Diseases

25 pages, 3357 KiB

Open AccessReview

Clinical Significance of LINC00261 in the Pathogenesis of Pancreatic, Colorectal, Hepatocellular, and Gallbladder Cancer

by Sanjana Bana, Sia Daffara, Aastha Dagar, Ashutosh Kumar Tiwari, Kanupriya Medhi, Sagarika Mukherjee, Vivek Uttam, Md Rizwan Ansari, Hardeep Singh Tuli, Vikas Yadav and Aklank Jain

Diseases 2025, 13(3), 89; https://doi.org/10.3390/diseases13030089 - 20 Mar 2025

Viewed by 380

Abstract

Pancreatic (PC), colorectal (CRC), hepatocellular (HCC), and gallbladder (GC) cancers together account for nearly 20% of all cancer cases. However, specific biomarkers and therapeutic targets for these cancers are lacking. Diagnosing these cancers early and providing timely, appropriate treatment to improve patient outcomes [...] Read more.

Pancreatic (PC), colorectal (CRC), hepatocellular (HCC), and gallbladder (GC) cancers together account for nearly 20% of all cancer cases. However, specific biomarkers and therapeutic targets for these cancers are lacking. Diagnosing these cancers early and providing timely, appropriate treatment to improve patient outcomes is crucial. In this context, previous studies, including ours, have highlighted the potential of non-coding RNAs, particularly long non-coding RNAs (lncRNAs), in diagnosing and prognosis of various cancers. This review focuses on the mechanistic role of the recently identified lncRNA LINC00261 in PC, CRC, HCC, and GC. Our comprehensive literature analysis revealed that LINC00261 functions as a tumor suppressor, and its reduced expression is associated with larger tumor size, advanced tumor-node-metastasis (TNM) stages, lymphatic metastasis, and poorer overall survival rates. Additionally, we discovered that LINC00261 acts as a molecular sponge for miRNAs, such as miR-550a-3p, miR-23a-3p, miR-148a, miR-324-3p, and miR-105-5p, regulating critical cancer-related signaling pathways, including PI3K/Akt/mTOR, Protein kinase B, and Mammalian target of rapamycin (mTOR). Further bioinformatic analysis revealed that LINC00261 regulates key cellular processes, such as protein-DNA complex formation, ribonuclease complex activity, histone deacetylase complexes, and nuclear matrix interactions. Overall, we believe that LINC00261 holds significant promise as a future biomarker and, when combined with existing treatment strategies, may enhance cancer patient care and survival. Full article

(This article belongs to the Section Oncology)

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9 pages, 975 KiB

Open AccessArticle

Early Evaluation of the Short Physical Performance Battery in Hospitalized Patients with Chronic Kidney Disease Predicts Long-Term Hospitalization

by Takashi Amari, Eiji Kubo, Yota Kuramochi, Shota Onoda, Kyosuke Fukuda, Emi Yokoyama, Masami Kimura and Tomoyuki Arai

Diseases 2025, 13(3), 88; https://doi.org/10.3390/diseases13030088 - 19 Mar 2025

Viewed by 215

Abstract

Background: The relationship between hospitalization duration and physical function in patients with chronic kidney disease (CKD) has not been thoroughly investigated. This study aimed to determine whether assessment of physical function one week after hospitalization can predict the length of stay in patients [...] Read more.

Background: The relationship between hospitalization duration and physical function in patients with chronic kidney disease (CKD) has not been thoroughly investigated. This study aimed to determine whether assessment of physical function one week after hospitalization can predict the length of stay in patients with CKD. Methods: A retrospective study was conducted on hospitalized patients with CKD who underwent rehabilitation between March 2019 and March 2020. Physical function was evaluated using the Short Physical Performance Battery (SPPB), grip strength, and Barthel Index and analyzed alongside clinical data. Results: The mean age of the participants was 73.4 ± 11.9 years, with 92% having stage G4 or G5 CKD. Multivariate analysis revealed that the SPPB (β = −0.33, p < 0.01) at one week after admission was significantly associated with the length of hospital stay (R² = 0.11, p < 0.02). Notably, in the subgroup of patients who were transferred to other facilities, the SPPB alone showed a strong association with the length of stay (β = −0.66, p < 0.03, R² = 0.23, p < 0.05). Conclusions: The SPPB score in the early stages of hospitalization for patients with CKD was found to be a significant predictor of the length of stay, even after considering the eGFR and the Charlson Comorbidity Index. These findings may contribute to optimizing inpatient management and rehabilitation strategies for patients with CKD. Full article

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22 pages, 6478 KiB

Open AccessArticle

Immunomodulatory Effect of Rivaroxaban Nanoparticles Alone and in Combination with Sitagliptin on Diabetic Rat Model

by Mohamed M. Elbadr, Heba A. Galal, Helal F. Hetta, Hassabelrasoul Elfadil, Fawaz E. Alanazi, Shereen Fawzy, Hashim M. Aljohani, Noura H. Abd Ellah, Marwa F. Ali, Ahmed K. Dyab and Esraa A. Ahmed

Diseases 2025, 13(3), 87; https://doi.org/10.3390/diseases13030087 - 19 Mar 2025

Viewed by 485

Abstract

Background: Chronic inflammation and immune dysregulation are key drivers of diabetes complications. Rivaroxaban (RX) and sitagliptin (SITA) are established therapies for thromboembolism and glycemic control, respectively. This study evaluated the novel therapeutic potential of nano-rivaroxaban (NRX) alone and in combination with sitagliptin (SITA) [...] Read more.

Background: Chronic inflammation and immune dysregulation are key drivers of diabetes complications. Rivaroxaban (RX) and sitagliptin (SITA) are established therapies for thromboembolism and glycemic control, respectively. This study evaluated the novel therapeutic potential of nano-rivaroxaban (NRX) alone and in combination with sitagliptin (SITA) in mitigating inflammation and restoring immune balance in streptozotocin (STZ)-induced diabetic rats. Methods: Type 2 diabetes was induced in rats using a single injection of STZ (60 mg/kg). Animals were divided into five groups: control, STZ-diabetic, RX-treated (5 mg/kg), NRX-treated (5 mg/kg), and NRX+SITA-treated (5 mg/kg + 10 mg/kg). After 4 weeks of treatment, blood glucose, coagulation markers, pro-inflammatory cytokines (TNF-α, IL-1β, IL-6), and anti-inflammatory cytokines (IL-35, TGF-β1, IL-10) were analyzed. Histopathological examination of the liver, kidney, pancreas, and spleen was conducted. Immunohistochemistry was used to assess hepatic NF-κB expression. Results: STZ significantly elevated pro-inflammatory cytokines (IL-1β, TNF-α, IL-6) and anti-inflammatory cytokines (IL-35, TGF-β1, IL-10), along with increased hepatic NF-κB expression and histopathological abnormalities in immune organs. NRX significantly reduced inflammatory cytokines, improved histopathological changes in organs, and decreased hepatic NF-κB expression. The combination therapy (NRX + SITA) achieved superior immune modulation, with enhanced cytokine profile restoration, reduced hepatic NF-κB expression, and near-complete histopathological normalization. Conclusions: This study underscores the promise of combining nanoparticle-based drug delivery with established therapies like sitagliptin to achieve superior immune modulation and inflammation control, presenting a potential therapeutic strategy for managing diabetes complications. Full article

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24 pages, 2530 KiB

Open AccessArticle

Genomic Landscape of Breast Cancer: Study Across Diverse Ethnic Groups

by Asbiel Felipe Garibaldi-Ríos, Luis E. Figuera, Guillermo Moisés Zúñiga-González, Belinda Claudia Gómez-Meda, Ana María Puebla-Pérez, Alicia Rivera-Cameras, María Teresa Magaña-Torres, José Elías García-Ortíz, Ingrid Patricia Dávalos-Rodríguez, Mónica Alejandra Rosales-Reynoso, Patricia Montserrat García-Verdín, Irving Alejandro Carrillo-Dávila, Blanca Miriam Torres-Mendoza, Guadalupe Ávalos-Navarro and Martha Patricia Gallegos-Arreola

Diseases 2025, 13(3), 86; https://doi.org/10.3390/diseases13030086 - 17 Mar 2025

Viewed by 479

Abstract

Background: Breast cancer (BC) is the most common cancer among women worldwide, with incidence and mortality rates varying across ethnic groups due to sociodemographic, clinicopathological, and genomic differences. This study aimed to characterize the genomic landscape of BC in diverse ethnic groups [...] Read more.

