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Diseases, Volume 13, Issue 6 (June 2025) – 26 articles

Cover Story (view full-size image): Puerperal mastitis is a common and often painful condition affecting women during breastfeeding. This study highlights the potential role of targeted microbiota therapy in the prevention and management of mastitis, offering an overview of how specific probiotic strains might modulate the mammary microbiota and support immune balance. By addressing dysbiosis, this approach could pave the way for an innovative, non-invasive strategy to improve maternal health during the postpartum period. View this paper
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19 pages, 585 KiB  
Article
Atherogenic Risk in Shift Versus Non-Shift Workers: Associations with Sociodemographic and Lifestyle Factors
by Javier Tosoratto, Pedro Juan Tárraga López, Ángel Arturo López-González, Hernán Paublini Oliveira, Carla Busquets-Cortés and José Ignacio Ramirez-Manent
Diseases 2025, 13(6), 188; https://doi.org/10.3390/diseases13060188 - 18 Jun 2025
Viewed by 932
Abstract
Introduction. Atherosclerosis is the histopathological lesion underlying most cardiovascular diseases. Several scales assess the risk of developing atherosclerosis, with the most recognized being atherogenic dyslipidemia (AD) and atherogenic indices (AIs). The aim of this study is to assess the associations between shift work, [...] Read more.
Introduction. Atherosclerosis is the histopathological lesion underlying most cardiovascular diseases. Several scales assess the risk of developing atherosclerosis, with the most recognized being atherogenic dyslipidemia (AD) and atherogenic indices (AIs). The aim of this study is to assess the associations between shift work, sociodemographic variables, and lifestyle with atherogenic risk, as determined by atherogenic indices, atherogenic dyslipidemia, and the lipid triad. Material and Methods. This is a descriptive, cross-sectional study involving 53,053 workers (28,808 shift workers and 24,245 non-shift workers) from various autonomous communities in Spain and multiple occupational sectors. The association between sociodemographic variables such as age, sex, and socioeconomic status, health habits including tobacco and alcohol consumption, physical activity (PA), adherence to the Mediterranean diet (MD), and shift work with the presence of AD and high values of three AIs (Cholesterol/HDL-c, LDL-c/HDL-c, and Triglycerides/HDL-c) were assessed. Results. All variables analyzed were associated with AD and AIs values. Among the variables, the strongest associations were observed for physical activity, with odds ratios (ORs) ranging from 7.70 (95% CI: 6.86–8.55) for high LDL-c/HDL-c to 14.10 (95% CI: 9.05–14.16) for AD; adherence to the Mediterranean diet, with ORs ranging from 1.98 (95% CI: 1.60–2.37) for high LDL-c/HDL-c to 5.89 (95% CI: 4.92–6.86) for AD; and age, with ORs of 2.11 (95% CI: 1.84–2.38) for high Triglycerides/HDL-c and 4.66 (95% CI: 4.04–5.28) for high Total Cholesterol/HDL-c. Conclusions. The profile of a worker with the highest atherogenic risk in our study is a male, older in age, with low socioeconomic status, a smoker, a habitual alcohol consumer, physically inactive, with low adherence to the Mediterranean diet, and engaged in shift work. Full article
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10 pages, 465 KiB  
Article
Single-Port Laparoscopic Hepatectomy: Slovenian Single-Center Experience
by Jerica Novak, Miha Petrič, Blaž Trotovšek and Mihajlo Đokić
Diseases 2025, 13(6), 187; https://doi.org/10.3390/diseases13060187 - 18 Jun 2025
Viewed by 420
Abstract
Background: Single-port laparoscopic hepatectomy is a minimally invasive modality for the treatment of benign and malignant liver lesions. Due to the method’s technical challenges, it is suitable for experienced hepatobiliary surgeons and selected groups of patients. The aim of this study was to [...] Read more.
