Previous Issue
Volume 13, September
 
 
Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
3.7
3.0
Journals
Diseases
Volume 13
Issue 10
share announcement

Diseases, Volume 13, Issue 10 (October 2025) – 31 articles

  • Issues are regarded as officially published after their release is announced to the table of contents alert mailing list.
  • You may sign up for e-mail alerts to receive table of contents of newly released issues.
  • PDF is the official format for papers published in both, html and pdf forms. To view the papers in pdf format, click on the "PDF Full-text" link, and use the free Adobe Reader to open them.
Order results
Result details
Section
Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:
19 pages, 625 KB  
Review
The Yin and Yang of Antibodies in Viral Infectious Diseases
by Jianning He, Yiu-Wing Kam and Fok-Moon Lum
Diseases 2025, 13(10), 341; https://doi.org/10.3390/diseases13100341 (registering DOI) - 15 Oct 2025
Abstract
Antibodies are a cornerstone of the adaptive immune response, serving as key defenders against viral infections; however, they can also act as a double-edged sword, contributing to immune-mediated pathologies. This review advances a “Yin-Yang” framework to integrate the dual activities of antibodies. The [...] Read more.
Antibodies are a cornerstone of the adaptive immune response, serving as key defenders against viral infections; however, they can also act as a double-edged sword, contributing to immune-mediated pathologies. This review advances a “Yin-Yang” framework to integrate the dual activities of antibodies. The protective ‘Yin’ functions are driven by high-affinity antibodies generated through processes like somatic hypermutation and class-switch recombination. These antibodies execute viral neutralization, activate the complement system, and engage Fc receptors (FcRs) to drive antibody-dependent cellular cytotoxicity (ADCC) and phagocytosis. These mechanisms form the immunological basis of effective vaccines, which aim to elicit durable and functionally specialized antibody isotypes like IgG and mucosal IgA. Conversely, the pathogenic ‘Yang’ of the response can be detrimental. This includes antibody-dependent enhancement (ADE) of infection, notably observed with flaviviruses, and the development of autoimmunity through mechanisms like molecular mimicry and bystander activation, which can lead to conditions such as multiple sclerosis and Guillain-Barré Syndrome. The balance between protection and pathology is tipped by a confluence of factors. These include viral evasion strategies like antigenic mutation and glycan shielding, as well as host-based determinants such as genetic polymorphisms in FcRs, immune history, and the gut microbiome. Understanding these molecular determinants informs the rational design of next-generation interventions. Promising strategies, such as Fc-region glyco-engineering and the design of tolerogenic vaccines, aim to selectively promote protective functions while minimizing pathological risks, offering a clear path forward in combating viral threats. Full article
►▼ Show Figures

Figure 1

11 pages, 4970 KB  
Article
Pioneering Endoscopic Calcium-Electroporation in Gastric Cancer: A Case Series of an Emerging Therapeutic Approach
by Giuliano Francesco Bonura, Noemi Gualandi, Paola Soriani, Pablo Cortegoso Valdivia, Tommaso Gabbani, Valentina Zadro, Federica Indulti, Gabriella Frassanito, Germana de Nucci and Mauro Manno
Diseases 2025, 13(10), 340; https://doi.org/10.3390/diseases13100340 - 15 Oct 2025
Abstract
Background/Objectives: Gastric cancer often presents at advanced stages with complications such as iron-deficiency anemia (IDA) due to chronic bleeding, representing a significant global health burden. Palliative management of bleeding tumors in frail patients remains challenging. This study evaluates the feasibility, safety, and efficacy [...] Read more.
Background/Objectives: Gastric cancer often presents at advanced stages with complications such as iron-deficiency anemia (IDA) due to chronic bleeding, representing a significant global health burden. Palliative management of bleeding tumors in frail patients remains challenging. This study evaluates the feasibility, safety, and efficacy of endoscopic calcium-electroporation (Ca-EP), a novel non-thermal ablation technique, for controlling bleeding in end-stage gastric cancer. Methods: Retrospective case series including consecutive patients with end-stage, bleeding gastric cancer and IDA requiring transfusions. Ca-EP was performed using the EndoVE system, which delivers bipolar electrical pulses (250 kHz) to induce reversible electroporation, enabling calcium influx and tumor cell apoptosis. Primary endpoints were clinical success (hemoglobin stabilization/reduced transfusions) and safety. Secondary endpoints included tumor regression, procedural time, and hospital stay. Results: Five patients (median age 81 years) were included. Clinical success was achieved in 80% (4/5) of patients, with reduced transfusion needs and stable hemoglobin levels. One patient required adjunctive hemostatic radiotherapy. No major or minor adverse events were reported, and all patients were discharged within 24 h. Procedural median time was 38 min (range: 22–65). Endoscopic follow-up in three patients showed mild tumor regression or stability. Three patients required repeat Ca-EP sessions due to recurrent bleeding. Conclusions: Endoscopic Ca-EP is a safe, minimally invasive palliative option for bleeding gastric cancer, offering sustained hemostasis and potential antitumor effects without systemic toxicity. Its feasibility in frail patients underscores its clinical relevance, though larger prospective studies are needed to optimize parameters and validate long-term outcomes. Full article
(This article belongs to the Special Issue Gastric Cancer: New Trends in Endoscopic Diagnosis Staging and Treatment)
►▼ Show Figures

Figure 1

10 pages, 5662 KB  
Case Report
COVID-19 and Superimposed Aspergillosis in a Dual Organ Recipient with Diagnosed B-Cell Lymphoproliferative Disorder: A Rare Case Report and Literature Review
by Vidna Karadžić-Ristanović, Jelena Pavlović, Voin Brković, Ana Bontić, Marko Baralić, Dragan Vasin, Maja Životić, Novica Boričić, Darko Antić, Vojin Vuković and Milan Radović
Diseases 2025, 13(10), 339; https://doi.org/10.3390/diseases13100339 - 14 Oct 2025
Abstract
Post-transplant lymphoproliferative disorder (PTLD) poses significant risks following organ transplantation, characterized by potential aggressiveness. This report aims to discuss a case of PTLD presenting as B-cell large-cell lymphoma (DLBCL) post kidney and pancreas transplantation. A 44-year-old female with type 1 diabetes underwent simultaneous [...] Read more.
Post-transplant lymphoproliferative disorder (PTLD) poses significant risks following organ transplantation, characterized by potential aggressiveness. This report aims to discuss a case of PTLD presenting as B-cell large-cell lymphoma (DLBCL) post kidney and pancreas transplantation. A 44-year-old female with type 1 diabetes underwent simultaneous cadaver kidney and pancreas transplantation. She presented with fever, night sweats, and weakness, revealing multiple lesions on CT, including in transplanted and native kidneys and pancreas. A biopsy of the transplant kidney confirmed PTLD, DLBCL subtype, with complex immunohistochemical findings. Chemotherapy (R-CHOP) was initiated but complicated by bowel perforation necessitating surgery and antibiotics, transplant renal vein thrombosis, pyelonephritis, and neutropenia. Despite the complications, the normal function of the transplanted kidney was maintained, which made it possible to implement the standard chemotherapy protocol. This case underscores the diagnostic challenges and therapeutic complexities of PTLD, specifically DLBCL, in transplant recipients. The co-infection of COVID-19 and aspergillosis in a multiple immunocompromised patient indicated a possible rapid course of the disease with global respiratory insufficiency and a fatal outcome despite all applied therapeutic modalities. Full article
►▼ Show Figures

