Flap transplantation is widely used in reconstructive surgery; however, ischemic injury remains a critical barrier to flap survival, primarily due to oxidative stress, ferroptosis, and impaired angiogenesis. In this study, we employed a random-pattern skin flap model in Sprague–Dawley rats to evaluate the protective effects of curcumin (Cur). Cur administration significantly enhanced antioxidant capacity by increasing superoxide dismutase (SOD) activity and heme oxygenase-1 (HO-1) expression while decreasing malondialdehyde (MDA) and lipid peroxidation (LPO) levels. Ferroptosis analysis revealed that Cur upregulated SLC7A11, GPX4, and FTH1 while downregulating ACSL4, indicating ferroptosis inhibition. Mechanistically, Cur activated the FoXO1/NCOA4 signaling pathway, suppressing NCOA4-mediated ferritinophagy and limiting iron-driven oxidative damage. Moreover, Cur promoted angiogenesis by upregulating VEGF, MMP9, and CDH5 and enhanced human umbilical vein endothelial cell (HUVEC) proliferation while reducing intracellular reactive oxygen species (ROS). Collectively, these findings demonstrate that Cur mitigates ischemic injury through antioxidative, antiferroptotic, and proangiogenic effects, supporting its therapeutic potential for improving flap survival in reconstructive surgery.
{"title":"Curcumin Mitigates Ischemic Damage in Flap Transplantation via Antioxidative, Antiferroptotic, and Proangiogenic Mechanisms","authors":"Xuejun Wu, Liang Guo, Yuning Li, Shibei Lin, Chu Chen","doi":"10.1155/ijcp/4773403","DOIUrl":"https://doi.org/10.1155/ijcp/4773403","url":null,"abstract":"<p>Flap transplantation is widely used in reconstructive surgery; however, ischemic injury remains a critical barrier to flap survival, primarily due to oxidative stress, ferroptosis, and impaired angiogenesis. In this study, we employed a random-pattern skin flap model in Sprague–Dawley rats to evaluate the protective effects of curcumin (Cur). Cur administration significantly enhanced antioxidant capacity by increasing superoxide dismutase (SOD) activity and heme oxygenase-1 (HO-1) expression while decreasing malondialdehyde (MDA) and lipid peroxidation (LPO) levels. Ferroptosis analysis revealed that Cur upregulated SLC7A11, GPX4, and FTH1 while downregulating ACSL4, indicating ferroptosis inhibition. Mechanistically, Cur activated the FoXO1/NCOA4 signaling pathway, suppressing NCOA4-mediated ferritinophagy and limiting iron-driven oxidative damage. Moreover, Cur promoted angiogenesis by upregulating VEGF, MMP9, and CDH5 and enhanced human umbilical vein endothelial cell (HUVEC) proliferation while reducing intracellular reactive oxygen species (ROS). Collectively, these findings demonstrate that Cur mitigates ischemic injury through antioxidative, antiferroptotic, and proangiogenic effects, supporting its therapeutic potential for improving flap survival in reconstructive surgery.</p>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/4773403","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145521440","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}
Helena Whitley, Wayne Nolan, Elisabeth Norton, Fergus Gracey
Background
The primary headache disorder, cluster headache (CH), is known as one of the most painful conditions a human can experience. This study aimed to explore the psychological experience of living with CH, both during acute headache attacks and between attacks.
Methods
Semistructured interviews were conducted with 13 adults with episodic or chronic CH. Interviews were carried out via Microsoft Teams or the telephone. Qualitative interview data were analysed using Reflective Thematic Analysis (RTA) through a critical realist lens. Participants also completed the Pain Self-Efficacy Questionnaire and Pain Catastrophising Scale.
Results
RTA resulted in five themes emerging related to the psychological experience of CH: “Darkness,” “Battling,” “Shifting,” “Control,” and “Despair.” Psychological experiences during the acute attack appeared distinct from experiences of the condition between attacks. The psychological experience was impacted by how long participants had lived with the condition and by whether they had the episodic or chronic form. Individuals living with the chronic form of CH reported increased despair and depression, due to lack of respite from the pain. In contrast, individuals living with episodic CH were less despairing due to pain-free periods but talked to increased uncertainty, with it being unclear when the painful bout would disrupt their life.
Conclusion
Living with CH is a complex and challenging psychological experience. Further research to identify how psychological processes may maintain distress and exacerbate pain could help establish a psychological model of CH. Such a model could, in turn, enable exploration of psychological techniques to support individuals during and between CH attacks. Authors also call for research to explore how to increase visibility of CH.
