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Clinical Feature and Predictive Model for Transplanted Patients With Functional High-Risk Multiple Myeloma 功能性高风险多发性骨髓瘤移植患者的临床特征及预测模型
IF 3.4 3区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2025-09-04 DOI: 10.1016/j.arcmed.2025.103291
Tongyong Yu , Meilan Chen , Beihui Huang, Junru Liu, Xiaozhe Li, Jingli Gu, Yanjuan Li, Juan Li

Objective

A subset of patients with multiple myeloma (MM) experience early relapse despite the absence of any high-risk features at diagnosis, defined as functional high-risk (FHR) MM with inferior prognosis. This study compared FHR and standard risk (SR) MM cohorts to investigate clinical risk factors and establish a validated prognostic model for early prediction of FHR in patients with MM that were transplanted.

Methods

A retrospective cohort study was conducted to analyze the clinical data of patients with MM. Univariate and multivariate analyses were performed to identify independent risk factors for FHR-MM. A prognostic nomogram was developed through logistic regression analysis and internally validated.

Results

The study cohort comprised 357 MM patients. Univariate and multivariate analyses identified the following as independent predictors of FHR-MM: lactate dehydrogenase (LDH) ≥190 U/L, PET-CT SUVmax ≥7.5 at baseline, post-induction ≥80% reduction in PET-CT SUVmax, platelet count <80×109/L, ferritin ≥650 µg/L, Pattern B of M-protein decline, and achieved complete remission (CR) after autologous stem cell transplantation (ASCT). The derived predictive model demonstrated area under the curve (AUC) scores of 0.753 (95% CI 0.666–0.840) for the training set and 0.857 (95% CI 0.759–0.954) for the validation set.

Conclusion

This study established a predictive nomogram for transplanted patients with FHR-MM that demonstrates robust discriminative capacity through internal validation.
目的:一部分多发性骨髓瘤(MM)患者在诊断时没有任何高危特征,但早期复发,定义为预后不良的功能性高风险(FHR) MM。本研究比较了FHR和标准风险(SR) MM队列,以探讨临床危险因素,并建立一个有效的预后模型,用于早期预测MM移植患者FHR的发生。方法采用回顾性队列研究对MM患者的临床资料进行分析,通过单因素和多因素分析确定FHR-MM的独立危险因素。通过逻辑回归分析和内部验证开发了预后nomogram。结果研究队列包括357例MM患者。单因素和多因素分析确定以下为FHR-MM的独立预测因素:乳酸脱氢酶(LDH)≥190 U/L,基线时PET-CT SUVmax≥7.5,诱导后PET-CT SUVmax降低≥80%,血小板计数和lt 80×109/L,铁蛋白≥650µg/L, m蛋白B型下降,自体干细胞移植(ASCT)后达到完全缓解(CR)。导出的预测模型显示,训练集的曲线下面积(AUC)得分为0.753 (95% CI 0.666-0.840),验证集的AUC得分为0.857 (95% CI 0.759-0.954)。结论本研究建立了FHR-MM移植患者的预测nomogram,该nomogram通过内部验证显示了稳健的判别能力。
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引用次数: 0
Use and Conditions of a Breastfeeding Room in a Tertiary Health Institution: An Exploratory Study 三级卫生机构母乳喂养室的使用和条件:一项探索性研究
IF 3.4 3区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2025-08-28 DOI: 10.1016/j.arcmed.2025.103284
Loraine Ledón-Llanes , Martha Kaufer-Horwitz , Consuelo Lomas-Soria , Berenice Palacios-González , Elena Zambrano

Background

Creating environments that facilitate breastfeeding (BF) practice in the workplace is an effective way to promote BF. However, few studies have addressed this sensitive and relevant topic in Mexican healthcare institutions.

Objective

Describe the conditions and use of the breastfeeding room (BFR) at a tertiary health institution and identify the perceptions of reproductive-age female workers, and the department heads and human resources staff (DH/HR).

