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Diseases, Volume 13, Issue 2 (February 2025) – 33 articles

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14 pages, 277 KiB  
Article
Evaluating the Association of Sociodemographic, Anthropometric, and Lifestyle Factors with Emotional Eating: A Cross-Sectional Study
by Maria Mentzelou, Sousana K. Papadopoulou, Evmorfia Psara, Theophanis Vorvolakos, Constantina Jacovides, Ioanna P. Chatziprodromidou, Eleftherios Lechouritis, Maria Mitsiou and Constantinos Giaginis
Diseases 2025, 13(2), 57; https://doi.org/10.3390/diseases13020057 - 14 Feb 2025
Abstract
Background/Objectives: Emotional eating is an eating behavior that is influenced by behaviors, stress, emotions, and individual feelings in relation to eating. For many decades, studies have shown that mental health is the complex outcome of numerous biological, psychological, and social factors, involving contextual [...] Read more.
Background/Objectives: Emotional eating is an eating behavior that is influenced by behaviors, stress, emotions, and individual feelings in relation to eating. For many decades, studies have shown that mental health is the complex outcome of numerous biological, psychological, and social factors, involving contextual factors beyond the individual. Aim: The objective of this study is to evaluate the interconnections between emotional eating and sociodemographic and anthropometric characteristics and lifestyle factors. Methods: This is a cross-sectional study conducted on 328 adults aged between 18 and 75 years. Relevant questionnaires were utilized to evaluate sociodemographic and anthropometric parameters and types of feeding and the expression of emotional food consumption (The Three-Factor Eating Questionnaire). Results: According to the analyses above, negative correlations between the emotional eating score and waist circumference and Body Mass Index (BMI) were noted. Furthermore, men were more likely to eat emotionally than women. According to a univariable regression analysis, it was also shown that there was an inverse relationship with age up to 35.92 years and a positive relationship for age > 35.92 years. In addition, an inverse relationship with a decrease in the emotional eating score was found with a BMI up to <49.32 kg/m2. Conclusion: Our findings have emphasized the importance of performing large, prospective, well-designed, randomized, interventional, clinical trials to generate data indicating improvements in eating behavior. Moreover, in future studies the researchers must indicate which assessment tool for emotional eating they will use. Full article
21 pages, 344 KiB  
Review
Nutritional Status of Adult People Living with HIV: A Narrative Review
by Stella Proikaki, Nikolaos Georgiadis, Theodoros N. Sergentanis, Eleni Kornarou and Tonia Vassilakou
Diseases 2025, 13(2), 56; https://doi.org/10.3390/diseases13020056 - 14 Feb 2025
Viewed by 72
Abstract
Background: The interaction between HIV infection, nutrition and immune system functioning is intricate, leading, in many cases, to a cycle of poor health outcomes. Despite the widespread use of highly active antiretroviral therapy (HAART) since the late 1990s and the concomitant increase in [...] Read more.
Background: The interaction between HIV infection, nutrition and immune system functioning is intricate, leading, in many cases, to a cycle of poor health outcomes. Despite the widespread use of highly active antiretroviral therapy (HAART) since the late 1990s and the concomitant increase in the life expectancy of people living with HIV (PLHIV), malnutrition and HIV-associated wasting continue to pose significant challenges, particularly in developing countries. Additionally, metabolic adverse effects associated with HAART, such as alterations in bone and lipid metabolism, as well as the impact on cardiovascular health, add further complexity to patient care. Methods: We conducted a comprehensive literature review of relevant studies involving adults diagnosed with HIV. The studies, published between 2000 and 2023, were identified using the Medline/PubMed, Scopus and Google Scholar databases. Results: Accumulating evidence in the literature indicates that careful monitoring and appropriate nutritional interventions can significantly enhance clinical outcomes in malnourished HIV-positive persons. The importance of addressing the prevalent deficiencies in certain micronutrients discussed in many of the studies is clearly underlined. However, challenges remain, particularly in low-income settings, where limited resources and infrastructure can impede effective implementation. Conclusions: There are critical research gaps with regard to the interaction between ART and nutrition, as well as the development of tailored nutritional approaches that aim to improve patient outcomes. Future research directions and policy strategies should focus on the development of sustainable programmes aimed at enhancing the quality of life for PLHIV. Full article
(This article belongs to the Section Infectious Disease)
19 pages, 1049 KiB  
Perspective
The Human Energy Balance: Uncovering the Hidden Variables of Obesity
by Nikolaos Theodorakis and Maria Nikolaou
Diseases 2025, 13(2), 55; https://doi.org/10.3390/diseases13020055 - 13 Feb 2025
Viewed by 238
Abstract
Obesity has emerged as a global epidemic, creating an increased burden of weight-related diseases and straining healthcare systems worldwide. While the fundamental principle of energy balance—caloric intake versus expenditure—remains central to weight regulation, real-world outcomes often deviate from simplistic predictions due to a [...] Read more.
Obesity has emerged as a global epidemic, creating an increased burden of weight-related diseases and straining healthcare systems worldwide. While the fundamental principle of energy balance—caloric intake versus expenditure—remains central to weight regulation, real-world outcomes often deviate from simplistic predictions due to a multitude of physiological and environmental factors. Genetic predispositions, variations in basal metabolic rates, adaptive thermogenesis, physical activity, and nutrient losses via fecal and urinary excretion contribute to interindividual differences in energy homeostasis. Additionally, factors such as meal timing, macronutrient composition, gut microbiota dynamics, and diet-induced thermogenesis (DIT) further modulate energy utilization and metabolic efficiency. This Perspective explores key physiological determinants of the energy balance, while also highlighting the clinical significance of thrifty versus spendthrifty metabolic phenotypes. Key strategies for individualized weight management include precision calorimetry, circadian-aligned meal timing, the use of protein- and whole food diets to enhance DIT, and increases in non-exercise activity, as well as mild cold exposure and the use of thermogenic agents (e.g., capsaicin-like compounds) to stimulate brown adipose tissue activity. A comprehensive, personalized approach to obesity management that moves beyond restrictive caloric models is essential to achieving sustainable weight control and improving long-term metabolic health. Integrating these multifactorial insights into clinical practice will enhance obesity treatment strategies, fostering more effective and enduring interventions. Full article
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34 pages, 779 KiB  
Review
An Analysis of Primary Hyperparathyroidism in Association with Depression or Anxiety
by Ana-Maria Gheorghe, Claudiu Nistor, Aurelian-Emil Ranetti and Mara Carsote
Diseases 2025, 13(2), 54; https://doi.org/10.3390/diseases13020054 - 12 Feb 2025
Viewed by 246
Abstract
Background: Non-classical manifestations such as neuropsychiatric manifestations in primary hyperparathyroidism (PHPT) have long been documented as symptoms of PHPT and are commonly reported by these patients, despite this connection still being a matter of debate, and they (per se) do not [...] Read more.