{"title":"“If We Had Blood Pouring Out of Our Eyeballs, People Would Notice”: A Qualitative Exploration Into the Psychological Experience of Cluster Headache","authors":"Helena Whitley, Wayne Nolan, Elisabeth Norton, Fergus Gracey","doi":"10.1155/ijcp/5004925","DOIUrl":"https://doi.org/10.1155/ijcp/5004925","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The primary headache disorder, cluster headache (CH), is known as one of the most painful conditions a human can experience. This study aimed to explore the psychological experience of living with CH, both during acute headache attacks and between attacks.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Semistructured interviews were conducted with 13 adults with episodic or chronic CH. Interviews were carried out via Microsoft Teams or the telephone. Qualitative interview data were analysed using Reflective Thematic Analysis (RTA) through a critical realist lens. Participants also completed the Pain Self-Efficacy Questionnaire and Pain Catastrophising Scale.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>RTA resulted in five themes emerging related to the psychological experience of CH: “Darkness,” “Battling,” “Shifting,” “Control,” and “Despair.” Psychological experiences during the acute attack appeared distinct from experiences of the condition between attacks. The psychological experience was impacted by how long participants had lived with the condition and by whether they had the episodic or chronic form. Individuals living with the chronic form of CH reported increased despair and depression, due to lack of respite from the pain. In contrast, individuals living with episodic CH were less despairing due to pain-free periods but talked to increased uncertainty, with it being unclear when the painful bout would disrupt their life.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Living with CH is a complex and challenging psychological experience. Further research to identify how psychological processes may maintain distress and exacerbate pain could help establish a psychological model of CH. Such a model could, in turn, enable exploration of psychological techniques to support individuals during and between CH attacks. Authors also call for research to explore how to increase visibility of CH.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/5004925","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145521443","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}
Shujuan Xu, Lingmei Li, Qiuxiao Ma, Chenchen Gu, Qing Peng, Lei Li, Bin Yang, Hao Guo, Yuanyuan Chen, Gaojie Xin, Jianhua Fu
<div> <section> <h3> Objective</h3> <p>Postinfection cough (PIC) is a lingering cough that occurs after the resolution of a primary respiratory infection, affecting the quality of life and potentially leading to complications, thus necessitating effective treatment. Qingfei Zhisou syrup, which has heat-clearing, cough-relieving, and phlegm-resolving properties, has demonstrated a mitigating effect on PIC. However, the exact mechanisms are largely unknown. The purpose of this study is to investigate the effect of Qingfei Zhisou syrup on the molecular mechanism of PIC.</p> </section> <section> <h3> Methods</h3> <p>A total of 105 Sprague–Dawley (SD) male rats were used to establish a PIC model via nasal drops of lipopolysaccharide (LPS), smoke, and capsaicin, which were divided into the normal group, model group, western medicine positive drugs dextromethorphan hydrobromide syrup group (3.50 mL/kg), and traditional Chinese medicine positive drugs Jinzhen oral liquid group (5.41 mL/kg), and the high-, medium-, and low-dose children’s Qingfei Zhisou syrup groups (3.66, 1.83, and 0.92 g/kg). The drug was given by continuous intragastric administration at 10 mL/kg for 10 days. The cough sensitivity of rats was determined by capsaicin aerosol-induced cough, the morphological changes of lung tissue were observed by hematoxylin–eosin staining, and the levels of inflammatory factors tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and interleukin-6 (IL-6) in the homogenate of lung tissue were determined by enzyme-linked immunosorbent assay. According to the previous literature, the expression levels of transient receptor potential Vanilloid 1 (TRPV1), prostaglandin E Receptor 2 (PTGER2), and protein Kinase A (PKA) were evaluated by immunohistochemistry (IHC), western blot (WB) analysis, and quantitative polymerase chain reaction using TRPV1 as the entry point, combined with key genes and pathway proteins screened by network pharmacology and molecular docking.</p> </section> <section> <h3> Results</h3> <p>Network analysis predicted Qingfei Zhisou syrup might relieve PIC symptoms through key target genes IL-1β, IL-6, and TNF-α and the action of neuroactive ligand–receptor and control the reaction of LPS and drugs. Animal experiments have shown that Qingfei Zhisou syrup for children decreased cough sensitivity, alleviated pathological changes in rat lung tissues, and inhibited IL-1β, IL-6, and TNF-α levels in lung tissue. Molecular-level studies revealed that children’s Qingfei Zhisou syrup decreased the expression of TRPV1, PTGER2, and PKA.</p> </section> <section> <h3> Conclusion</h3>
{"title":"Therapeutic Effect of Children’s Qingfei Zhisou Syrup on Postinfection Cough Rats Based on Network Pharmacology and Molecular Docking","authors":"Shujuan Xu, Lingmei Li, Qiuxiao Ma, Chenchen Gu, Qing Peng, Lei Li, Bin Yang, Hao Guo, Yuanyuan Chen, Gaojie Xin, Jianhua Fu","doi":"10.1155/ijcp/1882215","DOIUrl":"https://doi.org/10.1155/ijcp/1882215","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Postinfection cough (PIC) is a lingering cough that occurs after the resolution of a primary respiratory infection, affecting the quality of life and potentially leading to complications, thus necessitating effective treatment. Qingfei Zhisou syrup, which has heat-clearing, cough-relieving, and phlegm-resolving properties, has demonstrated a mitigating effect on PIC. However, the exact mechanisms are largely unknown. The purpose of this study is to investigate the effect of Qingfei Zhisou syrup on the molecular mechanism of PIC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 105 Sprague–Dawley (SD) male rats were used to establish a PIC model via nasal drops of lipopolysaccharide (LPS), smoke, and capsaicin, which were divided into the normal group, model group, western medicine positive drugs dextromethorphan hydrobromide syrup group (3.50 mL/kg), and traditional Chinese medicine positive drugs Jinzhen oral liquid group (5.41 mL/kg), and the high-, medium-, and low-dose children’s Qingfei Zhisou syrup groups (3.66, 1.83, and 0.92 g/kg). The drug was given by continuous intragastric administration at 10 mL/kg for 10 days. The cough sensitivity of rats was determined by capsaicin aerosol-induced cough, the morphological changes of lung tissue were observed by hematoxylin–eosin staining, and the levels of inflammatory factors tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and interleukin-6 (IL-6) in the homogenate of lung tissue were determined by enzyme-linked immunosorbent assay. According to the previous literature, the expression levels of transient receptor potential Vanilloid 1 (TRPV1), prostaglandin E Receptor 2 (PTGER2), and protein Kinase A (PKA) were evaluated by immunohistochemistry (IHC), western blot (WB) analysis, and quantitative polymerase chain reaction using TRPV1 as the entry point, combined with key genes and pathway proteins screened by network pharmacology and molecular docking.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Network analysis predicted Qingfei Zhisou syrup might relieve PIC symptoms through key target genes IL-1β, IL-6, and TNF-α and the action of neuroactive ligand–receptor and control the reaction of LPS and drugs. Animal experiments have shown that Qingfei Zhisou syrup for children decreased cough sensitivity, alleviated pathological changes in rat lung tissues, and inhibited IL-1β, IL-6, and TNF-α levels in lung tissue. Molecular-level studies revealed that children’s Qingfei Zhisou syrup decreased the expression of TRPV1, PTGER2, and PKA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 ","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/1882215","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145470110","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}
Shiji Xu, Ailun Zhang, Rong Yang, Ying Xiong, Lin Zhao, Jing Yang, Jing Zhu, Baishen Pan, Wei Guo, Wenqi Shao, Beili Wang
Background
To analyze the subsequent conversion situation and associated risk factors in patients with mild subclinical hypothyroidism.