Background: Breast cancer (BC) is the most common cancer among women worldwide, with incidence and mortality rates varying across ethnic groups due to sociodemographic, clinicopathological, and genomic differences. This study aimed to characterize the genomic landscape of BC in diverse ethnic groups using computational tools to explore these variations. Methodology: cBioPortal was used to analyze genomic, clinicopathological, and sociodemographic data from 1084 BC samples. Mutated genes were classified based on GeneCards platform data. Enrichment analysis was performed with CancerHallmarks, and genes not found were compared with MSigDB’s Hallmark Gene Sets. Genes absent from both were further analyzed using NDEx through Cytoscape.org to explore their role in cancer. Results: Significant differences (p < 0.05) were observed in sex, tumor subtypes, genetic ancestry, median of the fraction of the altered genome, mutation count, and mutation frequencies of genes across ethnic groups. We identified the most frequently mutated genes. Some of these genes were found to be associated with classic cancer hallmarks, such as replicative immortality, sustained proliferative signaling, and the evasion of growth suppressors. However, the exact role of some of these genes in cancer remains unclear, highlighting the need for further research to better understand their involvement in tumor biology. Conclusions: This study identified significant clinicopathological and genomic variations in BC across ethnic groups. While key genes associated with cancer hallmarks were found, the incomplete characterization of some highlights the need for further research, especially focusing on ethnic groups, to understand their role in tumor biology and improve personalized treatments. Full article

(This article belongs to the Section Oncology)

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14 pages, 261 KiB

Open AccessArticle

Impact of Personalized Recovery Interventions on Spinal Instability and Psychological Distress in Oncological Patients with Vertebral Metastases

by Noémi Németh, Florica Voiță-Mekeres, Liviu Lazăr, Lavinia Davidescu and Călin Tudor Hozan

Diseases 2025, 13(3), 85; https://doi.org/10.3390/diseases13030085 - 16 Mar 2025

Viewed by 432

Abstract

Background: Patients with vertebral metastases often experience spinal instability, chronic pain, and psychological distress, all of which can significantly reduce quality of life. Spinal instability, measured by the Spinal Instability Neoplastic Score (SINS), may exacerbate functional impairment and emotional distress, underscoring the potential [...] Read more.

Background: Patients with vertebral metastases often experience spinal instability, chronic pain, and psychological distress, all of which can significantly reduce quality of life. Spinal instability, measured by the Spinal Instability Neoplastic Score (SINS), may exacerbate functional impairment and emotional distress, underscoring the potential benefit of personalized recovery interventions. Material and methods: This prospective, observational study investigated the impact of personalized recovery interventions on spinal instability, psychological distress, and quality of life in oncological patients with vertebral metastases. Results: The experimental group received tailored rehabilitation strategies, while the control group underwent standard oncological care. Spinal instability was assessed using the Spinal Instability Neoplastic Score (SINS), psychological distress was measured with the Hopelessness Depression Symptom Questionnaire (HDSQ), and quality of life was evaluated using the European Quality of Life-5 Dimensions (EQ-5D). The experimental group demonstrated significantly lower mean SINS scores, indicating reduced spinal instability, and lower HDSQ scores, suggesting decreased psychological distress. They also exhibited improvements in mobility, self-care, usual activities, and anxiety/depression dimensions of the EQ-5D. Furthermore, the experimental group had longer survival times, lower fracture rates, and reduced prevalence of osteoporosis, anemia, and vomiting. These findings underscore the potential benefits of integrating physical and psychological rehabilitation into routine oncological management. Conclusions: Personalized recovery interventions appear to enhance functional independence, emotional well-being, and overall quality of life in patients with vertebral metastases. Future research should focus on longitudinal, multicenter, randomized controlled trials to confirm these findings and further elucidate the complex interplay between spinal instability, psychological distress, and functional recovery. Full article

(This article belongs to the Special Issue Mental Health Across the Lifespan: Integrating Multidisciplinary Perspectives)

9 pages, 3457 KiB

Open AccessArticle

Surgical Treatment of Enchondromas of the Hand: Our Experience in Curettage Only and Early Mobilization

by Silvia Pietramala, Giuseppe Rovere, Camilla Ravaioli, Ciro Mignano, Amarildo Smakaj, Andrea Fidanza, Pasquale Farsetti, Lorenzo Rocchi and Camillo Fulchignoni

Diseases 2025, 13(3), 84; https://doi.org/10.3390/diseases13030084 - 16 Mar 2025

Viewed by 417

Abstract

(1) Background: Enchondroma is one of the most common primary tumors of the hand. Usually asymptomatic, it can present with pain, deformity, and sometimes pathologic fractures. Surgical treatment is advised in these cases. Curettage is the basic treatment, but there is no consensus [...] Read more.

(1) Background: Enchondroma is one of the most common primary tumors of the hand. Usually asymptomatic, it can present with pain, deformity, and sometimes pathologic fractures. Surgical treatment is advised in these cases. Curettage is the basic treatment, but there is no consensus in the literature regarding post-void filling. The aim of our study is to present simple curettage and early mobilization as a safe and effective treatment. (2) Methods: We retrospectively analyzed patients treated at our center between 2020 and 2024. Each patient was treated with simple curettage and early mobilization. We collected demographic data and follow-up data. (3) Conclusions: We recorded no complications in our cohort, pointing out that our method is safe and reliable without any kind of immobilization. Bone grafts and other methods such as cement are good options but should be considered in specific cases. Full article

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12 pages, 2845 KiB

Open AccessArticle

An Application for Spatial Frailty Models: An Exploration with Data on Fungal Sepsis in Neonates

by Palaniyandi Paramasivam, Nagaraj Jaganathasamy, Srinivasan Ramalingam, Vasantha Mahalingam, Selvam Nagarajan, Fayaz Ahamed Shaik, Sundarakumar Karuppasamy, Adhin Bhaskar, Padmanaban Srinivasan, Tamizhselvan Manoharan, Adalarasan Natesan and Ponnuraja Chinnaiyan

Diseases 2025, 13(3), 83; https://doi.org/10.3390/diseases13030083 - 14 Mar 2025

Viewed by 565

Abstract

Background: Globally, neonatal fungal sepsis (NFS) is a leading cause of neonatal mortality, particularly among vulnerable populations in neonatal intensive care units (NICU). The use of spatial frailty models with a Bayesian approach to identify hotspots and risk factors for neonatal deaths due [...] Read more.