Background: Non-classical manifestations such as neuropsychiatric manifestations in primary hyperparathyroidism (PHPT) have long been documented as symptoms of PHPT and are commonly reported by these patients, despite this connection still being a matter of debate, and they (per se) do not represent an indication of parathyroidectomy. Objective: We aimed to overview the most recent findings regarding the link between depression and/or anxiety (D/A) in subjects confirmed with PHPT, including the impact of the surgery in improving their outcome. Methods: This was a comprehensive review of English-based original studies published between January 2020 and October 2024. Results: The studies (n = 16) included a total of 10,325 patients and an additional 152,525 patients with hypercalcemia (out of whom 13,136 had a PHPT diagnosis and 45,081 were at risk of PHPT diagnosis). Out of these subjects with PHPT, 10,068 underwent parathyroidectomy. Female prevalence was between 62.5 and 92%. Most individuals were over 50, with the youngest studied population having a mean age of 52.7 ± 13.8 years, and the oldest had a median of 71. Depression was documented based on ICD-10 codes (n = 3) and patients’ records (n = 2), Depression Anxiety Stress Scales (DASS) (n = 2), Beck Depression Inventory (BDI) (n = 3), BDI-II (n = 3), Symptom Check List 90-revised (SCL) (n = 1), Hamilton Depression Rating Scale (HAM-D) (n = 2), HADS (n = 2), Patient Health Questionnaire-9 (n = 1), and European Quality of Life 5 Dimensions 3-Level Version (EuroQOL-5D-3L) (n = 1). Patient records’ (n = 1) and ICD-10 codes (n = 2) were also used for anxiety. Most studies used questionnaires to identify anxiety in PHPT: DASS (n = 2), SCL90R (n = 1), Generalized Anxiety Disorder-7 (n = 1), HADS (n = 2), EuroQOL-5D-3L (n = 1), and State–Trait Anxiety Inventory (n = 1). Depression prevalence varied from 20–36.6% to 65.7% (scale-based assessment) and to 10.5% upon ICD-10. A rate of newly onset depression was reported of 10.7% and of 0.2% with concern to the prevalent suicidal ideation (an incidental rate of 0.4% after a median follow-up of 4.2 years). Most studies identified a moderate depression (when assessing its severity), affecting approximately one third of the surgery candidates. The prevalence of anxiety in PHPT varied between 10.4% and 38.6% (n = 8). Discordant results were generated when applying distinct questionnaires for the same population, and this might come as a potential bias. Other confounding factors are generated by the sub-population referred for surgery that typically displays a more severe parathyroid condition or non-endocrine overlapping conditions (e.g., related to the social or familial status). Conclusion: The modern approach of the patient with PHPT should be complex and go beyond the traditional frame. D/A had a high prevalence in the mentioned studies, associated with increased medication use. Yet, the underlying pathogenic mechanisms remain incompletely elucidated. No correlations between D/A and serum calcium levels were confirmed, while PTH had a slight positive correlation with depression. Parathyroid surgery appears to be beneficial for D/A as it improves the scores, prevalence, and severity. Cinacalcet might reduce depression scores, although more evidence is needed. Women are prone to both PHPT and D/A. The optimal method of D/A screening in PHPT remains to be determined, and the current scales need validation and perhaps adjustment for this specific population sub-group, while PHPT management should be refined upon D/A identification. Full article
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20 pages, 2487 KiB  
Review
Oxidative Stress in Benign Prostatic Hyperplasia: Mechanisms, Clinical Relevance and Therapeutic Perspectives
by Aris Kaltsas, Timoleon Giannakas, Marios Stavropoulos, Zisis Kratiras and Michael Chrisofos
Diseases 2025, 13(2), 53; https://doi.org/10.3390/diseases13020053 - 11 Feb 2025
Viewed by 328
Abstract
Background/Objectives: Benign prostatic hyperplasia (BPH) is among the most common conditions affecting men as they age, resulting in lower urinary tract symptoms (LUTS) that can profoundly impact quality of life. While historically attributed primarily to androgenic imbalances, current evidence implicates additional factors—particularly oxidative [...] Read more.
Background/Objectives: Benign prostatic hyperplasia (BPH) is among the most common conditions affecting men as they age, resulting in lower urinary tract symptoms (LUTS) that can profoundly impact quality of life. While historically attributed primarily to androgenic imbalances, current evidence implicates additional factors—particularly oxidative stress (OS) and chronic inflammation—in BPH pathogenesis. This review aims to synthesize research on the interplay between OS, inflammation, and hormonal regulation in BPH, emphasizing their clinical relevance and potential therapeutic implications. Methods: A comprehensive review of peer-reviewed literature was conducted focusing on mechanistic studies, clinical trials, and observational reports. Searches included data on ROS generation, antioxidant capacity, inflammatory mediators, and their contribution to pathological prostatic overgrowth. Potential interventions targeting OS—such as antioxidant supplementation, anti-inflammatory drugs, vitamin D receptor agonists, and phytotherapeutics—were also evaluated for their efficacy and safety profiles. Results: Chronic inflammation and OS were consistently identified within hyperplastic prostate tissue. Excessive ROS production, diminished antioxidant defense, and sustained cytokine release create a proproliferative and antiapoptotic environment, accelerating disease progression. Metabolic comorbidities (e.g., obesity, insulin resistance) further exacerbate these imbalances. Standard therapies (α-blockers and 5-ARIs) effectively relieve symptoms but do not directly address the oxidative–inflammatory axis. Emerging evidence suggests that pharmacological and dietary approaches targeting OS and inflammation may reduce prostate volume expansion and alleviate LUTS. Conclusions: Findings indicate that OS and inflammation are key contributors to BPH progression. Incorporating antioxidant and anti-inflammatory strategies alongside conventional treatments holds promise for improving clinical outcomes and patient quality of life. Future research should focus on validating OS-specific biomarkers and optimizing personalized therapy regimens. Full article
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14 pages, 786 KiB  
Article
Occurrence of Metabolic Disorders in Bilateral Primary Aldosteronism Compared to Unilateral Primary Aldosteronism
by Chiara Grasselli, Maicol Baldini, Lucia Salvi, Grazia Vestita, Maurizio Zizzo, Davide Felaco, Maria Carolina Balli, Giulia Besutti, Aurelio Negro and Angelo Ghirarduzzi
Diseases 2025, 13(2), 52; https://doi.org/10.3390/diseases13020052 - 10 Feb 2025
Viewed by 375
Abstract
Background: Metabolic syndrome (MetS) is a common comorbidity associated with hypertension that occurs more often in primary aldosteronism (PA). Our work aims to investigate the prevalence of MetS and its determinants in unilateral PA and bilateral PA, as confirmed by adrenal venous sampling [...] Read more.
Background: Metabolic syndrome (MetS) is a common comorbidity associated with hypertension that occurs more often in primary aldosteronism (PA). Our work aims to investigate the prevalence of MetS and its determinants in unilateral PA and bilateral PA, as confirmed by adrenal venous sampling (AVS). Methods: This was a retrospective, cross-sectional study. We investigated metabolic indicators in 160 cases of PA, categorized by AVS—82 with unilateral PA and 78 with bilateral PA. A control group of 80 non-PA patients with essential hypertension, matched for age and sex, was also included. Results: Unilateral PA had a higher aldosterone–renin ratio and lower serum potassium levels than bilateral PA. Nevertheless, bilateral PA exhibited a higher prevalence of MetS (41% vs. 30.5%; p = 0.001), obesity, BMI, LDL hypercholesterolemia, and hypertriglyceridemia than unilateral PA. Conclusions: Bilateral PA presents a greater incidence of MetS than unilateral PA, in spite of the latter showing a higher aldosterone–renin ratio and lower serum potassium levels. The results suggest that the mechanisms underlying MetS may differ between unilateral and bilateral PA. Full article
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10 pages, 2810 KiB  
Article
Clinical Impact of Olaparib for Platinum-Sensitive Recurrent Ovarian Cancer
by Hiroaki Ishida, Megumi Manrai, Akiko Takashima, Hiroki Egashira, Mizuki Nonaka and Hideaki Shimada
Diseases 2025, 13(2), 51; https://doi.org/10.3390/diseases13020051 - 10 Feb 2025
Viewed by 251
Abstract
Background/Objectives: Olaparib, a poly ADP ribose polymerase inhibitor, has been effective in prolonging progression-free survival in platinum-sensitive recurrent ovarian cancer. The clinicopathological factors that predict a favorable prognosis remain unclear. Therefore, we retrospectively analyzed the prognostic effect of clinicopathological factors in the [...] Read more.
Background/Objectives: Olaparib, a poly ADP ribose polymerase inhibitor, has been effective in prolonging progression-free survival in platinum-sensitive recurrent ovarian cancer. The clinicopathological factors that predict a favorable prognosis remain unclear. Therefore, we retrospectively analyzed the prognostic effect of clinicopathological factors in the patients treated with olaparib for platinum-sensitive recurrent ovarian cancer. Methods: A total of 16 patients were treated with olaparib from 2018 to 2023. We categorized these patients into the responder (five cases who had not relapsed within 2 years) and non-responder groups (11 cases who had relapsed within 2 years). Clinical factors, including age, number of platinum drug courses, platinum-free interval, and CA125 value before olaparib treatment, were compared between the responder and non-responder groups. Results: The age of the responder group was significantly younger than that of the non-responder group (52 vs. 69 years old, p = 0.02). The CA125 value of the responder group was significantly lower than that of the non-responder group (14.2 vs. 82.7 U/mL, p = 0.02). Conclusions: The good predictive factors that enabled continued olaparib administration without recurrence were younger age and a lower CA125 value before olaparib treatment. The younger group (<65 years old) and the low CA125 value group (<20 U/mL) in PSR may be treated with olaparib for a long period, suppressing disease progression. Providing this information to patients with PSR may help in decision-making regarding performing maintenance therapy with olaparib. Full article
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7 pages, 2009 KiB  
Case Report
Clinical Resolution of Plantar Warts Using the Needling Technique
by María-Luisa Sobrín-Valbuena, Alberto Aldana-Caballero, Laura Martín-Casado, Inés Palomo-Fernández, Raquel Mayordomo and Félix Marcos-Tejedor
Diseases 2025, 13(2), 50; https://doi.org/10.3390/diseases13020050 - 7 Feb 2025
Viewed by 399
Abstract
Background: Plantar warts, caused by the human papillomavirus (HPV), are a common skin condition characterized by painful lesions on the soles of the feet. These lesions can significantly impact skin appearance, quality of life, and, in severe cases, mobility. Traditional treatment methods, such [...] Read more.
