Journal of Clinical Medicine临床医学杂志
Journal of Clinical Medicine(英文缩写 J CLIN MED),ISSN 2077-0383,eISSN 2077-0383,中文译名:临床医学杂志 是一本学术期刊。本页汇总该期刊的最新影响因子、分区信息以及最新收录于 PubMed 的文献,帮助您快速了解期刊全貌。
发文量统计区间：2025-09-27 至 2026-09-27，按本站收录文献的发表日期统计。
期刊介绍
Journal of Clinical Medicine 最新收录文献
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1. {"_":"Correction: Baglioni et al. Non-Pharmacological Treatments in Paediatric Migraine. 2024, , 1278.","i":["J. Clin. Med.","13"]}
PMID:日期:2026-09-07In the original publication [...].
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2. Perceived Vaccination Knowledge and Self-Reported Uptake in a Nationwide Heart Failure Telemonitoring Cohort in France.
PMID:日期:2026-09-07: Patients with heart failure (HF) are vulnerable to vaccine-preventable infections, yet vaccination data remain limited. We assessed perceived vaccination knowledge, attitudes, self-reported vaccine receipt, and variation by age, sex, region, and delivery pathway among digitally connected patients with HF enrolled in a nationwide telemonitoring program. : This cross-sectional electronic survey was conducted from 5 to 28 November 2025, during the ongoing 2025-2026 influenza and COVID-19 vaccination campaigns, among app-connected Satelia Cardio participants across France. Of 4856 invited app-connected patients, 1100 completed the questionnaire (response rate: 22.7%). Uptake of seasonal influenza and COVID-19 booster vaccination for the 2025-2026 season and lifetime receipt of pneumococcal, tetanus-diphtheria-pertussis-poliomyelitis (Tdap-polio), and herpes zoster vaccines were analyzed using Wilson 95% confidence intervals (CIs), age-adjusted logistic regression, and regional models adjusted for age and sex. : Respondents had a mean age of 71.5 years (SD: 12.6), and 718 (65.3%) were men. Overall, 87.5% considered vaccination useful, 96.0% knew where to be vaccinated, and 55.1% wanted telemonitoring-based reminders. Current-season reported vaccination was 62.2% for influenza and 31.4% for the COVID-19 booster, whereas lifetime self-reported receipt was 38.5% for Tdap-polio, 34.5% for pneumococcal vaccination, and 11.5% for herpes zoster. Influenza and COVID-19 uptake increased with age, whereas pneumococcal uptake peaked at 65-74 years. Pneumococcal receipt was higher in women than men (42.2% vs. 30.4%; age-adjusted odds ratio [aOR], 1.67; 95% confidence interval [CI], 1.29-2.17; < 0.001). Community pharmacies delivered most influenza and COVID-19 vaccinations. : Vaccination attitudes were favorable, while current-season vaccination and lifetime-reported vaccine receipt showed distinct patterns across age groups. These descriptive findings identify potential target groups for future telemonitoring-based preventive interventions, whose effectiveness requires prospective evaluation.
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3. The Maximal Vertical Pocket Better Identifies Pregnancies with Polyhydramnios at Increased Risk of Severe Neonatal Morbidity than the Amniotic Fluid Index: A Retrospective Cohort Study.