Background: Globally, neonatal fungal sepsis (NFS) is a leading cause of neonatal mortality, particularly among vulnerable populations in neonatal intensive care units (NICU). The use of spatial frailty models with a Bayesian approach to identify hotspots and risk factors for neonatal deaths due to fungal sepsis has not been explored before. Methods: A cohort of 80 neonates admitted to the NICU at a Government Hospital in Tamil Nadu, India and diagnosed with fungal sepsis through blood cultures between 2018–2020 was considered for this study. Bayesian spatial frailty models using parametric distributions, such as Log-logistic, Log-normal, and Weibull proportional hazard (PH) models, were employed to identify associated risk factors for NFS deaths and hotspot areas using the R version 4.1.3 software and QGIS version 3.26 (Quantum Geographic Information System). Results: The spatial parametric frailty models were found to be good models for analyzing NFS data. Abnormal levels of activated thromboplastin carried a significantly higher risk of death in neonates across all PH models (Log-logistic, Hazard Ratio (HR), 95% Credible Interval (CI): 22.12, (5.40, 208.08); Log-normal: 20.87, (5.29, 123.23); Weibull: 18.49, (5.60, 93.41). The presence of hemorrhage also carried a risk of death for the Log-normal (1.65, (1.05, 2.75)) and Weibull models (1.75, (1.07, 3.12)). Villivakkam, Tiruvallur, and Poonamallee blocks were identified as high-risk areas. Conclusions: The spatial parametric frailty models proved their effectiveness in identifying these risk factors and quantifying their association with mortality. The findings from this study underline the importance of the early detection and management of risk factors to improve survival outcomes in neonates with fungal sepsis. Full article

(This article belongs to the Section Infectious Disease)

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14 pages, 902 KiB

Open AccessSystematic Review

Dancing Towards Stability: The Therapeutic Potential of Argentine Tango for Balance and Mobility in Parkinson’s Disease

by Federica Giorgi, Daniela Platano, Lisa Berti, Danilo Donati and Roberto Tedeschi

Diseases 2025, 13(3), 82; https://doi.org/10.3390/diseases13030082 - 13 Mar 2025

Viewed by 557

Abstract

Background: Parkinson’s Disease (PD) is a progressive neurodegenerative disorder characterized by motor impairments, including balance deficits, gait disturbances, and postural instability. Given the limitations of pharmacological treatments, alternative rehabilitative strategies such as Argentine Tango (AT) have been explored for their potential benefits in [...] Read more.

Background: Parkinson’s Disease (PD) is a progressive neurodegenerative disorder characterized by motor impairments, including balance deficits, gait disturbances, and postural instability. Given the limitations of pharmacological treatments, alternative rehabilitative strategies such as Argentine Tango (AT) have been explored for their potential benefits in improving mobility and quality of life in individuals with PD. This systematic review evaluates the effectiveness of AT in enhancing balance, gait, and functional mobility in PD patients. Methods: A systematic literature search was conducted across PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, PEDro, and Web of Science. Studies were included if they were randomized controlled trials (RCTs) assessing the impact of AT on motor outcomes in PD. Data extraction and risk of bias assessment were performed independently by two reviewers using the Risk of Bias 2 (RoB 2) tool. Results: Five randomized controlled trials (RCTs) were included, with sample sizes ranging from 10 to 62 participants and intervention durations varying from 10 weeks to 24 months. AT significantly improved balance (Mini-BESTest, BBS, FRT), gait performance (6MWT, TUG), and mobility compared to usual care or conventional exercise. Some studies also reported psychological benefits, including reduced depressive symptoms and increased balance confidence. However, freezing of gait outcomes were inconclusive, and methodological limitations, such as small sample sizes and inconsistent intervention durations, were noted. Outcomes for freezing of gait (FoG) remained inconclusive due to the variability in assessment methods and inconsistent reporting across studies. Conclusions: AT appears to be an effective rehabilitation strategy for improving balance, gait, and functional mobility in PD. While preliminary evidence suggests additional psychological benefits, larger, high-quality trials are needed to confirm its long-term efficacy and establish standardized intervention protocols. AT may be integrated into multimodal rehabilitation programs to enhance motor and psychosocial outcomes in PD management. However, the small sample sizes of included studies and the heterogeneity in intervention durations limit the generalizability of findings. AT may serve as a structured rehabilitative approach for improving mobility and psychosocial outcomes in PD and could be integrated into community-based or clinical rehabilitation programs. Full article

(This article belongs to the Section Neuro-psychiatric Disorders)

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18 pages, 7616 KiB

Open AccessArticle

Evaluating Osteotomy Accuracy in Mandibular Reconstruction: A Preliminary Study Using Custom Cutting Guides and Virtual Reality

by Claudia Borbon, Andrea Novaresio, Oreste Iocca, Francesca Nonis, Sandro Moos, Enrico Vezzetti, Guglielmo Ramieri and Emanuele Zavattero

Diseases 2025, 13(3), 81; https://doi.org/10.3390/diseases13030081 - 13 Mar 2025

Viewed by 442

Abstract

Background: Mandibular reconstruction has evolved significantly since its inception in the early 1900s. Currently, the fibula free flap (FFF) is considered the gold standard for mandibular and maxillary reconstructions, particularly for extensive defects, and the introduction of Extended Reality (XR) and virtual surgical [...] Read more.

Background: Mandibular reconstruction has evolved significantly since its inception in the early 1900s. Currently, the fibula free flap (FFF) is considered the gold standard for mandibular and maxillary reconstructions, particularly for extensive defects, and the introduction of Extended Reality (XR) and virtual surgical planning (VSP) is revolutionizing maxillofacial surgery. Methods: This study focuses on evaluating the accuracy of using in-house cutting guides for mandibular reconstruction with FFF supported by virtual surgical planning (VSP). Planned and intraoperative osteotomies obtained from postoperative CT scans were compared in 17 patients who met the inclusion criteria. The proposed analysis included measurements of deviation angles, thickness at the centre of gravity, and the maximum thickness of the deviation volume. Additionally, a mandibular resection coding including 12 configurations was defined to classify and analyze the precision of mandibular osteotomies and investigate systematic errors. Preoperative, planned, and postoperative models have been inserted in an interactive VR environment, VieweR, to enhance surgical planning and outcome analysis. Results: The results proved the efficiency of adopting customized cutting guides and highlighted the critical role of advanced technologies such as CAD/CAM and VR in modern maxillofacial surgery. A novel coding system including 12 possible configurations was developed to classify and analyze the precision of mandibular osteotomies. This system considers (1) the position of the cutting blade relative to the cutting plane of the mandibular guide; (2) the position of the intersection axis between the planned and intraoperative osteotomy relative to the mandible; (3) the direction of rotation of the intraoperative osteotomy plane around the intersection axis from the upper view of the model. Conclusions: This study demonstrates the accuracy and reliability of in-house cutting guides for mandibular reconstruction using fibula free flaps (FFF) supported by virtual surgical planning (VSP). The comparison between planned and intraoperative osteotomies confirmed the precision of this approach, with minimal deviations observed. These findings highlight the critical role of CAD/CAM and XR technologies in modern maxillofacial surgery, offering improved surgical precision and optimizing patient outcomes. Full article

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32 pages, 562 KiB

Open AccessReview

Non-Pharmacological Interventions for Managing the Symptoms of Depression in Women with Breast Cancer: A Literature Review of Clinical Trials

by Mayra Alejandra Mafla-España and Omar Cauli

Diseases 2025, 13(3), 80; https://doi.org/10.3390/diseases13030080 - 11 Mar 2025

Viewed by 965

Abstract

Symptoms of depression represent a significant burden to patients with breast cancer, not only because of the psychological stress associated with their diagnosis, but also because of the adverse effects of its treatment. We reviewed the clinical trials examining the management of the [...] Read more.

