Yong Jie Tu, Wei Chen, Ning Xu, Pengrui Zhao, Lei Jiang, Bin Zhao
The application of ultrasound technology in rehabilitation therapy has garnered increasing popularity among physical therapists, with a growing body of evidence supporting its use. As an emerging rehabilitation technique, ultrasound imaging presents numerous challenges, including the lack of standardized operating procedures, unclear operational parameters, and intervention responses, which necessitate further exploration. This study aims to provide an overview of the application of ultrasound technology in physical therapy–assisted rehabilitation. It covers various rehabilitation fields such as postpartum recovery, musculoskeletal pain rehabilitation, and speech and swallowing rehabilitation. The study introduces the concept of rehabilitative ultrasound imaging (RUSI) and its application in visualizing patient dysfunction and treatment responses. Additionally, it highlights the role of this technology as a biofeedback tool in physical therapy and discusses the limitations of RUSI to enhance physical therapists’ understanding of its application.
{"title":"Advances in the Application of Ultrasound Imaging Technology in Physical Therapy–Assisted Rehabilitation","authors":"Yong Jie Tu, Wei Chen, Ning Xu, Pengrui Zhao, Lei Jiang, Bin Zhao","doi":"10.1155/ijcp/6698518","DOIUrl":"https://doi.org/10.1155/ijcp/6698518","url":null,"abstract":"<p>The application of ultrasound technology in rehabilitation therapy has garnered increasing popularity among physical therapists, with a growing body of evidence supporting its use. As an emerging rehabilitation technique, ultrasound imaging presents numerous challenges, including the lack of standardized operating procedures, unclear operational parameters, and intervention responses, which necessitate further exploration. This study aims to provide an overview of the application of ultrasound technology in physical therapy–assisted rehabilitation. It covers various rehabilitation fields such as postpartum recovery, musculoskeletal pain rehabilitation, and speech and swallowing rehabilitation. The study introduces the concept of rehabilitative ultrasound imaging (RUSI) and its application in visualizing patient dysfunction and treatment responses. Additionally, it highlights the role of this technology as a biofeedback tool in physical therapy and discusses the limitations of RUSI to enhance physical therapists’ understanding of its application.</p>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/6698518","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145572479","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}
Negative fluid balance during continuous renal replacement therapy (CRRT) is associated with improved clinical outcomes. The effects of negative fluid balance in patients with heterogeneous characteristics undergoing CRRT remain unknown.
Methods
This retrospective study included 2658 adult patients who received CRRT for ≥ 4 days between 2009 and 2020. Patients were divided according to disease category. Fluid balance was assessed using percent change in body weight (PCB) or cumulative input/output (I/O). Primary outcome was 90-day mortality.
Results
More positive PCB results in the fluid overload phase and fewer negative PCB results in the fluid removal phase were associated with mortality. A less negative PCB in the fluid removal phase was associated with mortality in medical patients (odds ratio [OR]: 1.052; 95% confidence interval [CI]: 1.023–1.082, and p = 0.001 in the medical patients and OR: 1.064; 95% CI: 1.011–1.120, and p = 0.017 in cardiovascular medical patients) but not in surgical patients. In patients with discrepancies between PCB and cumulative I/O, PCB was associated with mortality, which was consistent with the overall pattern; however, cumulative I/O was not associated with mortality.
Conclusions
Early negative fluid balance is associated with better survival in medical patients but not in surgical patients, who may require more careful fluid balance.