Figure 1

17 pages, 2249 KB  
Article
Vaginal Microbiota in Short Cervix Pregnancy: Secondary Analysis of Pessary vs. Progesterone Trial
by Antonio G. Amorim Filho, Roberta C. R. Martins, Lucas A. M. Franco, Juliana V. C. Marinelli, Stela V. Peres, Rossana P. V. Francisco and Mário H. B. Carvalho
Diseases 2025, 13(10), 338; https://doi.org/10.3390/diseases13100338 - 14 Oct 2025
Abstract
Background/Objectives: Preterm birth (PTB) is a leading cause of neonatal mortality, particularly in women with a short cervix. Vaginal dysbiosis has been associated with increased PTB risk. Progesterone (PR) and Arabin pessary (PE) are commonly used for PTB prevention, but their impact on [...] Read more.
Background/Objectives: Preterm birth (PTB) is a leading cause of neonatal mortality, particularly in women with a short cervix. Vaginal dysbiosis has been associated with increased PTB risk. Progesterone (PR) and Arabin pessary (PE) are commonly used for PTB prevention, but their impact on vaginal microbiome composition is unclear. This study aimed to compare the effects of these interventions on the vaginal microbiome in women at risk of PTB. Methods: In a secondary analysis of a randomized trial at Hospital das Clínicas, Universidade de São Paulo, 203 women with singleton pregnancies and cervical length ≤ 25 mm at the second trimester were assigned to daily vaginal PR (200 mg) or PE. Vaginal swabs from 44 participants (n = 22 per group) were collected at baseline and 4 weeks post-treatment and analyzed via 16S rRNA gene sequencing. Results: From 88 samples analyzed, 80 showed a low-diversity, Lactobacillus-dominated microbiota, 42 classified into Lactobacillus iners-dominated community state type (CST-III), and 38 presented other Lactobacillus species dominance (termed CST-I/II/V). The remaining eight samples presented non-Lactobacillus dominance (CST-IV). Comparing the two groups, no significant changes in CST were observed between sampling timepoints (PE group, p = 0.368; PR group, p = 0.223). Similarly, Shannon alpha diversity did not change (PE group, p = 0.62; PR group, p = 0.30), and Bray–Curtis dissimilarity also did not change after treatment (p = 0.96, before; p = 0.87, after treatment). Conclusions: Arabin pessary and vaginal progesterone maintain vaginal microbiome stability in women at high PTB risk, supporting the microbiological safety of both interventions. Full article
(This article belongs to the Special Issue Microbiota in Human Disease)
►▼ Show Figures

Graphical abstract

15 pages, 1551 KB  
Article
Severe Acute SARS-CoV-2 Infection and Long COVID: What Do We Know So Far? New Challenges in Diagnosis and Management
by Sara Mazzanti, Francesco Barchiesi, Francesco Pallotta, Ilenia Luchetti, Andrea Giacometti and Lucia Brescini
Diseases 2025, 13(10), 337; https://doi.org/10.3390/diseases13100337 - 13 Oct 2025
Abstract
Background/Objectives: The long-term impact of the COVID-19 pandemic is not just limited to socioeconomic aspects; there are also important health issues to consider. Among these, one of the most important and obvious is long COVID. Despite a significant amount of scientific work having [...] Read more.
Background/Objectives: The long-term impact of the COVID-19 pandemic is not just limited to socioeconomic aspects; there are also important health issues to consider. Among these, one of the most important and obvious is long COVID. Despite a significant amount of scientific work having been published, this condition is still semi-unknown. The objective of this study was to collect useful information for the clarification of some epidemiological, clinical, and laboratory characteristics of this disease. Methods: This was a single-center study carried out at the Infectious Diseases Clinic of the hospital “AUO delle Marche” on all patients hospitalized for COVID-19 between November 2021 and March 2022. Results: From the data, it emerged that, following the resolution of the acute phase of SARS-CoV-2 infection, the majority of people experienced health problems that persisted for at least 6 months. The manifestations and outcomes affect different systems; therefore, long COVID, like COVID-19, has systemic involvement and the clinical manifestations may be residues of the damage caused by the disease during the acute phase, or new manifestations whose pathogenesis is still a matter of discussion. Conclusions: The persistence of inflammation and the dysregulation of the immune system represent some of the pathogenetic hypotheses. Inflammation could therefore represent one of the physiopathogenetic mechanisms of long COVID, and it is possible that it is responsible for the clinical symptoms that appear in the months following the resolution of the acute phase of the disease. Full article
(This article belongs to the Section Infectious Disease)
►▼ Show Figures

Figure 1

8 pages, 528 KB  
Case Report
Molecular Analysis of Cerebrospinal Fluid Tumor-Derived DNA to Aid in the Diagnosis and Targeted Treatment of Breast Cancer Brain Metastasis
by Michael Youssef, Alexandra Larson, Vindhya Udhane, Viriya Keo, Kala F. Schilter, Qian Nie and Honey V. Reddi
Diseases 2025, 13(10), 336; https://doi.org/10.3390/diseases13100336 - 11 Oct 2025
Viewed by 168
Abstract
A woman in her 40s with a history of ER/PR+, HER2-negative breast cancer presented with a seizure three years after mastectomy. Magnetic resonance imaging (MRI) revealed a right caudate head mass, which was concerning for either high-grade glioma or metastatic disease, but biopsy [...] Read more.
A woman in her 40s with a history of ER/PR+, HER2-negative breast cancer presented with a seizure three years after mastectomy. Magnetic resonance imaging (MRI) revealed a right caudate head mass, which was concerning for either high-grade glioma or metastatic disease, but biopsy was deemed too high risk. Cerebrospinal fluid (CSF) tumor-derived DNA (tDNA) analysis by next-generation sequencing (NGS) was ordered, revealing a gain-of-function variant in PIK3CA, ERBB2 copy number gain, and high aneuploidy, findings consistent with breast cancer brain metastasis. Based on these results, the patient was treated with stereotactic radiosurgery (SRS) followed by trastuzumab deruxtecan, a HER2-targeted therapy. This case highlights the diagnostic and therapeutic value of CSF tDNA analysis in central nervous system (CNS) lesions when biopsy is not feasible. The report also illustrates how clonal evolution, such as acquired ERBB2 amplification, can occur in metastatic disease and influence treatment decisions. Full article
►▼ Show Figures

Figure 1

27 pages, 2039 KB  
Article
Psychiatric Comorbidity, Functional Status, and Neuroinflammatory Pathways in Cancer Patients with and Without Type 2 Diabetes
by Ana-Maria Pâslaru, Iulian Bounegru, Drăguș Laurențiu and Anamaria Ciubară
Diseases 2025, 13(10), 335; https://doi.org/10.3390/diseases13100335 - 10 Oct 2025
Viewed by 331
Abstract
Background: Cancer, type 2 diabetes mellitus (T2DM), and psychiatric comorbidities such as depression and anxiety frequently coexist, with shared mechanisms involving systemic inflammation and neuroinflammatory pathways. Understanding these interactions is critical for improving multidisciplinary oncological care. Methods: We conducted a monocentric [...] Read more.
Background: Cancer, type 2 diabetes mellitus (T2DM), and psychiatric comorbidities such as depression and anxiety frequently coexist, with shared mechanisms involving systemic inflammation and neuroinflammatory pathways. Understanding these interactions is critical for improving multidisciplinary oncological care. Methods: We conducted a monocentric cross-sectional study (n = 174). Beyond descriptive and univariate analyses, we fitted multivariable models: linear regressions (HADS-Anxiety/Depression) with robust HC3 errors and the predictors ECOG, T2DM, age, sex, and residence, and logistic regression for ECOG ≥ 3. We assessed collinearity and model fit, and performed sensitivity checks. Results: Psychiatric comorbidity was present in 58% of patients, while more than 80% of those with available HADS data (n = 136) exceeded the clinical threshold for anxiety or depression. No significant differences in ECOG status were observed between patients with and without T2DM (mean ECOG 2.5 in both groups). Higher ECOG remained positively associated with both HADS-Depression (adjusted β = 2.77, 95% CI −1.03–6.57, p = 0.149) and HADS-Anxiety (β = 1.62, 95% CI −2.76–6.00, p = 0.468), although not statistically significantly. T2DM showed no independent association with either outcome (Depression β = −2.91, p = 0.130; Anxiety β = −0.80, p = 0.595). In logistic regression, T2DM was not significantly associated with ECOG ≥ 3 (aOR = 3.58, 95% CI 0.23–56.66, p = 0.365). Conclusions: The psychiatric burden is high among Romanian cancer patients, irrespective of T2DM status, and strongly associated with functional decline. These findings support the relevance of a neuroinflammatory framework linking somatic comorbidities and psychological distress. Routine psychiatric screening, early intervention, and integration of psycho-oncology into multidisciplinary care are recommended. Future prospective studies should incorporate inflammatory biomarkers to better define underlying mechanisms. Full article
(This article belongs to the Special Issue Mental Health—Management and Care, Multidisciplinary Approaches and Perspectives)
►▼ Show Figures