Background: Single-port laparoscopic hepatectomy is a minimally invasive modality for the treatment of benign and malignant liver lesions. Due to the method’s technical challenges, it is suitable for experienced hepatobiliary surgeons and selected groups of patients. The aim of this study was to evaluate the results of a single Slovenian center performing single-port laparoscopic hepatectomy with a literature overview. Methods: A single-center retrospective consecutive case series of the twenty-six patients with liver disease operated with the single-port technique from January 2018 to July 2024 at the Department of Abdominal Surgery at the University Medical Centre, Ljubljana, was performed. Lesions were located in easy-to-treat segments. Operative time, conversion rate, length of hospital stay, and surgical complications were recorded and evaluated. Results: We performed twenty-six single-port laparoscopic liver resections (median age 63.5, range 31 to 79 years). The mean operative time was 92 ± 31 min. None of the cases were converted to multi-port laparoscopic or open surgery. Safe resection margins were obtained in cases of malignant disease. The mean hospital stay was 4 days. The post-operative complication rate involving intervention was 7% (2/26). The incisional hernia rate was 11.5% (3/26). No life-threatening surgical complications or morbidity were noted. Conclusions: Single-port laparoscopic hepatectomy is a safe and feasible technique for the resection of benign and malignant liver lesions in the hands of skilled and well-trained hepatobiliary surgeons. Full article
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17 pages, 647 KiB  
Systematic Review
The Impact of Preventive Protocols on Oral Health Outcomes in Cancer Patients Undergoing Chemotherapy or Radiotherapy: A Systematic Review and Meta-Analysis
by Carol Moussa, Laurent Estrade, Jeremy Glomet, Gael Y. Rochefort, Frédéric Denis and Maha H. Daou
Diseases 2025, 13(6), 186; https://doi.org/10.3390/diseases13060186 - 16 Jun 2025
Viewed by 414
Abstract
Background/Objectives: Cancer patients undergoing chemotherapy (CT) or radiotherapy (RT) are at increased risk of oral complications. Preventive dental care has been proposed to mitigate these risks, yet its effectiveness is not sufficiently evaluated. This systematic review and meta-analysis aimed to assess the [...] Read more.
Background/Objectives: Cancer patients undergoing chemotherapy (CT) or radiotherapy (RT) are at increased risk of oral complications. Preventive dental care has been proposed to mitigate these risks, yet its effectiveness is not sufficiently evaluated. This systematic review and meta-analysis aimed to assess the impact of preventive oral health interventions on key clinical outcomes in oncology patients. Methods: A systematic search of MEDLINE, Embase, and CENTRAL databases was conducted (March 2025), adhering to PRISMA guidelines with a PROSPERO-registered protocol (CRD 420251006799). Eligible studies included randomized trials, cohort studies, and pre–post intervention studies evaluating preventive dental care in patients receiving CT or RT. The outcomes included gingival index (GI), dental caries (DMFT), plaque levels, and periodontal health. Meta-analyses were performed on GI and DMFT outcomes using random-effects models. Results: Eleven studies were included in the qualitative synthesis and four in the meta-analyses. Preventive interventions, such as fluoride applications, oral hygiene education, and regular professional cleanings, were associated with stabilization or improvement of gingival health. The pooled estimate for GI showed no significant deterioration over time (MD = −0.05, 95% CI: −0.34 to 0.24, p = 0.72). For DMFT, a slight but significant increase was observed (MD = 1.07, 95% CI: 0.08 to 2.05, p = 0.03), suggesting a continued risk of caries despite intervention. Conclusions: Preventive dental care interventions appear to support the maintenance of gingival health in cancer patients undergoing CT or RT. However, despite these interventions, a slight increase in dental caries was still observed, indicating that preventive strategies may not fully eliminate the risk of caries. These findings highlight the importance of sustained and individualized oral health programs as part of comprehensive oncology care. Future studies using standardized protocols and longer follow-up periods are needed to better evaluate their long-term effectiveness across diverse cancer populations. Full article
(This article belongs to the Special Issue Oral Health and Care)
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17 pages, 793 KiB  
Review
Tumor Necrosis Factor-Alpha’s Role in the Pathophysiology of Colon Cancer
by Saleha Khan, Yara Aldawood, Ayesha Hanin Shaikh, Aleena Zobairi, Urwa Nabilah, H. M. Alqahtani and Mansoor-Ali Vaali-Mohammed
Diseases 2025, 13(6), 185; https://doi.org/10.3390/diseases13060185 - 15 Jun 2025
Viewed by 733
Abstract
Colon cancer remains a significant global health challenge, with inflammatory pathways such as TNF-α playing a central role in its progression. TNF-α, a key proinflammatory cytokine, is implicated in various stages of colon cancer development, including inflammation, tumor growth, and metastasis. This review [...] Read more.