PMID:日期:2026-09-07Polyhydramnios is associated with adverse perinatal outcomes and is commonly assessed using either the amniotic fluid index (AFI) or the maximal vertical pocket (MVP). Although both methods are accepted in clinical practice, they frequently classify the same pregnancy differently, and their relative ability to predict adverse neonatal outcomes remains uncertain. We conducted a retrospective cohort study of pregnancies delivered at a tertiary university medical center between 2010 and 2025. Pregnancies with an AFI or MVP measurement within two weeks before delivery were eligible. Pregnancies complicated by diabetes mellitus or major fetal anomalies were excluded. Polyhydramnios severity was classified separately according to AFI and MVP criteria. The primary outcome was a composite of severe neonatal morbidity including neonatal intensive care unit admission, umbilical artery pH < 7.1, 5 min Apgar score < 7, or perinatal death. Separate multivariable logistic regression models were constructed for AFI- and MVP-based severity classifications. Among 32,928 pregnancies, 3146 (9.6%) had polyhydramnios. Moderate-to-severe polyhydramnios defined by MVP was independently associated with severe neonatal morbidity (adjusted odds ratio [aOR] 2.47, 95% confidence interval [CI] 1.57-3.90; < 0.001), whereas AFI-based severity classification was not (aOR 1.44, 95% CI 0.98-2.12; = 0.07). Severe neonatal morbidity increased progressively with increasing MVP measurements. Mild polyhydramnios, regardless of the measurement method, was not associated with increased neonatal morbidity. Similar findings were observed in sensitivity analyses. MVP-based severity classification identified pregnancies at increased risk of severe neonatal morbidity, whereas AFI-based classification did not, at their conventional thresholds. These findings suggest that MVP may provide better risk stratification in pregnancies complicated by polyhydramnios and support prospective studies to validate its role in clinical management.
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4. Study-Specific Morphological Signs of Non-Carious Tooth Surface Loss in Second Permanent Molars and Caries Experience in a Clinical Sample of Adolescents from Southwest Romania: A Multicenter Cross-Sectional Study.
PMID:日期:2026-09-07Morphological signs of non-carious tooth surface loss are clinically heterogeneous, and their prevalence depends strongly on the diagnostic framework and threshold used. This exploratory secondary analysis evaluated a study-specific combined morphological outcome restricted to second permanent molars and its association with cumulative caries experience in a regional clinical sample of adolescents. The analysis included 231 adolescents aged 13-19 years from Dolj, Gorj, and Olt counties, selected from a parent clinical database of 638 participants. The study-specific outcome was coded when a clearly discernible non-carious hard-tissue change compatible with an abrasive, erosive, or abfraction-related morphology was identified on any clinically accessible surface of tooth 17, 27, 37, or 47. This study did not use BEWE, the Smith and Knight Tooth Wear Index, or another validated severity-based tooth wear index; subtype, surface, and severity were not retained separately in the analytical dataset. Dental caries experience was measured using DMF-T. Group comparisons, correlations, and multivariable logistic regression were performed in JASP version 0.96.0. Sensitivity analyses included a participant-level coding audit and a logistic model using DMF-T recalculated after excluding the contribution of teeth 17, 27, 37, and 47. The study-specific morphological outcome was present in 50/231 participants (21.6%). A coding audit confirmed that 181 participants had no positive second molar and 50 had exactly one positive second molar; tooth-specific counts were 14, 15, 12, and 9 for teeth 17, 27, 37, and 47, respectively. In the primary model, male sex (adjusted OR = 3.34, 95% CI 1.67-6.71) and DMF-T (adjusted OR = 1.15 per point, 95% CI 1.01-1.31) were associated with the outcome. After excluding the four evaluated second molars from DMF-T, the caries experience association remained positive but borderline (OR = 1.198, 95% CI 1.000-1.435, = 0.049), while male sex remained associated (OR = 3.310, 95% CI 1.647-6.652, < 0.001). A modest exploratory association was observed between the study-specific morphological outcome and cumulative caries experience in this clinical sample. The result should not be interpreted as a standardized NCDL prevalence estimate, a causal relationship, or a prediction model. Confirmation using validated whole-mouth tooth wear measures, outcome-specific reliability assessment, and population-based longitudinal data is required.
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5. Predictors of Severe Course in Odontogenic Cervicofacial Infections: A Prospective Multicenter Cohort Study.