Figure 1

11 pages, 1316 KB  
Article
Vitamin B12 Deficiency Associated with Metformin and Proton Pump Inhibitors and Their Combinations: Results from a Disproportionality and Interaction Analysis
by Kannan Sridharan
Diseases 2025, 13(10), 334; https://doi.org/10.3390/diseases13100334 - 10 Oct 2025
Viewed by 309
Abstract
Background: Metformin and proton pump inhibitors (PPIs) are independently associated with vitamin B12 deficiency. Despite frequent co-prescription, particularly in diabetics with gastroesophageal disorders, evidence regarding the combined risk of these medications on vitamin B12 deficiency remains limited. This study aimed to evaluate the [...] Read more.
Background: Metformin and proton pump inhibitors (PPIs) are independently associated with vitamin B12 deficiency. Despite frequent co-prescription, particularly in diabetics with gastroesophageal disorders, evidence regarding the combined risk of these medications on vitamin B12 deficiency remains limited. This study aimed to evaluate the real-world risk of vitamin B12 deficiency associated with metformin, PPIs, and their combinations using the United States Food and Drug Administration Adverse Event Reporting System (USFDA AERS) database. Methods: We conducted a disproportionality analysis using USFDA AERS data from 2004 to 2024. We assessed whether metformin, PPIs, or their combinations were reported more often than expected with vitamin B12 deficiency and evaluated associated clinical outcomes, such as hospitalization and life-threatening events. Results: Among 29,661,136 reports, 552 met inclusion criteria, with metformin monotherapy accounting for 274 cases. Positive safety signals were detected for both metformin and all PPIs individually. While statistical interaction measures were not conclusive, patients on metformin–pantoprazole combination therapy experienced significantly higher rates of hospitalization and life-threatening events compared to those on pantoprazole alone. Conclusions: These findings suggest that patients receiving metformin and PPIs together, particularly the elderly, may face a higher risk of serious vitamin B12 deficiency-related complications. Clinicians should consider closer monitoring of vitamin B12 levels and supplementation when needed in patients on combination therapy. Full article
►▼ Show Figures

Figure 1

18 pages, 586 KB  
Systematic Review
Thrombophilic Changes and Hematological Complications in Asthmatic Patients with COVID-19: A Systematic Review
by Gabriela Mara, Gheorghe Nini, Stefan Marian Frent, Ana Lascu, Maria Daniela Mot, Casiana Boru and Coralia Cotoraci
Diseases 2025, 13(10), 333; https://doi.org/10.3390/diseases13100333 - 8 Oct 2025
Viewed by 152
Abstract
Background/Objectives: The interplay between asthma and COVID-19 raises critical clinical questions, particularly regarding the risk of hematological complications in patients affected by both conditions. While COVID-19 is known to cause coagulopathy and thromboembolic events, it remains unclear whether asthma independently influences these [...] Read more.
Background/Objectives: The interplay between asthma and COVID-19 raises critical clinical questions, particularly regarding the risk of hematological complications in patients affected by both conditions. While COVID-19 is known to cause coagulopathy and thromboembolic events, it remains unclear whether asthma independently influences these risks. This systematic review aimed to synthesize existing evidence on hematological abnormalities—including D-dimer elevation, thrombocytopenia, and venous thromboembolism (VTE)—in asthmatic patients with confirmed SARS-CoV-2 infection. Methods: A systematic search was conducted in PubMed and Web of Science databases for studies published between January 2020 and May 2025. Inclusion criteria were studies reporting hematologic outcomes in asthmatic patients with COVID-19. After duplicate removal, 139 unique articles were screened, with 40 studies meeting inclusion criteria. These included observational cohorts, retrospective analyses, and clinical investigations. Data were synthesized in a systematic review with qualitative synthesis due to heterogeneity in design and reporting. Results: The review identified variable patterns of D-dimer elevation and thrombotic events among asthmatic COVID-19 patients. Some studies reported a higher incidence of ICU admission, elevated inflammatory and coagulation markers, and increased thromboembolic risk in asthmatic individuals—particularly those with poor disease control or non-allergic phenotypes. However, findings were inconsistent and often limited by the absence of asthma stratification, standardized outcome measures, and prospective designs. Conclusions: Current evidence does not support a definitive link between asthma and increased thrombotic risk in COVID-19. Further research with prospective, phenotype-stratified methodologies and harmonized hematologic endpoints is needed to clarify whether asthma modifies the hematologic trajectory of SARS-CoV-2 infection. Full article
(This article belongs to the Special Issue COVID-19 and Global Chronic Disease 2025: New Challenges)
►▼ Show Figures

Figure 1

13 pages, 249 KB  
Article
Concussions in Portuguese Professional Football: A Preliminary Epidemiological Study
by André Moreira, Filipe Froes, Gonçalo Vaz, Alexandre Fernandes, Basil Ribeiro, Frank Mederos, Gabriel Nogueira, Hugo Almeida, Pedro Caetano, Pedro Prata, Ana Teixeira and Reinaldo Teixeira
Diseases 2025, 13(10), 332; https://doi.org/10.3390/diseases13100332 - 8 Oct 2025
Viewed by 176
Abstract
Introduction: Concussions are a growing concern in professional football due to their potential short- and long-term neurological consequences. Despite increasing global awareness, data on the epidemiology and clinical management of concussions in Portuguese football remain scarce. This preliminary exploratory study aimed to characterize [...] Read more.
Introduction: Concussions are a growing concern in professional football due to their potential short- and long-term neurological consequences. Despite increasing global awareness, data on the epidemiology and clinical management of concussions in Portuguese football remain scarce. This preliminary exploratory study aimed to characterize the incidence, mechanisms, symptomatology, and medical response to concussions in Portugal’s Professional Football Leagues during the 2023/2024 season, based on reported cases. Methods: A retrospective observational analysis was conducted on head injuries reported by club medical teams during official matches in Liga Portugal First and Second Leagues. Collected variables included player position, time of injury, mechanism, symptoms, medical interventions and hospital referral. Results: Only six concussions were reported during official matches, with an overall incidence of 0.60 per 1000 player-hours. Most occurred in defenders, primarily due to head-to-head collisions, followed by ball impact, falls, and maxillofacial trauma. Injuries were more frequent during the final third of matches. Common symptoms included loss of consciousness, headache, and amnesia. Half of the players were referred to hospital care and underwent cranial CT scans. Among all variables analyzed, a statistically significant association was found between mechanism of injury and occurrence of amnesia (p = 0.014), with non-head-to-head impacts more frequently associated with amnesia. However, given the extremely limited sample size, this finding should be interpreted with extreme caution and requires replication in larger cohorts. Conclusions: This preliminary study suggests that defenders face a higher risk of head injuries, particularly from head-to-head impacts occurring late in matches. The prevalence of severe symptoms and the potential association between non-head-to-head impacts and amnesia highlight the need for more robust injury surveillance systems and underscore the importance of improved sideline assessment and return-to-play protocols. The findings emphasize the urgent need for comprehensive, standardized reporting mechanisms for concussions. Further research should explore long-term neurological effects and the effectiveness of preventive measures such as rule modifications, protective measures, and enhanced concussion management protocols, supported by more extensive and systematically collected data. Full article
13 pages, 1838 KB  
Article
C-Reactive Protein Levels Predict Improvement in the Liver Functional Reserve by Long-Term Rifaximin Treatment
by Kensuke Kitsugi, Kazuhito Kawata, Go Murohisa, Yashiro Yoshizawa, Masaharu Kimata, Yosuke Kobayashi, Shuhei Unno, Hidenao Noritake, Takeshi Chida and Yoshisuke Hosoda
Diseases 2025, 13(10), 331; https://doi.org/10.3390/diseases13100331 - 8 Oct 2025
Viewed by 186
Abstract
Objectives: Rifaximin is a non-absorbable antibiotic that has an efficacy for hepatic encephalopathy (HE). We previously demonstrated that rifaximin improved liver functional reserve, but this was a single-center study with a limited number of cases, and there were few cases of long-term use. [...] Read more.
Objectives: Rifaximin is a non-absorbable antibiotic that has an efficacy for hepatic encephalopathy (HE). We previously demonstrated that rifaximin improved liver functional reserve, but this was a single-center study with a limited number of cases, and there were few cases of long-term use. Here, we conducted a multicenter study to evaluate the efficacy of long-term rifaximin administration on the liver functional reserve. Methods: A multicenter retrospective study was conducted on cirrhotic patients who received rifaximin for more than 12 months. We evaluated the efficacy of long-term rifaximin administration on the liver functional reserve. Results: A total of 65 cirrhotic patients were enrolled. Administration of rifaximin for 12 months significantly improved the Child–Pugh score (CPS) and albumin–bilirubin (ALBI) score. Regarding the parameters of the CPS, albumin scores significantly improved in addition to HE scores at 12 months. Univariate and multivariate analysis revealed that high C-reactive protein (CRP) levels (>0.69 mg/dL) at baseline were the predictive factor for improvement in the liver functional reserve. Conclusions: This study suggests that long-term rifaximin administration may improve the liver functional reserve in cirrhotic patients through improvement in albumin levels. CRP levels predict improvement in the liver functional reserve. Full article
(This article belongs to the Section Gastroenterology)
►▼ Show Figures

