative and qualitative outcomes; aspects of high interest to participants were often not reflected in outcome measurements.</p> </section> <section> <h3> Conclusion</h3> <p>Narrative interventions offer a promising and innovative approach to treating mental disorders, effectively improving psychopathological symptoms with small to large effect sizes. Positive and process-related outcom
目的叙事性干预在减少创伤症状、自我耻辱和抑郁方面显示出希望。然而，对各种叙事方法对广泛的精神健康状况的系统审查是缺失的。本研究探讨了现有精神障碍（包括人格障碍）患者叙事干预的特点、有效性和参与者和咨询师的经验。方法采用混合方法进行系统评价，检索PsychINFO、PubMed、Scopus、Web of Science和Ovid Embase，检索截止到2023年12月22日发表的研究，包括前向和后向引文。其中包括同行评议的实证研究文章（定量和定性），用英语写的，关于生活故事或自我定义的记忆，目标人群是精神病理患者。排除了仅关注精神发育、认知、自传式记忆、儿童和痴呆症患者的干预措施。两名研究人员独立选择研究并使用混合方法评估工具评估证据质量。统合综合了参与者和咨询师的定量效果和定性评价。本研究已在PROSPERO注册（2024 CRD42024526703）。结果在1451份文献中，36项研究符合纳入标准，均为低至中等偏倚。大多数研究发表于2004年至2024年之间，主要是在过去十年，重点关注各种精神障碍。干预措施分为四类：叙事暴露疗法（14项研究）、叙事强化与认知疗法（5项研究）、回忆疗法（8项研究）和其他叙事干预（9项研究）。干预措施针对个人和群体，由1-20次会议组成。与创伤、抑郁、焦虑和自我耻辱相关的症状持续减少，而积极的心理健康方面的评估频率较低。定性综合揭示了三个主题：干预措施的欣赏，身份的变化和恢复的变化。定量和定性结果之间的重叠很少；参与者高度感兴趣的方面往往没有反映在结果测量中。结论叙事性干预是治疗精神障碍的一种有前景的创新方法，可有效改善精神病理症状，效果大小不等。积极的和过程相关的结果较少被测量，并且在显著性上有所不同。未来的研究应该持续评估积极的结果，如身份、恢复、生活意义、自尊、希望和生活质量，以及精神病理结果，为叙事干预的有效性提供更广泛的证据。
{"title":"Narrative Interventions for Persons With Mental Disorders Including Personality Disorders: A Mixed-Methods Systematic Review","authors":"Silvia M. Pol, Victoria M. Link, Heidi Toivonen, Floortje E. Scheepers, Constance H. C. Drossaert","doi":"10.1155/ijcp/5023850","DOIUrl":"https://doi.org/10.1155/ijcp/5023850","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Narrative interventions show promise in reducing trauma symptoms, self-stigma, and depression. However, a systematic review of various narrative approaches for a broad range of mental health conditions is missing. This study explores the characteristics, effectiveness, and experiences of participants and counselors in existing narrative interventions for people with mental disorders, including personality disorders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>This mixed-methods systematic review searched PsychINFO, PubMed, Scopus, Web of Science, and Ovid Embase, including forward and backward citations, for studies published up to December 22, 2023. Included were peer-reviewed, empirical research articles (quantitative and qualitative), written in English, about life stories or self-defining memories, and targeting people with psychopathology. Excluded were interventions focusing solely on mental flourishing, cognition, autobiographical memories, children, and people with dementia. Two researchers independently selected studies and assessed evidence quality using the Mixed-Methods Appraisal Tool. Metasynthesis integrated quantitative effects and qualitative evaluations by participants and counselors. This study is registered on PROSPERO (2024 CRD42024526703).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 1451 records identified, 36 studies met the inclusion criteria, all with low to moderate overall bias. Most studies were published between 2004 and 2024, mainly in the last decade, and focused on various mental disorders. Interventions were categorized into four types: Narrative Exposure Therapy (14 studies), Narrative Enhancement and Cognitive Therapy (5 studies), Reminiscence therapies (8 studies), and other narrative interventions (9 studies). Interventions targeted individuals and groups, consisting of 1–20 sessions. Symptoms related to trauma, depression, anxiety, and self-stigma were consistently reduced, while positive mental health aspects were less frequently assessed. Qualitative synthesis revealed three themes: appreciation of interventions, changes in identity, and changes in recovery. There was minimal overlap between quantitative and qualitative outcomes; aspects of high interest to participants were often not reflected in outcome measurements.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Narrative interventions offer a promising and innovative approach to treating mental disorders, effectively improving psychopathological symptoms with small to large effect sizes. Positive and process-related outcom","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/5023850","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145887697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hou Huang, Jiaming Yu, Xianlong Li, Ming Ling, Chaobao Zhang, Yongqian Fan
Background
Osteoporosis is a foremost public health challenge, especially with the global aging population. Both frailty and osteoporosis share many risk factors, although the relationship between them remains partially explored. This study aims to explore the correlation between varying frailty statuses and osteoporosis incidence.
