Medicine
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Research suggests that cathepsins, due to their extensive mechanisms of action, may play a crucial role in cardiomyopathies. However, further studies are necessary to establish causality. This study aims to investigate the causal relationship between cathepsins and various types of cardiomyopathies. ⋯ Cathepsin L2 was also found to be associated with an increased risk of restrictive cardiomyopathy (IVW: P = .0374, OR = 2.1337, 95% CI = 1.0450-4.3565). This study demonstrates the causal relationship between cathepsins E, B, L2, O and the development of cardiomyopathy. The findings may be crucial for early diagnosis, prognosis prediction, molecular classification, and identifying potential therapeutic targets for cardiomyopathy.
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Review Case Reports
Immunochemotherapy for small cell lung cancer with paraneoplastic Cushing syndrome: A case report and literature review.
Paraneoplastic Cushing syndrome (PCS) is an adverse prognostic factor for small cell lung cancer (SCLC) patients. Retrospective studies have shown that the median survival of SCLC complicated with PCS was <7 months. No immunochemotherapy has been recorded in the treatment of SCLC with PCS. Previous preclinical and clinical studies have suggested glucocorticoid exposure may affect the efficacy of immunotherapy. ⋯ The case preliminarily demonstrated the efficacy of immunochemotherapy in the management of SCLC complicated with PCS. The regime of serplulimab with irinotecan-based chemotherapy also indicated its satisfactory efficacy as a second-line treatment for extensive-stage SCLC. Furthermore, the case has highlighted that the management of hypercortisolism, the improvement of myelosuppression, and the prophylaxis against infection were 3 hinges for the continuation of immunochemotherapy and the holistic management of SCLC with PCS.
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Observational Study
Early pulmonary rehabilitation in ARDS patients: Effects on respiratory function and long-term outcomes: A retrospective study.
This retrospective cohort study, conducted at People's Hospital of Wenjiang Chengdu (January 2018 to January 2022), aimed to evaluate the effects of early pulmonary rehabilitation (PR) on respiratory function in acute respiratory distress syndrome patients after discontinuing invasive mechanical ventilation in the intensive care unit. Patients were divided into PR and control groups based on an offline training protocol. Outcome measures included short physical performance battery scores, respiratory muscle strength, and pulmonary function indicators at discharge and 3 months post-discharge, including peak expiratory flow, forced expiratory volume in 1 second/forced vital capacity, and vital capacity. ⋯ The number of sputum aspirations in the PR group significantly decreased (P < .05), and intensive care unit stays after weaning were significantly shorter (P < .05). Kaplan-Meier survival analysis revealed that the cumulative survival rate at 6 months post-discharge was significantly higher in the PR group compared to the control group (hazard ratio = 0.660, 95% CI: 0.472-0.922, P = .014). These findings suggest that early PR significantly enhances respiratory function recovery, reduces complications, and improves survival outcomes in acute respiratory distress syndrome patients after invasive ventilation.
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Observational Study
The factors associated with clozapine polypharmacy for schizophrenia patients discharged from a large public psychiatric hospital in Taiwan, 2006-2021.
Clozapine treatment continues to be recognized as the gold standard for managing treatment-resistant schizophrenia. Combining clozapine with other antipsychotics (i.e., clozapine polypharmacy) has emerged as an option for clozapine-resistant schizophrenia. We aimed to investigate the factors associated with clozapine polypharmacy in schizophrenia patients discharged on clozapine from a public psychiatric hospital. ⋯ Compared with clozapine monotherapy, clozapine polypharmacy was associated with male gender, younger, earlier age of onset, a greater number of previous hospitalizations, shorter length of hospital stay, and lower clozapine daily dose. The utilization of clozapine polypharmacy has seen a significant increase over time. Further research is necessary to clarify its efficacy, safety, and overall risk/benefit ratio.
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Medication therapy management (MTM) includes various clinical pharmacy services that greatly influence society and economy. Despite extensive research in recent years, there is currently a lack of bibliometric analysis on this subject. Articles and reviews on MTM published from 2003 to 2023 were identified and selected from the Web of Science Core Collection. ⋯ Optimizing medication and ensuring drug safety in elderly patients are current research frontiers. Topics such as "polypharmacy," "dementia," "oncology," and "anticholinergic burden" were identified as potential research priorities in the future. This study is the first to utilize bibliometric analysis to uncover the global status, research hotspots, and future development trends of MTM for scholars, thereby providing valuable guidance for future research endeavors.