Figure 1

16 pages, 3383 KB  
Article
Leiomyosarcomas of the Great Saphenous Vein: Diagnostic and Therapeutic Strategies to Prevent Unplanned Excisions and Improve Oncologic, Functional, and Psychological Outcomes
by Luis R. Ramos Pascua, Elena Ramos García, Manuel Robustillo Rego, Violeta González Méndez, Ana Belén Enguita Valls, María I. Mora Fernández, Gabriel Rubio Valladolid and Jesús E. Vilá y Rico
Diseases 2025, 13(10), 330; https://doi.org/10.3390/diseases13100330 - 6 Oct 2025
Viewed by 145
Abstract
Background/Objectives: There are very few publications on unplanned excisions of great saphenous vein leiomyosarcomas (GSV-LMS), and their impact on the prognosis of the disease is not well known. The objective of this study is to present a series of nine new leiomyosarcomas of [...] Read more.
Background/Objectives: There are very few publications on unplanned excisions of great saphenous vein leiomyosarcomas (GSV-LMS), and their impact on the prognosis of the disease is not well known. The objective of this study is to present a series of nine new leiomyosarcomas of the great saphena vein (LMS-GSV) cases, with the aim of increasing diagnostic awareness and proposing guidelines for therapeutic management. Methods: This is a prospective single-centre study of a series of nine GSV-LMS in thigh (stage IIIA AJCC), knee and proximal leg (IB, 1 II and 3 IIIA), and ankle (2 IIIB and 1 II). Eight patients were female, and the mean age was 72 years. All patients were surgically treated. Five (56%) were unplanned excisions. All these patients were reoperated on to attempt wide resection margins. In a patient, an infra-patellar amputation was performed. Another amputation was refused by another patient. Eight patients received adjuvant radiotherapy. Results: One patient died 8 years after amputation for a reason other than LMS. The patient who refused amputation has been alive, disease-free, for 28 months. The mean follow-up of surviving patients was 39 months (6–78 months). In these patients, there were no local recurrences or metastases. The mean functional outcome according to the MSTS score was 28.9 (range: 24–30). Conclusions: Unplanned excision of GSV-LMS can be prevented through clinical and imaging suspicion. Surgery and re-excision in case of inadequate previous margins and adjuvant radiotherapy lead to a good oncological and functional outcome. Full article
►▼ Show Figures

Figure 1

11 pages, 458 KB  
Article
Impact of Red Pack Cell Transfusion Before or After Endoscopy on Mortality in Patients with Upper Gastrointestinal Bleeding: A Multicenter Cohort Study
by Clelia Marmo, Cristina Bucci, Marco Soncini, Maria Elena Riccioni and Riccardo Marmo
Diseases 2025, 13(10), 329; https://doi.org/10.3390/diseases13100329 - 4 Oct 2025
Viewed by 213
Abstract
Background: The impact of transfusion timing relative to endoscopy in upper gastrointestinal bleeding (UGIB) remains unclear. Aim: To assess whether transfusion performed before versus after endoscopy affects 30-day mortality in UGIB. Methods: We conducted a post hoc analysis of a multicenter cohort study [...] Read more.
Background: The impact of transfusion timing relative to endoscopy in upper gastrointestinal bleeding (UGIB) remains unclear. Aim: To assess whether transfusion performed before versus after endoscopy affects 30-day mortality in UGIB. Methods: We conducted a post hoc analysis of a multicenter cohort study including 3324 UGIB patients consecutively admitted in hospital. Propensity score matching adjusted for clinical and procedural variables. Results: Among 2017 transfused patients, 34.7% received Red Blood Cells (RBC) before endoscopy. Patients who received transfusions before endoscopy were older, had more severe comorbidities, and presented with a worse physical and hemodynamic status. This study also explored whether transfusion timing relative to endoscopy affects clinical outcomes in patients stratified by baseline hemoglobin levels. While pre-endoscopy transfusion was not significantly associated with reduced 30-day mortality in the overall population, we observed an advantage in patients transfused before the endoscopy when the Hb value was <7 g/dL. Pre-endoscopy transfusion was associated with a 6% absolute reduction in 30-day mortality (p < 0.06), with a greater benefit observed in patients with Hb < 7 g/dL (−27%) and <8 g/dL (−21%). Moreover, for this group of patients more favorable outcome was observed when the endoscopy was performed between 6 and 12 h from admission. These findings suggest that transfusion timing should be integrated into individualized UGIB management and may impact future clinical guidelines. Conclusions: In patients with severe anemia and UGIB, transfusion before endoscopy may reduce mortality. Timing to transfusion should be considered alongside hemodynamic and procedural factors in future guidelines. Full article
(This article belongs to the Section Gastroenterology)
►▼ Show Figures

Figure 1

9 pages, 228 KB  
Article
Low-Grade Inflammatory Hematological Markers in Otolaryngologic Diseases: A Preliminary Report
by María Aurora Maravilla-Domínguez, Beatriz Teresita Martín-Márquez, Flavio Sandoval-García, Verónica Adriana Montes-Varela, Nicté Selene Fajardo-Robledo, Fernanda Isadora Corona-Meraz and Soraya Amalí Zavaleta-Muñiz
Diseases 2025, 13(10), 328; https://doi.org/10.3390/diseases13100328 - 3 Oct 2025
Viewed by 172
Abstract
Background/Objectives: Complete blood count tests are inexpensive and widely available and may help identify low-grade inflammation in otolaryngologic (Ear, Nose and Throat, ENT) diseases, such as facial paralysis and hearing loss. This study aimed to describe the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio [...] Read more.
Background/Objectives: Complete blood count tests are inexpensive and widely available and may help identify low-grade inflammation in otolaryngologic (Ear, Nose and Throat, ENT) diseases, such as facial paralysis and hearing loss. This study aimed to describe the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), eosinophil-to-lymphocyte ratio (ELR), and lymphocyte-to-monocyte ratio (LMR) in ENT diseases and to provide preliminary evidence supporting further research. Methods: Data from 62 patients with ENT diseases were analyzed in a cross-sectional design. Results: The prevalence of ENT diseases was higher in women (63%) and adults (85.5%), highlighting vertigo, hearing loss, and septal deviation. Most marker values were within normal ranges; however, NLR values were elevated in patients with either septal deviation or vertigo, and ELR values were increased in cases of allergic or infectious rhinitis and sinusitis. In contrast, LMR values were at the lower normal limits in patients with septal deviation. Conclusions: These findings highlight the need for further studies to clarify the role of these biomarkers in chronic conditions and morphological alterations associated with ENT diseases, using more complex study designs. Full article
23 pages, 904 KB  
Article
Association of Maternal Sociodemographic, Anthropometric, and Lifestyle Factors with Childhood Anthropometric Measures and Anxiety Symptoms: A Nationally Representative Cross-Sectional Study of Preschool-Aged Children in Greece
by Exakousti-Petroula Angelakou, Athina Spyrilioti, Maria Tsiakara, Maria Vasilakaki and Constantinos Giaginis
Diseases 2025, 13(10), 327; https://doi.org/10.3390/diseases13100327 - 2 Oct 2025
Viewed by 863
Abstract
Background/Objective: Childhood obesity and mental health disorders in preschool-aged children represent critical public health challenges with a rising global prevalence, closely linked to lifestyle behaviors and the family environment. This cross-sectional study aims to investigate the combined influence of maternal sociodemographic, socioeconomic, anthropometric [...] Read more.
Background/Objective: Childhood obesity and mental health disorders in preschool-aged children represent critical public health challenges with a rising global prevalence, closely linked to lifestyle behaviors and the family environment. This cross-sectional study aims to investigate the combined influence of maternal sociodemographic, socioeconomic, anthropometric characteristics, and lifestyle factors on the physical and mental health status of preschool-aged children. Methods: Validated questionnaires were administered to assess dietary habits, psychosocial parameters (depression, anxiety, stress), and sociodemographic, socioeconomic, and anthropometric variables among 200 preschool-aged children and their mothers, who served as the primary informants. Results: Maternal obesity was associated with a higher prevalence of childhood overweight/obesity (36.7% vs. 18.5% in children of non-obese mothers, p = 0.009). Maternal psychological factors, specifically depressive symptoms (B = 0.998, OR = 2.712, 95% CI: 1.222–6.020, p = 0.014) and anxiety (B = 1.676, OR = 5.346, 95% CI: 2.471–11.565, p < 0.001), were independently associated with an increased likelihood of child anxiety. Anthropometric measures, including waist circumference (p = 0.032) and hip circumference (p = 0.031), primarily influenced children’s physical health, whereas maternal psychological factors predominantly affected their emotional well-being. Conclusions: The findings underscore the necessity for targeted interventions focusing on enhancing maternal nutrition and mental health literacy, aiming to promote healthy dietary patterns, physical activity, and lifestyle behaviors. Such interventions are pivotal for preventing childhood obesity and fostering overall well-being at the population level. Full article
►▼ Show Figures

