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}
This study aimed to elucidate the regulatory role of circadian rhythm–related genes (CRGs) in immune cell function and their potential contribution to vitiligo pathogenesis. Characterizing the crosstalk between CRGs and immune cells may yield novel insights into the immune dysregulation underlying vitiligo development.
Methods
We integrated expression quantitative trait loci (eQTL) data from the eQTLGen and GTEx projects to analyze 2091 CRGs comprehensively. Summary data–based Mendelian randomization (SMR) and heterogeneity in dependent instruments (HEIDI) analyses were performed to identify key CRGs associated with vitiligo. Colocalization analysis and single-cell RNA sequencing data were used to assess CRG expression in immune cells of vitiligo patients.
Results
Nine key CRGs were identified, showing significant associations with vitiligo in both eQTL datasets. USP40, PEBP, NPM, FBXL1, and GCLC exhibited negative correlations with vitiligo risk, while RPTO, FAM228B, DPH, and CHST1 were positively correlated. Single-cell analysis revealed reduced CRG expression in vitiligo patients, particularly in natural killer (NK)/T cells, naive T cells, and monocytes. This CRG downregulation correlated with impaired immune cell functionality, implicating circadian dysregulation in the aberrant immune responses characteristic of vitiligo pathogenesis.
Conclusion
The results demonstrate that CRGs constitute potential regulatory components in vitiligo pathogenesis through their modulation of immune cell function. The identification of both protective and risk-associated CRGs, coupled with evidence of circadian–immune crosstalk disruption in affected tissues, establishes a new mechanistic framework for understanding vitiligo etiology. These findings not only advance our knowledge of the circadian–immune axis in autoimmune skin disorders but also highlight CRGs as promising therapeutic targets for precision medicine approaches in vitiligo treatment.
{"title":"Analysis of the Correlation Between Circadian Rhythms and Immune Regulation Mechanisms in Vitiligo: Evidence From Summary Data–Based Mendelian Randomization Combined With Single-Cell Analysis","authors":"Fang Miao, Xiaohui Li, Ying Shi","doi":"10.1155/ijcp/9296851","DOIUrl":"https://doi.org/10.1155/ijcp/9296851","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to elucidate the regulatory role of circadian rhythm–related genes (CRGs) in immune cell function and their potential contribution to vitiligo pathogenesis. Characterizing the crosstalk between CRGs and immune cells may yield novel insights into the immune dysregulation underlying vitiligo development.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We integrated expression quantitative trait loci (eQTL) data from the eQTLGen and GTEx projects to analyze 2091 CRGs comprehensively. Summary data–based Mendelian randomization (SMR) and heterogeneity in dependent instruments (HEIDI) analyses were performed to identify key CRGs associated with vitiligo. Colocalization analysis and single-cell RNA sequencing data were used to assess CRG expression in immune cells of vitiligo patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Nine key CRGs were identified, showing significant associations with vitiligo in both eQTL datasets. <i>USP40</i>, <i>PEBP</i>, <i>NPM</i>, <i>FBXL1</i>, and <i>GCLC</i> exhibited negative correlations with vitiligo risk, while <i>RPTO</i>, <i>FAM228B</i>, <i>DPH</i>, and <i>CHST1</i> were positively correlated. Single-cell analysis revealed reduced CRG expression in vitiligo patients, particularly in natural killer (NK)/T cells, naive T cells, and monocytes. This CRG downregulation correlated with impaired immune cell functionality, implicating circadian dysregulation in the aberrant immune responses characteristic of vitiligo pathogenesis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The results demonstrate that CRGs constitute potential regulatory components in vitiligo pathogenesis through their modulation of immune cell function. The identification of both protective and risk-associated CRGs, coupled with evidence of circadian–immune crosstalk disruption in affected tissues, establishes a new mechanistic framework for understanding vitiligo etiology. These findings not only advance our knowledge of the circadian–immune axis in autoimmune skin disorders but also highlight CRGs as promising therapeutic targets for precision medicine approaches in vitiligo treatment.</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/9296851","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145406630","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}
Mohammad Abdi, Ali Norouzi, Mahboobeh Khabaz Mafinejad
Background
Attitude toward medical law reasoning is the first step in improving medical law reasoning skills in physicians. Despite its importance, no validated instrument currently exists to assess it. This study aimed to develop and validate a Medical Law Reasoning Attitude Questionnaire (MLRAQ) in medical students.