Background: Plantar warts, caused by the human papillomavirus (HPV), are a common skin condition characterized by painful lesions on the soles of the feet. These lesions can significantly impact skin appearance, quality of life, and, in severe cases, mobility. Traditional treatment methods, such as chemical cauterization or pharmaceutical therapies, are often painful and require multiple visits to achieve complete wart removal and skin regeneration. This study aims to assess the clinical effectiveness of the needling technique as an alternative treatment. This method involves repeatedly puncturing the lesion under local anesthesia or posterior tibial nerve block to trigger an immune response and promote wart clearance. Methods: A total of 26 patients underwent the needling procedure, which included puncturing the wart under local anesthesia, followed by wound dressing and topical application of iodopovidone to facilitate scab formation. Follow-up visits were scheduled until full wart resolution was observed. Analgesics were provided for moderate pain management when necessary. Results: After 30 days, a success rate of 57.7% was achieved. Patients reported mild pain, which subsided within a few days, and expressed high levels of satisfaction with the treatment outcome. Conclusions: The needling technique emerges as an effective alternative to chemical treatments, offering a notable wart clearance rate. Its use under local anesthesia enhances patient comfort and reduces treatment-associated anxiety compared to conventional therapies. Full article
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10 pages, 1421 KiB  
Article
Sagittal Parameters and Clinical Outcomes in Cervical Spondylitis: The Cohort Analysis
by Denis Naumov, Sergey Tkach, Natalia Linkova, Dmitrii Medvedev, Alexander Krasichkov, Olga Sokolova, Victoria Polyakova, Giuseppe Gullo and Piotr Yablonskiy
Diseases 2025, 13(2), 49; https://doi.org/10.3390/diseases13020049 - 6 Feb 2025
Viewed by 359
Abstract
Background. Cervical spondylitis is accompanied by segmental instability and sagittal imbalance. The purpose of this work is to conduct a search of correlation between sagittal parameters and clinical outcomes in cervical spondylitis. Materials and Methods. The monocentric cohort study encompassed the clinical and [...] Read more.
Background. Cervical spondylitis is accompanied by segmental instability and sagittal imbalance. The purpose of this work is to conduct a search of correlation between sagittal parameters and clinical outcomes in cervical spondylitis. Materials and Methods. The monocentric cohort study encompassed the clinical and radiological data of 59 patients who underwent reconstructive surgeries on the suboccipital, subaxial, and cervicothoracic spine. We evaluated local cervical sagittal parameters: cervical sagittal vertical axis (CSVA), T1 slope (T1S), Health-Related Quality of Life—HRQOL (Oswestry Disability Index—ODI)—and others pre- and postoperatively. Results. The duration of the therapeutic pause and T1S correlated with HRQOL. It revealed the direct relationship between the age of the patient and the value of CSVA. A significant predictor of postoperative complications is the level of comorbidity with an index of 7 or more on the Charlson scale. Conclusions. The factors influencing HRQOL in this pathology are the duration of the therapeutic pause and the magnitude of T1S compensation. Anterior reconstruction of the cervical spine in the presence of spondylitis yields a correction of the sagittal balance parameters. The leading predictors of complications from the surgical treatment of cervical spondylitis are the Charlson comorbidity index and the variant of anterior reconstruction. Full article
(This article belongs to the Section Infectious Disease)
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13 pages, 531 KiB  
Article
SARS-CoV-2 Variants and Their Impact on Pediatric COVID-19: Clinical Manifestations and Hematological Profiles
by Konstantinos Paris Trempelis, Chrysoula Kosmeri, Panagiotis Kalavas, Fani Ladomenou, Ekaterini Siomou and Alexandros Makis
Diseases 2025, 13(2), 48; https://doi.org/10.3390/diseases13020048 - 6 Feb 2025
Viewed by 515
Abstract
Background: The aim of this study was to analyze data on pediatric cases of COVID-19 admitted to a tertiary referral hospital in northwest Greece. Methods: A retrospective analysis was conducted on the most common clinical manifestations and laboratory findings, stratified by age group [...] Read more.
Background: The aim of this study was to analyze data on pediatric cases of COVID-19 admitted to a tertiary referral hospital in northwest Greece. Methods: A retrospective analysis was conducted on the most common clinical manifestations and laboratory findings, stratified by age group and SARS-CoV-2 strain. Results: A total of 254 children were hospitalized, with a mean age of 4.5 years. Underlying conditions were present in 10.2% of cases; two children required pediatric intensive care unit (PICU) admission, and one child died. The most common hematological manifestations, in general, were neutropenia (30%) and lymphopenia (23%), whereas the findings varied when the children were stratified by age group. Eight children developed multisystem inflammatory syndrome (MIS-C), with the most common findings being anemia (75%), lymphopenia (50%), and thrombocytopenia (25%). Analysis of the SARS-CoV-2 strains revealed the proportions of the dominant strain over time. Fever was the predominant symptom across all strains, particularly in the Omicron group, which also had a high incidence of gastrointestinal symptoms. The longest hospital admission occurred in children with the Omicron strain, followed by the Wuhan, Alpha, and Delta strains. Conclusions: Fever was the most consistent symptom across all age groups and virus strains. The most common hematological manifestations were neutropenia (30%) and lymphopenia (23%). The Omicron strain was associated with the longest hospital stay. Full article
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12 pages, 248 KiB  
Article
Association Between Biomass Fuel Use and Depression Symptoms in the Adult Population of Oaxaca, Mexico
by Roberto Ariel Abeldaño Zuñiga, Silvia Mercedes Coca, Moréniké Oluwátóyin Foláyan, Javiera Fanta Garrido and Gabriela Narcizo de Lima
Diseases 2025, 13(2), 47; https://doi.org/10.3390/diseases13020047 - 5 Feb 2025
Viewed by 362
Abstract
Background: The impact of biomass fuel exposure on mental health, along with the associated gender disparities, remains largely unexplored. This study aimed to examine the association between biomass fuel use and depressive symptoms in the population of Oaxaca, Mexico, while also identifying gender [...] Read more.
Background: The impact of biomass fuel exposure on mental health, along with the associated gender disparities, remains largely unexplored. This study aimed to examine the association between biomass fuel use and depressive symptoms in the population of Oaxaca, Mexico, while also identifying gender differences in this relationship. Methods: This study used data from the 2022 National Health and Nutrition Survey (ENSANUT). Depressive symptoms, the outcome variable, were assessed using the Center for Epidemiologic Studies Depression Scale (CESD). The primary predictor variable was biomass fuel use, with gender, age, and residency stratum included as covariates. First, a binary logistic regression model was developed to estimate the dichotomous variable “depression symptoms”. Subsequently, a second binary logistic regression model was constructed to evaluate potential interactions between the covariates and the predictor variable. Findings: The sample included 1.4 million adults from Oaxaca, with a prevalence of depressive symptoms of 15%. Biomass fuel was used by 15.4% of the population. The first logistic regression model showed that women (Odds Ratio (OR): 1.249; 95% CI: 1.235–1.263; p < 0.001), individuals aged 60 years and older compared to the younger population group (OR: 12.192; 95% CI: 12.064–12.321; p < 0.001), those residing in rural areas (OR: 1.245; 95% CI: 1.232–1.259; p < 0.001), and individuals using firewood or charcoal for cooking (OR: 1.674; 95% CI: 1.651–1.697; p < 0.001) had higher odds of depressive symptoms. In the second binary logistic regression model, all associations and OR coefficients retained their direction, although the coefficients underwent a slight adjustment following the introduction of the interaction term, indicating the presence of an interaction. Conclusions: The study findings suggest a gendered association between biomass fuel exposure and depressive symptoms in the adult population of Oaxaca, with older women and women dwelling in rural areas being the most vulnerable. Interventions aimed at reducing biomass air pollution exposure and strengthening mental health support for women are strongly recommended. Full article
17 pages, 1371 KiB  
Article
Combined Effects of Social and Behavioral Factors on Stress and Depression
by Emmanuel Obeng-Gyasi and Sonya Parker
Diseases 2025, 13(2), 46; https://doi.org/10.3390/diseases13020046 - 4 Feb 2025
Viewed by 539
Abstract
Background: Chronic stress, driven by the persistent activation of the body’s stress response system—including the sympathetic nervous system and hypothalamic–pituitary–adrenal (HPA) axis—has far-reaching effects on both physical and mental health. This study examines the combined effects of social and behavioral factors on a [...] Read more.