Figure 1

17 pages, 668 KB  
Article
Triglycerides, Cholesterol, and Depressive Symptoms Among Undergraduate Medical Students: A Cross-Sectional Study
by Maximiliano Olguín-Montiel, Alejandro Álvarez-Flores, Dulce Milagros Razo-Blanco-Hernández, María Alicia Mejía-Blanquel, Verónica Fernández-Sánchez, Gledy Manuela Olmos-Rivera, Ana Cristina Castañeda-Márquez, Edith Araceli Cano-Estrada, Mónica Alethia Cureño-Díaz and José Ángel Hernández-Mariano
Diseases 2025, 13(10), 326; https://doi.org/10.3390/diseases13100326 - 2 Oct 2025
Viewed by 521
Abstract
Background: Depression is one of the most common mental disorders among undergraduate students, particularly those in medical training, who face high academic demands and emotional burdens. Biological factors such as lipid abnormalities have been proposed as contributors to depressive symptoms, although evidence in [...] Read more.
Background: Depression is one of the most common mental disorders among undergraduate students, particularly those in medical training, who face high academic demands and emotional burdens. Biological factors such as lipid abnormalities have been proposed as contributors to depressive symptoms, although evidence in this group is scarce. Therefore, we aimed to evaluate the association between triglyceride and total cholesterol levels and depressive symptoms in medical students. Methods: We conducted a cross-sectional study including 219 medical students from a public university in Mexico. Depressive symptoms were assessed using the CESD-7 scale, validated in the Mexican population. Fasting triglyceride and total cholesterol concentrations were measured with the Accutrend Plus analyzer. Prevalence ratios (PRs) and 95% confidence intervals (CIs) were estimated using robust Poisson regression, adjusting for potential confounders. Results: Overall, 38.8% of students presented depressive symptoms. In adjusted continuous models, each 10 mg/dL increase in triglycerides was associated with a 4% higher prevalence of depression (PR = 1.04, 95% CI 1.03–1.06), while each 10 mg/dL increase in total cholesterol was associated with a 13% higher prevalence (PR = 1.13, 95% CI 1.05–1.21). Analyses using clinically relevant cutoffs confirmed these associations: triglycerides ≥ 150 mg/dL (PR = 1.76, 95% CI 1.24–2.48) and cholesterol ≥ 200 mg/dL (PR = 1.66, 95% CI 1.19–2.31). Conclusions: Dyslipidemias may play a relevant role in the mental health of young adults and highlight the importance of incorporating metabolic risk assessment into strategies to prevent and address depression in medical students. Full article
(This article belongs to the Section Neuro-psychiatric Disorders)
►▼ Show Figures

Figure 1

11 pages, 706 KB  
Article
Revolving Door in Older Patients: An Observational Study of Risk Assessment of Rehospitalization Using the BRASS Scale
by Francesco Saverio Ragusa, Anna La Vattiata, Antonio Terranova, Giuseppina Pesco, Davide Mariani, Ligia J. Dominguez, Nicola Veronese, Pasquale Mansueto and Mario Barbagallo
Diseases 2025, 13(10), 325; https://doi.org/10.3390/diseases13100325 - 1 Oct 2025
Viewed by 224
Abstract
Introduction: The “revolving” door is a phenomenon that refers to the rehospitalization of older patients who, after being discharged, soon require specialized hospital care again. Unfortunately, the use of tools able to predict this phenomenon is still limited. The aim of this [...] Read more.
Introduction: The “revolving” door is a phenomenon that refers to the rehospitalization of older patients who, after being discharged, soon require specialized hospital care again. Unfortunately, the use of tools able to predict this phenomenon is still limited. The aim of this study was to highlight the validity of the Blaylock Risk Assessment Screening (BRASS) Scale in objectively assessing the risk of rehospitalization and mortality among older patients. Methods: Patients were classified as low, medium, or high risk using the BRASS scale. Adverse events (rehospitalization or death) were recorded at baseline and at 12 months. Kaplan–Meier curves evaluated survival and rehospitalization across risk groups, and ROC analysis assessed the BRASS Scale’s predictive value for mortality. Results: Out of 179 enrolled older adults (mean age 67.7 years), 54.2% were classified as low risk, 29.5% as medium, and 16.8% as high risk based on the BRASS Scale. High-risk patients had significantly higher mortality (HR: 4.40; 95% CI: 1.60–12.19, p = 0.004) and lower survival rates, while intermediate-risk patients had increased rehospitalization (HR: 2.11; 95% CI: 1.09–4.08, p = 0.02). The BRASS scale showed good predictive value for mortality (AUC 0.76). Conclusion: The BRASS Scale has a good predictive value for negative outcomes, and it confirms that a substantial proportion of older patients are at risk of future hospital readmissions and complex discharges. These findings underscore the importance of early post-discharge care planning and the implementation of protected discharge programs. Full article
(This article belongs to the Special Issue Frailty and Frequent Hospitalizations in Older Adults: Risk, Management, and Interventions)
►▼ Show Figures

Figure 1

12 pages, 248 KB  
Article
Factors Associated with Hepatitis B Vaccination Status Among U.S. Adults with Diabetes
by Douwné L. Müller, Jessica Yingst, William A. Calo, Heather Stuckey, Thomas Godfrey and Li Wang
Diseases 2025, 13(10), 324; https://doi.org/10.3390/diseases13100324 - 1 Oct 2025
Viewed by 262
Abstract
Background/Objectives: Adults aged 19–59 with diabetes are recommended by the Advisory Committee on Immunization Practices (ACIP) to receive vaccination against Hepatitis B Virus (HBV) infection because of their increased risk of contracting HBV. This study aimed to examine hepatitis B (HepB) vaccination rates [...] Read more.
Background/Objectives: Adults aged 19–59 with diabetes are recommended by the Advisory Committee on Immunization Practices (ACIP) to receive vaccination against Hepatitis B Virus (HBV) infection because of their increased risk of contracting HBV. This study aimed to examine hepatitis B (HepB) vaccination rates among U.S. adults aged 19–59 years with diabetes and explore sociodemographic factors associated with HepB vaccination. Methods: Data from the 2015–2018 National Health and Nutrition Examination Survey (NHANES) were analyzed to compare HepB vaccination between adults with and without diabetes. Weighted Chi-square analysis was used to test the associations between HepB vaccination status and various categorical variables. Weighted logistic regression was employed to identify factors associated with being fully vaccinated. Results: A total of 5988 adults aged 19–59 were included in the study, of whom 504 (8.4%) had diabetes. The HepB vaccination rate was 32.3% for those with diabetes vs. 43.6% for those without diabetes (p = 0.01). However, after adjusting for other covariates, having diabetes was not associated with being fully vaccinated against HBV (p = 0.583). Adults aged 45–59 years were less likely to be vaccinated against HBV compared to those aged 19–29 (OR: 0.12, p < 0.0001). Having health insurance, being female, and having a higher educational level were all associated with HepB vaccination status (all p < 0.01). Overall, the HBV infection rate was 1.1%. Having HepB vaccination was associated with a lower risk of HBV infection among both groups with and without diabetes. Conclusions: HepB vaccination among U.S. adults with diabetes was suboptimal and lower than among those without diabetes. Age and education were associated with being fully vaccinated against HBV. Future research is needed to identify and better understand barriers to receiving HepB vaccines. Full article
23 pages, 8637 KB  
Article
Comprehensive Explorations and Preliminary Experimental Verification of RNA Modification-Related Diagnostic Markers in the Subtype Classification of Peripheral Blood-Derived Mononuclear Cells Derived from Post-Traumatic Stress Disorder Patients
by Lesheng Wang, Gaomeng Luo, Sha Liu, Zhipeng Xu, Wei Wei and Xiang Li
Diseases 2025, 13(10), 323; https://doi.org/10.3390/diseases13100323 - 1 Oct 2025
Viewed by 150
Abstract
Background: The precise role of RNA modification in post-traumatic stress disorder (PTSD) remains incompletely understood. This study aims to elucidate the effects of five common RNA modifications in PTSD, specifically m6A, m5C, m1A, m7G, and [...] Read more.
Background: The precise role of RNA modification in post-traumatic stress disorder (PTSD) remains incompletely understood. This study aims to elucidate the effects of five common RNA modifications in PTSD, specifically m6A, m5C, m1A, m7G, and ψ. Methods: We extracted data from the GEO repository to conduct a series of bioinformatics analyses. These included differential analysis to identify key regulators of five common RNA modifications, model construction using random forest (RF), least absolute shrinkage and selection operator (LASSO), and nomogram techniques, as well as consensus clustering of RNA modification subtypes. Furthermore, GO enrichment analysis was performed on DEGs associated with various RNA modification patterns. Immune cell infiltration was assessed using PCA and ssGSEA. RT-qPCR was performed to validate RNA modification-related genes (RMGs). Results: Twenty-one differentially expressed RMGs were identified. LASSO and RF intersection yielded eight signature genes (YTHDC1, IGFBP1, IGF2BP1, ALKBH5, NSUN4, TET2, TET3, WDR4) that robustly diagnosed PTSD (AUC = 0.804). Furthermore, these feature genes were validated using RT-qPCR, which was basically consistent with the results of bioinformatics analysis. Consensus clustering analysis may reveal two distinguishable subtypes: clusterA marked by high immunoinflammation, and clusterB characterized by high-neuroendocrine dysregulation. Conclusions: RMGs may play a crucial role in the pathogenesis of PTSD. Analyzing RNA modification patterns could offer potential diagnostic markers and help to guide immunotherapeutic approaches or neurotransmitter system interventions for PTSD in the future. Full article
(This article belongs to the Section Neuro-psychiatric Disorders)
►▼ Show Figures