Symptoms of depression represent a significant burden to patients with breast cancer, not only because of the psychological stress associated with their diagnosis, but also because of the adverse effects of its treatment. We reviewed the clinical trials examining the management of the symptoms of depression in breast cancer patients through different non-pharmacological interventions in different databases (PubMed, Embase, Scopus, and the American Psychological Association). Cognitive behavioural therapy, interpersonal psychotherapy or psychodynamic psychotherapy, as well as acceptance and commitment therapy have been effective in improving symptoms of depression in cancer patients with moderate to severe symptoms. Physical exercise, yoga, mindfulness, and support groups have been shown to benefit patients with mild depressive symptoms. These interventions not only showed positive results in interventions in women with breast cancer in terms of the symptoms of depression, but also highlighted their benefits for comorbid anxiety, stress, and poor sleep quality; moreover, it is suggested that these interventions should be leveraged to manage mental health issues in breast cancer patients. The molecular effects of these interventions, such as the reduction in inflammatory cytokines and cortisol levels, have seldom been reported and need further studies. Full article

(This article belongs to the Section Neuro-psychiatric Disorders)

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10 pages, 1975 KiB

Open AccessArticle

Gemcitabine Plus Docetaxel, Dacarbazine, Doxorubicin Combinations, or Doxorubicin Alone as First-Line Treatment for Advanced/Metastatic Leiomyosarcoma: A Retrospective Analysis at a Sarcoma Center

by Ted Kim, Clara Hao, Minggui Pan, Kristen N. Ganjoo and Nam Q. Bui

Diseases 2025, 13(3), 79; https://doi.org/10.3390/diseases13030079 - 11 Mar 2025

Viewed by 532

Abstract

Background/Objectives: Locally advanced and metastatic leiomyosarcoma (LMS) is an aggressive cancer with limited treatment options. This single-institution, retrospective study evaluated the efficacy of first-line chemotherapy regimens in patients with advanced or metastatic LMS treated at Stanford Medical Center. Methods: Seventy-four patients with unresectable [...] Read more.

Background/Objectives: Locally advanced and metastatic leiomyosarcoma (LMS) is an aggressive cancer with limited treatment options. This single-institution, retrospective study evaluated the efficacy of first-line chemotherapy regimens in patients with advanced or metastatic LMS treated at Stanford Medical Center. Methods: Seventy-four patients with unresectable or metastatic LMS were deemed eligible and treated with first-line chemotherapy regimens, including gemcitabine plus docetaxel, dacarbazine, doxorubicin combinations (with evofosfamide or ifosfamide), and doxorubicin monotherapy. Progression-free survival (PFS), overall survival (OS), and disease control rate (DCR) were assessed using RECIST v1.1, with survival analyses performed using Kaplan–Meier and Cox proportional hazards methods. Results: The cohort consisted of 56 females (75.7%) and 18 males (24.3%), with a median age of 55.5 years. The majority (93.2%) had metastatic disease. The median PFS for the entire cohort was 4.9 months (range: 0.6–28.1 mo), and the median OS was 27.3 months (range: 1.9–140.2 mo). The doxorubicin combination (DC) group had the highest median PFS of 7.9 months (range: 0.6–15.8 mo). Doxorubicin alone had the highest median OS of 33.8 months (4.2–100.2 mo). Doxorubicin combinations demonstrated superior PFS in both uterine and non-uterine LMS subgroups. Conclusions: These findings reaffirm the efficacy of doxorubicin-based combination regimens as a first-line treatment for locally advanced and metastatic LMS, particularly in non-uterine LMS. Full article

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15 pages, 1118 KiB

Open AccessArticle

Lifestyle and Biochemical Parameters That May Hamper Immune Responses in Pediatric Patients After Immunization with the BNT162b2 mRNA COVID-19 Vaccine

by Anthie Damianaki, Antonios Marmarinos, Margaritis Avgeris, Dimitrios Gourgiotis, Elpis-Athina Vlachopapadopoulou, Marietta Charakida, Maria Tsolia and Lydia Kossiva

Diseases 2025, 13(3), 78; https://doi.org/10.3390/diseases13030078 - 10 Mar 2025

Viewed by 557

Abstract

Background: The aim of this study was to evaluate whether increased body mass index (BMI) and biochemical and lifestyle parameters linked to obesity and smoke exposure disrupt immune responses of children and adolescents following vaccination with the mRNA BNT162b2 vaccine. Methods: A prospective, [...] Read more.

Background: The aim of this study was to evaluate whether increased body mass index (BMI) and biochemical and lifestyle parameters linked to obesity and smoke exposure disrupt immune responses of children and adolescents following vaccination with the mRNA BNT162b2 vaccine. Methods: A prospective, single-center, cohort study was conducted. Participants were assigned to receive two doses of the mRNA vaccine. Anti-SARS-CoV-2 IgG and neutralizing antibodies (AB) were measured before vaccination (T0) and 14 days after the second dose (T1). BMI and biochemical parameters were evaluated at T0. A questionnaire on lifestyle characteristics was filled in. Results: IgG optical density (OD) ratio at T1 was lower in the overweight–obese group regardless of COVID-19 disease positive history [p = 0.028 for the seronegative group, p = 0.032 for the seropositive group]. Neutralizing AB were lower in overweight–obese participants in the seronegative group at T1 [p = 0.008]. HDL, fasting glucose/insulin ratio (FGIR), C-reactive protein (CRP), HBA1c, uric acid, and smoke exposure were significantly correlated with BMI [p = 0.006, p < 0.001, p < 0.001, p = 0.006, p = 0.009, p < 0.001, respectively]. The main biochemical parameters that were inversely correlated with IgG and neutralizing AB titers at T1 were uric acid [p = 0.018, p = 0.002], FGIR [p = 0.001, p = 0.008] and HBA1C [p = 0.027, p = 0.038], while smoke exposure negatively affected the humoral immune responses at T0 in the convalescent group [p = 0.004, p = 0.005]. Conclusions: Current data suggests that uric acid, insulin resistance (IR), and smoke exposure could adversely affect the immune responses in overweight–obese vaccinated children, highlighting the need for actions to enhance the protection of this particular subgroup. Full article

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9 pages, 214 KiB

Open AccessArticle

The Influence of Occupational Factors on Contact Dermatitis in Symptomatic Healthcare Workers: A Patch Test Study

by Cristiana Ferrari, Giuseppina Somma, Viola Giovinazzo, Margherita Iarossi, Michele Treglia, Margherita Pallocci, Luca Di Giampaolo, Andrea Magrini and Luca Coppeta

Diseases 2025, 13(3), 77; https://doi.org/10.3390/diseases13030077 - 7 Mar 2025

Viewed by 706

Abstract

Healthcare workers (HCWs) are frequently exposed to a variety of chemical agents, which can result in the development of allergic or irritant contact dermatitis. The present study aimed to assess the prevalence of skin sensitization among HCWs who presented with symptoms of contact [...] Read more.