{"title":"Association Between Fluid Balance and 90-Day Mortality in CRRT Patients: A Retrospective Analysis by Disease Category","authors":"Sungbin Yoon, Kyungho Lee, Hye Ryoun Jang, Jung Eun Lee, Wooseong Huh, Junseok Jeon","doi":"10.1155/ijcp/9988442","DOIUrl":"https://doi.org/10.1155/ijcp/9988442","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Negative fluid balance during continuous renal replacement therapy (CRRT) is associated with improved clinical outcomes. The effects of negative fluid balance in patients with heterogeneous characteristics undergoing CRRT remain unknown.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study included 2658 adult patients who received CRRT for ≥ 4 days between 2009 and 2020. Patients were divided according to disease category. Fluid balance was assessed using percent change in body weight (PCB) or cumulative input/output (I/O). Primary outcome was 90-day mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>More positive PCB results in the fluid overload phase and fewer negative PCB results in the fluid removal phase were associated with mortality. A less negative PCB in the fluid removal phase was associated with mortality in medical patients (odds ratio [OR]: 1.052; 95% confidence interval [CI]: 1.023–1.082, and <i>p</i> = 0.001 in the medical patients and OR: 1.064; 95% CI: 1.011–1.120, and <i>p</i> = 0.017 in cardiovascular medical patients) but not in surgical patients. In patients with discrepancies between PCB and cumulative I/O, PCB was associated with mortality, which was consistent with the overall pattern; however, cumulative I/O was not associated with mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Early negative fluid balance is associated with better survival in medical patients but not in surgical patients, who may require more careful fluid balance.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/9988442","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145572308","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}
Spirometry remains the cornerstone for diagnosing obstructive and restrictive lung disorders, yet the reference equation used to define “normal” function can significantly shift diagnostic outcomes, particularly in underrepresented populations. While the global lung function initiative (GLI) provides several equation sets, the implications of switching among them have not been fully explored in Middle Eastern populations. Therefore, the present study aimed to evaluate how diagnostic classification of respiratory disease changes when applying different GLI equations. This retrospective analysis included spirometric measures of 9731 participants obtained at a specialized allergy and asthma center in Anbar, Iraq. The cohort comprised both patients and individuals examined for other purposes, with 4341 males and 5390 females, and a markedly sex-skewed smoking prevalence (28.4% in males vs. 1.6% in females). Predicted values, lower limits of normal (LLN), and z-scores were computed using the GLI Caucasian (GLI-C), GLI Other or Mixed (GLI-O), and the more recent race-neutral GLI equation (GLI-N). Diagnostic classifications for each equation were compared and stratified by sex and smoking status. GLI-C equations consistently yielded higher predicted values and more negative z-scores. The GLI-O identified more cases of obstruction, with the GLI-N producing the largest proportion of normal classifications. Reclassification was common, particularly from restrictive to normal categories. The agreement between equations ranged from 0.80 to 0.94. The choice of reference equations significantly affects spirometric interpretation among this Iraqi cohort. It is recommended that laboratories and clinics explicitly report, justify, and standardize the selected reference set and prioritize prospective evaluations comparing GLI-N, GLI-O, and local equations with clinical correlates such as symptoms and outcomes to reduce misclassification across Middle Eastern populations.
{"title":"Impact of Different Spirometric Reference Equations on Diagnosing Respiratory Diseases in Iraqi Patients","authors":"Alaa Hussein Alsajri, Walid Al-Qerem, Dzul Azri Mohamed Noor, Judith Eberhardt, Lama Sawaftah","doi":"10.1155/ijcp/1959021","DOIUrl":"https://doi.org/10.1155/ijcp/1959021","url":null,"abstract":"<p>Spirometry remains the cornerstone for diagnosing obstructive and restrictive lung disorders, yet the reference equation used to define “normal” function can significantly shift diagnostic outcomes, particularly in underrepresented populations. While the global lung function initiative (GLI) provides several equation sets, the implications of switching among them have not been fully explored in Middle Eastern populations. Therefore, the present study aimed to evaluate how diagnostic classification of respiratory disease changes when applying different GLI equations. This retrospective analysis included spirometric measures of 9731 participants obtained at a specialized allergy and asthma center in Anbar, Iraq. The cohort comprised both patients and individuals examined for other purposes, with 4341 males and 5390 females, and a markedly sex-skewed smoking prevalence (28.4% in males vs. 1.6% in females). Predicted values, lower limits of normal (LLN), and <i>z</i>-scores were computed using the GLI Caucasian (GLI-C), GLI Other or Mixed (GLI-O), and the more recent race-neutral GLI equation (GLI-N). Diagnostic classifications for each equation were compared and stratified by sex and smoking status. GLI-C equations consistently yielded higher predicted values and more negative <i>z</i>-scores. The GLI-O identified more cases of obstruction, with the GLI-N producing the largest proportion of normal classifications. Reclassification was common, particularly from restrictive to normal categories. The agreement between equations ranged from 0.80 to 0.94. The choice of reference equations significantly affects spirometric interpretation among this Iraqi cohort. It is recommended that laboratories and clinics explicitly report, justify, and standardize the selected reference set and prioritize prospective evaluations comparing GLI-N, GLI-O, and local equations with clinical correlates such as symptoms and outcomes to reduce misclassification across Middle Eastern populations.</p>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/1959021","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145572309","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}
Jiarong Fan, Gaoyu Zhang, Shuai Gao, He Chen, Xinyu Shen, Wei Wang, Jiani Wu, Zhishun Liu
Purpose
To evaluate nondrug treatments for hot flashes (HFs) in prostate cancer (PC) patients.