Figure 1

12 pages, 3187 KB  
Review
Psoriasis in the Context of Dermatologic Disorders: A Comprehensive Overview
by Julia Nowowiejska-Purpurowicz, Patrycja Lemiesz and Iwona Flisiak
Diseases 2025, 13(10), 322; https://doi.org/10.3390/diseases13100322 - 1 Oct 2025
Viewed by 291
Abstract
Psoriasis is a chronic, immune-mediated dermatosis that affects approximately 125 million people worldwide. Traditionally considered a dermatologic condition, it is now perceived as a systemic disease with numerous comorbidities. While its associations with psoriatic arthritis, metabolic syndrome, and psychiatric disorders are well established, [...] Read more.
Psoriasis is a chronic, immune-mediated dermatosis that affects approximately 125 million people worldwide. Traditionally considered a dermatologic condition, it is now perceived as a systemic disease with numerous comorbidities. While its associations with psoriatic arthritis, metabolic syndrome, and psychiatric disorders are well established, less attention has been given to its coexistence with other dermatoses. This narrative review aims to explore and summarize the existing evidence on the relationships between psoriasis and other skin diseases, highlighting potential overlaps in clinical presentation, pathogenesis, and treatment challenges. Psoriasis may coexist with several inflammatory and autoimmune skin disorders, including atopic dermatitis, lichen simplex chronicus, anti-p200 pemphigoid, pityriasis rubra pilaris, seborrheic dermatitis, inflammatory linear verrucous nevus (ILVEN), Sneddon–Wilkinson disease, and vitiligo. The review highlights the shared genetic pathways (e.g., the Th1/Th17 axis and IL-17 pathway), diagnostic challenges (e.g., sebopsoriasis and psoriasis–eczema overlap), and therapeutic considerations (e.g., paradoxical reactions to biologics and effectiveness of JAK inhibitors in both psoriasis and vitiligo). The coexistence of psoriasis with other dermatoses is more common and clinically significant than previously appreciated. Recognizing these associations is crucial for an accurate diagnosis, avoiding mismanagement, and optimizing individualized treatment strategies. Further research is needed to elucidate the underlying mechanisms and improve the multidisciplinary care for patients with complex dermatologic presentations. Full article
►▼ Show Figures

Figure 1

10 pages, 667 KB  
Article
Incidence and Prognostic Factors for Colectomy in Acute Severe Ulcerative Colitis with Concomitant CMV Infection
by Konstantina Kitsou, Konstantina Chalakatevaki, Georgios Kokkotis, Evgenia Papathanasiou, Vassiliki Kitsou, Spyridon Michopoulos, Evanthia Zampeli and Giorgos Bamias
Diseases 2025, 13(10), 321; https://doi.org/10.3390/diseases13100321 - 1 Oct 2025
Viewed by 221
Abstract
Background/Objectives: Cytomegalovirus (CMV) is an opportunistic pathogen, complicating acute severe ulcerative colitis (ASUC), and its role in ASUC prognosis remains a debate. This study aims to report the rates and identify predictors for colectomy at 12 months, following an episode of ASUC with [...] Read more.
Background/Objectives: Cytomegalovirus (CMV) is an opportunistic pathogen, complicating acute severe ulcerative colitis (ASUC), and its role in ASUC prognosis remains a debate. This study aims to report the rates and identify predictors for colectomy at 12 months, following an episode of ASUC with concomitant CMV colonic infection. Methods: This is a retrospective cohort study of patients with ASUC and CMV colonic infection confirmed by PCR or Immunohistochemistry. Baseline clinical, biochemical, endoscopic and disease-related characteristics were recorded. Patients were followed-up for 12 months to calculate the one-year colectomy rate. Predictors of colectomy were identified via multivariate logistic regression. Results: Forty-five cases of CMV colonic infection in 37 patients with ASUC were recorded [66.7% men, mean age: 47.0 years (SD = 18.5)]. At diagnosis, 20% were on monotherapy with advanced treatment and 37.8% on advanced treatment plus corticosteroids and/or immunomodulators. Twenty-three (51.1%) were receiving corticosteroids, while 17.8% did not receive any immunosuppressive agent. Forty (88.9%) patients were treated with ganciclovir and valganciclovir and one (2.2%) with foscarnet for at least 21 days. Eleven patients (24.4%) required colectomy, two (4.4%) during their initial hospitalization and nine (20%) during the follow-up period. The recurrence of CMV was recorded in nine (20.9%) cases, three of which required colectomy. Patients with hemoglobin < 12 g/dL (p = 0.023) and patients on vedolizumab at diagnosis (p = 0.050) had a higher probability of colectomy. Conclusions: We report a 25% one-year colectomy rate in our cohort with ASUC and superimposed CMV colonic infection. At baseline, anemia and vedolizumab treatment were associated with a higher probability of colectomy. Full article
(This article belongs to the Section Gastroenterology)
►▼ Show Figures

Figure 1

24 pages, 1469 KB  
Review
Applications of Multiparameter Flow Cytometry in the Diagnosis, Prognosis, and Monitoring of Multiple Myeloma Patients
by Dimitrios Leonardos, Leonidas Benetatos, Elisavet Apostolidou, Epameinondas Koumpis, Lefkothea Dova, Eleni Kapsali, Ioannis Kotsianidis and Eleftheria Hatzimichael
Diseases 2025, 13(10), 320; https://doi.org/10.3390/diseases13100320 - 1 Oct 2025
Viewed by 598
Abstract
Multiple myeloma (MM) is one of the most common hematological malignancies and remains incurable. However, the survival of multiple myeloma patients has significantly increased due to the implementation of novel therapies along with autologous stem cell transplantation, changing the natural history of the [...] Read more.
Multiple myeloma (MM) is one of the most common hematological malignancies and remains incurable. However, the survival of multiple myeloma patients has significantly increased due to the implementation of novel therapies along with autologous stem cell transplantation, changing the natural history of the disease. Consequently, there is an unmet need for more sensitive response assessment techniques capable of quantifying minimal tumor burden to identify patients at higher risk of early relapse. Multiparameter flow cytometry (MFC) is an essential tool for diagnosing and monitoring patients with various hematological conditions and has recently gained prominence in identifying, characterizing, and monitoring malignant plasma cells. The implementation of Next-Generation Flow (NGF) by EuroFlow aims to overcome the pitfalls of conventional MFC, including lack of standardization and lower sensitivity, by offering standardized and optimized protocols for evaluating response depth. Both MFC and NGF have wide-ranging applications in MM for diagnosis and measurable residual disease (MRD) monitoring. Plasma cell identification and clonality evaluation through MFC and NGF assist in diagnostic workup and are routinely used to assess therapeutic response through MRD analysis. Additionally, flow cytometry is applied for circulating tumor plasma cell (CTPC) enumeration, which has demonstrated significant prognostic value. Immune composition studies through MFC may provide better understanding of disease biology. Furthermore, MFC provides additional information about other bone marrow cell populations, assessing cellularity, immunophenotypic characteristics of plasma cells, and possible hemodilution. This review explores the applications of MFC and NGF in MM, highlighting their roles in diagnosis, response assessment, and prognosis. Beyond their established use in MRD monitoring, flow cytometry-derived immunophenotypic profiles show strong potential as cost-effective prognostic tools. We advocate for future studies to validate and integrate these markers into risk stratification models, complementing cytogenetic analyses and guiding individualized treatment strategies. Full article
►▼ Show Figures