PMID:日期:2026-09-07Odontogenic cervicofacial infections are prevalent and can progress to life-threatening conditions, imposing a substantial burden on both patients and healthcare systems. The present study evaluated the association of presentation delay and comorbidities with clinical severity and healthcare resource utilization. This prospective multicenter cohort study enrolled patients admitted with odontogenic cervicofacial infection at two university hospitals over a one-year period. Demographic and clinical data were systematically collected. Disease severity at presentation was quantified using the Cervicofacial Infection Severity Index (CFISI), a clinically derived composite index incorporating predefined indicators of airway compromise, systemic involvement, and physiological derangement. A total of 61 patients (median age 45 years; range 4-88) were included. The median time to admission was 4 days (IQR 2-5), and the median number of involved anatomical spaces was two (IQR 1-3). The number of involved spaces was significantly associated with a severe clinical course (OR 1.72, 95% CI 1.13-2.63, and = 0.011). Secondary space involvement correlated with prolonged hospitalization, with a mean length of stay of 11.5 days (95% CI 7.1-15.9) compared to 5.1 days (95% CI 4.6-5.7) in patients without secondary space involvement ( < 0.00001). CFISI was significantly associated with severe clinical course in both univariable (OR 1.16, 95% CI 1.01-1.26, and = 0.044) and multivariable analyses (OR 1.20, 95% CI 1.01-1.42, and = 0.042). Increasing age was also independently associated with severe clinical course (OR 1.04 per year, 95% CI 1.00-1.07, and = 0.028). No predictor demonstrated a significant association with high healthcare resource utilization. Within this cohort, clinical severity was associated with patient age, infection extent, and CFISI. In contrast, delay in presentation and comorbidities did not predict severe outcomes. Secondary space involvement was linked to prolonged hospitalization. No significant predictors of high healthcare resource utilization were identified.
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6. Beyond Tumor Control in Sporadic Neuroendocrine Tumor: Metabolic and Bone Health During Treatment with Somatostatin Analogs.
PMID:日期:2026-09-07: Somatostatin analogs (SSAs) are widely used in the treatment of neuroendocrine tumors (NETs). Despite SSAs having a favorable safety profile, their long-term impact on glucose metabolism and bone health remains uncertain. This study aimed to compare glycemic, calcium-phosphorus, and densitometric parameters between patients with sporadic NETs receiving SSA therapy and untreated patients. : A retrospective observational study enrolling patients with sporadic NETs was conducted at Federico II University of Naples, Endocrinology Unit, ENETS Center of Excellence. : A total of 40 patients were enrolled: 18 (45%) treated with SSA (SSA+) and 22 (55%) untreated (SSA-). The median duration of SSA treatment was 24.5 months (range 12-180). HbA1c was significantly higher in the SSA+ group compared to SSA- (median 6.20% vs. 5.70%; = 0.027). Corrected calcium levels were significantly lower in SSA+ patients (8.90 vs. 9.47 mg/dL; = 0.045). No significant differences were observed between groups in phosphorus, vitamin D or PTH levels. Median lumbar T-score was -0.15 in SSA+ vs. -1.10 in SSA- ( = 0.256); lumbar BMD was 1.23 vs. 0.97 g/cm ( = 0.127). Femoral neck T-score was -0.85 vs. -1.55 and femoral BMD was 0.89 vs. 0.78 g/cm. The prevalence of osteoporosis and osteopenia did not differ significantly between groups. Within the SSA+ group, treatment duration showed no significant correlations with any densitometric parameter. : SSA treatment in patients with sporadic NETs is associated with a significant impairment of glycemic control. The reduction in serum calcium observed in SSA+ patients may indicate an indirect effect on calcium-phosphorus metabolism that warrants further investigation. These findings support careful metabolic assessment during follow-up. Although routine densitometric evaluation based solely on SSA exposure does not appear warranted, bone health assessment may be considered according to individual skeletal risk factors and the patient's overall clinical profile.
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7. Management of Severe Epithelial Ingrowth Following KLEx Using Crocodile-Forceps Extraction: Surgical Technique and Literature Review.