Methods
Eight databases (Cochrane Library, Embase, PubMed, Web of Science, ClinicalTrials.gov, China National Knowledge Infrastructure, Wanfang Data, and Chinese Biomedical Literature Service System) were searched from their inception to May 2025. R software was used to conduct the meta-analysis. Risk of bias and the overall quality of evidence were assessed using the Risk of Bias 2.0 tool and the Grade Profiler 3.6.
Results
A total of 5 studies were included, and 4 were eligible for meta-analysis. Compared to the control group, nonpharmacological therapies showed a small but significant improvement in the severity of HFs (d = −0.27; 95% CI: −0.81 to 0.26; p = 0.1; I2 = 57.4%) but was not statistically significant with HFs frequency (d = 0.2; 95% CI: −0.11 to 0.5; p = 0.34; I2 = 11.1%). Cognitive-behavioral therapy (CBT) showed short-term reductions in HFs severity and psychological distress, but these benefits diminished over time. One trial reported significant HF frequency reductions with both electroacupuncture and traditional acupuncture, with benefits persisting up to 9 months, though no modality outperformed the other. Dietary interventions (soy protein) yielded inconsistent HFs relief but transient QoL improvements. High heterogeneity in intervention protocols, small sample sizes, and variable outcome measures limited comparability. Adverse events were minimal and mild.
Conclusion
Nonpharmacological therapies (e.g., CBT and acupuncture) may help alleviate ADT-related HFs in PC patients. However, the evidence is limited; future large-scale, high-quality research is required to verify effectiveness.
目的探讨前列腺癌（PC）患者潮热（HFs）的非药物治疗方法。方法检索自Cochrane Library、Embase、PubMed、Web of Science、ClinicalTrials.gov、中国国家知识基础设施、万方数据、中国生物医学文献服务系统等8个数据库。采用R软件进行meta分析。使用Risk of bias 2.0工具和Grade Profiler 3.6评估偏倚风险和总体证据质量。结果共纳入5项研究，其中4项符合meta分析。与对照组相比，非药物治疗对hf的严重程度有轻微但显著的改善（d = - 0.27; 95% CI: - 0.81 ~ 0.26; p = 0.1; I2 = 57.4%），但对hf发生频率无统计学意义（d = 0.2; 95% CI: - 0.11 ~ 0.5; p = 0.34; I2 = 11.1%）。认知行为疗法（CBT）在短期内降低了HFs的严重程度和心理困扰，但随着时间的推移，这些益处逐渐减少。一项试验报告了电针和传统针灸均能显著降低高频频率，其益处持续长达9个月，尽管没有一种方式优于另一种。饮食干预（大豆蛋白）产生了不一致的HFs缓解，但短暂的生活质量改善。干预方案的高异质性、小样本量和可变结果测量限制了可比性。不良事件极少且轻微。结论非药物治疗（如CBT和针灸）可能有助于缓解PC患者adt相关性HFs。然而，证据是有限的；未来需要大规模、高质量的研究来验证其有效性。
{"title":"Nonpharmacological Therapies for Hot Flashes in Prostate Cancer: A Systematic Review and Meta-Analysis of Randomized Clinical Trials","authors":"Jiarong Fan, Gaoyu Zhang, Shuai Gao, He Chen, Xinyu Shen, Wei Wang, Jiani Wu, Zhishun Liu","doi":"10.1155/ijcp/6017883","DOIUrl":"https://doi.org/10.1155/ijcp/6017883","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To evaluate nondrug treatments for hot flashes (HFs) in prostate cancer (PC) patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Eight databases (Cochrane Library, Embase, PubMed, Web of Science, ClinicalTrials.gov, China National Knowledge Infrastructure, Wanfang Data, and Chinese Biomedical Literature Service System) were searched from their inception to May 2025. R software was used to conduct the meta-analysis. Risk of bias and the overall quality of evidence were assessed using the Risk of Bias 2.0 tool and the Grade Profiler 3.6.