Methods

A cross-sectional study (observational and exploratory) was conducted with 150 female reproductive-age workers and 41 DH/HR staff. They completed self-administered questionnaires, and responded to a semi-structured interview guide designed for the study. Participant observations were conducted in the BFR. Descriptive and inferential analyses were performed, considering statistical significance at p<0.05.

Results

Only 40 of the women of reproductive-age were aware of the existence of the BFR; and only one of the 20 who knew the specific location considered it to have proper conditions for milk extraction and storage. Between 21 and 28% of the participants considered that BF promotion actions were being conducted at the Institute. Although 61% of DH/HR reported knowing the existence of the BFR, the majority (80%) did not know if any female worker had used it.

Conclusions

Most of the Institute’s female workers of reproductive age did not know of the BFR’s existence, seldom used it, and said it lacked optimal conditions. Efforts to improve BFR conditions and functioning, as well as raise breastfeeding awareness at the workplace must be systematically promoted.
在工作场所创造有利于母乳喂养(BF)实践的环境是促进BF的有效途径。然而,很少有研究在墨西哥医疗保健机构中解决这一敏感和相关的主题。目的描述某三级卫生机构母乳喂养室(BFR)的条件和使用情况,并确定育龄女工、部门主管和人力资源工作人员(DH/HR)的看法。方法采用横断面研究(观察性和探索性)对150名育龄女工和41名卫生/人力资源工作人员进行调查。他们完成了自我管理的问卷,并回答了为研究设计的半结构化访谈指南。参与者在BFR中进行观察。进行描述性和推断性分析,考虑统计学显著性为p<;0.05。结果育龄妇女中仅有40人知晓BFR的存在;在知道具体地点的20人中,只有一人认为那里有合适的条件提取和储存牛奶。21%至28%的参与者认为该研究所正在开展男友推广活动。尽管61%的卫生保健/人力资源报告知道BFR的存在,但大多数(80%)不知道是否有女工使用过BFR。结论大多数育龄女工不知道BFR的存在,很少使用BFR,并表示BFR缺乏最佳条件。必须系统地促进改善BFR条件和功能以及提高工作场所母乳喂养意识的努力。
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引用次数: 0
A Pattern of Increased Aggressiveness for Colorectal Cancer in Northern Mexico: A Multicenter Retrospective Cohort From 2018 to 2023 墨西哥北部结直肠癌侵袭性增加的模式:2018年至2023年的多中心回顾性队列
IF 3.4 3区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2025-08-27 DOI: 10.1016/j.arcmed.2025.103285
Raymundo A. Muñoz Cabello , Luis A. Hernández Flores , Alfonzo E. Muñoz Cabello , Salvador Pizarro Chávez

Background

Colorectal cancer (CRC) is the third most prevalent cancer worldwide and the second leading cause of cancer-related deaths. Early-onset CRC is often more aggressive and is on the rise. In Mexico, 16,082 cases were diagnosed in 2022; however, epidemiological data remain limited—especially in northern regions where red meat consumption is high and screening adherence is low. This study aims to identify regional CRC trends in Chihuahua, a northeastern Mexican state.

Methods

A retrospective cohort study of CRC cases from 2018 to 2023 was conducted at two centers in Chihuahua City. Data on demographics, tumor location, stage, and genetic testing (KRAS, NRAS, and BRAF) were obtained from medical and pathology records. Analysis included descriptive statistics, t-tests and χ2 tests (p≤0.05), and a moving average analysis to assess annual trends.

Results

Among 451 CRC cases, the mean age was 60 ± 12 years and 57.8% were male. Two-thirds presented with advanced-stage disease (III/IV). Patients ≤49 years showed a high prevalence of proximal tumors and advanced-stage diagnoses, especially stage IVc. Over half of metastatic cases lacked genetic analysis. There was a U-shaped trend among age groups, with patients under 50 and over 70 being diagnosed at higher clinical stages (p=0.6).