Methods
A retrospective review was conducted using thyroid function data from health examinations at Zhongshan Hospital, Fudan University, from 2012 to 2022. A total of 12,394 patients with initial subclinical hypothyroidism (SCH) were included. Subsequent thyroid function results were categorized into four outcomes: progression to overt hypothyroidism (115), progression to severe-SCH (191), maintenance of mild-SCH (5658), and reversion to euthyroidism (6430). The correlation between baseline parameters and thyroid function levels with the conversion outcomes within 2 years was analyzed using multinomial logistic regression analysis.
Results
Lower baseline FT4 was strongly associated with overt hypothyroidism progression (OR = 0.366, p < 0.001), with the lowest FT4 quartile showing an 8-fold higher overt hypothyroidism incidence (3.02%) compared to other quartiles. In contrast, higher baseline TSH was the primary driver of severe-SCH progression (OR = 1.898, p < 0.001), with the highest TSH quartile having a 7-fold higher severe-SCH incidence (4.83%). Baseline TSH inversely correlated with euthyroidism reversion rates, with milder TSH elevations more likely to normalize.
Conclusions
FT4 and TSH exhibit distinct predictive roles in mild-SCH progression: low FT4 drives overt hypothyroidism conversion, while high TSH predicts severe-SCH. Combining both markers may improve risk stratification for tailored follow-up and intervention. Prospective studies with treatment records are needed to validate these findings.
背景分析轻度亚临床甲状腺功能减退患者的后续转化情况及相关危险因素。方法回顾性分析2012 - 2022年复旦大学中山医院甲状腺功能体检资料。本研究共纳入12394例首发亚临床甲状腺功能减退（SCH）患者。随后的甲状腺功能结果分为四种结果：进展到明显的甲状腺功能减退（115），进展到严重的甲状腺功能减退（191），维持轻度甲状腺功能减退（5658），恢复到甲状腺功能减退（6430）。采用多项logistic回归分析基线参数和甲状腺功能水平与2年内转换结果的相关性。结果基线FT4较低与明显甲状腺功能减退进展密切相关（OR = 0.366, p < 0.001）， FT4最低的四分位数显示明显甲状腺功能减退发生率比其他四分位数高8倍（3.02%）。相比之下，较高的基线TSH是严重sch进展的主要驱动因素（OR = 1.898, p < 0.001），最高TSH四分位数的严重sch发生率高出7倍（4.83%）。基线TSH与甲亢逆转率呈负相关，轻度TSH升高更有可能恢复正常。结论FT4和TSH在轻度sch进展中具有明显的预测作用：低FT4驱动明显的甲状腺功能减退转化，而高TSH预测严重sch。结合这两种指标可以改善风险分层，以便进行针对性的随访和干预。需要有治疗记录的前瞻性研究来验证这些发现。
{"title":"Analysis of Progression and Risk Factors in Chinese Population With Mild-Subclinical Hypothyroidism","authors":"Shiji Xu, Ailun Zhang, Rong Yang, Ying Xiong, Lin Zhao, Jing Yang, Jing Zhu, Baishen Pan, Wei Guo, Wenqi Shao, Beili Wang","doi":"10.1155/ijcp/8862604","DOIUrl":"https://doi.org/10.1155/ijcp/8862604","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>To analyze the subsequent conversion situation and associated risk factors in patients with mild subclinical hypothyroidism.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective review was conducted using thyroid function data from health examinations at Zhongshan Hospital, Fudan University, from 2012 to 2022. A total of 12,394 patients with initial subclinical hypothyroidism (SCH) were included. Subsequent thyroid function results were categorized into four outcomes: progression to overt hypothyroidism (115), progression to severe-SCH (191), maintenance of mild-SCH (5658), and reversion to euthyroidism (6430). The correlation between baseline parameters and thyroid function levels with the conversion outcomes within 2 years was analyzed using multinomial logistic regression analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Lower baseline FT4 was strongly associated with overt hypothyroidism progression (OR = 0.366, <i>p</i> < 0.001), with the lowest FT4 quartile showing an 8-fold higher overt hypothyroidism incidence (3.02%) compared to other quartiles. In contrast, higher baseline TSH was the primary driver of severe-SCH progression (OR = 1.898, <i>p</i> < 0.001), with the highest TSH quartile having a 7-fold higher severe-SCH incidence (4.83%). Baseline TSH inversely correlated with euthyroidism reversion rates, with milder TSH elevations more likely to normalize.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>FT4 and TSH exhibit distinct predictive roles in mild-SCH progression: low FT4 drives overt hypothyroidism conversion, while high TSH predicts severe-SCH. Combining both markers may improve risk stratification for tailored follow-up and intervention. Prospective studies with treatment records are needed to validate these findings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/8862604","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145469865","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}
Severe pneumonia remains a leading cause of high mortality globally. While numerous new detection markers for pneumonia of this type have been introduced in clinical practice, their application in primary healthcare settings remains limited. The neutrophil-to-lymphocyte-to-monocyte ratio (NLMR) is a simple and easily accessible parameter. The aim of this study was to explore its potential as an early warning indicator for the prognosis of pneumonia.