Background: Chronic stress, driven by the persistent activation of the body’s stress response system—including the sympathetic nervous system and hypothalamic–pituitary–adrenal (HPA) axis—has far-reaching effects on both physical and mental health. This study examines the combined effects of social and behavioral factors on a latent variable consisting of stress and depressive symptoms, using a comprehensive framework to explore the complex interactions of these factors. Methods: Leveraging data from the United States Centers for Disease Control and Prevention’s (CDC’s) National Health and Nutrition Examination Survey (NHANES), we operationalized allostatic load—a measure of cumulative physiological stress—through 10 biomarkers spanning cardiovascular, inflammatory, and metabolic systems. Depressive symptoms were measured via the Patient Health Questionnaire-9 (PHQ-9), and a latent variable capturing the shared variance between stress and depressive symptoms was derived using factor analysis. To assess the influence of social (income and education) and behavioral (alcohol consumption and smoking) factors on this latent variable, we employed Bayesian Kernel Machine Regression (BKMR), allowing us to examine potential non-linear and interactive effects among these predictors. Results: Our results revealed a significant positive association between allostatic load and depressive symptoms across the sample, regardless of ethnic background. Alcohol consumption emerged as a key behavioral factor, with significant positive associations with stress. Conversely, education showed a protective effect, with higher education levels associated with decreased stress and depressive symptoms. Conclusions: These findings underscore the importance of addressing both social determinants and behavioral risk factors in mitigating the cumulative impacts of stress and depressive symptoms. By highlighting the roles of alcohol consumption and education, this study provides insights that can inform public health strategies aimed at promoting resilience and reducing stress-related health disparities. Full article
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20 pages, 313 KiB  
Article
Understanding Loneliness in Older Adults During the Pandemic: Predictors and Questionnaire Validation
by Rahela Orlandini, Linda Lušić Kalcina and Vesna Antičević
Diseases 2025, 13(2), 45; https://doi.org/10.3390/diseases13020045 - 4 Feb 2025
Viewed by 455
Abstract
Background/Objectives: The COVID-19 pandemic is behind us, but the experiences gained during its course can serve as a framework for preventive actions in future crises. The main objectives were to examine the predictors of loneliness in older adults during the pandemic and to [...] Read more.
Background/Objectives: The COVID-19 pandemic is behind us, but the experiences gained during its course can serve as a framework for preventive actions in future crises. The main objectives were to examine the predictors of loneliness in older adults during the pandemic and to explore the mediating effects of emotional stability between pandemic-specific stressors and loneliness. To achieve the set objectives, we developed a questionnaire to measure pandemic-specific stressors in older adults. Methods: A cross-sectional research design was used. A total of 578 participants of both genders (38.9% male, 61.1% female) aged 65 and above (M = 74.09, SD = 6.72) participated in this study. The self-reported measures used included the following: The Ten-Item Personality Inventory, The Revised Loneliness Scale, The Clinical Outcomes in Routine Evaluation, and The Pandemic-Specific Stressors Questionnaire for Older Adults. Results: Using exploratory factor analysis, two factors were extracted, providing evidence of face and convergent validity, together explaining 71.3% of the variance. The results of the confirmatory factor analysis indicated a good model fit. Hierarchical regression analysis indicated the greatest contribution of the psychological factors to loneliness in older adults during the pandemic, while marital status and pandemic-specific stressors had a minor but still significant impact. Mediation analysis revealed that emotional stability mediated the association between social distancing experiences and loneliness. Conclusions: In future global pandemics, it is necessary to pay full attention to psychological factors to preserve the mental health of older people. The newly-constructed questionnaire identifies pandemic-specific stressors in older adults, aiding their mitigation and easing recovery from the pandemic crisis. Full article
(This article belongs to the Special Issue COVID-19 and Global Chronic Disease 2024: The Post-pandemic Era)
8 pages, 1197 KiB  
Article
Real-World Efficacy and Safety of Dupilumab Use in Japanese Adult Patients with Atopic Dermatitis: A Single-Center, Retrospective, 104-Week, Observational Study
by Tetsuharu Ikegami and Ken Igawa
Diseases 2025, 13(2), 44; https://doi.org/10.3390/diseases13020044 - 3 Feb 2025
Viewed by 479
Abstract
Background/Objectives: Dupilumab is an interlekin-4 receptor antibody that exerts its efficacy by inhibiting the signaling pathway of interleukin-4/interleukin-13, and it is currently used clinically as a highly potent therapeutic for atopic dermatitis. However, there have been few reports on the therapeutic effect of [...] Read more.
Background/Objectives: Dupilumab is an interlekin-4 receptor antibody that exerts its efficacy by inhibiting the signaling pathway of interleukin-4/interleukin-13, and it is currently used clinically as a highly potent therapeutic for atopic dermatitis. However, there have been few reports on the therapeutic effect of dupilumab using long-term real-world data. To accumulate further real-world data through long-term use of dupilumab, we performed a retrospective study on the courses of patients with atopic dermatitis who were treated with dupilumab for at least 104 weeks in our university hospital. Methods: We examined the treatment courses of 30 adult patients. Results: Subjective (e.g., itch visual analog scale and Dermatology Life Quality Index) and objective (e.g., Eczema Area and Severity Index) indices and some biomarkers showed improvements over time with dupilumab treatment, even in cases with poor early response to dupilumab treatment. As for the therapeutic effect on anatomical regions, although the therapeutic effect on the head and neck region was weak in the early stages, it improved over time, and at 104 weeks, it showed a therapeutic effect that was comparable to other regions. Conclusions: Therefore, our study demonstrated the advantages of prolonged administration of dupilumab in atopic dermatitis. Full article
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11 pages, 893 KiB  
Communication
Impact of HPV Types and Dendritic Cells on Recurrent Respiratory Papillomatosis’ Aggressiveness
by Ellen Eduarda Fernandes, Maria Leticia de Almeida Lança, Yan Aparecido de Souza, Vivian Narana El-Achkar, Victor Costa, Román Carlos, Alfredo Ribeiro-Silva, Laura Sichero, Luisa Lina Villa, Jorge Esquiche León and Estela Kaminagakura
Diseases 2025, 13(2), 43; https://doi.org/10.3390/diseases13020043 - 3 Feb 2025
Viewed by 510
Abstract
Objective: This study assesses the associations between dendritic cells, HPV 6 and 11, and Recurrent Respiratory Papillomatosis (RRP) aggressiveness. Methods: The Derkay score was calculated using information obtained from the medical records. Biopsies from 36 patients with juvenile RRP (JRRP) and 43 adult [...] Read more.
Objective: This study assesses the associations between dendritic cells, HPV 6 and 11, and Recurrent Respiratory Papillomatosis (RRP) aggressiveness. Methods: The Derkay score was calculated using information obtained from the medical records. Biopsies from 36 patients with juvenile RRP (JRRP) and 43 adult RRP (ARRP) patients were analyzed under light microscopy, and their clinical data were collected. Immunohistochemical analysis using antibodies against CD83, CD1a, Factor XIIIa, and S100 was performed, and inflammatory cells were quantified. Data obtained were analyzed using the chi-squared test, in addition to the Mann–Whitney and Z tests for two proportions, considering a confidence interval of 95% and p < 0.05 as statistically significant. Results: A higher quantity of S100 was identified in the epithelium (p < 0.001) and in the conjunctive tissue (p = 0.027) among the ARRP cases, while CD83 (p = 0.025) and Factor XIIIa (p = 0.018), both in the epithelium, were identified among the JRRP cases. We observed significant association between a higher quantity of CD83 in the epithelium in the juvenile group with a low Derkay index (p = 0.034) and with HPV 6 (p = 0.039). Conclusions: An increased quantity of dendritic cells is present in individuals diagnosed with RRP, regardless of age, and this may be related to the lower Derkay index, regardless of the HPV type detected. Full article
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28 pages, 2910 KiB  
Review
The Role of Cortisol and Dehydroepiandrosterone in Obesity, Pain, and Aging
by Nikolina Erceg, Miodrag Micic, Eli Forouzan and Nebojsa Nick Knezevic
Diseases 2025, 13(2), 42; https://doi.org/10.3390/diseases13020042 - 1 Feb 2025
Viewed by 568
Abstract
Obesity, chronic pain, and aging are prevalent global challenges with profound implications for health and well-being. Central to these processes are adrenal hormones, particularly cortisol and dehydroepiandrosterone (DHEA), along with its sulfated form (DHEAS). Cortisol, essential for stress adaptation, can have adverse effects [...] Read more.