Methods
The MLRAQ was developed based on the seven steps of AMEE Guide No. 87, related to designing questionnaires for educational research. In the first step, relevant articles were extracted through a systematic search. In the second step, medical law micro-skills were explored through a qualitative study by conducting 20 interviews. In the third and fourth steps, the identified medical law micro-skills were compared conceptually with previous studies, and the MLRAQ items were developed. Finally, content validity, cognitive interview, exploratory factor analysis, confirmatory factor analysis, and reliability analysis were performed in the fifth to seventh steps.
Results
MLRAQ consists of five factors and 24 items. The validation results showed that the content validity index (CVI) and content validity ratio (CVR) were greater than 0.90. Five subscales (prerequisites, problem identification, application of rule, analysis, and conclusion) explained 67.26% of the variance in exploratory factor analysis. Cronbach’s alpha = 0.894, indicating high internal consistency. ICC = 0.771–0.942, demonstrating strong reliability across measurements. In confirmatory factor analysis, SRMR and RMSEA were 0.078 and 0.058, respectively. GFI was 0.880, and CFI was 0.901, indicating acceptable fit indices.
Conclusion
The MLRAQ demonstrated valid and reliable evidence. Therefore, this instrument can assess attitudes toward medical law reasoning.
{"title":"Development and Psychometric Validation of a Questionnaire to Assess Attitudes Toward Medical Law Reasoning (MLRAQ)","authors":"Mohammad Abdi, Ali Norouzi, Mahboobeh Khabaz Mafinejad","doi":"10.1155/ijcp/5167920","DOIUrl":"https://doi.org/10.1155/ijcp/5167920","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Attitude toward medical law reasoning is the first step in improving medical law reasoning skills in physicians. Despite its importance, no validated instrument currently exists to assess it. This study aimed to develop and validate a Medical Law Reasoning Attitude Questionnaire (MLRAQ) in medical students.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The MLRAQ was developed based on the seven steps of AMEE Guide No. 87, related to designing questionnaires for educational research. In the first step, relevant articles were extracted through a systematic search. In the second step, medical law micro-skills were explored through a qualitative study by conducting 20 interviews. In the third and fourth steps, the identified medical law micro-skills were compared conceptually with previous studies, and the MLRAQ items were developed. Finally, content validity, cognitive interview, exploratory factor analysis, confirmatory factor analysis, and reliability analysis were performed in the fifth to seventh steps.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>MLRAQ consists of five factors and 24 items. The validation results showed that the content validity index (CVI) and content validity ratio (CVR) were greater than 0.90. Five subscales (prerequisites, problem identification, application of rule, analysis, and conclusion) explained 67.26% of the variance in exploratory factor analysis. Cronbach’s alpha = 0.894, indicating high internal consistency. ICC = 0.771–0.942, demonstrating strong reliability across measurements. In confirmatory factor analysis, SRMR and RMSEA were 0.078 and 0.058, respectively. GFI was 0.880, and CFI was 0.901, indicating acceptable fit indices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The MLRAQ demonstrated valid and reliable evidence. Therefore, this instrument can assess attitudes toward medical law reasoning.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/5167920","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145367008","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}
Betânia Ferreira Leite, Dalila Fernandes Gomes, Gustavo Laine Araújo de Oliveira, Roberta Borges Silva, Cecília Menezes Farinasso, Tania Sales de Alencar Fidelix, Virgínia Fernandes Moça Trevisani
Background
Osteoarthritis (OA) is a common illness that is widespread globally, especially among individuals aged 65 and older. Since 2019/2020, the OARSI and ACR recommendations have included the use of medicines such duloxetine, which function as analgesics for pain patients including central sensitization. Recent studies have assessed duloxetine as an adjunctive treatment in decreasing OA pain.