Colon cancer remains a significant global health challenge, with inflammatory pathways such as TNF-α playing a central role in its progression. TNF-α, a key proinflammatory cytokine, is implicated in various stages of colon cancer development, including inflammation, tumor growth, and metastasis. This review provides a comprehensive overview of the molecular mechanisms through which TNF-α contributes to colon cancer progression, with a focus on its interaction with signaling pathways like NF-κB and the Wnt/β-catenin in humans. TNF-α’s involvement in promoting tumorigenesis and its complex role in the tumor microenvironment highlight its potential as both a therapeutic target and a challenge for effective treatment. This review explores the potential of anti-TNF-α therapies and the emerging role of combination strategies with immune checkpoint inhibitors. Despite promising preclinical findings, clinical application faces challenges due to the dual role of TNF-α in both promoting and inhibiting tumor progression. Future research should aim to overcome resistance mechanisms, develop personalized therapeutic strategies, and balance the effects of TNF-α in cancer therapy. Full article
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24 pages, 1677 KiB  
Review
Integration of AI and ML in Tuberculosis (TB) Management: From Diagnosis to Drug Discovery
by Sameeullah Memon, Shabana Bibi and Guozhong He
Diseases 2025, 13(6), 184; https://doi.org/10.3390/diseases13060184 - 11 Jun 2025
Viewed by 1218
Abstract
Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis. Despite the improvements in diagnostic techniques, the accuracy of TB diagnosis is still low. In recent years, the development of artificial intelligence (AI) has opened up new possibilities in diagnosing and treating TB [...] Read more.
Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis. Despite the improvements in diagnostic techniques, the accuracy of TB diagnosis is still low. In recent years, the development of artificial intelligence (AI) has opened up new possibilities in diagnosing and treating TB with high accuracy compared to traditional methods. Traditional diagnostic techniques, such as sputum smear microscopy, culture tests, and chest X-rays, are time-consuming, with less sensitivity for the detection of TB in patients. Due to the new developments in AI, advanced diagnostic and treatment techniques have been developed with high accessibility, speed, and accuracy. AI, including various specific methodologies, is becoming vital in managing TB. Machine learning (ML) methodologies, such as support vector machines (SVMs) and random forests (RF), alongside deep learning (DL) technologies, particularly convolutional neural networks (CNNs) for image analysis, are employed to analyze diverse patient data, including medical images and biomarkers, to enhance the accuracy and speed of tuberculosis diagnosis. This study summarized the benefits and drawbacks of both traditional and AI-driven TB diagnosis, highlighting how AI can support traditional techniques to increase early detection, lower misdiagnosis, and strengthen international TB control initiatives. Full article
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26 pages, 1018 KiB  
Review
Supporting Post-ICU Recovery: A Narrative Review for General Practitioners
by Charikleia S. Vrettou and Athina G. Mantelou
Diseases 2025, 13(6), 183; https://doi.org/10.3390/diseases13060183 - 11 Jun 2025
Viewed by 647
Abstract
Survivors of intensive care unit (ICU) hospitalization often face persistent health challenges after discharge, collectively referred to as post-intensive care syndrome (PICS). This condition affects physical, cognitive, and mental health, significantly impacting patients’ quality of life and increasing their healthcare utilization. Additionally, caregivers [...] Read more.
Survivors of intensive care unit (ICU) hospitalization often face persistent health challenges after discharge, collectively referred to as post-intensive care syndrome (PICS). This condition affects physical, cognitive, and mental health, significantly impacting patients’ quality of life and increasing their healthcare utilization. Additionally, caregivers may develop PICS-F (PICS family), experiencing stress-related health burdens. Despite the growing awareness of these issues, structured post-ICU follow-up remains inconsistent, leaving a gap in care that general practitioners (GPs) must often fill. This review examines the role of GPs in managing post-ICU patients, outlining common complications, screening tools, rehabilitation strategies, and potential areas for improved collaboration between primary care and ICU teams. Emphasizing a multidisciplinary and proactive approach, we propose practical interventions that GPs can adopt to enhance long-term recovery outcomes for ICU survivors. Full article
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16 pages, 2864 KiB  
Article
Immune Response and Serum Biomarker Screening in Pregnant Women with Influenza A Virus Infection: Insight into Susceptibility and Disease Severity
by Suping Zhang, Jiarun Jiang, Rui Wang, Yuanyuan Zhang, Jinghui Sun, Wanting Hong, Likai Qi, Jia Zang, Zeyi Liu, Yu Xia, Haibing Yang and Liling Chen
Diseases 2025, 13(6), 182; https://doi.org/10.3390/diseases13060182 - 10 Jun 2025
Viewed by 390
Abstract
Background: Seasonal influenza infection poses substantial risks to pregnant women, yet the immunological mechanisms underlying their heightened disease susceptibility remain incompletely characterized. Methods: This study employed multiparametric immunophenotyping and metabolic profiling to investigate cellular immunity, cytokine dynamics, and serum biomarkers in pregnant women [...] Read more.
