Int J Med Sci
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Background: Sodium‒glucose cotransporter-2 (SGLT2) inhibitors offer glycaemic and cardiorenal benefits in the early stage of chronic kidney disease (CKD). However, the use of SGLT2 inhibitors may increase the risk of genitourinary tract infection (GUTI). Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) may also cause deterioration of kidney function. ⋯ Notably, SGLT2 inhibitor usage was associated with a greater GUTI incidence (aHR = 1.78, 95% CI = 1.122.84) shortly after initiation, irrespective of prior GUTI history status. Conclusion: Among patients with CKD stages 3-5, SGLT2 inhibitor use was linked to increased GUTI incidence, but it also significantly reduced the ESRD/dialysis risk without an episodic AKI or AKD risk. Clinical physicians should consider a personalized medicine approach by balancing GUTI episodes and cardiorenal outcomes for advanced CKD patients receiving SGLT2 inhibitors.
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Background: Alterations in circulating CCL4 levels have been implicated in coronary artery disease (CAD), but the causal relationship and underlying mechanisms remain unclear. Objective: This study aims to analyse the role of CCL4 and its receptor (CCR5) in CAD using Mendelian randomisation (MR) analysis, bulk RNA and single cell RNA sequencing (scRNA-seq). Methods: The MR analysis was used to determine the causal relationship between 91 circulating inflammatory proteins and CAD. ⋯ Clinical specimens confirmed high levels of serum CCL4 expression in CAD patients by ELISA. Functional enrichment analysis revealed that CCL4 was primarily enriched in the cytokines and cytokine receptors, viral proteins with cytokines and cytokine receptors, and chemokine signaling pathways. Conclusion: Our study presented a genetic insight into the pathogenetic role of CCL4-CCR5 in CAD, which may provide new insights for further mechanistic and clinical investigations of inflammatory cytokine-mediated CAD.
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Observational Study
The Association between Percentage of Mean Arterial Pressure and Long-Term Mortality in Acute Myocardial Infarction Patients: An Observational Cohort Study.
Background: Acute myocardial infarction (AMI) is a critical cardiovascular disease with high morbidity and mortality. Identifying practical parameters for predicting long-term mortality is crucial in this patient group. The percentage of mean arterial pressure (%MAP) is a useful parameter used to assess peripheral artery disease. ⋯ However, high % MAP was only associated with cardiovascular mortality in the univariable analysis but became insignificant after the multivariable analysis. Conclusions: In conclusion, this study is the first to evaluate the usefulness of %MAP in predicting long-term mortality in AMI patients. Our study shows that %MAP might be an independent predictor of long-term overall mortality in AMI patients and has better predictive power than ABI.
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Objective: This study aims to propose a personalized cancer prediction model based on the metabolic-inflammatory-nutritional score (MINS) for predicting lymph node metastasis (LNM) in endometrial cancer (EC) and validated prediction of survival probability in patients with a family history of Lynch syndrome-associated cancers (LSAC). Methods: A total of 676 patients diagnosed with EC were enrolled in this study. We calculated the optimal cutoff value using restricted cubic splines (RCS) analysis or the mean value. ⋯ Additionally, a nomogram was demonstrated effective predictive performance with a C-index of 0.778 (95% CI: 0.725-0.832). Conclusion: Preoperative MINS has been determined to be associated with the risk of LNM in EC patients. Utilizing MINS as a basis, the development of a prognostic nomogram holds promise as an effective tool for risk stratification in clinical settings among EC patients with a family history of LSAC.
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Objectives: In this study, we aimed to assess the maximal oxygen uptake (VO2max) of young, healthy, non-athletic Saudi men using maximum graded exercise with instant breath-by-breath analysis and to compare this value to the predicted VO2max by international formulae. Methods: In this cross-sectional study, 88 young non-athletic normal-weight Saudi subjects were recruited from Eastern Province of Saudi Arabia with mean age (21.3 ± 1.5 years), weight: (64.7 ± 7.5 kg), height: (172.3 ± 6.1 cm) and body mass index: (21.8 ± 2.1). All subjects were interviewed and examined for eligibility, after which they performed maximum graded exercise testing on a treadmill to obtain VO2max. ⋯ This value was lower than Western values, which might be due to low physical activity or racial differences. Most international formulae overestimate the VO2max in this population, except for the Hansen equation. Therefore, Hansen's predicted VO2max might be the best available reference value for the diagnosis and prognosis of young Saudi individuals undergoing maximum exercise testing.