Conclusions

The high proportion of advanced-stage CRC in patients under 50, combined with the lack of genetic testing, highlights two key issues in our region: aggressive disease and limited access to adequate care. These findings underscore the need for targeted research and improved public health strategies in high-risk areas such as northern Mexico.
结直肠癌(CRC)是全球第三大流行癌症,也是癌症相关死亡的第二大原因。早发性结直肠癌通常更具侵袭性,并且呈上升趋势。在墨西哥,2022年确诊病例为16082例;然而,流行病学数据仍然有限,特别是在红肉消费量高、筛查依从性低的北部地区。本研究旨在确定墨西哥东北部奇瓦瓦州的区域CRC趋势。方法对2018 - 2023年美国奇瓦瓦市两个中心的结直肠癌病例进行回顾性队列研究。从医学和病理记录中获得人口统计学、肿瘤位置、分期和基因检测(KRAS、NRAS和BRAF)的数据。分析采用描述性统计、t检验和χ2检验(p≤0.05),并采用移动平均分析评估年度趋势。结果451例结直肠癌患者平均年龄为60±12岁,男性占57.8%。三分之二的患者表现为晚期疾病(III/IV)。≤49岁的患者近端肿瘤和晚期诊断的患病率较高,尤其是IVc期。超过一半的转移病例缺乏基因分析。50岁以下和70岁以上患者的临床分期较高,各年龄组呈u型趋势(p=0.6)。结论:50岁以下晚期结直肠癌患者比例高,再加上缺乏基因检测,突出了本地区的两个关键问题:疾病侵袭性和获得适当护理的机会有限。这些发现强调了在墨西哥北部等高风险地区进行有针对性的研究和改进公共卫生战略的必要性。
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引用次数: 0
Ethical considerations in the use of add-ons in assisted reproductive technologies 辅助生殖技术中使用附加组件的伦理考虑
IF 3.4 3区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2025-08-25 DOI: 10.1016/j.arcmed.2025.103287
Rocío Núñez Calonge , Rafael Trinchant , Josep Santaló , Fernando Abellán , Lydia Feito , Alfonso De La Fuente , Javier Marqueta , Montserrat Roca , Marina Martinez , Elisa Salo , Ignacio Arnott , Víctor Saul Vital Reyes
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引用次数: 0
Mechanism of SENP1-Mediated Regulation of Liver Sinusoidal Endothelial Cells to Promote Regeneration Via the HIF-1α Signaling Pathway senp1通过HIF-1α信号通路调控肝窦内皮细胞促进再生的机制
IF 3.4 3区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2025-08-22 DOI: 10.1016/j.arcmed.2025.103295
Zhe Qing , Jian Duan , Qun Luo , Jinlan He , Hanfei Huang , Zhong Zeng

Background and Aims

Liver sinusoidal endothelial cells (LSECs) play a critical role in liver regeneration, but the specific molecular mechanism underlying this process remains unclear. Previous studies have shown that Sentrin/SUMO-specific protease 1 (SENP1) maintains the differentiation state of LSECs and promotes their proliferation under hypoxic conditions; however, the role of SENP1 in promoting liver regeneration by regulating LSECs is still unknown.

Methods

We employed a 70% hepatectomy (PHx) mouse model to explore the molecular mechanism underlying SENP1 regulation of LSECs and to observe the promotion of liver regeneration via the HIF-1α signaling pathway in vitro and in vivo.

Results

First, we found that the liver regeneration began on the first day after hepatectomy, while SENP1 expression in liver tissue was significantly upregulated. After SENP1 downregulation, the expression of Ki-67 and von Willebrand factor (vWF) in liver tissue decreased, as did the rate of liver regeneration. Second, in vitro, the proliferation activity of LSECs with SENP1 overexpression increased, and fenestration was better maintained. After co-culturing hepatocytes with LSECs that overexpress SENP1, an EdU assay showed that hepatocyte proliferation ability increased significantly. However, the opposite occurred when either a SENP1 or a HIF-1α inhibitor was used. In vivo, we observed that SENP1 can activate the VEGF/VEGFR2/Id1 signaling axis, upregulating the expression of VEGF and HGF through the HIF-1α signaling pathway, thus promoting hepatocyte proliferation and angiogenesis.