Methods
We conducted a retrospective analysis of the first pneumonia patients admitted to the intensive care unit (ICU) from January 2019 to June 2025. We compared the 24 h scores and laboratory data of the survival group and with those of the nonsurvival group, analyzed the prognostic factors for pneumonia via multivariate logistic regression, and assessed their predictive value via receiver operating characteristic (ROC) curves. The Kaplan–Meier (K–M) method was used to estimate survival outcomes on the basis of differing ICU admission NLMR levels.
Results
The study included a total of 181 patients, 39 of whom died within 30 days. Compared with the survival group, the nonsurvival group presented significantly higher NLMR values upon ICU admission. The multivariate binary logistic analysis revealed that the NLMR independently contributed to an increased risk of mortality (OR = 1.013, 95% CI 1.00–1.018; p < 0.05). The NLMR exhibited an ROC-AUC of 0.844 (95% CI, 0.768–0.921), and both the Hosmer–Lemeshow test and calibration plots indicated superior accuracy for the NLMR model. K–M analysis demonstrated that higher NLMR values at ICU admission were associated with significantly reduced 30-day survival.
Conclusion
Elevated NLMR at ICU admission was an independent risk factor for increased 30-day mortality in patients with pneumonia, especially when the NLMR was greater than 120.
背景：严重肺炎仍然是全球高死亡率的主要原因。虽然在临床实践中已经引入了许多这种类型的肺炎的新检测标记物，但它们在初级卫生保健机构中的应用仍然有限。中性粒细胞/淋巴细胞/单核细胞比值（NLMR）是一个简单且容易获得的参数。本研究的目的是探讨其作为肺炎预后早期预警指标的潜力。方法对2019年1月至2025年6月我院重症监护病房（ICU）收治的首批肺炎患者进行回顾性分析。我们比较存活组与非存活组的24小时评分和实验室数据，通过多因素logistic回归分析肺炎的预后因素，并通过受试者工作特征（ROC）曲线评估其预测价值。Kaplan-Meier （K-M）法用于根据不同的ICU入院NLMR水平估计生存结果。结果共纳入181例患者，其中39例在30天内死亡。与生存组相比，非生存组入院时NLMR值明显高于生存组。多变量二元logistic分析显示NLMR独立导致死亡风险增加（OR = 1.013, 95% CI 1.00-1.018; p < 0.05）。NLMR模型的ROC-AUC为0.844 (95% CI为0.768 ~ 0.921)，Hosmer-Lemeshow检验和校正图均显示NLMR模型具有较高的准确性。K-M分析显示，ICU入院时NLMR值较高与30天生存率显著降低相关。结论入院时NLMR升高是肺炎患者30天死亡率升高的独立危险因素，特别是当NLMR大于120时。
{"title":"Neutrophil-Lymphocyte-Monocyte Ratio in Predicting the Risk of Death in Patients With Severe Pneumonia in the Intensive Care Unit: A Single-Center Retrospective Cohort Study","authors":"Lian-Fang Zhang, Ya-Bin Zheng, Rong-Cheng Xie, Xiang-Yu Hong, Zhao-Peng Zhou, Sheng-Wen Tu, Jie-Fei Ma, Xiao-Ming Lin","doi":"10.1155/ijcp/9274092","DOIUrl":"https://doi.org/10.1155/ijcp/9274092","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Severe pneumonia remains a leading cause of high mortality globally. While numerous new detection markers for pneumonia of this type have been introduced in clinical practice, their application in primary healthcare settings remains limited. The neutrophil-to-lymphocyte-to-monocyte ratio (NLMR) is a simple and easily accessible parameter. The aim of this study was to explore its potential as an early warning indicator for the prognosis of pneumonia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective analysis of the first pneumonia patients admitted to the intensive care unit (ICU) from January 2019 to June 2025. We compared the 24 h scores and laboratory data of the survival group and with those of the nonsurvival group, analyzed the prognostic factors for pneumonia via multivariate logistic regression, and assessed their predictive value via receiver operating characteristic (ROC) curves. The Kaplan–Meier (K–M) method was used to estimate survival outcomes on the basis of differing ICU admission NLMR levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included a total of 181 patients, 39 of whom died within 30 days. Compared with the survival group, the nonsurvival group presented significantly higher NLMR values upon ICU admission. The multivariate binary logistic analysis revealed that the NLMR independently contributed to an increased risk of mortality (OR = 1.013, 95% CI 1.00–1.018; <i>p</i> < 0.05). The NLMR exhibited an ROC-AUC of 0.844 (95% CI, 0.768–0.921), and both the Hosmer–Lemeshow test and calibration plots indicated superior accuracy for the NLMR model. K–M analysis demonstrated that higher NLMR values at ICU admission were associated with significantly reduced 30-day survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Elevated NLMR at ICU admission was an independent risk factor for increased 30-day mortality in patients with pneumonia, especially when the NLMR was greater than 120.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/9274092","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145469497","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}
Z. Luo, W. Zeng, X. Chen, et al., “Cocktail of Ropivacaine, Morphine, and Diprospan Reduces Pain and Prolongs Analgesic Effects after Total Knee Arthroplasty: A Prospective Randomized Controlled Trial,” International Journal of Clinical Practice 2024, no. 1 (2024): 1–10, https://doi.org/10.1155/2024/3697846.