Figure 1

15 pages, 309 KB  
Case Report
Psychological Involvement in the Journey of a Patient with Localized Prostate Cancer—From Diagnosis to Treatment
by Daniela Mihalcia Ailene, Gabriela Rahnea-Nita, Alexandru Nechifor, Liliana Florina Andronache, Mihaela Emilia Dumitru, Alexandru-Mihai Rebegea, Cristina Stefanescu, Roxana-Andreea Rahnea-Nita and Laura-Florentina Rebegea
Diseases 2025, 13(10), 319; https://doi.org/10.3390/diseases13100319 - 1 Oct 2025
Viewed by 261
Abstract
Introduction: Prostate cancer is one of the most common neoplasia in men, and its clinical evolution is highly influenced by psycho-emotional factors, especially in elderly patients. Comorbidities, the perception of one’s identity and its impact on life quality become relevant variables in the [...] Read more.
Introduction: Prostate cancer is one of the most common neoplasia in men, and its clinical evolution is highly influenced by psycho-emotional factors, especially in elderly patients. Comorbidities, the perception of one’s identity and its impact on life quality become relevant variables in the therapeutic decision. Sexual dysfunction after treatment along with decreased libido, erectile dysfunction and ejaculatory dysfunction are significant problems in patients with prostate cancer. Case presentation: The present study presents the oncological evolution of an elderly patient with a dual diagnosis, prostate adenocarcinoma and lung squamous cell carcinoma, who faced a significant amount of medical and psychological challenges. Reluctance to hormone therapy was closely linked to the fear of sexual dysfunction, a very common reaction in elderly men concerned with maintaining autonomy and intimacy. The peculiarity of the case consists in the interaction between the evolution of the disease, the therapeutic decisions and the psychological impact on the patient. Discussion: Androgen deprivation therapy negatively influences multiple aspects of sexual function, significantly impairing the life quality of patients diagnosed with prostate cancer. In this context, therapy through acceptance and commitment is the appropriate one, its main purpose being to change the patient’s relationship with suffering—from struggle and rejection to active acceptance and value of the present. The intervention of the psychologist or the psychotherapist is essential in decision-making counseling, using coping techniques, the clarification of personal values and the involvement of the family in the decision-making process. Oncological psychology helps the patient redefine their life goals and priorities, not just to choose a treatment. Conclusions: Sexuality and psychological health are deeply affected by prostate cancer. Psychological flexibility and emotional support can mitigate this negative impact. The integration of therapy through acceptance and commitment in the rehabilitation after treatment increases effectiveness and patient satisfaction. Full article
(This article belongs to the Special Issue Mental Health—Management and Care, Multidisciplinary Approaches and Perspectives)
►▼ Show Figures

Figure 1

13 pages, 1056 KB  
Review
Syphilis and Tuberculosis as Mimickers of Autoimmune Diseases: Diagnostic Overlap and Surveillance Implications in Mexico
by Gustavo Esteban Lugo-Zamudio, Oscar Sosa-Hernández, Briceida López-Martínez, Clemente Cruz-Cruz, Emilio Mariano Durán-Manuel, Miguel Ángel Loyola-Cruz, José Carlos Gasca-Aldama, Paulina Carpinteyro-Espin, Luis Gustavo Zárate-Sánchez, Enzo Vásquez-Jiménez and Juan Manuel Bello-López
Diseases 2025, 13(10), 318; https://doi.org/10.3390/diseases13100318 - 28 Sep 2025
Viewed by 372
Abstract
In Mexico, syphilis and tuberculosis are infectious diseases subject to mandatory and immediate epidemiological surveillance, both with special systems that allow nominal follow-up for either variant. Surveillance uses the operational definitions of probable and confirmed cases established in the manual for epidemiological surveillance [...] Read more.
In Mexico, syphilis and tuberculosis are infectious diseases subject to mandatory and immediate epidemiological surveillance, both with special systems that allow nominal follow-up for either variant. Surveillance uses the operational definitions of probable and confirmed cases established in the manual for epidemiological surveillance issued by the General Directorate of Epidemiology of the Ministry of Health. However, both diseases, mainly in the chronic state, present challenges because of their ability to mimic autoimmune disorders. This review explores the phenomenon of clinical and immunological mimicry in secondary and tertiary syphilis, as well as in extrapulmonary tuberculosis, and analyzes its implications for the accuracy of case reporting at the national level. Evidence shows that both infections can present systemic inflammatory features, such as elevated acute phase reactants, positive autoantibodies, and alterations in cerebrospinal fluid that resemble autoimmune profiles. These overlaps can lead to misdiagnosis, inappropriate immunosuppressive treatment and misclassification of confirmed cases within the Mexican surveillance system. Surveillance of these conditions is robust; however, current operational definitions have weaknesses, particularly when atypical or autoimmune conditions are present, as they only focus on cases with the highest prevalence or public health impact. This manuscript proposes the integration of differential diagnostic algorithms and expanded laboratory criteria, including autoimmune markers and molecular tests, into surveillance protocols. Although individual efforts exist in health institutions, in our country, the absence of autoimmune diseases in the national register of obligatory notification stands out, contrasting with surveillance models in other countries, where autoimmune diseases are tracked systematically. To improve diagnostic accuracy and reporting, surveillance systems should incorporate a syndromic and etiological approach, recognizing infectious autoimmune mimicry as a factor in the final recording of confirmed cases to avoid epidemiological silence. Full article
(This article belongs to the Section Infectious Disease)
►▼ Show Figures

Figure 1

13 pages, 251 KB  
Review
The Effect of Bacteria Modulation with Probiotic Consumption in Neurodegeneration During Aging: A Narrative Review of the Literature
by Nayeli Valdez Gayosso, Arianna Omaña Covarrubias, Ana Teresa Nez Castro, Lydia López Pontigo, María del Refugio Acuña Gurrola and Bertha Maribel Pimentel Pérez
Diseases 2025, 13(10), 317; https://doi.org/10.3390/diseases13100317 - 26 Sep 2025
Viewed by 404
Abstract
Aging is the result of the accumulation of a great variety of molecular and cellular damage over time. During aging, the brain undergoes changes and diseases such as depression, dementia, anxiety, Alzheimer’s, delirium, behavioral disorders and aggression, and prolonged mourning, among others, appear. [...] Read more.
Aging is the result of the accumulation of a great variety of molecular and cellular damage over time. During aging, the brain undergoes changes and diseases such as depression, dementia, anxiety, Alzheimer’s, delirium, behavioral disorders and aggression, and prolonged mourning, among others, appear. The gut–brain axis suggests that the gut and the brain have a bidirectional communication, so it is important to maintain proper intestinal health to strengthen the neurological changes of this age group. The intestinal microbiota is a dynamic and highly complex ecosystem of microorganisms residing in the gastrointestinal tract. The bidirectional and dynamic communication between the homeostatic systems, such as the endocrine and immune systems, as well as the nervous system, allow us to face problems associated with several diseases. Probiotics are defined as non-pathogenic live microorganisms that provide beneficial effects to the organism and participate in the prevention and treatment of diseases, which is the reason why it is important to promote interventions that keep intestinal microbiota in eubiosis (microbiota balance). The concentration and balance of the intestinal microbiota depend on several conditions, such as diet, antibiotic consumption, and lifestyle, to mentioned a few. However, interventions with probiotics have shown improvements in both cognitive function and processes that promote neurodegeneration. It is such that the research has been directed on designing strategies that improve not only oral bioavailability but also intestinal adhesion and retention, to clarify the frequency and dosage that should be consumed. Full article
(This article belongs to the Section Clinical Nutrition)
11 pages, 885 KB  
Systematic Review
Efficacy and Safety of Different Treatments for Melasma: Network Meta-Analysis of Updated Data
by John Hang Leung, Henry W. C. Leung, Shyh-Yau Wang, Yeu-Chai Jang and Agnes L. F. Chan
Diseases 2025, 13(10), 316; https://doi.org/10.3390/diseases13100316 - 25 Sep 2025
Viewed by 1079
Abstract
Background: Melasma is a chronic, relapsing pigmented skin disease with challenging and unsatisfactory treatment outcomes. This study aims to compare the efficacy and safety of different treatments for melasma. Methods: We conducted a comprehensive search of PubMed and EMBASE databases to [...] Read more.
Background: Melasma is a chronic, relapsing pigmented skin disease with challenging and unsatisfactory treatment outcomes. This study aims to compare the efficacy and safety of different treatments for melasma. Methods: We conducted a comprehensive search of PubMed and EMBASE databases to identify randomized controlled clinical trials (RCTs) for melasma treatment modalities between January 2022 and January 2025. Relative efficacy refers to the comparison of the improvement in melasma severity before and after treatment for all modalities of interest at a specific time point. The Melasma Area Severity Index (MASI) (also known as modified MASI (mMASI) or half-MASI score) was defined as the efficacy index. Safety refers to the incidence of the most common adverse events. The quality of the included trials was assessed using the GRADE method. Results: The analysis included 14 clinical trials with 15 treatment modalities involving 738 women who met the inclusion criteria. The mean difference in efficacy index showed that intradermal PRP (platelet-rich plasma) and intradermal PRP + oTXA (oral tranexamic acid) were the best treatment options compared with HQ4%, intradermal TXA, intradermal PRGF (plasma rich in growth factor) + HQ4 (hydroquinone 4%), followed by intradermal TXALaser (intradermal TXA + Q-switched fractional 1064-nmNd:YAG lasers). The efficacy indices of other modalities were comparable. Most treatment-related adverse events were mild, were well tolerated, or resolved with treatment. The quality of evidence was generally high. Conclusions: This NMA showed that intradermal PRP in combination or alone is an effective and safe treatment option for melasma. PRP may be a direction for the development of new melasma treatment options in the future, but well-designed, comprehensive, large-scale randomized controlled trials are needed to verify it. Full article
►▼ Show Figures