Conclusions

SENP1 may promote liver regeneration by regulating LSECs dependent on the HIF-1α signaling pathway.
背景和目的:肝窦内皮细胞(LSECs)在肝脏再生中起着关键作用,但这一过程的具体分子机制尚不清楚。先前的研究表明,Sentrin/ sumo特异性蛋白酶1 (SENP1)在缺氧条件下维持LSECs的分化状态,促进其增殖;然而,SENP1通过调节LSECs促进肝脏再生的作用尚不清楚。方法采用70%肝切除(PHx)小鼠模型,探讨SENP1调控LSECs的分子机制,并在体外和体内观察HIF-1α信号通路对肝脏再生的促进作用。结果首先,我们发现肝脏再生开始于肝切除术后第一天,肝组织中SENP1的表达显著上调。SENP1下调后,肝组织中Ki-67和血管性血变因子(vWF)的表达下降,肝脏再生率下降。其次,在体外,SENP1过表达的LSECs增殖活性增强,并且能更好地维持开窗状态。将肝细胞与过表达SENP1的LSECs共培养后,EdU检测显示肝细胞的增殖能力显著增强。然而,当使用SENP1或HIF-1α抑制剂时,情况正好相反。在体内,我们观察到SENP1可以激活VEGF/VEGFR2/Id1信号轴,通过HIF-1α信号通路上调VEGF和HGF的表达,从而促进肝细胞增殖和血管生成。结论senp1可能通过HIF-1α信号通路调控LSECs促进肝脏再生。
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引用次数: 0
Biochemical Profile of Recovered Individuals With Mild COVID-19: A Cross-Sectional View at Two Different Time Points 轻度COVID-19恢复个体的生化特征:两个不同时间点的横断面观察
IF 3.4 3区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2025-08-20 DOI: 10.1016/j.arcmed.2025.103286
Uzair Abbas , Ishfaque Ahmed , Muhib Ullah Khalid , Sumbal Hafeez , Sawairah Mukhtiar , Niaz Hussain , Maryam Nasrumminallah , Muhammad Shahid Khan , Nisha Babar , Shizrah Ashraf , Pershad Kumar

Aim

This study was designed to cross–sectionally evaluate the frequency of long COVID-19, along with their hematological and biochemical parameters in survivors of mild COVID-19 after 6–15 months of acute infection.

Methods

We recruited 75 age-matched healthy controls (HC) and 150 individuals who had recovered from mild cases of COVID-19. The recovered individuals were grouped according to the time elapsed since acute infection: 6–10 month (CoV_A) and >10–15 month of recovery (CoV_B). A brief clinical history was taken and detailed hematological and biochemical blood parameters were measured.

Results

In our study, 64% of individuals had symptoms of long COVID. There were differential symptoms and presenting complaints associated with time since acute infection. The recovered group had significantly different hemoglobin concentration, red blood cell (RBC) count, white blood cell (WBC) count, lymphocyte, interleukin-6 (IL-6), alanine aminotransferase (ALT), alkaline phosphatase (ALP) and vitamin D3 levels, compared with the healthy controls (p<0.05). Differences were also found between the 6-10 months and the >10–15 month recovery groups (p<0.05).