In the article titled “Cocktail of Ropivacaine, Morphine, and Diprospan Reduces Pain and Prolongs Analgesic Effects after Total Knee Arthroplasty: A Prospective Randomized Controlled Trial”, there was an error in section 3.1.
This error is shown below:
‘For inflammatory markers, Group A had significantly lower levels of CRP and IL-6 than Group B at PO 48 h (P < 0.05)’
The statement should read:
‘For inflammatory markers, Group B had significantly lower levels of CRP and IL-6 than Group A at PO 48 h (P < 0.05).’
{"title":"Correction to “Cocktail of Ropivacaine, Morphine, and Diprospan Reduces Pain and Prolongs Analgesic Effects after Total Knee Arthroplasty: A Prospective Randomized Controlled Trial”","authors":"","doi":"10.1155/ijcp/9869024","DOIUrl":"https://doi.org/10.1155/ijcp/9869024","url":null,"abstract":"<p>Z. Luo, W. Zeng, X. Chen, et al., “Cocktail of Ropivacaine, Morphine, and Diprospan Reduces Pain and Prolongs Analgesic Effects after Total Knee Arthroplasty: A Prospective Randomized Controlled Trial,” <i>International Journal of Clinical Practice</i> 2024, no. 1 (2024): 1–10, https://doi.org/10.1155/2024/3697846.</p><p>In the article titled “Cocktail of Ropivacaine, Morphine, and Diprospan Reduces Pain and Prolongs Analgesic Effects after Total Knee Arthroplasty: A Prospective Randomized Controlled Trial”, there was an error in section 3.1.</p><p>This error is shown below:</p><p>‘For inflammatory markers, Group A had significantly lower levels of CRP and IL-6 than Group B at PO 48 h (<i>P</i> < 0.05)’</p><p>The statement should read:</p><p>‘For inflammatory markers, Group B had significantly lower levels of CRP and IL-6 than Group A at PO 48 h (<i>P</i> < 0.05).’</p><p>We apologize for this error.</p>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/9869024","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145407423","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}
During the novel coronavirus epidemic, family physicians played a pivotal role in the primary health care system. They provided essential infrastructural support for the implementation of community prevention and control strategies and helped advance the frontline of epidemic containment.
Objective
This study aims to gather the latest research on the role of family doctors during the COVID-19 pandemic, analyze publication trends and underlying thematic structures, and thereby provide a comprehensive overview of research hotspots and developments in this field, offering robust support for future scientific inquiry.
Methods
Data were retrieved from the Science Citation Index Expanded (SCIE) and Social Sciences Citation Index (SSCI) databases within the Web of Science Core Collection. The search was limited to articles published between January 1, 2019, and December 31, 2024. Tableau was used to analyze institutional distribution, Excel was employed to organize journal distribution data, and VOSviewer was utilized to examine author and keyword distributions. Latent Dirichlet Allocation (LDA) was applied to identify research topics and thematic clusters, with results visualized and interpreted using pyLDAvis.
Results
A total of 1206 articles were included in the analysis. During the COVID-19 pandemic, the United Kingdom led in publication output in this research domain, contributing 327 articles. The University of Oxford was the most productive institution, publishing 111 articles. Among journals, BMJ Open published 83 relevant articles, which received 912 citations (excluding self-citations) and achieved an H-index of 13. The most prolific author was Mehrkar, A., with 25 publications. Thematic analysis revealed that research largely centered on the management of high-risk groups and public health responses in primary care. Specifically, the topics “management of high-risk groups in primary care” and “COVID-19 prevention and public health response” accounted for 34.7% and 18.3% of the publications during the pandemic, respectively.
在新型冠状病毒流行期间，家庭医生在初级卫生保健系统中发挥了关键作用。他们为实施社区预防和控制战略提供了必要的基础设施支持，并帮助推进了流行病控制的前线。目的收集新冠肺炎大流行期间家庭医生角色的最新研究成果，分析发表趋势和潜在的专题结构，从而全面概述该领域的研究热点和进展，为今后的科学探究提供有力支持。方法从Web of Science Core Collection中的科学引文索引扩展（SCIE）和社会科学引文索引（SSCI）数据库中检索。搜索仅限于2019年1月1日至2024年12月31日之间发表的文章。使用Tableau分析机构分布，使用Excel组织期刊分布数据，使用VOSviewer检查作者和关键词分布。潜在狄利克雷分配（Latent Dirichlet Allocation， LDA）用于识别研究主题和主题集群，并使用pyLDAvis对结果进行可视化和解释。结果共纳入1206篇文献。在2019冠状病毒病大流行期间，英国在这一研究领域的出版物产量最高，发表了327篇文章。牛津大学是最多产的机构，发表了111篇论文。期刊中BMJ Open发表相关文章83篇，被引用912次（不含自引用），h指数为13。最多产的作者是美国的Mehrkar，发表了25篇论文。专题分析显示，研究主要集中在高危人群的管理和初级保健中的公共卫生对策。其中，“初级保健高危人群管理”和“COVID-19预防与公共卫生应对”主题分别占大流行期间出版物的34.7%和18.3%。
{"title":"Overview of Family Doctor Services Under Major Public Health Emergencies 2019–2024: A Bibliometric Analysis","authors":"Gan Wang, Li Luo","doi":"10.1155/ijcp/7504263","DOIUrl":"https://doi.org/10.1155/ijcp/7504263","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>During the novel coronavirus epidemic, family physicians played a pivotal role in the primary health care system. They provided essential infrastructural support for the implementation of community prevention and control strategies and helped advance the frontline of epidemic containment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aims to gather the latest research on the role of family doctors during the COVID-19 pandemic, analyze publication trends and underlying thematic structures, and thereby provide a comprehensive overview of research hotspots and developments in this field, offering robust support for future scientific inquiry.