Obesity, chronic pain, and aging are prevalent global challenges with profound implications for health and well-being. Central to these processes are adrenal hormones, particularly cortisol and dehydroepiandrosterone (DHEA), along with its sulfated form (DHEAS). Cortisol, essential for stress adaptation, can have adverse effects on pain perception and aging when dysregulated, while DHEA/S possess properties that may mitigate these effects. This review explores the roles of cortisol and DHEA/S in the contexts of obesity, acute and chronic pain, aging, and age-related diseases. We examine the hormonal balance, specifically the cortisol-to-DHEA ratio (CDR), as a key marker of stress system functionality and its impact on pain sensitivity, neurodegeneration, and physical decline. Elevated CDR and decreased DHEA/S levels are associated with worsened outcomes, including increased frailty, immune dysfunction, and the progression of age-related conditions such as osteoporosis and Alzheimer’s disease. This review synthesizes the current literature to highlight the complex interplay between these hormones and their broader implications for health. It aims to provide insights into potential future therapies to improve pain management and promote healthy weight and aging. By investigating these mechanisms, this work contributes to a deeper understanding of the physiological intersections between pain, aging, and the endocrine system. Full article
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11 pages, 858 KiB  
Review
The Critical Role of Penicillin in Syphilis Treatment and Emerging Resistance Challenges
by Arun Kumar Jaiswal, Lucas Gabriel Rodrigues Gomes, Aline Ferreira Maciel de Oliveira, Siomar de Castro Soares and Vasco Azevedo
Diseases 2025, 13(2), 41; https://doi.org/10.3390/diseases13020041 - 31 Jan 2025
Viewed by 447
Abstract
Syphilis, a global healthcare burden, is a sexually transmitted infection caused by the spirochete Treponema pallidum, a spiral-shaped, Gram-negative obligate human pathogen. Despite its easy identification and treatability, the disease affects over 50 million people worldwide, with 8 million new cases in [...] Read more.
Syphilis, a global healthcare burden, is a sexually transmitted infection caused by the spirochete Treponema pallidum, a spiral-shaped, Gram-negative obligate human pathogen. Despite its easy identification and treatability, the disease affects over 50 million people worldwide, with 8 million new cases in the 15–49 age group annually, as per the WHO 2024 report. If left untreated, syphilis progresses through its primary, secondary, latent, and tertiary stages, causing severe complications like neurosyphilis, congenital syphilis, and organ damage. The first-line treatment, penicillin, faces challenges, including logistical issues, shortages, allergic reactions, and patient non-compliance. Secondary treatment options are sparse, and there are reported cases of T. pallidum strains resistant to those antibiotics. The absence of an effective vaccine for syphilis has led to efforts to control its spread through sexual education, condom usage, and post-exposure prophylaxis with doxycycline, which raises concerns about antimicrobial resistance (AMR). The continued reliance on penicillin and the increasing rates of doxycycline post-exposure prophylaxis (DoxyPEP) use have both contributed to concerns about AMR development. Recent works pointing to emerging antibiotic resistance and treatment failures highlight the urgent need for new antibiotics to manage syphilis effectively and reduce dependency on penicillin. This review has focused on the shortcomings and limitations of penicillin treatment, recently identified antimicrobial-resistant strains of T. pallidum, and case studies where its application failed to treat the disease adequately. Full article
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10 pages, 663 KiB  
Article
A Retrospective Review of 28 Cases of Pediatric Malignant Renal Tumors at a Single Institution
by Takafumi Kawano, Koshiro Sugita, Ryuta Masuya, Nanako Nishida, Ayaka Nagano, Masakazu Murakami, Keisuke Yano, Shun Onishi, Toshio Harumatsu, Tatsuro Nakamura, Koji Yamada, Waka Yamada, Mitsuru Muto, Yuichi Kodama, Takuro Nishikawa, Tatsuru Kaji, Yasuhiro Okamoto and Satoshi Ieiri
Diseases 2025, 13(2), 40; https://doi.org/10.3390/diseases13020040 - 31 Jan 2025
Viewed by 431
Abstract
Advances in treatment have dramatically improved the outcomes of pediatric renal malignancies. We reviewed cases of renal malignant tumors that were managed in our institution. The patients’ background factors, pathological diagnoses, stages, outcomes and late complications were retrospectively reviewed using medical records of [...] Read more.
Advances in treatment have dramatically improved the outcomes of pediatric renal malignancies. We reviewed cases of renal malignant tumors that were managed in our institution. The patients’ background factors, pathological diagnoses, stages, outcomes and late complications were retrospectively reviewed using medical records of 28 patients with renal tumors who were treated at our institution from 1984 to 2022. Wilms’ tumors were recognized in 24 patients (85.7%), all of whom had favorable histology. Wilms’ tumors were Stage I in six patients (6/24; 25.0%), Stage II in nine patients (9/24; 37.5%), Stage III in five patients (5/24; 20.8%), Stage IV in two patients (2/24; 8.3%), and Stage V in two patients (2/24; 8.3%). Two patients (7.1%) with clear cell sarcoma of the kidney both had Stage I disease. One patient had Stage IV rhabdoid sarcoma of the kidney (3.5%), and one had Stage IV renal cell carcinoma (3.5%). The overall 5-year survival rate was 85.2% for all renal malignancies. Late complications included chronic renal failure in four patients (14.2%). The outcomes are comparable to those reported previously. However, the prognosis of MRTK and renal cell carcinoma remained poor in advanced cases; thus, another therapeutic protocol should be established. Full article
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31 pages, 488 KiB  
Review
The Spectrum of Cognitive Impairment in Atypical Parkinsonism Syndromes: A Comprehensive Review of Current Understanding and Research
by Kurt A. Jellinger
Diseases 2025, 13(2), 39; https://doi.org/10.3390/diseases13020039 - 31 Jan 2025
Viewed by 337
Abstract
Multiple system atrophy (MSA), progressive supranuclear palsy (PSP), and corticobasal degeneration (CBD) are the most common atypical parkinsonism (AP) syndromes. They are clinically characterized by varying combinations of levodopa-poorly responsive parkinsonism, motor, cerebellar, and other signs. They are associated with a wide spectrum [...] Read more.
Multiple system atrophy (MSA), progressive supranuclear palsy (PSP), and corticobasal degeneration (CBD) are the most common atypical parkinsonism (AP) syndromes. They are clinically characterized by varying combinations of levodopa-poorly responsive parkinsonism, motor, cerebellar, and other signs. They are associated with a wide spectrum of non-motor symptoms, including prominent cognitive impairment such as global cognitive deficits, memory, executive, attentional, visuospatial, language, and non-verbal reasoning dysfunctions. Within the APs, their cognitive functioning is distributed along a continuum from MSA with the least impaired cognitive profile (similar to Parkinson’s disease) to PSP and CBD with the greatest decline in global cognitive and executive domains. Although their pathological hallmarks are different—MSA α-synucleinopathy, CBD, and PSP 4-repeat tauopathies—cognitive dysfunctions in APs show both overlaps and dissimilarities. They are often preceding and anticipate motor dysfunctions, finally contributing to reduced quality of life of patients and caregivers. The present paper will review the current evidence of the prevalence and type of cognitive impairment in these AP syndromes, their neuroimaging, pathogenic backgrounds, and current management options based on extensive literature research. Cognitive dysfunctions in APs are due to disruption of prefronto-subcortical and striato-thalamo-cortical circuitries and multiple essential brain networks. This supports the concept that they are brain network disorders due to complex pathogenic mechanisms related to the basic proteinopathies that are still poorly understood. Therefore, the pathophysiology and pathogenesis of cognitive impairment in APs deserve further elucidation as a basis for early diagnosis and adequate treatment of these debilitating comorbidities. Full article
(This article belongs to the Section Neuro-psychiatric Disorders)
9 pages, 1015 KiB  
Case Report
Herpes Simplex Keratitis and Vitamin D Receptor Agonist: Two Case Reports
by Atsushi Kawahara
Diseases 2025, 13(2), 38; https://doi.org/10.3390/diseases13020038 - 30 Jan 2025
Viewed by 552
Abstract
Background: Herpes simplex keratitis (HSK) is a disease characterized by the recurrent infection of the cornea, mainly due to infection caused by herpes simplex virus type 1. The suppression of recurrence can suppress progressive corneal scarring, ulcers, and perforation. Cornea contains vitamin D [...] Read more.
