Medicine
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This study explores the relationship between 25-hydroxyvitamin D/calcium/alkaline phosphatase (ALP) levels and kidney stone development via cross-sectional and Mendelian randomization (MR) analyses. We used data from the National Health and Nutrition Examination Survey (NHANES) 2013 to 2018 to explore the associations of 25(OH)D metabolite, calcium, and ALP levels with kidney stone development, LDSC analysis to determine the associations between their genetically predicted levels and kidney stone development, and MR analysis to determine the causality of those relationship via genome-wide association studies (GWASs). The cross-sectional study revealed a relationship between ALP levels and kidney stone development (Model 1: OR = 1.004, 95% CI = 1.001-1.007, P = .005; Model 2: OR = 1.004, 95% CI = 1.001-1.007, P = .007; Model 3: OR = 1.003, 95% CI = 1.001-1.006, P = .011) in both men and women. ⋯ Our study strongly supports a positive association between kidney stone development and ALP levels. Although observational studies did not reveal an association between calcium levels and kidney stone development, MR analysis suggested a positive association between calcium levels and kidney stone development. Our study provides new and more reliable evidence and research directions for the prevention, diagnosis and treatment of kidney stones.
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Thrombus is the most common occupying lesion in the cardiac chambers, it is often distinguished from cardiac neoplastic occupations. Among them, the most common is cardiac myxoma, whose imaging manifestations are often confused with thrombus. However, the 2 types of lesions have different therapeutic strategies and are both potentially high-risk sources of embolism, so early differentiation between intracardiac thrombus and cardiac tumor is essential. In this study, we intend to investigate the value of dual-energy computed tomography (CT) in the differential diagnosis of cardiac thrombus and myxoma by retrospectively analyzing the dual-energy CT-related parameters of 2 cases of intracardiac thrombus and 1 case of cardiac myxoma. ⋯ Drawing upon existing literature, we propose combining different quantitative analysis methodologies to create a more objective foundation for distinguishing between cardiac thrombosis and myxoma.
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The correlation between cathepsins and pulmonary arterial hypertension (PAH) is well-established, but the causative link between them remains uncertain. This study aimed to explore the causal role of circulating metabolites mediating cathepsins in PAH using Mendelian randomization (MR). A 2-sample 2-step MR method was used to identify causal relationship between cathepsins and PAH; causal relationship between circulating metabolites and PAH; and mediated effects of these circulating metabolites. ⋯ Cathepsin S was associated with high risk of PAH (OR: 1.346, 95% CI: 1.039-1.742, P = .024), and positively with circulating metabolite 1-oleoylglycerol (18:1) levels (OR: 1.062, 95% CI: 1.018-1.108, P = .005). Finally, mediation analysis showed evidence of mediated effect of cathepsin S on PAH through 1-oleoylglycerol (18:1) levels (OR: 0.062, CI: 0.0183-0.106) with a mediated proportion of 20.9% of the total effect. This study reveals cathepsin S increases the risk of PAH mediating by circulating metabolite 1-oleoylglycerol (18:1) levels.
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Case Reports
Right coronary sinus of Valsalva pseudoaneurysm after a motorcycle accident: A case report.
Traumatic pseudoaneurysm of the sinus of Valsalva (PSV) is a rare but life-threatening condition, often resulting from blunt chest trauma. Rapid progress and a high risk of rupture highlight the importance of prompt diagnosis and intervention. We present a case of a rare pseudoaneurysm linked to the right coronary sinus after blunt chest trauma. ⋯ Traumatic PSV, though rare, demands heightened clinical awareness in cases of blunt chest trauma. Noninvasive computed tomography angiography serves as a rapid and reliable diagnostic tool. Early surgical intervention remains the definitive treatment to prevent catastrophic outcomes.
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This study aimed to investigate the direct association between domestic violence and the indirect association of exposure through pregnancy, delivery, and neonatal risk factors with severe maternal morbidity (SMM). The target population of this case-control study included all women who gave birth in the hospitals of the Torbat Heidarieh University of Medical Science from June 2018 to May 2020. A total of 123 mothers with SMM according to the World Health Organization criteria were selected as cases, and 127 mothers who did not meet the World Health Organization criteria were included in the control group. ⋯ Domestic violence against women is directly associated with severe maternal morbidity. Physical and social violence showed a significant interaction with severe maternal morbidity. A preventive program for domestic violence should be considered an effective intervention to prevent severe maternal morbidity and improve the health of mothers by implementing control strategies.