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data were retrieved from the Science Citation Index Expanded (SCIE) and Social Sciences Citation Index (SSCI) databases within the Web of Science Core Collection. The search was limited to articles published between January 1, 2019, and December 31, 2024. Tableau was used to analyze institutional distribution, Excel was employed to organize journal distribution data, and VOSviewer was utilized to examine author and keyword distributions. Latent Dirichlet Allocation (LDA) was applied to identify research topics and thematic clusters, with results visualized and interpreted using pyLDAvis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 1206 articles were included in the analysis. During the COVID-19 pandemic, the United Kingdom led in publication output in this research domain, contributing 327 articles. The University of Oxford was the most productive institution, publishing 111 articles. Among journals, BMJ Open published 83 relevant articles, which received 912 citations (excluding self-citations) and achieved an H-index of 13. The most prolific author was Mehrkar, A., with 25 publications. Thematic analysis revealed that research largely centered on the management of high-risk groups and public health responses in primary care. Specifically, the topics “management of high-risk groups in primary care” and “COVID-19 prevention and public health response” accounted for 34.7% and 18.3% of the publications during the pandemic, respectively.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/7504263","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145407447","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}
Junwei Xu, Jianpeng Li, Hao Zhang, Yang Gao, Qiming Dai
Background
There is growing evidence that platelet-related parameters can influence a wide range of cardiovascular diseases. However, the effect of platelet-related parameters on cardiac hypertrophy is unknown. To verify this, the present study proposes to use Mendelian randomization (MR) to explore bidirectional causality between multiple platelet-related parameters and cardiac hypertrophy and to assess the potential mediating role of plasma metabolites.
Methods
Single-nucleotide polymorphisms (SNPs), the instrumental variable required for the study, were obtained through the public genome-wide association study (GWAS) database, and samples were obtained from European populations. We obtained summary statistics of cardiac hypertrophy (4113 cases, 839,403 controls) after GWAS meta-analysis of two independent datasets. In this study, we mainly used the inverse variance weighted (IVW) method to assess the causal effect; two-step MR analysis was used to assess the mediating effect.
Results
MR analysis showed a positive causal relationship between mean platelet volume (MPV) and the risk of cardiac hypertrophy (odds ratio, 1.72 for cardiac hypertrophy per one-standard-deviation increment in MPV; 95% confidence interval, 1.24 to 2.38; p = 0.001). Multivariate MR showed that the risk role of MPV in promoting cardiac hypertrophy persisted after adjustment for other platelet parameters. Mediation analysis via two-step MR showed that this effect was partially mediated by vanillic acid glycine levels, with a mediation ratio of 20.4% (95% confidence interval, 3.7% to 40.7%).
Conclusions
This study revealed a positive causal relationship between MPV and cardiac hypertrophy risk, partly mediated by plasma vanillic acid glycine levels.
{"title":"Relationship Between Mean Platelet Volume and Cardiac Hypertrophy and Mediating Effect of Vanillic Acid Glycine Levels in Plasma Metabolites: A Mendelian Randomization Study","authors":"Junwei Xu, Jianpeng Li, Hao Zhang, Yang Gao, Qiming Dai","doi":"10.1155/ijcp/7734971","DOIUrl":"https://doi.org/10.1155/ijcp/7734971","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>There is growing evidence that platelet-related parameters can influence a wide range of cardiovascular diseases. However, the effect of platelet-related parameters on cardiac hypertrophy is unknown. To verify this, the present study proposes to use Mendelian randomization (MR) to explore bidirectional causality between multiple platelet-related parameters and cardiac hypertrophy and to assess the potential mediating role of plasma metabolites.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Single-nucleotide polymorphisms (SNPs), the instrumental variable required for the study, were obtained through the public genome-wide association study (GWAS) database, and samples were obtained from European populations. We obtained summary statistics of cardiac hypertrophy (4113 cases, 839,403 controls) after GWAS meta-analysis of two independent datasets. In this study, we mainly used the inverse variance weighted (IVW) method to assess the causal effect; two-step MR analysis was used to assess the mediating effect.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>MR analysis showed a positive causal relationship between mean platelet volume (MPV) and the risk of cardiac hypertrophy (odds ratio, 1.72 for cardiac hypertrophy per one-standard-deviation increment in MPV; 95% confidence interval, 1.24 to 2.38; <i>p</i> = 0.001). Multivariate MR showed that the risk role of MPV in promoting cardiac hypertrophy persisted after adjustment for other platelet parameters. Mediation analysis via two-step MR showed that this effect was partially mediated by vanillic acid glycine levels, with a mediation ratio of 20.4% (95% confidence interval, 3.7% to 40.7%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study revealed a positive causal relationship between MPV and cardiac hypertrophy risk, partly mediated by plasma vanillic acid glycine levels.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/7734971","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145407249","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}