Background: Herpes simplex keratitis (HSK) is a disease characterized by the recurrent infection of the cornea, mainly due to infection caused by herpes simplex virus type 1. The suppression of recurrence can suppress progressive corneal scarring, ulcers, and perforation. Cornea contains vitamin D receptors (VDRs). VDR agonists show antimicrobial activity. Case presentation: In this case report, I describe two female patients aged 76 and 85 years old in whom the administration of a VDR agonist led to the suppression of the recurrence of HSK. The former patient had repeated HSK recurrence for over 10 years after the initial infection. The latter patient developed HSK immediately after vitrectomy, and her cornea remained susceptible to infection, resulting in recurrence. Both patients were trying to suppress recurrence by applying acyclovir ophthalmic ointment, but their medication adherence was declining. So, they switched to oral treatment with 0.5 μg of the VDR agonist per day, and since then, there has been no recurrence of HSK. Oral treatment with the VDR agonist is still ongoing. Conclusions: This report highlights the cases where ways were examined to improve medication adherence in elderly patients who had a risk of HSK recurrence. Both patients responded to VDR agonist treatment and were able to suppress recurrence. Full article
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12 pages, 806 KiB  
Article
Is There Bias in the Assessment of Contraindications for Resection? Disparities in the Surgical Management of Early-Stage Esophageal Cancer
by Christina S. Boutros, Lauren M. Drapalik, Christine E. Alvarado, Aria Bassiri, Jillian Sinopoli, Leonidas Tapias Vargas, Philip A. Linden and Christopher W. Towe
Diseases 2025, 13(2), 37; https://doi.org/10.3390/diseases13020037 - 30 Jan 2025
Viewed by 446
Abstract
Background: Resection is considered the standard of care for patients with localized esophageal cancer who are “physiologically fit”. Patients who do not meet this standard are considered contraindicated to receive surgery. We hypothesized that among patients with non-metastatic esophageal cancer, the consideration of [...] Read more.
Background: Resection is considered the standard of care for patients with localized esophageal cancer who are “physiologically fit”. Patients who do not meet this standard are considered contraindicated to receive surgery. We hypothesized that among patients with non-metastatic esophageal cancer, the consideration of contraindication status would vary based on clinical and demographic factors and would vary between institutions. Methods: We identified patients with non-metastatic gastric and esophageal cancer in the National Cancer Database (NCDB) from 2004 to 2018. Patients were categorized into three groups based on surgical treatment: surgical resection (including endoscopic mucosal resection), resection contraindicated, and refusal of resection based on the coding of the “reason for no surgery” data element. Demographic, clinical, and institutional characteristics were compared between the groups using bivariate and multivariate techniques to identify factors associated with contraindicated status. A subgroup analysis of cT1N0M0 patients was also used to assess every institution in the NCDB’s observed–expected ratio for contraindication status. Results: In total, 144,591 patients with non-metastatic disease met inclusion criteria: 124,972 (86%) underwent resection, 13,793 (10%) were contraindicated for resection, and 5826 (4%) refused resection. Contraindication was associated with age, non-Hispanic Black race, socioeconomic status, Charlson–Deyo score, insurance type, institution characteristics, clinical T-stage, and clinical N-stage. There were 9459 patients who were cT1N0M0 and had no co-morbidities. In this cohort, there were more than 1000-fold differences between individual programs regarding observed–expected ratio of contraindication status when adjusting for clinical and demographic characteristics. Conclusions: Variation in the assessment of contraindication status varies dramatically between institutions. Underserved minorities, including age, race, and insurance type, are risk factors for being considered contraindicated. These findings highlight the disparities that exist regarding surgical care of non-metastatic esophageal cancer in the United States. Full article
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27 pages, 12265 KiB  
Article
Ultradiluted Eupatorium perfoliatum Prevents and Alleviates SARS-CoV-2 Spike Protein-Induced Lung Pathogenesis by Regulating Inflammatory Response and Apoptosis
by Anirban Roy, Avipsha Sarkar, Asit Kumar Roy, Tanusree Ghorai, Debadatta Nayak, Subhash Kaushik and Satadal Das
Diseases 2025, 13(2), 36; https://doi.org/10.3390/diseases13020036 - 30 Jan 2025
Viewed by 493
Abstract
Background/Objectives: SARS-CoV-2 provokes acute oxidative stress in the lungs via cytokines, inflammatory mediators, and apoptotic factors, which might cause alveolar injury followed by severe respiratory syndrome during COVID-19 infection. The lack of particular antivirals for SARS-CoV-2 has opened novel avenues of complementary and [...] Read more.
Background/Objectives: SARS-CoV-2 provokes acute oxidative stress in the lungs via cytokines, inflammatory mediators, and apoptotic factors, which might cause alveolar injury followed by severe respiratory syndrome during COVID-19 infection. The lack of particular antivirals for SARS-CoV-2 has opened novel avenues of complementary and alternative medicine as a potential remedy. The current study explored the mechanistic role of the ultradiluted formulation of Eupatorium (UDE) against SARS-CoV-2 recombinant S protein-mediated oxidative stress and mitochondriopathy. Methods: Cell line and BALB/c mice were used to report that SARS-CoV-2 S protein caused an inflammatory response and subsequent cytokine storm via the NF-κB pathway in the lung along with oxidative damage. Morphological examination was performed using DAPI staining and histology for treated cells and lung tissues of animals, respectively. The molecular mechanism of action of UDE was investigated through qRT-PCR for the genetic expressions of various cytokines, inflammatory, and apoptotic mediators; ELISA, immunofluorescence, immunohistochemistry, and Western blot for the translational expression of the same molecules assayed for genetic expressions; and biochemical assays for various enzymes and ROS. Results: UDE treatment suppressed the inflammatory cell infiltration and tissue-level oxidative stress and safeguarded mitochondrial integrity from free radical-mediated oxidative damage. Additionally, UDE played a direct role in restoring cellular redox homeostasis and reducing the inflammatory response by suppressing NF-κB, IL-1β, IL-18, caspase-1 expression, and ROS formation. Further, a plausible mechanism of action of UDE against S protein-induced damage was proposed. Conclusions: This study described a novel therapeutic approach against S protein-mediated hyperinflammation, apoptosis, and oxidative damage. Hence, UDE may be considered as a prospective alternative to combat life-threatening consequences of SARS-CoV-2 infection. Full article
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14 pages, 310 KiB  
Article
Burden and Economic Impact of Respiratory Viral Infections in Adults Aged 60 and Older: A Focus on RSV
by Adrián Peláez, Sara Jimeno Ruiz, Mercedes Villarreal, Manuel Gil, Inés Gutiérrez, Marta Sanz and Silvina Natalini Martínez
Diseases 2025, 13(2), 35; https://doi.org/10.3390/diseases13020035 - 28 Jan 2025
Viewed by 549
Abstract
Background/Objectives: Respiratory syncytial virus (RSV) represents a significant cause of acute respiratory infections (ARIs) in adults aged 60 years and older, often leading to severe clinical outcomes and high healthcare costs. This study aimed to evaluate the clinical and economic burden of RSV [...] Read more.
Background/Objectives: Respiratory syncytial virus (RSV) represents a significant cause of acute respiratory infections (ARIs) in adults aged 60 years and older, often leading to severe clinical outcomes and high healthcare costs. This study aimed to evaluate the clinical and economic burden of RSV compared to other ARIs, focusing on specific age groups, comorbidities, and demographic factors. Methods: A retrospective observational study was conducted using the electronic medical records of adults aged ≥60 years hospitalized for ARIs, including RSV, in Spain. Direct costs related to hospitalizations, intensive care unit (ICU) admissions, and treatments were analyzed. The study also assessed demographic, clinical, and comorbidity-related factors influencing the economic burden. Results: RSV infections resulted in significantly higher direct costs compared to other ARIs, particularly in patients aged 70–80 years. Comorbidities such as asthma and smoking history were associated with increased costs in RSV cases. Although ICU costs were comparable between groups, hospitalizations for RSV required longer stays and more intensive treatments, amplifying the overall economic burden. Differences in costs by age and sex highlighted the need for tailored clinical management strategies. Conclusions: RSV poses a substantial economic and clinical burden on adults aged 60 years and older, particularly in those with comorbidities. Preventive measures, such as vaccination, could reduce healthcare costs and improve outcomes in this vulnerable population. These findings support the inclusion of RSV vaccines in immunization programs, especially in aging populations like Spain, to alleviate healthcare pressures during peak respiratory disease seasons. Full article
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17 pages, 837 KiB  
Article
Understanding General Practitioner and Patient Perceptions Regarding Integration of Non-Pharmacological Interventions in Chronic Non-Cancer Pain Management—A Cross-Sectional Mixed-Methods Study in the RELIEF Project
by Regina Poß-Doering, Sarina Carter, Sabrina Brinkmöller, Melanie Möhler, Dominik Dupont, Cinara Paul, Marco R. Zugaj, Viktoria Wurmbach, Alexandra Balzer, Michel Wensing and Cornelia Straßner
Diseases 2025, 13(2), 34; https://doi.org/10.3390/diseases13020034 - 28 Jan 2025
Viewed by 565
Abstract
Background: Chronic non-cancer-related pain is an independent condition with a multicausal genesis. Guidelines highlight the need for holistic treatment based on the bio-psycho-social model. While prescribing medication is common, it remains unclear how and to what extent non-pharmacological interventions are considered and recommended [...] Read more.