Figure 1

10 pages, 390 KB  
Review
Hearing Loss and Chiari Malformation Type I: A Scoping Review
by Andrea Migliorelli, Marianna Manuelli, Chiara Bianchini, Francesco Stomeo, Stefano Pelucchi, Silvia Palma and Andrea Ciorba
Diseases 2025, 13(10), 315; https://doi.org/10.3390/diseases13100315 - 25 Sep 2025
Viewed by 271
Abstract
Background/Objectives: Chiari malformation (CM) type I is an uncommon condition that can be associated with a variety of neurological and otoneurological symptoms, including sensorineural hearing loss. The aim of this paper is to analyze the association between type I CM and hearing loss. [...] Read more.
Background/Objectives: Chiari malformation (CM) type I is an uncommon condition that can be associated with a variety of neurological and otoneurological symptoms, including sensorineural hearing loss. The aim of this paper is to analyze the association between type I CM and hearing loss. Methods: A review of the literature was performed using PubMed/MEDLINE, EMBASE, and Cochrane Library databases, according to PRISMA criteria for scoping review (from 2000 to April 2025). Results: A total of 8 articles and 139 patients with type I CM have been included; the majority of studies focused on women, with a mean age of 38.5 years (range: 10–44 years). In two cases, surgery was necessary for restoring normal hearing thresholds. Conclusions: To date, the pathophysiological mechanisms related to type I CM and hearing loss are not fully understood yet; further studies are necessary to clarify these features and to evaluate the correct management of these patients. Full article
►▼ Show Figures

Figure 1

12 pages, 460 KB  
Article
Obesity, High Blood Pressure and Monocytosis in Truck Drivers of the Western Border of a State in Southern Brazil: A Cross-Sectional Study
by Carolina Pereira de Oliveira, Laura Smolski dos Santos, Gênifer Erminda Schreiner, Camila Berny Pereira, Silvia Muller de Moura Sarmento, Itamar Luís Gonçalves and Vanusa Manfredini
Diseases 2025, 13(10), 314; https://doi.org/10.3390/diseases13100314 - 24 Sep 2025
Viewed by 271
Abstract
Objective: This study aimed to analyze the epidemiological, hematological, and oxidative stress profile of truck drivers. Method: It involved 63 drivers from the western border of a state in southern Brazil who completed a questionnaire, had vital signs and anthropometric evaluations, and provided [...] Read more.
Objective: This study aimed to analyze the epidemiological, hematological, and oxidative stress profile of truck drivers. Method: It involved 63 drivers from the western border of a state in southern Brazil who completed a questionnaire, had vital signs and anthropometric evaluations, and provided blood samples. Hematological parameters, leukocytes, and oxidative damage to proteins and lipids were analyzed. Results: A high prevalence of overweight and obesity was found among the drivers, with an increased risk of cardiovascular issues and hypertension. Obese drivers had higher monocyte counts, while those with normal weight had increased protein carbonylation levels. Conclusions: It is crucial to implement health interventions to prevent chronic diseases in truck drivers, given their high exposure to risk factors. Full article
►▼ Show Figures

Figure 1

20 pages, 1366 KB  
Review
Non-Communicable Disease Burden and Dietary Determinants in Women of Reproductive Age in Sub-Saharan Africa: A Scoping Review
by Perpetua Modjadji, Ntevhe Thovhogi, Machoene Derrick Sekgala and Kotsedi Daniel Monyeki
Diseases 2025, 13(10), 313; https://doi.org/10.3390/diseases13100313 - 24 Sep 2025
Viewed by 418
Abstract
Background/Objectives: Sub-Saharan Africa (SSA) is experiencing a rising burden of non-communicable diseases (NCDs), projected to surpass infectious diseases as the leading cause of mortality. This shift reflects a complex public health challenge driven by changing dietary patterns and persistent social and gender inequities. [...] Read more.
Background/Objectives: Sub-Saharan Africa (SSA) is experiencing a rising burden of non-communicable diseases (NCDs), projected to surpass infectious diseases as the leading cause of mortality. This shift reflects a complex public health challenge driven by changing dietary patterns and persistent social and gender inequities. Women of reproductive age are particularly vulnerable due to biological and sociocultural factors, with diet playing a central role in NCD development and maternal health. This scoping review explores dietary determinants of NCDs in this population and identifies evidence gaps to support context-specific, gender-responsive interventions. Methods: The review followed the Joanna Briggs Institute methodology and PRISMA-ScR guidelines. A comprehensive search was conducted across PubMed, Scopus, and Google Scholar for studies published between January 2010 and May 2025. After removing duplicates, 577 articles were screened, and 19 met the inclusion criteria. Data were synthesized using descriptive statistics and thematic analysis. An adapted conceptual framework informed by the ecological model was developed to illustrate the multilevel pathways linking dietary determinants to NCD outcomes. Results: Frequent consumption of ultra-processed foods, salty snacks, processed meats, and sugar-sweetened beverages was consistently associated with increased NCD risk. Central obesity was prevalent among nearly half of the women studied, and a high intake of sugary drinks was common across diverse populations. Among pregnant women, overweight was observed in approximately one-quarter of participants, despite the inadequate intake of protein and iron. Vitamin A deficiency was moderately prevalent, and urban residence was linked to a twofold increase in the coexistence of obesity and micronutrient deficiencies. These patterns were shaped by poverty, food insecurity, and the cultural norms influencing dietary behaviors and access to nutritious foods. Conclusion: Dietary determinants significantly contribute to the rising NCD burden among women of reproductive age in SSA, yet adolescent women remain underrepresented in research. Addressing these gaps through culturally sensitive, multisectoral interventions and biomarker-informed longitudinal studies is essential for guiding inclusive policies and sustainable health strategies for this vulnerable population. Full article
(This article belongs to the Special Issue Body Composition, Energy Expenditure and Lifestyle During Obesity Management)
►▼ Show Figures

Figure 1

8 pages, 1281 KB  
Commentary
Real-World Technical Hurdles of ctDNA NGS Analysis: Lessons from Clinical Implementation
by Simon Cabello-Aguilar, Julie A. Vendrell and Jérôme Solassol
Diseases 2025, 13(10), 312; https://doi.org/10.3390/diseases13100312 - 23 Sep 2025
Viewed by 406
Abstract
Next-generation sequencing (NGS) of circulating tumor DNA (ctDNA) represents a minimally invasive alternative to conventional tissue biopsies, providing real-time genomic snapshots of heterogeneous tumors from blood draws. This liquid biopsy approach has demonstrated significant utility for early detection, molecular profiling, and monitoring treatment [...] Read more.
Next-generation sequencing (NGS) of circulating tumor DNA (ctDNA) represents a minimally invasive alternative to conventional tissue biopsies, providing real-time genomic snapshots of heterogeneous tumors from blood draws. This liquid biopsy approach has demonstrated significant utility for early detection, molecular profiling, and monitoring treatment response in cancer patients. However, significant barriers to widespread clinical implementation still remain, such as a lack of standardized methods for ctDNA content quantification and limited variant detection sensitivity at ultra-low frequencies. Herein, we discuss three key improvements: (i) reducing the limit of detection (LoD) from 0.5% to 0.1%, which would increase alteration detection from 50% to approximately 80%; (ii) developing a dynamic LoD approach calibrated to sequencing depth, thereby enhancing result reliability and confidence in clinical interpretation; and (iii) utilizing strategic bioinformatics pipelines with “allowed” and “blocked” lists to enhance accuracy while minimizing false positives. While ctDNA analysis remains approximately 30% less sensitive than tissue-based testing, addressing these limitations through technological advancement and standardization protocols could accelerate integration into routine clinical practice, potentially transforming cancer management while reducing healthcare costs. Full article
►▼ Show Figures

Figure 1

Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:
 
Displaying articles 1-31
Previous Issue
Back to TopTop