Healthcare workers (HCWs) are frequently exposed to a variety of chemical agents, which can result in the development of allergic or irritant contact dermatitis. The present study aimed to assess the prevalence of skin sensitization among HCWs who presented with symptoms of contact dermatitis, considering both occupational and non-occupational risk factors. The study population comprised 127 HCWs who attended routine occupational health surveillance at the Tor Vergata Teaching Hospital in Rome between November 2023 and May 2024. A structured dermatitis questionnaire and patch testing were administered to the participants. Demographic and lifestyle data, including information on occupation, night shift work, smoking habits, and body mass index (BMI), were collected. Patch test positivity was observed in 31.5% of participants, with the most common clinical presentation being erythematous-desquamative allergic contact dermatitis. A significantly higher likelihood of patch test positivity was observed among nurses (57.1%), particularly for nickel sensitization, compared to other occupational groups. A trend towards an association between night shift work and skin sensitization was observed, although this did not reach statistical significance. No significant associations were found for ages over 35 years, sex, or BMI. These findings highlight the elevated risk of contact sensitization among nurses, emphasizing the need for targeted interventions, including exposure reduction strategies and protective measures, to mitigate occupational skin hazards in healthcare settings. Full article

11 pages, 481 KiB

Open AccessCommunication

Setting the Stage for Branched-Chain Amino Acids Use in Neurological Pathologies: Does a Single Oral Dose Provide Hours of Elevated Systemic Levels?

by Ezek Mathew, Nathan Jones, McKinley Dews, Dominique Neal and Anders Cohen

Diseases 2025, 13(3), 76; https://doi.org/10.3390/diseases13030076 - 6 Mar 2025

Viewed by 479

Abstract

Background: Recent studies have demonstrated that branched-chain amino acids are neuroprotective and neurorestorative. Branched-chain amino acid supplements are now being recommended to be taken before contact sports to reduce concussions. While peaks and troughs in branched-chain amino acids have previously been reported in [...] Read more.

Background: Recent studies have demonstrated that branched-chain amino acids are neuroprotective and neurorestorative. Branched-chain amino acid supplements are now being recommended to be taken before contact sports to reduce concussions. While peaks and troughs in branched-chain amino acids have previously been reported in hospital settings, the metabolism of a single recommended dose of over-the-counter branched-chain amino acids has yet to be elucidated. Methods: We analyzed a patented branched-chain amino acid product to assess its metabolism in 10 healthy adults. Results: Over the defined time points, measured levels of branched-chain amino acids remained significantly elevated when compared to the physiological baseline. The elevations in measured plasma levels indicate that a single oral dose is a viable intake option for increasing levels of branched-chain amino acids. Conclusions: This information can be leveraged to better plan branched-chain amino acid-based treatment doses in order to treat pathologies such as brain injury. Full article

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29 pages, 762 KiB

Open AccessReview

The Genetic and Biological Basis of Pseudoarthrosis in Fractures: Current Understanding and Future Directions

by Amalia Kotsifaki, Georgia Kalouda, Sousanna Maroulaki, Athanasios Foukas and Athanasios Armakolas

Diseases 2025, 13(3), 75; https://doi.org/10.3390/diseases13030075 - 3 Mar 2025

Viewed by 1325

Abstract

Pseudoarthrosis—the failure of normal fracture healing—remains a significant orthopedic challenge affecting approximately 10–15% of long bone fractures, and is associated with significant pain, prolonged disability, and repeated surgical interventions. Despite extensive research into the pathophysiological mechanisms of bone healing, diagnostic approaches remain reliant [...] Read more.

Pseudoarthrosis—the failure of normal fracture healing—remains a significant orthopedic challenge affecting approximately 10–15% of long bone fractures, and is associated with significant pain, prolonged disability, and repeated surgical interventions. Despite extensive research into the pathophysiological mechanisms of bone healing, diagnostic approaches remain reliant on clinical findings and radiographic evaluations, with little innovation in tools to predict or diagnose non-union. The present review evaluates the current understanding of the genetic and biological basis of pseudoarthrosis and highlights future research directions. Recent studies have highlighted the potential of specific molecules and genetic markers to serve as predictors of unsuccessful fracture healing. Alterations in mesenchymal stromal cell (MSC) function, including diminished osteogenic potential and increased cellular senescence, are central to pseudoarthrosis pathogenesis. Molecular analyses reveal suppressed bone morphogenetic protein (BMP) signaling and elevated levels of its inhibitors, such as Noggin and Gremlin, which impair bone regeneration. Genetic studies have uncovered polymorphisms in BMP, matrix metalloproteinase (MMP), and Wnt signaling pathways, suggesting a genetic predisposition to non-union. Additionally, the biological differences between atrophic and hypertrophic pseudoarthrosis, including variations in vascularity and inflammatory responses, emphasize the need for targeted approaches to management. Emerging biomarkers, such as circulating microRNAs (miRNAs), cytokine profiles, blood-derived MSCs, and other markers (B7-1 and PlGF-1), have the potential to contribute to early detection of at-risk patients and personalized therapeutic approaches. Advancing our understanding of the genetic and biological underpinnings of pseudoarthrosis is essential for the development of innovative diagnostic tools and therapeutic strategies. Full article

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14 pages, 631 KiB

Open AccessArticle

In and Outpatients Bacteria Antibiotic Resistances in Positive Urine Cultures from a Tertiary Care Hospital in the Western Part of Romania—A Cross-Sectional Study

by Nicu Olariu, Monica Licker, Lazar Chisavu, Flavia Chisavu, Adalbert Schiller, Luciana Marc, Oana Albai, Andrei Paunescu, Vlad Tucicovschi, Adelina Mihaescu and Adrian Apostol

Diseases 2025, 13(3), 74; https://doi.org/10.3390/diseases13030074 - 1 Mar 2025

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Abstract

Background/Objectives: Urinary tract infections (UTI) represent a global problem with implications for mortality and morbidity. Published data present different bacterial incidences and different antibiotic resistance. The objective of our study is to evaluate the bacteria distribution in positive urine cultures in a mixed [...] Read more.

Background/Objectives: Urinary tract infections (UTI) represent a global problem with implications for mortality and morbidity. Published data present different bacterial incidences and different antibiotic resistance. The objective of our study is to evaluate the bacteria distribution in positive urine cultures in a mixed adult population and evaluate the differences in antibiotic resistance in in- and outpatients. Methods: We analyzed 1186 positive urine cultures in 2021 from the Emergency County Hospital “Pius Brinzeu” from Timisoara, Romania. We evaluated the bacteria distribution and antibiotic resistance stratified by in and outpatients from a mixed adult population. Results: The median age was 67, with 65.7% females and 28.5% were outpatients. In inpatients, the most commonly identified bacteria was E. coli, followed by Enterococcus spp., and Klebsiella spp., while in outpatients, E. coli, Enterococcus spp., and Klebsiella spp. were the leading ones. Overall, E. coli presented the highest resistance rate to ampicillin, Enterococcus spp. to ciprofloxacin, Klebsiella spp. to cephalosporins, and Proteus spp. to trimethoprim/sulfamethoxazole. Inpatients presented higher resistance rates for E. coli to ceftazidime, cefuroxime, gentamycin, ciprofloxacin, and trimethoprim/sulfamethoxazole, Klebsiella spp. to most cephalosporin, gentamycin and levofloxacin, Proteus spp. to gentamycin and Enterococcus spp. to gentamycin and quinolones when compared to outpatients. The highest incidence of extensively drug-resistant (XDR) bacteria was among Acinetobacter baumanii, followed by Pseudomonas spp., and Serratia spp. Conclusions: susceptibility. Bacteria identified in inpatients’ positive urine cultures present higher resistance rates to several antibiotics. Our study could be a foundation for a local or even national guideline for the antibiotic treatment of urinary tract infections. Full article

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13 pages, 885 KiB

Open AccessArticle

The Severity of Carotid Calcifications, but Not Fibroblast Growth Factor 23, Is Associated with Mortality in Hemodialysis: A Single Center Experience

by Diana Moldovan

Diseases 2025, 13(3), 73; https://doi.org/10.3390/diseases13030073 - 28 Feb 2025

Viewed by 350

Abstract

Background. The study goal was to assess the mortality effect of carotid vascular calcifications (VC), of fibroblast growth factor 23 (FGF-23), mineral markers, and comorbidities in hemodialysis (HD) patients. Methods. The influence of carotid VC severity, FGF-23, laboratory markers, clinical features, and comorbidities [...] Read more.