Background: Seasonal influenza infection poses substantial risks to pregnant women, yet the immunological mechanisms underlying their heightened disease susceptibility remain incompletely characterized. Methods: This study employed multiparametric immunophenotyping and metabolic profiling to investigate cellular immunity, cytokine dynamics, and serum biomarkers in pregnant women infected with H3N2 across gestational stages. Through integrated flow cytometric analysis of peripheral blood mononuclear cells (PBMCs), multiple cytokine quantification, and LC-MS-based serum metabolomics, we compared immunological parameters, serum cytokines, and metabolites across trimesters in pregnant women infected and not infected with H3N2. Results: The results revealed reduced CD4+/CD8+ T cell ratios, a diminished CD27+ memory B cell population in pregnant women infected with H3N2, and elevated NK cells and Th2-skewed cytokines (IL-4, IL-6, IL-10) in severe influenza cases. Metabolomic profiling identified the dysregulation of the tryptophan–kynurenine (Trp–Kyn) pathway, with a 15-fold increase in the Kyn/Trp ratio in severe influenza compared to a normal pregnancy as a potential biomarker. Conclusions: These results elucidate synergistic pathophysiological axes-immune dysregulation and tryptophan metabolism alteration that potentially drive adverse outcomes. The identified biomarker panel (CD4/CD8 ratio, IL-6, Kyn/Trp ratio) shows potential clinical promise for early risk stratification in high-risk pregnancies with influenza infection. Full article
(This article belongs to the Section Infectious Disease)
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13 pages, 624 KiB  
Article
A Potential Oncoprotective Role of Cytomegalovirus Against Breast Cancer: Worldwide Correlation and Survey of Evidence
by Marko Jankovic, Sofija Glumac, Aleksandra Knezevic, Ana Tomic, Danijela Miljanovic, Jovana Cupic, Ana Banko, Djurdjina Kablar, Ivana Celic, Sara Urosevic and Ivana Lazarevic
Diseases 2025, 13(6), 181; https://doi.org/10.3390/diseases13060181 - 9 Jun 2025
Viewed by 403
Abstract
Introduction: While not considered a genuine tumorigenic pathogen, the human cytomegalovirus (CMV) has been associated with a wide assortment of malignancies, including breast cancer (BC). In recent years, increasing evidence has been detailing the potential anti-oncogenic capabilities of CMV. Works in the literature [...] Read more.
Introduction: While not considered a genuine tumorigenic pathogen, the human cytomegalovirus (CMV) has been associated with a wide assortment of malignancies, including breast cancer (BC). In recent years, increasing evidence has been detailing the potential anti-oncogenic capabilities of CMV. Works in the literature addressing the issue are scarce, and a global approach elucidating the role of CMV in breast cancer is lacking. Aim: We inquired into the association between CMV and BC on a global level and surveyed the related literature. Material and Methods: Virus–tumor interaction was examined by correlating country-specific CMV seroprevalence and the age-standardized BC incidence rates for 73 countries, as provided by the International Agency for Research on Cancer (IARC). Statistical analysis was conducted using Spearman’s correlation, along with univariate and multivariate linear regression analysis. The literature review included works available in the PubMed® database until and including February 2025. Results: The worldwide incidence of BC correlated strongly and inversely with CMV prevalence the world over (p < 0.001, Spearman ρ = −0.553). This association was upheld after univariate and multivariate linear regression, extending to other tumors such as skin melanoma and kidney cancer (p < 0.001). Conclusions: In this study, we draw attention to a previously unexplored global inverse relationship between the prevalence of CMV and the incidence of BC, which suggests a potential oncoprotective role for this pathogen. Although the association itself does not imply causality, these data provide an intriguing possibility of observing CMV as a tentative factor of protection against this malignancy. Full article
(This article belongs to the Section Oncology)
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23 pages, 2935 KiB  
Review
Germline Non-CDKN2A Variants in Melanoma and Associated Hereditary Cancer Syndromes
by Chiara Anna Fiasconaro, Alice Carbone, Silvia Giordano, Francesco Cavallo, Paolo Fava, Barbara Pasini, Yuliya Yakymiv, Sara Marchisio, Pietro Quaglino, Simone Ribero and Gabriele Roccuzzo
Diseases 2025, 13(6), 180; https://doi.org/10.3390/diseases13060180 - 9 Jun 2025
Viewed by 417
Abstract
The etiology of melanoma is multifactorial and arises from the interplay of genetic, phenotypic, and environmental factors. The genetic predisposition to melanoma is influenced by a complex interaction among genes exhibiting varying levels of penetrance (high, moderate, and low), each contributing differently to [...] Read more.