Background: Chronic non-cancer-related pain is an independent condition with a multicausal genesis. Guidelines highlight the need for holistic treatment based on the bio-psycho-social model. While prescribing medication is common, it remains unclear how and to what extent non-pharmacological interventions are considered and recommended in general practice pain management. The project RELIEF explored the integration of non-pharmacological interventions in general practices in Germany from both physician and patient perspectives. Methods: A mixed-methods study collected data with patients and general practitioners via semi-structured telephone interviews and self-developed questionnaires. Qualitative data were analyzed in a reflexive thematic analysis. Survey data were analyzed descriptively. Results: N = 383 questionnaires (n = 131 general practitioners, n = 252 patients) and n = 61 interviews (n = 21 general practitioners, n = 40 patients) were analyzed. Patient and physician perceptions regarding the integration of non-pharmacological interventions differed. Patients felt pharmacological therapy was recommended primarily, applied non-pharmacological interventions based on their own initiative, and were aware of bio-psycho-social interrelations. Physicians perceived that they often recommended physiotherapy and psychotherapy alongside analgesics, and asked about non-pharmacological interventions (79.4%), explained the bio-psycho-social chronic pain genesis (55.7%), and provided information on physical (48.9%) and social (35.9%) activity, relaxation techniques (42%), topical applications (31.9%), and support groups (25.2%). Conclusions: The integration of holistic pain management and communication between patients and general practitioners appear to need strengthening. Full article
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16 pages, 689 KiB  
Article
Risk of Insulin Resistance in 44,939 Spanish Healthcare Workers: Association with Sociodemographic Variables and Healthy Habits
by Pedro Javier Tárraga Marcos, Ángel Arturo López-González, Emilio Martínez-Almoyna Rifá, Hernán Paublini Oliveira, Cristina Martorell Sánchez, Pedro Juan Tárraga López and José Ignacio Ramírez-Manent
Diseases 2025, 13(2), 33; https://doi.org/10.3390/diseases13020033 - 27 Jan 2025
Viewed by 461
Abstract
Introduction: Insulin resistance (IR) is a highly prevalent pathophysiological entity implicated in the development of a wide variety of metabolic, cardiovascular, and endocrine disorders. The aim of this study is to assess the association between sociodemographic variables and healthy habits with IR risk [...] Read more.
Introduction: Insulin resistance (IR) is a highly prevalent pathophysiological entity implicated in the development of a wide variety of metabolic, cardiovascular, and endocrine disorders. The aim of this study is to assess the association between sociodemographic variables and healthy habits with IR risk scales. Methodology: This dual study, incorporating both longitudinal-retrospective and cross-sectional designs, analyzed healthcare workers across four professional categories (physicians, nurses, healthcare technicians, and auxiliary personnel). It examined the association of age, sex, professional category, smoking status, physical activity, and adherence to the Mediterranean diet with elevated scores on insulin resistance risk scales. Results: All the variables analyzed were associated with the presence of elevated values of the IR scales, with age, sex, and physical activity showing the strongest association (reflected in the odds ratio values). Conclusions: The profile of an individual with a higher risk of presenting elevated values of the IR risk scales would be an elderly male auxiliary health worker who is a smoker and is physically inactive, with a low adherence to the Mediterranean diet. Full article
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30 pages, 15119 KiB  
Article
Novel Pathways of Oxidative and Nitrosative Inactivation of the Human MGMT Protein in Colon Cancer and Glioblastoma Cells: Increased Efficacy of Alkylating Agents In Vitro and In Vivo
by Debasish Basak, Agm Mostofa, Hanumantha Rao Madala and Kalkunte S. Srivenugopal
Diseases 2025, 13(2), 32; https://doi.org/10.3390/diseases13020032 - 25 Jan 2025
Viewed by 424
Abstract
Background: O6-Methylguanine-DNA methyltransferase (MGMT) is a unique antimutagenic DNA repair protein that plays a crucial role in conferring resistance to various alkylating agents in brain tumor therapy. In this study, we exploited the susceptibility of the active site Cys145 of MGMT [...] Read more.
Background: O6-Methylguanine-DNA methyltransferase (MGMT) is a unique antimutagenic DNA repair protein that plays a crucial role in conferring resistance to various alkylating agents in brain tumor therapy. In this study, we exploited the susceptibility of the active site Cys145 of MGMT for thiolation and nitrosylation, both of which inactivate the enzyme. Methods: We designed a redox perturbing glutathione mimetic, a platinated homoglutathione disulfide (hGTX) by adding small amounts of cisplatin (1000:10) and used a nitric oxide-donor spermine NONOate. N6022, a potent inhibitor of S-nitrosoglutathione reductase was used to extend the retention of nitrosylated MGMT in tumor cell culture and subcutaneous xenografts. Results: Both hGTX and spermine NONOate inhibited MGMT activity in HT29, SF188, T98G, and other brain tumor cells. There was a robust increase in the alkylation-induced DNA interstrand cross-linking, G2/M cell cycle arrest, cytotoxicity, and the levels of apoptotic markers when either of the agents was used with alkylating agents. In the nude mice bearing T98G and HT29-luc2 xenografts, combinations of hGTX and spermine NONOate with alkylating agents produced a marked reduction in MGMT protein and tumor growth delay and regressions. N6022 treatment increased the presence of nitrosylated MGMT for a longer time, thereby extending the DNA-repair deficient state both in cell culture and preclinical settings. Conclusions: Our findings highlight the options for redox-driven therapeutic strategies for MGMT and suggest that oxidative and/or nitrosative inactivation of DNA repair in combination with alkylating agents could be exploited. Full article
(This article belongs to the Section Oncology)
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13 pages, 214 KiB  
Article
Age and Tumor Stage Interplay in Intrahepatic Cholangiocarcinoma: Prognostic Factors, Mortality Trends, and Therapeutic Implications from a SEER-Based Analysis
by Ayrton Bangolo, Vignesh K. Nagesh, Hadrian Hoang-Vu Tran, Brooke Sens, Daniel Elias, Behzad Amoozgar, Chase Tomasino, Izage Kianifar Aguilar, Charlene Mansour, Elizabeth Gagen, Lili Zhang, Sarvarinder Gill, Nisrene Jebara, Emma Madigan, Christin Candela, Dohaa Amin, Peter Giunta, Shubhangi Singh, Aman Siddiqui, Auda Auda, Paul Peej, Timophyll Y. H. Fong, Simcha Weissman, Printhia Matshi Lihau and John Bukasa-Kakambaadd Show full author list remove Hide full author list
Diseases 2025, 13(2), 31; https://doi.org/10.3390/diseases13020031 - 25 Jan 2025
Viewed by 896
Abstract
Background: Intrahepatic cholangiocarcinoma (ICC), a malignancy originating from the epithelial cells of bile ducts, has shown a notable rise in its incidence over the years. It ranks as the second most frequent primary liver cancer after hepatocellular carcinoma. This study investigates how independent [...] Read more.