Background. The study goal was to assess the mortality effect of carotid vascular calcifications (VC), of fibroblast growth factor 23 (FGF-23), mineral markers, and comorbidities in hemodialysis (HD) patients. Methods. The influence of carotid VC severity, FGF-23, laboratory markers, clinical features, and comorbidities on mortality was analyzed in a cohort of 88 HD patients. The follow-up period lasted 8 years. The cut-off value for carotid VC was 4 for all-cause and cardiovascular mortality. Results. Carotid VC, diabetes, low serum albumin, high serum C-reactive protein (CRP), and the presence of cardiovascular diseases are associated with all-cause and cardiovascular mortality. Carotid VC score over 4 was an independent predictor of all-cause and cardiovascular mortality, along with diabetes, low albumin, and high CRP. FGF-23 was not found to be predictable for the study outcomes. Conclusions. The study documented in a cohort of patients prevalent in chronic HD that carotid VC predicts all-cause and cardiovascular mortality at 8 years and improves risk stratification, but FGF-23 is not associated with mortality. Other risk factors for all-cause and cardiovascular mortality were diabetes, inflammation, and malnutrition. However, future efforts are needed to assess whether a risk-based approach, including VC screening, improves survival. Full article

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17 pages, 1699 KiB

Open AccessArticle

Optimal Timing of Colostomy Reversal Following Hartmann’s Procedure: A Retrospective Analysis of Postoperative Outcomes

by Constantin Popazu, Dragoș Voicu, Dorel Firescu, Ionica Grigore, Alexandra Toma and Răzvan Petru Derihaci

Diseases 2025, 13(3), 72; https://doi.org/10.3390/diseases13030072 - 28 Feb 2025

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Abstract

Background/Objectives: Hartmann’s procedure is commonly employed to manage complications of acute sigmoid diverticulitis, such as perforation or abscess formation. However, determining the optimal timing for colostomy reversal remains a topic of debate. This study aims to evaluate the effect of early versus [...] Read more.

Background/Objectives: Hartmann’s procedure is commonly employed to manage complications of acute sigmoid diverticulitis, such as perforation or abscess formation. However, determining the optimal timing for colostomy reversal remains a topic of debate. This study aims to evaluate the effect of early versus delayed colostomy reversal on postoperative outcomes, focusing on complications, hospital stay duration, and readmission rates. Methods: A retrospective cohort study was conducted on 148 patients who underwent Hartmann’s procedure for acute sigmoid diverticulitis at a single tertiary care center between 2014 and 2023. Participants were grouped based on the timing of colostomy reversal: early (45–120 days), intermediate (121–180 days), and late (>180 days). Data on complications, hospital stay length, and readmissions were analyzed. Results: Early reversal was associated with fewer postoperative complications, shorter hospital stays, and reduced readmissions compared to delayed reversal. The late reversal group had higher rates of complications, longer hospital stays, and a higher need for reintervention. Advanced age and comorbidities, such as cardiovascular disease and diabetes, were significant predictors of poor outcomes, contributing to delayed reversal. Logistic regression analysis indicated that late reversal was independently associated with higher complication rates. Conclusions: Early colostomy reversal within 45–120 days following Hartmann’s procedure is associated with improved postoperative outcomes, including fewer complications and a shorter hospital stay. The timing of colostomy reversal should be individualized based on patient health status, with early reversal preferred for those without significant comorbidities. Further prospective research is needed to confirm these findings and refine guidelines for optimal reversal timing. Full article

(This article belongs to the Section Gastroenterology)

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14 pages, 291 KiB

Open AccessReview

Herpes Zoster: Risk Factors for Occurrence, Complications, and Recurrence with a Focus on Immunocompromised Patients

by Michał Oleszko, Paweł Zapolnik, Wojciech Kmiecik and Hanna Czajka

Diseases 2025, 13(3), 71; https://doi.org/10.3390/diseases13030071 - 26 Feb 2025

Viewed by 1085

Abstract

Background: The varicella-zoster virus is a highly contagious human herpesvirus that primarily causes varicella (chickenpox) as an initial infection, targeting T cells, neurons, as well as skin cells, and can later reactivate to cause herpes zoster (shingles). Following reactivation, the varicella-zoster virus infection [...] Read more.

Background: The varicella-zoster virus is a highly contagious human herpesvirus that primarily causes varicella (chickenpox) as an initial infection, targeting T cells, neurons, as well as skin cells, and can later reactivate to cause herpes zoster (shingles). Following reactivation, the varicella-zoster virus infection can lead to severe complications, the most common of which is postherpetic neuralgia. Risk factors include aging, immunosuppression, chronic diseases such as diabetes, cardiovascular disorders, respiratory conditions, and others. Objective: In this article, we present an analysis of factors increasing the risk of herpes zoster occurrence, complications, and recurrences (in particular in immunocompromised patients). Full article

(This article belongs to the Special Issue Infectious Disease Epidemiology 2024)

12 pages, 833 KiB

Open AccessArticle

Quality of Life and Stress-Related Psychological Distress Among Patients with Cervical Cancer: A Cross-Sectional Analysis

by Razvan Betea, Mirabela Dima and Veronica Daniela Chiriac

Diseases 2025, 13(3), 70; https://doi.org/10.3390/diseases13030070 - 25 Feb 2025

Viewed by 520

Abstract

Background and Objectives: Cervical cancer places substantial burdens on physical and psychosocial health. This study evaluated changes in quality of life (QoL) and perceived stress in patients with cervical cancer before and six months after initiating standard treatment. Four validated instruments were used: [...] Read more.

Background and Objectives: Cervical cancer places substantial burdens on physical and psychosocial health. This study evaluated changes in quality of life (QoL) and perceived stress in patients with cervical cancer before and six months after initiating standard treatment. Four validated instruments were used: the 36-Item Short Form Survey (SF-36), the Perceived Stress Scale (PSS), the World Health Organization Quality of Life-BREF (WHOQOL-BREF), and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). Methods: Ninety-six women (mean age: 48.3 ± 7.4 years) with histologically confirmed cervical cancer were enrolled. Baseline (pre-treatment) assessments included SF-36, PSS, WHOQOL-BREF, and EORTC QLQ-C30. Follow-up was conducted six months after initiating either surgery or chemoradiation. Paired t-tests (or Wilcoxon signed-rank for non-parametric data) compared baseline and follow-up scores. Subgroup analyses were performed by disease stage (early vs. advanced) and marital status (married vs. unmarried). Results: Post-treatment assessments showed significant improvements in SF-36 physical functioning (from 61.9 ± 11.6 to 66.7 ± 12.3, p = 0.015) and mental health (from 63.4 ± 12.2 to 68.1 ± 12.4, p = 0.022). PSS scores declined from 23.2 ± 5.7 to 20.6 ± 5.5 (p = 0.001). WHOQOL-BREF physical and psychological domains increased, with physical health rising from 56.4 ± 12.0 to 60.7 ± 12.5 (p = 0.032). EORTC QLQ-C30 global health improved from 61.4 ± 13.8 to 66.3 ± 14.2 (p = 0.014). Advanced-stage patients exhibited greater absolute QoL gains yet remained below the early-stage scores. Married patients reported sharper reductions in PSS and higher final QoL scores. Conclusions: Over six months of standard cervical cancer treatment, these patients demonstrated significant QoL improvements and reduced perceived stress. While advanced-stage disease remained associated with lower post-treatment scores, these individuals benefited from notable gains compared to baseline. Marital status emerged as a protective factor. Ongoing psychosocial support may amplify these beneficial effects, warranting further longitudinal studies to optimize integrative survivorship care. Full article