PMID:日期:2026-09-07: Epithelial ingrowth is an uncommon but potentially vision-threatening complication after keratorefractive lenticule extraction (KLEx). Although this complication is well described after flap-based refractive surgery, its occurrence after flapless lenticule extraction remains rare and is mainly reported in isolated cases. This narrative review summarizes the available literature on epithelial ingrowth after KLEx, with particular attention to proposed mechanisms, clinical presentation, imaging findings, and surgical management. An illustrative case of severe epithelial ingrowth managed with crocodile-forceps extraction is also presented. : A literature search was performed to identify published reports describing epithelial ingrowth after SMILE/KLEx. Relevant articles were reviewed and compared with regard to onset, suspected mechanism, clinical severity, treatment strategy, anatomical outcome, visual recovery, and recurrence. : The affected eye developed extensive epithelial ingrowth associated with a postoperative tunnel laceration and marked visual deterioration during the first postoperative week. Surgical clearance through the original incision was performed using crocodile forceps followed by copious interface irrigation. Approximately one hour after treatment, AS-OCT demonstrated complete clearance of the hyperreflective interface material, corneal topography showed marked regularization, and wavefront aberrometry demonstrated a reduction in overall OPD RMS from 1.21 to 0.58 µm and higher-order RMS from 1.03 to 0.37 µm at a 4 mm pupil. Visual acuity subsequently improved over the following postoperative days, with no recurrence during 6-month follow-up. : Severe epithelial ingrowth after KLEx may require prompt surgical intervention when rapid progression and visual deterioration occur. In this case, crocodile-forceps-assisted interface clearance through the original incision was feasible and was associated with rapid anatomical and optical recovery without cap-to-flap conversion or chemical adjuvants. Further cases are required to determine the reproducibility, safety, and long-term outcomes of this approach.
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8. Association Between Cardiorespiratory Fitness and a Composite Index of Cardiac Autonomic Control: Potential Implications for Exercise Training Evaluation.
PMID:日期:2026-09-07: Cardiorespiratory fitness (CRF), measured as VOpeak during cardiopulmonary exercise testing (CPX), represents a fundamental marker of cardiovascular health. Heart Rate Variability (HRV) assesses cardiac autonomic regulation (CAR) non-invasively, though technical issues limit clinical use. Combining CRF and CAR may provide complementary information on cardiovascular and autonomic function. We examined the relationship between CRF and HRV using a composite autonomic index, the Autonomic Nervous System Index (ANSI), which incorporates multiple HRV variables accounting for age/sex-related influences. : This cross-sectional study involved 200 adults undergoing preventive health evaluation without overt cardiometabolic disease. CRF was expressed as VOpeak and as VOpeak percentile from the FRIEND registry. CAR was assessed at rest using HRV. : We observed significant correlations between VOpeak and several HRV variables, with ANSI showing the strongest association (r = 0.457, < 0.001). In simple regressions, ANSI was linked to VOpeak (R = 0.175, < 0.001) and VOpeak percentile (R = 0.209, < 0.001). In multiple regression, several autonomic variables were retained for VOpeak, whereas ANSI was the only autonomic variable retained for VOpeak percentile. This association remained significant after adjustment for age, sex, smoking, and anthropometric measures. Trend analyses ( < 0.001) and ordinal regression analyses ( < 0.001) further substantiated these findings. A 10-point increase in ANSI corresponded to an OR of 1.39 for belonging to a higher CRF percentile category. : Multiple HRV indices were associated with CRF, with ANSI showing the strongest association. These findings highlight the potential of ANSI as a simple, integrated measure of CAR in individuals with different levels of CRF.
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9. Incremental Prognostic Value of Glucose Variability and the Lactate-to-Albumin Ratio Beyond APACHE II After a 48-Hour Landmark in Critically Ill Adults: A Retrospective Cohort Study.