Rebecca Day Benfield, Andrew Thomas Reyes, Huaxin Song, Reimund Serafica, Alicia Brown, Catherine Dingley
<div> <section> <h3> Introduction</h3> <p>Posttraumatic stress disorder (PTSD) is prevalent among military veterans around the world, with many remaining symptomatic despite standard therapies. We hypothesized that warm water immersion might have a positive therapeutic effect on veteran’s mood, anxiety, and pain.</p> </section> <section> <h3> Methods</h3> <p>This clinical trial used a mixed methods approach: a quantitative single case design with repeated measures followed by a qualitative descriptive semistructured interview of participant perceptions and experiences to examine the effects of warm water immersion on improving mood, anxiety, and pain. Veterans with PTSD symptoms and comorbid depression, anxiety, and pain were immersed to the chest in 33°C water for 45 min. Repeated measures of the Multidimensional Mood State Questionnaire and the visual analog scales for anxiety and pain were taken at dry baseline and at 15 and 45 min of immersion, followed by a semistructured interview.</p> </section> <section> <h3> Results</h3> <p>A mixed regression model (Holm–Bonferroni adjusted <i>p</i> values), controlling for veteran participants’ (<i>N</i> = 13; mean age = 31 years; male = 9, female = 4) PTSD symptoms, depression status, and combat score, revealed significant improvements compared to baseline. At 15 min, scores improved for good mood (<i>B</i> = 3.85, SE = 1.21, <i>t</i> = 3.18, <i>p</i> = 0.016), calmness (<i>B</i> = 8.15, SE = 1.57, <i>t</i> = 5.19, <i>p</i> < 0.001), and anxiety (<i>B</i> = −10.92, SE = 4.53, <i>t</i> = −2.41, <i>p</i> = 0.048). At 45 min, improvements were observed in good mood (<i>B</i> = 6.38, SE = 1.21, <i>t</i> = 5.27, <i>p</i> < 0.001), calmness (<i>B</i> = 11.38, SE = 1.57, <i>t</i> = 7.25, <i>p</i> < 0.001), and anxiety (<i>B</i> = −23.69, SE = 4.53, <i>t</i> = −5.23, <i>p</i> < 0.001). Pain scores also improved significantly at 45 min (<i>B</i> = −17.69, SE = 4.42, <i>t</i> = −4.00, <i>p</i> = 0.003). Veterans described the experience as relaxing, calming, pain-relieving, and promoting mental rest as they actively engaged with the properties of the water.</p> </section> <section> <h3> Conclusion</h3> <p>Warm water immersion provides an effective, fast-acting, low-risk, nonstigmatizing, accessible adjunct therapy for veterans experiencing PTSD symptoms and comorbid depression, anxiety, and pain. A comparison of the same participants’ responses on the psychosocial instruments with qualitative themes yields similar results, providing additional credence for immersion effectiveness.</p> </section>
创伤后应激障碍（PTSD）在世界各地的退伍军人中普遍存在，尽管有标准的治疗方法，但许多人仍然有症状。我们假设温水浸泡可能对退伍军人的情绪、焦虑和疼痛有积极的治疗作用。方法本临床试验采用混合方法：定量单例设计，重复测量，然后对参与者的感知和经历进行定性描述性半结构化访谈，以检验温水浸泡对改善情绪、焦虑和疼痛的影响。将有PTSD症状并伴有抑郁、焦虑和疼痛的退伍军人浸泡在33°C的水中45分钟。多维情绪状态问卷和焦虑和疼痛的视觉模拟量表在干基线和浸泡15和45分钟时进行重复测量，随后进行半结构化访谈。结果采用混合回归模型（Holm-Bonferroni调整p值），控制了退伍军人（N = 13，平均年龄= 31岁，男= 9，女= 4）PTSD症状、抑郁状态和战斗得分，与基线相比有显著改善。好心情在15分钟,分数提高(B = 3.85, = 1.21, t = 3.18, p = 0.016),冷静(B = 8.15, = 1.57, t = 5.19, p & lt; 0.001),和焦虑(B =−10.92,SE = 4.53, t =−2.41,p = 0.048)。在45分钟,观察改进好心情(B = 6.38, = 1.21, t = 5.27, p & lt; 0.001),冷静(B = 11.38, = 1.57, t = 7.25, p & lt; 0.001),和焦虑(B =−23.69,SE = 4.53, t =−5.23,p & lt; 0.001)。疼痛评分在45 min时也有显著改善（B = - 17.69, SE = 4.42, t = - 4.00, p = 0.003）。老兵们将这种体验描述为放松、平静、缓解疼痛，并在他们积极参与水的特性时促进精神休息。结论温水浸泡是一种有效、快速、低风险、无污名化、可及的辅助治疗方法，可用于治疗退伍军人PTSD症状及伴随的抑郁、焦虑和疼痛。同样的参与者对具有定性主题的心理社会工具的反应的比较也产生了类似的结果，为沉浸式的有效性提供了额外的证据。试验注册ClinicalTrials.gov标识符：NCT0530903
{"title":"The Positive Effects of Water Immersion for Symptoms of PTSD in Veterans: A Mixed Methods Study","authors":"Rebecca Day Benfield, Andrew Thomas Reyes, Huaxin Song, Reimund Serafica, Alicia Brown, Catherine Dingley","doi":"10.1155/ijcp/1369052","DOIUrl":"https://doi.org/10.1155/ijcp/1369052","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Posttraumatic stress disorder (PTSD) is prevalent among military veterans around the world, with many remaining symptomatic despite standard therapies. We hypothesized that warm water immersion might have a positive therapeutic effect on veteran’s mood, anxiety, and pain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This clinical trial used a mixed methods approach: a quantitative single case design with repeated measures followed by a qualitative descriptive semistructured interview of participant perceptions and experiences to examine the effects of warm water immersion on improving mood, anxiety, and pain. Veterans with PTSD symptoms and comorbid depression, anxiety, and pain were immersed to the chest in 33°C water for 45 min. Repeated measures of the Multidimensional Mood State Questionnaire and the visual analog scales for anxiety and pain were taken at dry baseline and at 15 and 45 min of immersion, followed by a semistructured interview.