Conclusion

Differential biochemical markers related to the time elapsed since acute infection show a different metabolic and biochemical status of the host at different time points after infection. Moreover, the pathophysiological pathways involved in these dysregulated biochemical markers should also be studied in relation to the long term impact of COVID-19 infection.
目的本研究旨在横断面评估轻度COVID-19急性感染6-15个月后存活患者长型COVID-19的频率及其血液学和生化指标。方法我们招募了75名年龄匹配的健康对照(HC)和150名COVID-19轻症康复者。根据急性感染后的恢复时间进行分组:6-10个月(CoV_A)和10-15个月(CoV_B)。简短的临床病史和详细的血液学和生化血液参数测量。结果在我们的研究中,64%的个体有长冠状病毒的症状。有不同的症状和表现主诉与时间有关,因为急性感染。恢复组血红蛋白浓度、红细胞(RBC)计数、白细胞(WBC)计数、淋巴细胞、白细胞介素-6 (IL-6)、谷丙转氨酶(ALT)、碱性磷酸酶(ALP)和维生素D3水平与健康对照组比较差异均有统计学意义(p < 0.05)。6-10个月和10-15个月恢复组之间也存在差异(p < 0.05)。结论与急性感染时间相关的差异性生化指标反映了感染后不同时间点宿主代谢生化状态的不同。此外,还应研究与COVID-19感染的长期影响相关的这些失调的生化标志物所涉及的病理生理途径。
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引用次数: 0
rs.11196205 Variant in the TCF7L2 Gene is Associated With an Increased Cardiovascular Risk in Individuals With Hypertension and Diabetes rs.11196205 TCF7L2基因变异与高血压和糖尿病患者心血管风险增加相关
IF 3.4 3区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2025-08-20 DOI: 10.1016/j.arcmed.2025.103268
Lívia da Cunha Agostini , Letícia Fernandes Dias Coelho , Renata Bárbara Machado e Silva , Nayara Nascimento Toledo Silva , Ana Cláudia Faria Lopes , Vanessa de Almeida Belo , Wendel Coura-Vital , Luiz Fernando de Medeiros Teixeira , Angélica Alves Lima , Glenda Nicioli da Silva

Background and Aims

The interaction between genetic polymorphisms and environmental factors increases the risk of developing a diabetic phenotype which is associated with systemic arterial hypertension (SAH) and cardiovascular diseases. Variants in the T-cell factor 7-like 2 (TCF7L2) gene have been associated with type 2 diabetes mellitus (T2DM). To investigate the association of the rs.11196205 polymorphism of the TCF7L2 gene with biochemical and anthropometric parameters and cardiovascular risk indices in Brazilian patients with SAH and T2DM.

Methods

The polymorphism was identified by qPCR in 664 samples from four groups: Control (CG-without diabetes or hypertension), diabetic (DG-normotensive), hypertensive (HG-without diabetes) and hypertensive diabetic (HDG), using the TaqMan® system. Biochemical dosages were taken for the lipid profile: triglycerides (TG), total cholesterol, HDL, LDL, and uric acid. Anthropometric measurements were taken for body mass index (BMI), visceral fat index and cardiovascular risk calculations, including the atherogenic index of plasma (AIP), visceral adiposity index (VAI), triglyceride-glucose (TyG) index and uric acid/HDL-c ratio (UA/HDL). Bivariate logistic regression was used to identify variables associated with SAH and T2DM. Subsequent categorical variables were analyzed using multinomial logistic regression.

Results

The GG genotype of the rs.11196205 variant of the TCF7L2 gene was associated with an increased risk of hypertension and diabetic hypertension. Patients in the GHD group with the GG genotype showed worsening BMI parameters and TyG index values.