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 5 studies were included, and 4 were eligible for meta-analysis. Compared to the control group, nonpharmacological therapies showed a small but significant improvement in the severity of HFs (<i>d</i> = −0.27; 95% CI: −0.81 to 0.26; <i>p</i> = 0.1; <i>I</i><sup>2</sup> = 57.4%) but was not statistically significant with HFs frequency (<i>d</i> = 0.2; 95% CI: −0.11 to 0.5; <i>p</i> = 0.34; <i>I</i><sup>2</sup> = 11.1%). Cognitive-behavioral therapy (CBT) showed short-term reductions in HFs severity and psychological distress, but these benefits diminished over time. One trial reported significant HF frequency reductions with both electroacupuncture and traditional acupuncture, with benefits persisting up to 9 months, though no modality outperformed the other. Dietary interventions (soy protein) yielded inconsistent HFs relief but transient QoL improvements. High heterogeneity in intervention protocols, small sample sizes, and variable outcome measures limited comparability. Adverse events were minimal and mild.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Nonpharmacological therapies (e.g., CBT and acupuncture) may help alleviate ADT-related HFs in PC patients. However, the evidence is limited; future large-scale, high-quality research is required to verify effectiveness.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/6017883","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145521789","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}
Influenza-like syndromes (ILS), characterized by fever, cough, myalgia, and fatigue, present significant challenges in clinical management. Paracetamol (acetaminophen), known for its antipyretic and analgesic properties, is widely used to alleviate these symptoms. This article reports the results of an expert consensus on the efficacy, safety, and appropriate use of paracetamol in managing ILS, particularly in vulnerable populations.
Methods
A Delphi methodology was employed to gather expert opinions from 72 healthcare professionals, including general practitioners (GPs) and infectious disease specialists. The panelists rated 27 statements on a 5-point Likert scale, with a consensus threshold set at 66%. Statements covered the efficacy, safety, drug interactions, and patient communication related to paracetamol use in ILS. Results were presented in aggregate form, with specific attention to areas of consensus and divergence.
Results
The panel reached consensus on 26 out of 27 statements. Paracetamol was unanimously recognized as the preferred treatment for ILS due to its effective symptom control and minimal risk of drug interactions. It was deemed safer for fragile populations, including the elderly and those with multiple comorbidities. Concerns regarding hepatotoxicity were noted mainly in cases of overdose; however, rare cases have been reported even at therapeutic doses in patients with pre-existing liver disease, where alternative antipyretics may sometimes be considered. Divergence occurred in opinions on the potential immunosuppressive effects of nonsteroidal anti-inflammatory drugs and the associated risk of bacterial superinfections.
Conclusions
Paracetamol is a safer and more suitable option for managing ILS. This work highlights the need for further research on its frequent use in specific populations and emphasizes the importance of patient education on appropriate dosing to improve medication safety and compliance.