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A mixed regression model (Holm–Bonferroni adjusted <i>p</i> values), controlling for veteran participants’ (<i>N</i> = 13; mean age = 31 years; male = 9, female = 4) PTSD symptoms, depression status, and combat score, revealed significant improvements compared to baseline. At 15 min, scores improved for good mood (<i>B</i> = 3.85, SE = 1.21, <i>t</i> = 3.18, <i>p</i> = 0.016), calmness (<i>B</i> = 8.15, SE = 1.57, <i>t</i> = 5.19, <i>p</i> < 0.001), and anxiety (<i>B</i> = −10.92, SE = 4.53, <i>t</i> = −2.41, <i>p</i> = 0.048). At 45 min, improvements were observed in good mood (<i>B</i> = 6.38, SE = 1.21, <i>t</i> = 5.27, <i>p</i> < 0.001), calmness (<i>B</i> = 11.38, SE = 1.57, <i>t</i> = 7.25, <i>p</i> < 0.001), and anxiety (<i>B</i> = −23.69, SE = 4.53, <i>t</i> = −5.23, <i>p</i> < 0.001). Pain scores also improved significantly at 45 min (<i>B</i> = −17.69, SE = 4.42, <i>t</i> = −4.00, <i>p</i> = 0.003). Veterans described the experience as relaxing, calming, pain-relieving, and promoting mental rest as they actively engaged with the properties of the water.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Warm water immersion provides an effective, fast-acting, low-risk, nonstigmatizing, accessible adjunct therapy for veterans experiencing PTSD symptoms and comorbid depression, anxiety, and pain. A comparison of the same participants’ responses on the psychosocial instruments with qualitative themes yields similar results, providing additional credence for immersion effectiveness.</p>\u0000 </section>\u0000 ","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/1369052","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145407147","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}
The 2020/2021 National Heart Failure Audit found prescribing rates of beta-blockers, angiotensin-converting enzyme inhibitors (ACEi), angiotensin receptor blockers (ARBs) and mineralocorticoid receptor antagonists (MRAs) were below target levels in individuals with heart failure with reduced ejection fraction (HFrEF). In Sheffield Teaching Hospitals (STH), prescribing rates of this triple therapy (TT) were below the national average. The aim of this study was to evaluate the impact of patients’ frailty and comorbidities on TT prescribing rates.
Methods
We analysed the clinical details of individuals with a diagnosis of moderate or severe HFrEF admitted to STH between May 2021 and December 2021. Patients’ electronic notes, investigations and heart failure specialist nurses’ assessments were reviewed.
Results
Electronic records of 310 patients were reviewed. About 45.5% were discharged on appropriate TT, compared to 52% nationally. Prescribing rates were 84.2% for beta-blockers and 61.3% for ACE-i/ARB/ARNIs, compared to national levels of 91% and 84%, respectively. The prescribing rate for MRA was 63.4%, which is higher than the national average (61%). About 92.6% of those not on TT had a documented clinical reason, with the commonest being ‘poor renal function’ (45.6%) and ‘low systolic blood pressure’ (25.5%). Those not on TT had a greater mean clinical frailty score (4.4 vs. 3.0, p < 0.001), were older (78.4 vs. 67.1, p < 0.001) and had worse 12-month readmission (p < 0.001) and mortality rates (p < 0.001).
Conclusions
Patients’ frailty and comorbidities play a significant role in HFrEF-prescribing patterns. Identifying and addressing the barriers to optimal HFrEF treatment may improve prescribing rates and patient outcomes.
{"title":"Barriers to Optimising Medication for Patients With Heart Failure With Reduced Ejection Fraction (HFrEF)","authors":"Omar Dirir, Ishika Prachee, Narjes Maasoumi, Abdallah Al-Mohammad","doi":"10.1155/ijcp/3468060","DOIUrl":"https://doi.org/10.1155/ijcp/3468060","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The 2020/2021 National Heart Failure Audit found prescribing rates of beta-blockers, angiotensin-converting enzyme inhibitors (ACEi), angiotensin receptor blockers (ARBs) and mineralocorticoid receptor antagonists (MRAs) were below target levels in individuals with heart failure with reduced ejection fraction (HFrEF). In Sheffield Teaching Hospitals (STH), prescribing rates of this triple therapy (TT) were below the national average. The aim of this study was to evaluate the impact of patients’ frailty and comorbidities on TT prescribing rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analysed the clinical details of individuals with a diagnosis of moderate or severe HFrEF admitted to STH between May 2021 and December 2021. Patients’ electronic notes, investigations and heart failure specialist nurses’ assessments were reviewed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Electronic records of 310 patients were reviewed. About 45.5% were discharged on appropriate TT, compared to 52% nationally. Prescribing rates were 84.2% for beta-blockers and 61.3% for ACE-i/ARB/ARNIs, compared to national levels of 91% and 84%, respectively. The prescribing rate for MRA was 63.4%, which is higher than the national average (61%). About 92.6% of those not on TT had a documented clinical reason, with the commonest being ‘poor renal function’ (45.6%) and ‘low systolic blood pressure’ (25.5%). Those not on TT had a greater mean clinical frailty score (4.4 vs. 3.0, <i>p</i> < 0.001), were older (78.4 vs. 67.1, <i>p</i> < 0.001) and had worse 12-month readmission (<i>p</i> < 0.001) and mortality rates (<i>p</i> < 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Patients’ frailty and comorbidities play a significant role in HFrEF-prescribing patterns. Identifying and addressing the barriers to optimal HFrEF treatment may improve prescribing rates and patient outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/3468060","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145406828","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号