Conclusion

The GG genotype of the rs.11196205 variant of the TCF7L2 gene acts as a cardiovascular risk genotype in patients with diabetic hypertension.
背景与目的遗传多态性与环境因素之间的相互作用增加了发生与全身性动脉高血压(SAH)和心血管疾病相关的糖尿病表型的风险。t细胞因子7-样2 (TCF7L2)基因变异与2型糖尿病(T2DM)有关。探讨巴西SAH合并T2DM患者TCF7L2基因rs.11196205多态性与生化、人体测量参数及心血管危险指标的关系。方法采用TaqMan®系统,对664份样本进行qPCR检测:对照组(cg -无糖尿病或高血压)、糖尿病组(dg -正常)、高血压组(hg -无糖尿病)和高血压糖尿病组(HDG)。采用生化剂量测定脂质谱:甘油三酯(TG)、总胆固醇、HDL、LDL和尿酸。采用人体测量法测量体重指数(BMI)、内脏脂肪指数和心血管风险计算,包括血浆动脉粥样硬化指数(AIP)、内脏脂肪指数(VAI)、甘油三酯-葡萄糖(TyG)指数和尿酸/HDL-c比值(UA/HDL)。双变量逻辑回归用于识别与SAH和T2DM相关的变量。随后的分类变量分析采用多项逻辑回归。结果TCF7L2基因rs.11196205变异的GG基因型与高血压和糖尿病高血压的风险增加相关。GG基因型GHD组患者BMI参数和TyG指数值恶化。结论TCF7L2基因rs.11196205变异GG基因型是糖尿病高血压患者的心血管危险基因型。
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引用次数: 0
Plasma Serotonin as a Biomarker of the Severity of Attention Deficit Hyperactivity Disorder, in Children and Overweight/Obesity 血浆血清素作为儿童和超重/肥胖中注意缺陷多动障碍严重程度的生物标志物
IF 3.4 3区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2025-08-20 DOI: 10.1016/j.arcmed.2025.103259
Gabriel Manjarrez-Gutiérrez , Martha Cristina Fernández-Cruz , Chiharu Murata , Teresa Neri-Gómez

Background and Aims

Recently, the potential use of plasma serotonin concentration as a biomarker for various diseases has been reported. However, whether plasma serotonin levels are useful for diagnosing attention deficit hyperactivity disorder (ADHD) remains controversial. To evaluate 5-hydroxytryptamine (5-HT, serotonin) as a biomarker for ADHD diagnosis, its severity, and overweight/obesity in school-aged children.

Methods

Eighty-nine school-aged children (20 controls and 69 with ADHD: 17 hyperactive, 26 inattentive, and 26 mixed) were analyzed. Free 5-HT (5-HTF) and platelet 5-HT (5-HTP) levels were compared for ADHD presence, severity, and obesity, respectively, using the Kruskal-Wallis test. Multiple regression models assessed the predictive value of 5-HTF and 5-HTP for the presence and severity of ADHD, adjusting for age and obesity. The diagnostic utility of 5-HTF was evaluated using odds ratios (OR) and area under the curve (AUC) from logistic regression.

Results

Patients with ADHD exhibited significantly elevated 5-HTF levels. No significant subgroup differences were found, but 5-HTF levels increased with ADHD severity. Higher 5-HTF levels were also observed in patients with overweight/obesity. Inverse trends were noted for 5-HTP, though less pronounced. Logistic regression showed a 71 % increase in ADHD odds for each 0.1 µmol/L rise in 5-HTF. ORs for ADHD severity were 8.77 (severe), 2.31 (moderate), and 0.45 (mild). The AUC for 5-HTF was 0.76 for ADHD diagnosis and 0.93 for moderate/severe ADHD.