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22 pages, 655 KiB

Open AccessReview

Electrolyte Imbalances and Metabolic Emergencies in Obesity: Mechanisms and Clinical Implications

by Iulia Najette Crintea, Alexandru Cristian Cindrea, Ovidiu Alexandru Mederle, Cosmin Iosif Trebuian and Romulus Timar

Diseases 2025, 13(3), 69; https://doi.org/10.3390/diseases13030069 - 24 Feb 2025

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Abstract

Electrolyte imbalances are a frequently overlooked yet critical component of obesity-related metabolic dysfunction, contributing to an increased risk of cardiovascular disease, kidney impairment, and metabolic emergencies such as diabetic ketoacidosis (DKA), hyperosmolar hyperglycemic state (HHS), and acute kidney injury (AKI). These disturbances arise [...] Read more.

Electrolyte imbalances are a frequently overlooked yet critical component of obesity-related metabolic dysfunction, contributing to an increased risk of cardiovascular disease, kidney impairment, and metabolic emergencies such as diabetic ketoacidosis (DKA), hyperosmolar hyperglycemic state (HHS), and acute kidney injury (AKI). These disturbances arise from insulin resistance, chronic inflammation, hormonal dysregulation, and renal dysfunction, leading to sodium retention, potassium depletion, and deficiencies in calcium and magnesium homeostasis. Managing electrolyte imbalances is essential in obesity management, as imbalances exacerbate hypertension, metabolic acidosis, neuromuscular complications, and insulin resistance. This review explores the pathophysiology of electrolyte disturbances in obesity and their impact on fluid balance, acid–base status, and metabolic health. Effective management strategies include individualized electrolyte monitoring, dietary sodium restriction, potassium supplementation, vitamin D and magnesium correction, and pharmacologic interventions targeting renin–angiotensin–aldosterone system (RAAS) activity and insulin resistance. Additionally, lifestyle interventions, including dietary modification, weight loss strategies, and hydration optimization, play a key role in preventing metabolic complications. Future research should investigate the long-term impact of electrolyte imbalances in obesity, the role of emerging therapies, and how lifestyle interventions can optimize electrolyte homeostasis and metabolic outcomes. A personalized, multidisciplinary approach integrating endocrinology, nephrology, and clinical nutrition is essential to improving the prevention and management of electrolyte imbalances in obese individuals. Full article

(This article belongs to the Special Issue Body Composition, Energy Expenditure and Lifestyle During Obesity Management)

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16 pages, 1269 KiB

Open AccessArticle

Healthcare Resource Utilization and Economic Outcomes of RSV-Hospitalized Patients Aged ≥ 60 Years: A Retrospective Cohort Study

by Anna Puggina, Melania Dovizio, Alexander Domnich, Alen Marijam, Chiara Veronesi, Caterina Rizzo, Marta Vicentini, Luca Degli Esposti, Giovanna Elisa Calabrò and Maria João Fonseca

Diseases 2025, 13(3), 68; https://doi.org/10.3390/diseases13030068 - 21 Feb 2025

Cited by 1 | Viewed by 513

Abstract

Background/Objectives The economic impact of respiratory syncytial virus (RSV) in Italy is not well defined. This analysis assessed the economic outcomes of RSV-hospitalized patients aged ≥ 60 years in Italy. Methods: Healthcare resource utilization and direct healthcare costs during the first RSV hospitalization [...] Read more.

Background/Objectives The economic impact of respiratory syncytial virus (RSV) in Italy is not well defined. This analysis assessed the economic outcomes of RSV-hospitalized patients aged ≥ 60 years in Italy. Methods: Healthcare resource utilization and direct healthcare costs during the first RSV hospitalization and 12-month follow-up were collected from Italian administrative databases. A propensity-score-matched (PSM) analysis was performed between patients hospitalized for RSV and those hospitalized for any cause (without an RSV diagnosis). Results: Among 201 patients, an average of 1.95 hospitalizations, 19.38 prescriptions, and 7.11 outpatient services were reported during the first RSV hospitalization and the following 12 months. The mean direct healthcare costs were EUR 11,599 (related to hospitalization [79%], prescriptions [16%], and outpatient services [5%]). Following PSM analyses, direct healthcare costs were 15% higher for RSV-hospitalized patients versus those hospitalized for any cause (EUR 9369 versus EUR 8173; p < 0.05), driven by differences in hospitalizations (EUR 7477 versus EUR 6327; p < 0.05) and intensive care unit admissions (EUR 818 versus EUR 178; p = 0.001). Conclusions: Despite a limited sample size, this study reports a substantial economic burden associated with RSV-hospitalized patients aged ≥ 60 years in Italy. The results provide important evidence to inform preventative RSV strategies to reduce the economic burden on the Italian National Health Service. Full article

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Graphical abstract

30 pages, 10079 KiB

Open AccessSystematic Review

SGLT2 Inhibitors in COVID-19: Umbrella Review, Meta-Analysis, and Bayesian Sensitivity Assessment

by Vinay Suresh, Muhammad Aaqib Shamim, Victor Ghosh, Tirth Dave, Malavika Jayan, Amogh Verma, Vivek Sanker, Priyanka Roy and Mainak Bardhan

Diseases 2025, 13(3), 67; https://doi.org/10.3390/diseases13030067 - 21 Feb 2025

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Abstract

Background: Several studies have reported a reduced risk of COVID-19-related mortality in patients taking antidiabetic medications. This is an umbrella review, meta-analysis, and Bayesian sensitivity assessment of SGLT2 inhibitors (SGLT2is) in COVID-19 patients with type 2 diabetes mellitus (T2DM). Methods: A search was [...] Read more.

Background: Several studies have reported a reduced risk of COVID-19-related mortality in patients taking antidiabetic medications. This is an umbrella review, meta-analysis, and Bayesian sensitivity assessment of SGLT2 inhibitors (SGLT2is) in COVID-19 patients with type 2 diabetes mellitus (T2DM). Methods: A search was conducted on the MEDLINE (PubMed), EMBASE, Cochrane, and ClinicalTrials.gov databases on 5/12/2023. We performed an umbrella review of systematic reviews and meta-analyses on the effects of SGLT2is in T2DM patients with COVID-19 and critically appraised them using AMSTAR 2.0. Trials investigating SGLT2i use in COVID-19 patients post-hospitalisation and observational studies on prior SGLT2i use among COVID-19 patients were included in the meta-analysis, adhering to the PRISMA guidelines. Results: SGLT2is exhibited significantly lower odds of mortality (OR 0.67, 95% CI 0.53–0.84) and hospitalisation (OR 0.84, 0.75–0.94) in COVID-19 patients with T2DM. Bayesian sensitivity analyses corroborated most of the findings, with differences observed in hospitalisation and mortality outcomes. SGLT-2 inhibitors showed an OR of 1.20 (95% CI 0.64–2.27) for diabetic ketoacidosis. Publication bias was observed for hospitalisation, but not for mortality. The GRADE assessment indicated a low to very low quality of evidence because of the observational studies included. Conclusions: The prophylactic use of SGLT2is reduces mortality and hospitalisation among COVID-19 patients, particularly in patients with diabetes. The utility of SGLT2is after hospitalisation is uncertain and warrants further investigation. A limited efficacy has been observed under critical conditions. Individualised assessment is crucial before integration into COVID-19 management. Full article