Objective
Assess the effectiveness and safety of duloxetine in treating OA pain in adults aged 40 and above.
Methods
We conducted a systematic review and meta-analysis of randomized clinical trials. The scientific evidence search was conducted in the following databases: MEDLINE via PubMed, Cochrane Library, Embase, LILACS, Web of Science, Scopus, CINAHL, ProQuest, SciELO, and Google Scholar.
Findings
The systematic review comprised nine randomized controlled trials (RCTs). The studies showed that using duloxetine for OA treatment was more effective than a placebo in achieving a 50% pain reduction (RR = 1.57, 95% CI = 1.31; 1.89) and a 30% pain reduction (RR = 1.41; 95% CI = 1.29; 1.55). This improvement was observed in pain, physical function, and stiffness as measured by the WOMAC subscales, as well as in the CGI-SEVERITY scale and the AUSCAN functional index. Duloxetine was found to be more effective than gabapentin and acetaminophen in treating moderate to severe knee OA, as it decreased ratings on the whole WOMAC scale and its subscales for pain, physical function, and stiffness. There was no statistically significant difference in adverse events between duloxetine and gabapentin, both of which were more effective than acetaminophen, which did not cause any adverse events.
Conclusion
This systematic review indicates that duloxetine is an effective treatment for pain in OA in adult patients over 40 years old, with a reasonable level of safety when compared to other centrally acting medications and placebo.
骨关节炎（OA）是一种全球普遍存在的常见病，尤其是在65岁及以上的人群中。自2019/2020年以来，OARSI和ACR的建议包括使用度洛西汀等药物，这些药物可作为疼痛患者的镇痛药，包括中枢致敏。最近的研究评估了度洛西汀作为减轻OA疼痛的辅助治疗。目的评价度洛西汀治疗40岁及以上成人OA疼痛的有效性和安全性。方法对随机临床试验进行系统评价和荟萃分析。在以下数据库中进行科学证据检索：MEDLINE通过PubMed、Cochrane Library、Embase、LILACS、Web of Science、Scopus、CINAHL、ProQuest、SciELO和谷歌Scholar。本系统综述包括9项随机对照试验（RCTs）。研究表明，使用度洛西汀治疗OA比安慰剂更有效，疼痛减轻50% (RR = 1.57, 95% CI = 1.31; 1.89)，疼痛减轻30% （RR = 1.41, 95% CI = 1.29; 1.55）。通过WOMAC亚量表以及cgi -严重性量表和AUSCAN功能指数测量，疼痛、身体功能和僵硬度均有改善。度洛西汀比加巴喷丁和对乙酰氨基酚在治疗中重度膝关节炎方面更有效，因为它降低了整个WOMAC量表及其子量表对疼痛、身体功能和僵硬的评分。度洛西汀与加巴喷丁的不良事件发生率无统计学差异，均优于对乙酰氨基酚，对乙酰氨基酚无不良事件发生。结论本系统评价表明，度洛西汀是治疗40岁以上成年OA患者疼痛的有效药物，与其他中枢作用药物和安慰剂相比具有合理的安全性。
{"title":"Efficacy and Safety of Duloxetine for the Treatment of Osteoarthritis: Systematic Review and Meta-Analysis","authors":"Betânia Ferreira Leite, Dalila Fernandes Gomes, Gustavo Laine Araújo de Oliveira, Roberta Borges Silva, Cecília Menezes Farinasso, Tania Sales de Alencar Fidelix, Virgínia Fernandes Moça Trevisani","doi":"10.1155/ijcp/4976407","DOIUrl":"https://doi.org/10.1155/ijcp/4976407","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Osteoarthritis (OA) is a common illness that is widespread globally, especially among individuals aged 65 and older. Since 2019/2020, the OARSI and ACR recommendations have included the use of medicines such duloxetine, which function as analgesics for pain patients including central sensitization. Recent studies have assessed duloxetine as an adjunctive treatment in decreasing OA pain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Assess the effectiveness and safety of duloxetine in treating OA pain in adults aged 40 and above.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a systematic review and meta-analysis of randomized clinical trials. The scientific evidence search was conducted in the following databases: MEDLINE via PubMed, Cochrane Library, Embase, LILACS, Web of Science, Scopus, CINAHL, ProQuest, SciELO, and Google Scholar.