Conclusions

Plasma 5-HTF concentration can be a useful biomarker for the ADHD diagnosis, its severity, and comorbidity with overweight/obesity in these patients.
背景和目的近年来,血浆血清素浓度作为多种疾病的生物标志物的潜在应用已被报道。然而,血浆血清素水平是否对诊断注意缺陷多动障碍(ADHD)有用仍有争议。评估5-羟色胺(5-HT, 5-羟色胺)作为学龄期儿童ADHD诊断、严重程度和超重/肥胖的生物标志物。方法89例学龄儿童(对照组20例,ADHD患儿69例:多动症17例,注意力不集中26例,混合型26例)进行分析。使用Kruskal-Wallis测试,分别比较ADHD存在、严重程度和肥胖的游离5-羟色胺(5-HTF)和血小板5-羟色胺(5-HTP)水平。多元回归模型评估5-HTF和5-HTP对ADHD存在和严重程度的预测价值,调整年龄和肥胖。使用logistic回归的比值比(OR)和曲线下面积(AUC)评估5-HTF的诊断效用。结果ADHD患者5-HTF水平明显升高。亚组间无显著差异,但5-HTF水平随ADHD严重程度升高。在超重/肥胖患者中也观察到较高的5-HTF水平。5-HTP呈相反趋势,尽管不那么明显。Logistic回归显示,5-HTF每升高0.1 μ mol/L, ADHD几率增加71%。ADHD严重程度的or值分别为8.77(重度)、2.31(中度)和0.45(轻度)。5-HTF诊断ADHD的AUC为0.76,诊断中度/重度ADHD的AUC为0.93。结论血浆5-HTF浓度可作为ADHD诊断、严重程度及与超重/肥胖合并症的有用生物标志物。
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引用次数: 0
Projections of the Burden of Rheumatoid Arthritis in Mexico from 2020 to 2040 2020年至2040年墨西哥类风湿关节炎负担预测
IF 3.4 3区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2025-08-20 DOI: 10.1016/j.arcmed.2025.103270
Claudia Mendoza-Pinto , Pamela Munguía-Realpozo , Ivet Etchegaray-Morales , Roberto Berra-Romani , Edith Ramírez-Lara , Socorro Méndez-Martínez , Alvaro José Montiel-Jarquín , Gabriela Medina-Valeriano , Jorge Ayón-Aguilar

Background and Aims

Rheumatoid arthritis (RA) can lead to disability and premature death. Knowledge of the RA burden is necessary for strategic healthcare management, resource allocation, and preventive measures. The burden of RA was analyzed with projected rates for 2030 and 2040.

Methods

Incidence, prevalence, mortality, and burden of suffering from RA were analyzed using the most recent Global Burden of Disease (GBD) dataset for RA from 1990 to 2019. Predictive estimates were calculated using the SPSS Time Series Modeler.

Results

In 2019, approximately 530,000 individuals had RA (64.0 % were female, and 35.9 % were between 15 and 49 years old). The age-standardized prevalence (ASP) and incidence (ASI) rates were 427.6 and 25.4 cases per 100,000 people, respectively. The Mexican states with the highest ASP, disability-adjusted life years (DALY), and years of healthy life lost due to disability rates were Oaxaca, Tlaxcala, and Zacatecas. The national ASP and ASI rates of RA are projected to increase to 465.5 and 27.9 by 2030, and to 518.9 and 30.2 per 100,000 inhabitants by 2040, respectively. In contrast, age-standardized mortality and DALY rates are projected to decline to 1.2 and 77.8 in 2030 and 1.1 and 73.6 per 100,000 inhabitants in 2040, respectively.

Conclusions

The burden of RA, especially the burden of disability continues to increase. Despite substantial investments in clinical care, research, and public health initiatives, the rate of increase shows no signs of abating. Certain regions of Mexico, such as Oaxaca, Tlaxcala, and Zacatecas, have a disproportionately high burden.
背景与目的类风湿性关节炎(RA)可导致残疾和过早死亡。了解RA负担对于战略性医疗保健管理、资源分配和预防措施是必要的。对RA的负担进行了分析,并预测了2030年和2040年的发病率。方法使用最新的全球疾病负担(GBD)数据集分析1990年至2019年RA的发病率、患病率、死亡率和患者负担。使用SPSS Time Series Modeler计算预测估计。结果2019年,约53万人患有RA,其中女性占64.0%,年龄在15 - 49岁之间的占35.9%。年龄标准化患病率(ASP)和发病率(ASI)分别为每10万人427.6例和25.4例。ASP、残疾调整生命年(DALY)和因残疾率而损失的健康生命年数最高的墨西哥州是瓦哈卡州、特拉斯卡拉州和萨卡特卡斯州。到2030年,全国平均年龄和平均年龄的RA比率预计将分别增加到465.5和27.9,到2040年将分别增加到每10万居民518.9和30.2。相比之下,预计到2030年,年龄标准化死亡率和DALY死亡率将分别降至每10万居民1.2人和77.8人,2040年降至每10万居民1.1人和73.6人。结论RA负担,尤其是致残负担持续加重。尽管在临床护理、研究和公共卫生倡议方面进行了大量投资,但增长率没有显示出减弱的迹象。墨西哥的某些地区,如瓦哈卡州、特拉斯卡拉州和萨卡特卡斯州,有不成比例的高负担。
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引用次数: 0
Comparative Analysis of Cortical and Trabecular Bone Structure Between Patients With Type 2 Diabetes and Healthy Controls 2型糖尿病患者与健康对照者皮质骨和骨小梁结构的比较分析
IF 3.4 3区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2025-08-20 DOI: 10.1016/j.arcmed.2025.103269
Griselda-Adriana Cruz-Priego , Miguel Ángel Guagnelli , Sergio Ortiz Santiago , Karina Geraldine González Castelan , Rita A. Gomez-Diaz , Ludovic Humbert , Patricia Clark