Methods
Participants from the 2017–2018 NHANES were classified into three groups: frailty, prefrailty, and robust, based on the frailty phenotype. The correlation between frailty and osteoporosis prevalence was assessed using weighted multivariate logistic regression models. Causal relationship was verified by Mendelian randomization using frailty data from the U.K. Biobank and osteoporosis data from the FinnGen database. Proteomic analysis including associated protein screening and functional enrichments was performed based on data from the Icelandic cohort.
Results
The study group comprised 1814 participants. An increased incidence of osteoporosis was observed in older age and lower body mass index populations. A significant frailty–osteoporosis correlation (odds ratio [OR]: 1.37; 95% confidence interval [CI]: 1.14–1.64; p = 0.001) was indicated both in the crude model and after adjustments (OR: 1.23; 95% CI: 1.01–1.51; p = 0.039). The inverse variance weighting method observed a potential effect of frailty on osteoporosis risk (β/SE, 0.209/0.099; OR: 1.233; 95% CI: 1.014–1.499; p = 0.036). Thirteen frailty–osteoporosis-associated proteins were found, and proteomic enrichment indicated oxidative stress-related pathways as a hypothesis-generating mechanism of frailty-mediated osteoporosis.
Conclusions
Our findings suggest a potential causal association between frailty and osteoporosis, with risk exacerbating with the progression of frailty severity. Frailty potentially impacts the progression of osteoporosis through response to oxidative stress.
骨质疏松症是一个重要的公共卫生挑战，特别是随着全球人口老龄化。虚弱和骨质疏松都有许多共同的危险因素，尽管它们之间的关系仍有待部分探索。本研究旨在探讨不同虚弱状态与骨质疏松发病率之间的关系。方法根据脆弱表型，将2017-2018年NHANES的参与者分为虚弱、脆弱和健壮三组。使用加权多变量logistic回归模型评估虚弱和骨质疏松患病率之间的相关性。因果关系通过孟德尔随机化验证，使用来自英国生物银行的脆弱性数据和来自FinnGen数据库的骨质疏松症数据。蛋白质组学分析，包括相关蛋白质筛选和功能富集，基于冰岛队列的数据进行。结果研究组共纳入1814名受试者。骨质疏松症的发病率在老年和低体重指数人群中增加。在原始模型和调整后的模型中，虚弱与骨质疏松均存在显著相关性（优势比[OR]: 1.37； 95%可信区间[CI]: 1.14-1.64; p = 0.001） （OR: 1.23; 95% CI: 1.01-1.51; p = 0.039）。反方差加权法观察到虚弱对骨质疏松风险的潜在影响（β/SE, 0.209/0.099; OR: 1.233; 95% CI: 1.014-1.499; p = 0.036）。13个脆弱骨质疏松相关蛋白被发现，蛋白质组学富集表明氧化应激相关途径是脆弱介导的骨质疏松的假设产生机制。结论：我们的研究结果表明，虚弱和骨质疏松之间存在潜在的因果关系，并且随着虚弱严重程度的进展，风险加剧。虚弱可能通过对氧化应激的反应影响骨质疏松症的进展。
{"title":"Frailty Promotes Osteoporosis Development via Oxidative Stress: Evidence From Multicohort and Proteomic Analyses","authors":"Hou Huang, Jiaming Yu, Xianlong Li, Ming Ling, Chaobao Zhang, Yongqian Fan","doi":"10.1155/ijcp/6662987","DOIUrl":"https://doi.org/10.1155/ijcp/6662987","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Osteoporosis is a foremost public health challenge, especially with the global aging population. Both frailty and osteoporosis share many risk factors, although the relationship between them remains partially explored. This study aims to explore the correlation between varying frailty statuses and osteoporosis incidence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants from the 2017–2018 NHANES were classified into three groups: frailty, prefrailty, and robust, based on the frailty phenotype. The correlation between frailty and osteoporosis prevalence was assessed using weighted multivariate logistic regression models. Causal relationship was verified by Mendelian randomization using frailty data from the U.K. Biobank and osteoporosis data from the FinnGen database. Proteomic analysis including associated protein screening and functional enrichments was performed based on data from the Icelandic cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study group comprised 1814 participants. An increased incidence of osteoporosis was observed in older age and lower body mass index populations. A significant frailty–osteoporosis correlation (odds ratio [OR]: 1.37; 95% confidence interval [CI]: 1.14–1.64; <i>p</i> = 0.001) was indicated both in the crude model and after adjustments (OR: 1.23; 95% CI: 1.01–1.51; <i>p</i> = 0.039). The inverse variance weighting method observed a potential effect of frailty on osteoporosis risk (β/SE, 0.209/0.099; OR: 1.233; 95% CI: 1.014–1.499; <i>p</i> = 0.036). Thirteen frailty–osteoporosis-associated proteins were found, and proteomic enrichment indicated oxidative stress-related pathways as a hypothesis-generating mechanism of frailty-mediated osteoporosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings suggest a potential causal association between frailty and osteoporosis, with risk exacerbating with the progression of frailty severity. Frailty potentially impacts the progression of osteoporosis through response to oxidative stress.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/6662987","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145887388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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