{"title":"Management of Influenza-Like Syndromes: Expert Consensus on the Use of Paracetamol","authors":"Ignazio Grattagliano, Massimo Andreoni, Annamaria Cattelan, Pierangelo Lora Aprile, Alessandro Rossi, Roberto Parrella","doi":"10.1155/ijcp/4880395","DOIUrl":"https://doi.org/10.1155/ijcp/4880395","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Influenza-like syndromes (ILS), characterized by fever, cough, myalgia, and fatigue, present significant challenges in clinical management. Paracetamol (acetaminophen), known for its antipyretic and analgesic properties, is widely used to alleviate these symptoms. This article reports the results of an expert consensus on the efficacy, safety, and appropriate use of paracetamol in managing ILS, particularly in vulnerable populations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A Delphi methodology was employed to gather expert opinions from 72 healthcare professionals, including general practitioners (GPs) and infectious disease specialists. The panelists rated 27 statements on a 5-point Likert scale, with a consensus threshold set at 66%. Statements covered the efficacy, safety, drug interactions, and patient communication related to paracetamol use in ILS. Results were presented in aggregate form, with specific attention to areas of consensus and divergence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The panel reached consensus on 26 out of 27 statements. Paracetamol was unanimously recognized as the preferred treatment for ILS due to its effective symptom control and minimal risk of drug interactions. It was deemed safer for fragile populations, including the elderly and those with multiple comorbidities. Concerns regarding hepatotoxicity were noted mainly in cases of overdose; however, rare cases have been reported even at therapeutic doses in patients with pre-existing liver disease, where alternative antipyretics may sometimes be considered. Divergence occurred in opinions on the potential immunosuppressive effects of nonsteroidal anti-inflammatory drugs and the associated risk of bacterial superinfections.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Paracetamol is a safer and more suitable option for managing ILS. This work highlights the need for further research on its frequent use in specific populations and emphasizes the importance of patient education on appropriate dosing to improve medication safety and compliance.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/4880395","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145521751","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}
Our objective was to analyze the impact of previous infection with atypical pneumonia pathogens on mortality in COVID-19 patients.
Materials and Methods
We retrospectively studied complete blood count, procalcitonin, C-reactive protein, D-dimer, ferritin, biochemistry, antibody levels of atypical pneumonia pathogens, and COVID-19 (SARS-CoV-2) reverse transcriptase-polymerase chain reaction (PCR) test results in combined (pharyngeal + nasopharyngeal) swab specimens from the airways of patients admitted to the pandemic wards and intensive care units of Adıyaman Training and Research Hospital between 04/01/2020 and 12/31/2021. Patients with positive COVID-19 PCR test results were included in the study.
Results
The mean age of the 323 patients was 60.9 ± 18.5 years, and 58.8% were male. When comparing patients with positive and negative antibodies to atypical pneumonia pathogens, we found no differences in mean age, sex, place of hospitalization, length of hospital stay, need for intensive care, and mortality. However, CRP, D-dimer, and ferritin were significantly higher in the group of patients with antibody positivity for atypical pneumonia pathogens (p values 0.008, 0.004, and 0.004). According to the results of multivariate regression analysis in COVID-19 patients with positive antibodies with respect to atypical pneumonia pathogens, a glucose level higher than 148.5, an AST level higher than 26.5, and a lymphocyte count lower than 0.54 were found to be the most important risk factors for mortality in these patients (OR = 2.2, 95% CI 1.1–4.3, and p = 0.048, OR = 3.0, 95% CI 1.2–7.2, and p = 0.015, and OR = 4.1, 95% CI 1.9–8.9, and p < 0.001, respectively). According to the results of multivariate regression analysis, no risk factors for mortality were identified in patients with COVID-19 without positive antibodies against atypical pneumonia pathogens.
Conclusion
We found no association between positivity of antibodies of atypical pneumonia pathogens and mortality in COVID-19 patients. However, elevated glucose and AST levels and low lymphocyte count were found to be important risk factors for mortality in COVID-19 patients with positive antibodies against atypical pneumonia pathogens.