Background and Aims

This study evaluates three-dimensional dual-energy X-ray absorptiometry (3D-DXA) parameters that determine the cortical and trabecular compartments in patients with type 2 diabetes (T2D) compared to nondiabetic subjects, with the aim of identifying their determinants.

Methods

Patients with T2D were diagnosed according to ADA criteria. Anthropometric measurements were taken, and body mass index (BMI) was calculated. Bone densitometry (DXA) images were analyzed with 3D Shaper software. Volumetric bone mineral density (vBMD), bone mineral content (BMC), and volume were calculated in various regions of the femur, along with cortical thickness. Data analysis was performed using SPSS 27.0, a Student t-test and ANCOVA.

Results

A total of 125 subjects were recruited: 51 healthy controls and 74 patients with T2D (70.3 % women), with an average age of 53.9 and 53.6 years, respectively. The average disease duration in the T2D group was 11.4 years. Significant vitamin D deficiencies (levels <20 ng/mL) were found in 56 % of the control group and in 64 % of the T2D group. No significant differences in aBMD were observed between the two groups. 3D-DXA analysis showed consistently lower vBMD in patients with T2D vs. controls, with significant differences in the trochanter, femoral neck, and average cortical thickness. A positive correlation was observed between waist circumference, BMI, and higher bone density in all regions.

Conclusions

This study demonstrates the potential of 3D-DXA to detect cortical and trabecular bone differences in patients with T2D, undetectable by aBMD. Women with T2D showed lower bone parameters in the trochanter and femoral neck, consistent with research linking long-term T2D and poor glycemic control to compromised bone quality.
背景和目的本研究评估了2型糖尿病(T2D)患者与非糖尿病患者的三维双能x线吸收仪(3D-DXA)参数,以确定其决定因素。方法根据ADA标准诊断t2dm患者。进行人体测量,计算身体质量指数(BMI)。使用3D Shaper软件分析骨密度(DXA)图像。计算股骨各区域的体积骨矿物质密度(vBMD)、骨矿物质含量(BMC)和体积以及皮质厚度。数据分析采用SPSS 27.0、Student t检验和ANCOVA。结果共纳入125例受试者:健康对照51例,T2D患者74例(70.3%为女性),平均年龄分别为53.9岁和53.6岁。T2D组的平均病程为11.4年。56%的对照组和64%的T2D组存在明显的维生素D缺乏(水平≤20 ng/mL)。两组间aBMD无显著差异。3D-DXA分析显示,与对照组相比,T2D患者的vBMD始终较低,在粗隆、股骨颈和平均皮质厚度方面存在显著差异。在所有地区,腰围、BMI和较高的骨密度之间都观察到正相关。结论:本研究证明3D-DXA可以检测到aBMD无法检测到的T2D患者皮质骨和小梁骨差异。患有T2D的女性股骨粗隆和股骨颈的骨参数较低,这与长期T2D和血糖控制不良与骨质量受损的研究相一致。
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Archives of Medical Research
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