PMID:日期:2026-09-07: Glucose variability (GV) and the lactate-to-albumin ratio (LAR) have been associated with adverse outcomes in critically ill patients, but their incremental prognostic contribution beyond established severity assessment remains uncertain. This study evaluated the associations of GV and LAR with subsequent mortality and their incremental value beyond APACHE II in a conditional 48 h landmark cohort. : This single-center retrospective cohort study included 384 critically ill adults who were alive and remained in the ICU through 48 h and had sufficient glucose, lactate, and albumin measurements. GV was quantified using the coefficient of variation (CV) from six glucose measurements closest to 0, 8, 16, 24, 32, and 48 h. The primary outcome was all-cause mortality during the 7 days following the 48 h landmark. Firth penalized logistic regression was used for prognostic modeling. Incremental performance was assessed sequentially for APACHE II, APACHE II + LAR, and APACHE II + LAR + GV using discrimination, calibration, Brier score, bootstrap internal validation, and decision-curve analysis. Sensitivity analyses adjusted for mean glycemia and restricted predictor information to the first 24 h. : Eighty-eight patients (22.9%) died during the 7-day post-landmark period. APACHE II (OR: 1.19 per point, 95% CI: 1.12-1.27; < 0.001), LAR (OR: 1.97 per unit, 95% CI: 1.48-2.69; < 0.001), and GV (OR: 1.07 per 1-percentage-point increase in CV, 95% CI: 1.02-1.11; = 0.002) were independently associated with mortality. The AUC increased from 0.804 for APACHE II alone to 0.844 after addition of LAR and to 0.857 after further addition of GV. The additional AUC increase attributable to GV after LAR was modest (ΔAUC = 0.013, 95% CI: -0.004 to 0.030; = 0.145), although model fit and Brier performance improved. The optimism-corrected C-index of the integrated model was 0.851. GV remained independently associated with mortality after adjustment for mean glucose (OR: 1.06, 95% CI: 1.02-1.11; = 0.002) and in the temporally matched 24 h analysis (OR: 1.05, 95% CI: 1.01-1.09; = 0.008). : Among critically ill adults who survived to a 48 h landmark, LAR and GV provided prognostic information beyond APACHE II. Most of the incremental improvement in discrimination was attributable to LAR, whereas GV provided a smaller additional contribution that remained consistent across sensitivity analyses. These findings support further evaluation of LAR and GV as complementary prognostic markers, but external validation is required before clinical implementation.
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10. Comparative Clinical Outcomes Between Successive Generations of Liberty Trifocal Intraocular Lenses.
PMID:日期:2026-09-07To compare the clinical and functional outcomes of two successive generations of a trifocal intraocular lens (IOL), the original Liberty 677MY and the optimized Liberty 677CMY. To the best of our knowledge, this is the first head-to-head comparison between two successive generations of any IOL model reported. This retrospective study included 42 patients (84 eyes) who underwent bilateral phacoemulsification with implantation of either the Liberty 677MY (26 eyes) or the Liberty 677CMY (58 eyes). The primary outcome was postoperative binocular intermediate visual acuity (VA). Secondary outcomes included monocular intermediate VA, monocular and binocular distance and near VA, the proportion of patients or eyes achieving ≤0.1 LogMAR, and defocus curves. Exploratory outcomes included spectacle independence, patient-reported satisfaction (Quality of vision-QoV- and Catquest-9SF), photic phenomena, and intraoperative or postoperative complications. At 3 months, binocular UIVA differed by approximately 0.10 LogMAR in favor of the 677CMY cohort, which was considered clinically significant, although the difference did not reach statistical significance ( = 0.052). Supporting this tendency, monocular UIVA was significantly better with the 677CMY IOL ( = 0.012). Also, a significantly higher percentage of patients and eyes achieved binocular and monocular UIVA ≤ 0.1 LogMAR with the 677CMY IOL ( = 0.025). Defocus curves additionally showed significant between-group differences at intermediate defocus levels (-1.00 and -1.50 D; < 0.05), favoring the 677CMY cohort. No between-group differences were observed for any distance VA parameter. Binocular near VA and near-vision thresholds were also comparable between groups, although a greater proportion of eyes achieved monocular UNVA ≤ 0.1 LogMAR with the 677CMY IOL ( = 0.016). Spectacle use, overall satisfaction, photic phenomena profile, and postoperative complications were comparable between groups. The optimized Liberty 677CMY exhibited a favorable pattern of intermediate visual performance compared with the 677MY while maintaining comparable distance and near VA and a similar safety profile. These findings suggest potential clinical benefits of the design modifications, although larger prospective studies are warranted to confirm these observations.