The etiology of melanoma is multifactorial and arises from the interplay of genetic, phenotypic, and environmental factors. The genetic predisposition to melanoma is influenced by a complex interaction among genes exhibiting varying levels of penetrance (high, moderate, and low), each contributing differently to the susceptibility of the disease. Furthermore, penetrance may vary based on the incidence of melanoma across diverse populations and geographical regions. Advances in genetic sequencing technologies have facilitated the identification of novel genes potentially associated with melanoma, as well as the characterization of relevant germline variants. While the most extensively researched variant is CDKN2A, recent studies have highlighted other variants unrelated to CDKN2A as significant areas of investigation. Among them, high-penetrance genes encompass CDK4, BAP1, POT1, TERT, ACD, and TERF2IP. In contrast, moderate-penetrance genes include MC1R, MITF, and SLC45A2, while low-penetrance genes consist of OCA2, TYRP1, and TYR. In addition to elevating the risk of melanoma, these genetic alterations may also predispose individuals to internal neoplasms. This review aims to provide a comprehensive overview of the definitions of sporadic, multiple primary, familial, and hereditary melanoma, with a particular emphasis on non-CDKN2A germline variants and their dermoscopic and phenotypic features. Full article
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16 pages, 1037 KiB  
Review
Renal Resistive Index from Renal Hemodynamics to Cardiovascular Risk: Diagnostic, Prognostic, and Therapeutic Implications
by Giulio Geraci, Pietro Ferrara, Luigi La Via, Alessandra Sorce, Vincenzo Calabrese, Giuseppe Cuttone, Valentina Paternò, Francesco Pallotti, Gianluca Sambataro, Luca Zanoli, Jacob George, Riccardo Polosa, Giuseppe Mulè and Caterina Carollo
Diseases 2025, 13(6), 178; https://doi.org/10.3390/diseases13060178 - 9 Jun 2025
Viewed by 529
Abstract
Duplex-Doppler ultrasonography has become an essential tool in the diagnosis and management of kidney diseases, allowing clinicians to assess renal hemodynamics, detect vascular abnormalities, and monitor disease progression. Among the various Doppler-derived parameters, the renal resistive index (RRI) has gained particular attention both [...] Read more.
Duplex-Doppler ultrasonography has become an essential tool in the diagnosis and management of kidney diseases, allowing clinicians to assess renal hemodynamics, detect vascular abnormalities, and monitor disease progression. Among the various Doppler-derived parameters, the renal resistive index (RRI) has gained particular attention both as a diagnostic tool and a prognostic marker in nephrology. Traditionally considered an indicator of parenchymal perfusion, recent evidence highlights its strong association with systemic hemodynamic factors, particularly arterial stiffness, positioning RRI as a valuable tool for evaluating patients with systemic vascular impairment, such as hypertension, diabetes mellitus, and atherosclerosis. RRI has been strongly linked to vascular damage, which in turn is influenced by inflammation and endothelial dysfunction, making it a reliable marker of cardiovascular damage and a potential predictor of cardiovascular risk. Furthermore, emerging studies suggest that RRI could serve as a dynamic parameter to monitor vascular changes induced by therapeutic interventions. This narrative review summarizes the classic and evolving applications of RRI, from its origin as a renal hemodynamic marker to its emerging role as a systemic vascular biomarker with diagnostic and prognostic significance in cardiovascular and metabolic diseases. Full article
(This article belongs to the Section Cardiology)
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24 pages, 486 KiB  
Review
Sex Differences in Immune Responses to Infectious Diseases: The Role of Genetics, Hormones, and Aging
by Pierluigi Rio, Mario Caldarelli, Edoardo Miccoli, Giulia Guazzarotti, Antonio Gasbarrini, Giovanni Gambassi and Rossella Cianci
Diseases 2025, 13(6), 179; https://doi.org/10.3390/diseases13060179 - 7 Jun 2025
Viewed by 1208
Abstract
In recent years, gender medicine has emerged as a field of research analyzing sex-related differences in health and disease. Biological sex, depending on sex chromosome complement, sex steroid hormones, and reproductive organs, has been demonstrated to influence human susceptibility to infections, immune responses [...] Read more.