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>The systematic review comprised nine randomized controlled trials (RCTs). The studies showed that using duloxetine for OA treatment was more effective than a placebo in achieving a 50% pain reduction (RR = 1.57, 95% CI = 1.31; 1.89) and a 30% pain reduction (RR = 1.41; 95% CI = 1.29; 1.55). This improvement was observed in pain, physical function, and stiffness as measured by the WOMAC subscales, as well as in the CGI-SEVERITY scale and the AUSCAN functional index. Duloxetine was found to be more effective than gabapentin and acetaminophen in treating moderate to severe knee OA, as it decreased ratings on the whole WOMAC scale and its subscales for pain, physical function, and stiffness. There was no statistically significant difference in adverse events between duloxetine and gabapentin, both of which were more effective than acetaminophen, which did not cause any adverse events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This systematic review indicates that duloxetine is an effective treatment for pain in OA in adult patients over 40 years old, with a reasonable level of safety when compared to other centrally acting medications and placebo.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/4976407","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145367009","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}
Metabolic dysfunction–associated fatty liver disease (MAFLD) is the most common chronic liver condition with a bidirectional relation with multimetabolic disorders. By considering lifestyle interventions as the approved treatment strategy, several herbal products have been examined as conjugated therapy in the prevention/treatment of the disease. The annual herbaceous plant known as Salvia hispanica L. (chia) is an ancient grain trending in modern diets. Chia seeds are not only an excellent source of nutrients and bioactive compounds but also have shown effectiveness in the management of a number of metabolic disorders. However, studies on MAFLD are limited and mainly include animal models. Moreover, the exact molecular mechanisms by which chia influences MAFLD-related outcomes remain inadequately investigated. Hence, the aim of the present comprehensive review is to explore the effectiveness of chia supplementation in MAFLD by various forms (seeds, oil, and flour) with a view point on molecular pathways, metabolic regulation, and clinical outcomes.
{"title":"A Comprehensive Review on the Therapeutic Effects of Salvia hispanica L. (Chia) on Metabolic Dysfunction–Associated Fatty Liver Disease: Special Focus on Pathogenesis","authors":"Maryam Parimi, Sara Arefhosseini, Helda Tutunchi, Seyed Rafie Arefhosseini, Mehrangiz Ebrahimi-Mameghani","doi":"10.1155/ijcp/8660821","DOIUrl":"https://doi.org/10.1155/ijcp/8660821","url":null,"abstract":"<p>Metabolic dysfunction–associated fatty liver disease (MAFLD) is the most common chronic liver condition with a bidirectional relation with multimetabolic disorders. By considering lifestyle interventions as the approved treatment strategy, several herbal products have been examined as conjugated therapy in the prevention/treatment of the disease. The annual herbaceous plant known as <i>Salvia hispanica</i> L. (chia) is an ancient grain trending in modern diets. Chia seeds are not only an excellent source of nutrients and bioactive compounds but also have shown effectiveness in the management of a number of metabolic disorders. However, studies on MAFLD are limited and mainly include animal models. Moreover, the exact molecular mechanisms by which chia influences MAFLD-related outcomes remain inadequately investigated. Hence, the aim of the present comprehensive review is to explore the effectiveness of chia supplementation in MAFLD by various forms (seeds, oil, and flour) with a view point on molecular pathways, metabolic regulation, and clinical outcomes.</p>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/8660821","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145366398","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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