目的分析既往非典型肺炎病原菌感染对COVID-19患者死亡率的影响。材料与方法回顾性研究了全血细胞计数、降钙素原、c反应蛋白、d -二聚体、铁蛋白、生化、非典型肺炎病原体抗体水平、对2020年4月1日至2021年12月31日在Adıyaman培训研究医院大流行病房和重症监护病房就诊的患者呼吸道联合（咽+鼻咽）拭子标本进行COVID-19 （SARS-CoV-2）逆转录聚合酶链反应（PCR）检测。将COVID-19 PCR检测结果阳性的患者纳入研究。结果323例患者平均年龄60.9±18.5岁，男性占58.8%。当比较非典型肺炎病原体抗体阳性和阴性的患者时，我们发现在平均年龄、性别、住院地点、住院时间、需要重症监护和死亡率方面没有差异。然而，CRP、d -二聚体和铁蛋白在非典型肺炎病原体抗体阳性的患者组中显著升高（p值分别为0.008、0.004和0.004）。根据多元回归分析的结果在COVID-19患者积极的抗体对非典型肺炎的病原体,血糖水平高于148.5,AST水平高于26.5,淋巴细胞计数低于0.54被发现是最重要的这些患者的死亡率的危险因素(OR = 2.2, 95% CI 1.1 - -4.3, p = 0.048, = 3.0, 95% CI 1.2 - -7.2, p = 0.015,或= 4.1,95% CI 1.9 - -8.9, p & lt; 0.001,分别)。多因素回归分析结果显示，非典型肺炎病原体抗体阳性的COVID-19患者未发现死亡危险因素。结论非典型肺炎病原体抗体阳性与COVID-19患者死亡率无相关性。然而，血糖和AST水平升高以及淋巴细胞计数低被发现是COVID-19非典型肺炎病原体抗体阳性患者死亡的重要危险因素。
{"title":"Relationship Between Atypical Pneumonia Agent Antibody Positivity, Laboratory Parameters, and Mortality in COVID-19 Patients","authors":"Ercan Çil, Gülistan Karadeniz, Gökhan Çoraplı, Ayşe Şahin Tutak, Emre Bayhan, Doğan Açar, Hakan Sezgin Sayiner","doi":"10.1155/ijcp/4342794","DOIUrl":"https://doi.org/10.1155/ijcp/4342794","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Our objective was to analyze the impact of previous infection with atypical pneumonia pathogens on mortality in COVID-19 patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We retrospectively studied complete blood count, procalcitonin, C-reactive protein, D-dimer, ferritin, biochemistry, antibody levels of atypical pneumonia pathogens, and COVID-19 (SARS-CoV-2) reverse transcriptase-polymerase chain reaction (PCR) test results in combined (pharyngeal + nasopharyngeal) swab specimens from the airways of patients admitted to the pandemic wards and intensive care units of Adıyaman Training and Research Hospital between 04/01/2020 and 12/31/2021. Patients with positive COVID-19 PCR test results were included in the study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean age of the 323 patients was 60.9 ± 18.5 years, and 58.8% were male. When comparing patients with positive and negative antibodies to atypical pneumonia pathogens, we found no differences in mean age, sex, place of hospitalization, length of hospital stay, need for intensive care, and mortality. However, CRP, D-dimer, and ferritin were significantly higher in the group of patients with antibody positivity for atypical pneumonia pathogens (<i>p</i> values 0.008, 0.004, and 0.004). According to the results of multivariate regression analysis in COVID-19 patients with positive antibodies with respect to atypical pneumonia pathogens, a glucose level higher than 148.5, an AST level higher than 26.5, and a lymphocyte count lower than 0.54 were found to be the most important risk factors for mortality in these patients (OR = 2.2, 95% CI 1.1–4.3, and <i>p</i> = 0.048, OR = 3.0, 95% CI 1.2–7.2, and <i>p</i> = 0.015, and OR = 4.1, 95% CI 1.9–8.9, and <i>p</i> < 0.001, respectively). According to the results of multivariate regression analysis, no risk factors for mortality were identified in patients with COVID-19 without positive antibodies against atypical pneumonia pathogens.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We found no association between positivity of antibodies of atypical pneumonia pathogens and mortality in COVID-19 patients. However, elevated glucose and AST levels and low lymphocyte count were found to be important risk factors for mortality in COVID-19 patients with positive antibodies against atypical pneumonia pathogens.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/4342794","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145521670","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}
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}
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