Background: Intrahepatic cholangiocarcinoma (ICC), a malignancy originating from the epithelial cells of bile ducts, has shown a notable rise in its incidence over the years. It ranks as the second most frequent primary liver cancer after hepatocellular carcinoma. This study investigates how independent prognostic factors, specifically, age and tumor stage, interact to impact mortality in ICC patients. Furthermore, it examines the clinical features, survival rates, and prognostic indicators of ICC cases diagnosed between 2010 and 2017. Methods: Using data from 5083 patients obtained from the Surveillance, Epidemiology, and End Results (SEER) database, this study evaluated demographic and clinical factors alongside overall mortality (OM) and cancer-specific mortality (CSM). Variables achieving a p-value below 0.1 in univariate Cox regression analysis were incorporated into multivariate Cox regression models to identify independent prognostic factors. Hazard ratios (HRs) exceeding 1 were interpreted as markers of poor prognosis. Additionally, this study explored the interaction between age and tumor stage in shaping survival outcomes. Results: The multivariate Cox proportional hazards analysis indicated higher OM in males (HR = 1.19, 95% CI: 1.12–1.26, p < 0.01) and residents of metropolitan counties with populations exceeding 250,000 (HR = 1.15, 95% CI: 1.01–1.31, p < 0.05). Conversely, lower OM was observed in individuals aged 40–59 years (HR = 0.58, 95% CI: 0.38–0.89, p < 0.05), those aged 60–79 years (HR = 0.65, 95% CI: 0.43–0.98, p < 0.05), and patients who received radiation therapy (HR = 0.78, 95% CI: 0.72–0.85, p < 0.01), chemotherapy (HR = 0.54, 95% CI: 0.51–0.58, p < 0.01), or surgery (HR = 0.29, 95% CI: 0.26–0.31, p < 0.01). For CSM, males exhibited higher risks (HR = 1.17, 95% CI: 1.10–1.25, p < 0.01), as did individuals in metropolitan counties with populations over 250,000 (HR = 1.18, 95% CI: 1.03–1.35, p < 0.05). Reduced CSM was observed in patients aged 40–59 years (HR = 0.52, 95% CI: 0.34–0.79, p < 0.01), those aged 60–79 years (HR = 0.57, 95% CI: 0.38–0.86, p < 0.01), and those undergoing radiation therapy (HR = 0.76, 95% CI: 0.70–0.83, p < 0.01), chemotherapy (HR = 0.55, 95% CI: 0.51–0.59, p < 0.01), or surgery (HR = 0.27, 95% CI: 0.25–0.30, p < 0.01). When examining the interaction between age and tumor stage, higher OM was observed in patients aged 40–59 with tumors involving lymph nodes (HR = 1.26, 95% CI: 1.14–2.67, p < 0.05). Similarly, CSM was elevated in patients aged 40–59 with lymph node involvement alone (HR = 2.60, 95% CI: 1.26–5.36, p < 0.05) or with direct spread (HR = 2.81, 95% CI: 1.04–7.61, p < 0.05). Among those aged 60–79, higher CSM was noted in cases with lymph node involvement only (HR = 2.24, 95% CI: 1.11–4.50, p < 0.05) or lymph node involvement accompanied by direct extension (HR = 2.93, 95% CI: 1.10–7.82, p < 0.05). Conclusions: This retrospective analysis, utilizing data from the SEER database, provides new insights into mortality patterns in intrahepatic cholangiocarcinoma (ICC). This study identifies a significant interplay between two key prognostic factors, emphasizing their collective role in influencing mortality outcomes. Despite the predominance of advanced-stage diagnoses, our analysis underscores the substantial survival benefits associated with treatment interventions, with surgical procedures demonstrating the most pronounced impact. These findings highlight the importance of recognizing patients who may benefit from timely and intensive therapeutic strategies. Furthermore, the results underscore the need for future prospective randomized studies to deepen our understanding of these interactions in ICC, particularly as advancements in precision oncology continue to refine patient care. Full article
(This article belongs to the Section Gastroenterology)
11 pages, 1940 KiB  
Article
Comparative Analysis of Blood MMP-9 Concentration in Alcohol- and Opioid-Addicted Patients
by Tamar Kartvelishvili, Nelly Sapojnikova, Nino Asatiani, Lali Asanishvili, Victor Sokhadze, Nestan Sichinava and Zaza Chikovani
Diseases 2025, 13(2), 30; https://doi.org/10.3390/diseases13020030 - 24 Jan 2025
Viewed by 381
Abstract
Background/Objectives: In brain physiology and disease, MMP-9 is a significant and apparently peculiar factor. Numerous studies have implicated neuroinflammatory processes involving MMP-9 in the pathophysiology of addiction. This study aims to evaluate plasma MMP-9 level as a biomarker for the stages of alcohol [...] Read more.
Background/Objectives: In brain physiology and disease, MMP-9 is a significant and apparently peculiar factor. Numerous studies have implicated neuroinflammatory processes involving MMP-9 in the pathophysiology of addiction. This study aims to evaluate plasma MMP-9 level as a biomarker for the stages of alcohol and opioid addiction. Methods: The case subjects were patients with opioid and alcohol addiction. The quantitative assessment of MMP-9 plasma concentration was performed using monoclonal antibodies against human MMP-9. Results: MMP-9 levels in the plasma of patients with alcohol and opioid dependence differ from MMP-9 concentrations in apparently healthy donors. During the intoxication stage, MMP-9 concentrations in individuals with alcohol and opioid dependence are similar and higher than in the control group. While the MMP-9 level is close to the control level after alcohol withdrawal, it stays increased during opioid withdrawal. When MMP-9 levels in plasma were measured in three distinct intoxicated states (light, moderate, and heavy) in cases of alcohol addiction, the results were all similar. Two distinct opioid intoxicated states (methadone and buprenorphine) and three withdrawals—following methadone, buprenorphine, and heroin abuse—were associated with high MMP-9 levels. Full article
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9 pages, 756 KiB  
Case Report
Pseudohypertriglyceridemia in a Patient with Pancreatitis Without Evidence for Glycerol Kinase Deficiency: A Rare Case Report and Review of the Literature
by Jianping Zhu, Chunjuan Zhang and Rui Zhao
Diseases 2025, 13(2), 29; https://doi.org/10.3390/diseases13020029 - 23 Jan 2025
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Abstract
Background: Pseudohypertriglyceridemia (pseudo-HTG) is a condition in patients with glycerol kinase deficiency or other disorders of glycerol metabolism, as well as in individuals with alcoholism, severe liver disease, or metabolic disturbances, and those receiving heparin therapy. Exogenous glycerol intake can also trigger this [...] Read more.
Background: Pseudohypertriglyceridemia (pseudo-HTG) is a condition in patients with glycerol kinase deficiency or other disorders of glycerol metabolism, as well as in individuals with alcoholism, severe liver disease, or metabolic disturbances, and those receiving heparin therapy. Exogenous glycerol intake can also trigger this condition. However, the causes of pseudo-HTG are poorly understood, and a clinical algorithm for its diagnosing remains to be developed. Case presentation: We present the case of a 46-year-old man admitted to hospital with hypertriglyceridemia-induced severe acute pancreatitis (HTG-SAP) and type 2 diabetes mellitus. Upon admission, his plasma triglyceride (TG) level was critically high at 43.78 mmol/L (3877 mg/dL). During hospitalization, he developed acute renal insufficiency and diabetic ketoacidosis (DKA). Despite conventional lipid-lowering treatments, including extracorporeal lipoprotein apheresis, his TG levels remained elevated. The unusually clear serum led to suspicion of pseudo-HTG. A glycerol-corrected TG assay confirmed normal TG values, thereby diagnosing pseudo-HTG. Conclusions: This report presents the first confirmed case of pseudo-HTG verified through definitive glycerol kinase (GK) gene testing in a patient without glycerol kinase deficiency. We also include a review of the relevant literature and propose a clinical algorithm. The case report highlights the importance of considering pseudo-HTG in hypertriglyceridemia patients who do not respond well to the standard TG-lowering treatment. Our proposed clinical algorithm for diagnosing pseudo-HTG is potentially invaluable in clinical practice, and helps to prevent unnecessary lipid-lowering treatments for patients with pseudo-HTG. Full article
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Article
The Association Between Childhood Experience of Living with a Heavy Drinker and Self-Rated Mental Health in the Adult General Population
by Danica Romac, Varja Gaić Đogaš, Ljiljana Muslić, Sandro Krašić, Marija Kušan Jukić and Sanja Musić Milanović
Diseases 2025, 13(2), 28; https://doi.org/10.3390/diseases13020028 - 23 Jan 2025
Viewed by 387
Abstract
Background and Objectives: Considering the link between childhood experiences with adult health and well-being, this study examined how living with a heavy drinker (HD) during childhood affected self-rated mental health (SRMH) in adulthood, while identifying risk and protective factors and assessing the prevalence [...] Read more.
Background and Objectives: Considering the link between childhood experiences with adult health and well-being, this study examined how living with a heavy drinker (HD) during childhood affected self-rated mental health (SRMH) in adulthood, while identifying risk and protective factors and assessing the prevalence within a regional context. Materials and Methods: Data (N = 11,113) were obtained from a cross-sectional DEEP SEAS survey (2021) of the general population, aged 18–64 years, in six countries (Croatia, Bosnia and Herzegovina, Slovenia, Austria, Hungary, and Italy). Results: A statistically significant difference in SRMH was found, related to the childhood experience of living with an HD (MD = −0.221, 95% CI −0.250–0.172, N = 10,886) and being negatively affected (MD = −0.216, 95% CI −0.311–0.122, N = 2978). The correlation analysis revealed that individuals who lived with an HD during childhood perceived poorer SRMH in adulthood, consistently across all observed countries. Subsequent logistic regression identified different predictors for SRMH between those who were negatively affected and those who were not. The relationship satisfaction (RAS) was the strongest predictor, significantly contributing to better SRMH, especially in the subgroup that was not negatively affected (OR 28.724, 95% CI 3.450–239.173). A high prevalence of individuals negatively affected was found, especially in Hungary (34.4%) and Croatia (26.5%). Conclusions: Growing up with someone who was a heavy drinker may have lasting negative consequences on SRMH, with a negative subjective evaluation of mental health in adulthood. Targeted public health and preventive measures are needed to protect those living with heavy drinkers. Full article
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