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11 pages, 462 KiB

Open AccessArticle

Demographic, Premorbid, and Clinical Characteristics of Schizophrenia Spectrum Patients with High and Low Polygenic Liability to the Disorder

by Margarita Alfimova, Marina Gabaeva, Tatyana Lezheiko, Victoria Plakunova, Yulia Chaika and Vera Golimbet

Diseases 2025, 13(3), 66; https://doi.org/10.3390/diseases13030066 - 21 Feb 2025

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Abstract

Background/Objectives: Schizophrenia is a clinically heterogeneous complex disorder with a substantial polygenic basis. The discovery of phenotypes indexing genetic differences advances research into the schizophrenia etiology but has proven to be challenging. The study aimed to further clarify the relationships of schizophrenia polygenic [...] Read more.

Background/Objectives: Schizophrenia is a clinically heterogeneous complex disorder with a substantial polygenic basis. The discovery of phenotypes indexing genetic differences advances research into the schizophrenia etiology but has proven to be challenging. The study aimed to further clarify the relationships of schizophrenia polygenic risk scores (SZ-PRSs) with a comprehensive array of schizophrenia antecedents and presentations using a culturally and ethnically homogeneous sample of schizophrenia spectrum patients. Methods: The top and bottom deciles (n = 172) of the SZ-PRS distribution in a group of 861 patients were compared on information derived from medical records using logistic regression. Results: High SZ-PRSs were associated with female sex, family history of a wide range of neuropsychiatric conditions, moderately poor premorbid social and cognitive adjustment in childhood, the schizophrenia diagnosis, and positive and “abnormal” psychomotor symptoms. The low-SZ-PRS group demonstrated an accumulation of both individuals with milder forms of SZ spectrum disorders and those with severe premorbid abnormalities in the social, cognitive, and neurological domains. Conclusions: The results highlight moderately poor premorbid social and cognitive adjustment as characteristic manifestations of the polygenic component of the schizophrenia etiology and provide the first piece of PRS-based evidence for the long-standing idea of a higher liability threshold in women. The presence of milder and severe cases in the bottom SZ-PRS decile, suggesting its etiological heterogeneity, might be an important source of the inconsistency in the previous research on SZ-PRSs’ relationship with schizophrenia phenotypes and should be considered in future studies. Full article

(This article belongs to the Section Neuro-psychiatric Disorders)

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1 pages, 121 KiB

Open AccessExpression of Concern

Expression of Concern: Gasser et al. Testosterone/Epitestosterone Ratios—Further Hints to Explain Hyperandrogenemia in Children with Autism. Diseases 2021, 9, 13

by Diseases Editorial Office

Diseases 2025, 13(3), 65; https://doi.org/10.3390/diseases13030065 - 21 Feb 2025

Viewed by 240

Abstract

With this notice, the Diseases Editorial Office states their awareness of the concerns regarding potential scientific errors and an authorship dispute relating to this publication [...] Full article

10 pages, 1578 KiB

Open AccessArticle

Examination of Respiratory Disturbance Index Before and After Cheiloplasty and Palatoplasty

by Ryo Murasugi, Hitoshi Kawanabe, Ayano Murakami, Yasuhiko Fukuya, Hideto Imura, Nagato Natsume, Ken Sato, Seiko Mitachi and Kazunori Fukui

Diseases 2025, 13(3), 64; https://doi.org/10.3390/diseases13030064 - 21 Feb 2025

Viewed by 358

Abstract

Background/Objectives: Pediatric sleep-disordered breathing (SDB) can cause behavioral and cognitive problems and even physical growth impairment, but it is often under-recognized. Cleft lip and/or palate (CLP) is a common birth defect and known risk factor for SDB. In this study, we examined the [...] Read more.

Background/Objectives: Pediatric sleep-disordered breathing (SDB) can cause behavioral and cognitive problems and even physical growth impairment, but it is often under-recognized. Cleft lip and/or palate (CLP) is a common birth defect and known risk factor for SDB. In this study, we examined the sleep breathing status in infants with unilateral CLP (UCLP) before and after cheiloplasty and palatoplasty. Methods: This prospective before–after study included infants with UCLP who could undergo the sleep breathing test and sleep for >1 h. Their sleep breathing status was assessed using a fiber-based sleep apnea sensor (Fiber-Based Sleep Apnea Syndrome Sensor^®) on the day before surgery and 1–3 d after surgery. We calculated and compared the pre- and postoperative respiratory disturbance index (RDI) following the criteria proposed by the American Academy of Sleep Medicine. Results: The mean RDI significantly improved both after cheiloplasty (from 7.5 ± 4.6 to 2.7 ± 1.4 events/h, p = 0.007) and after palatoplasty (from 4.4 ± 2.3 to 1.7 ± 0.4 events/h, p = 0.010). Conclusions: Cheiloplasty and palatoplasty could improve SDB and reduce its adverse effects on the physical growth and development of infants with UCLP. Full article

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12 pages, 4256 KiB

Open AccessArticle

Is Global Limb Anatomic Staging System Classification a Useful Tool in Predicting Lower Limb Revascularization Procedures’ Success?

by Andreea Luciana Rata, Nawaf Al Khazaleh, Sergiu Sirca, Cătălin Alexandru Pîrvu, Alexandru Furdui, Elena Rizea and Sorin Barac

Diseases 2025, 13(3), 63; https://doi.org/10.3390/diseases13030063 - 20 Feb 2025

Viewed by 317

Abstract

Background. GLASS (Global Limb Anatomic Staging System) classification is a classification proposed in 2019 by The Lower Extremity Guidelines Committee of the Society for Vascular Surgery, which aims to identify the anatomic substrate that defines the severity of a lower extremity arterial injury [...] Read more.

Background. GLASS (Global Limb Anatomic Staging System) classification is a classification proposed in 2019 by The Lower Extremity Guidelines Committee of the Society for Vascular Surgery, which aims to identify the anatomic substrate that defines the severity of a lower extremity arterial injury and predict the success rate of possible revascularization. The aim of the study is to demonstrate the usefulness of this classification and if it is a reliable tool in predicting the success of the revascularization procedures for patients with chronic limb-threatening ischemia (CLTI). Methods. A retrospective study was conducted on patients undergoing revascularization for CLTI. Glass staging was applied to angiographic data, categorizing them into GLASS 1, 2, or 3 based on the complexity of the femoropopliteal and infrapopliteal lesions. We investigated the clinical characteristics and types of endovascular treatment in correlation with GLASS classification. We also evaluated the technical success of revascularization procedures and the specificity and accuracy of the GLASS classification. Results. After the first testing, we found out that GLASS classification has a sensitivity of 63% and a specificity of 77%. After the second testing, the sensitivity was 82%. of 77% also. The follow-up of this sample was made after 1 year, with no patients lost to follow-up and with an amputation-free survival of 81.3%. Conclusions. GLASS 1 and 2 patients had significantly higher rates of success compared to GLASS 3. GLASS serves as a valuable tool in predicting revascularization success and provides a standardized approach to anatomical complexity, but further studies should integrate more data in order to enhance its predictive capability. Full article

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Diseases, Volume 13, Issue 3 (March 2025) – 27 articles

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