In recent years, gender medicine has emerged as a field of research analyzing sex-related differences in health and disease. Biological sex, depending on sex chromosome complement, sex steroid hormones, and reproductive organs, has been demonstrated to influence human susceptibility to infections, immune responses against pathogens, the clinical severity of infectious diseases, and responses to the available treatments. Men and women differ in their chromosome set, with men having one X chromosome (XY) and women two (XX). This different genetic composition results in a sex-dimorphic expression of genes and pathways involved in immune regulation, as well as in shaping immune responses to infectious agents. Moreover, estrogen, progesterone, and testosterone, impacting cells and pathways involved in both innate and adaptive immunity, have been shown to drive sex dimorphism in infectious diseases. This narrative review aims to explore the sex-related differences in responses to infections, specifically focusing on the underlying genetic and hormonal mechanisms. Hence, aging-related changes in the immune system and their potential impact on immune responses against pathogens will be discussed. Understanding sex differences and stratifying the population according to them will open the door to precision medicine and personalized patient care. Full article
(This article belongs to the Section Infectious Disease)
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13 pages, 277 KiB  
Systematic Review
Evaluation of Prognostic Factors in Myxoid Liposarcoma Treated with Combined Neoadjuvant Radiotherapy and Surgical Excision: Systematic Review
by Giuseppe Francesco Papalia, Giulia De Marco, Claudia Luciano, Luisana Sisca, Pasquale Farsetti, Bruno Vincenzi and Rocco Papalia
Diseases 2025, 13(6), 177; https://doi.org/10.3390/diseases13060177 - 6 Jun 2025
Viewed by 361
Abstract
Purpose: Myxoid liposarcoma (MLPS) is a malignant tumor that occurs predominantly in the deep soft tissues of the extremities. Preoperative radiotherapy (RT) is used to reduce tumor volume to achieve adequate surgical margins. This systematic review aims to evaluate the impact of preoperative [...] Read more.
Purpose: Myxoid liposarcoma (MLPS) is a malignant tumor that occurs predominantly in the deep soft tissues of the extremities. Preoperative radiotherapy (RT) is used to reduce tumor volume to achieve adequate surgical margins. This systematic review aims to evaluate the impact of preoperative RT on surgical margins, local recurrence (LR) rates, metastasis development, and overall survival in patients with MLPS and associated prognostic factors. Methods: A systematic literature search was conducted by two reviewers following PRISMA guidelines on PubMed, Scopus, and the Cochrane Library on 30 November 2024. We included prospective and retrospective cohort studies published in English that evaluate surgical margin status, LR and metastasis rates, and survival outcomes in patients undergoing surgical excision of MLPS following neoadjuvant radiotherapy. Two authors extracted tumor characteristics, percentage of round cells (RCs), change in tumor volume post-RT, surgical margins, postoperative complications, LR and metastasis rates, survival rates, and related prognostic factors. Results: The twelve studies included in this review involved 1483 patients with a mean age of 44.8 years. Tumors were mostly located in the lower limbs, deeply localized, and larger than 5 cm in most cases. The average LR and metastasis rates were 5.2% and 17%, respectively. The mean 5-year and 10-year overall survival rates were 87% and 74%, respectively. Poor prognosis was associated with >5% RC components, tumors larger than 15 cm, deep localization, and inadequate surgical margins. Conclusion: The management of MLPS requires a multidisciplinary approach. Preoperative radiotherapy offers several advantages in reducing tumor volume and facilitating the achievement of adequate surgical margins, finally improving local control and long-term outcomes. Full article
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23 pages, 1011 KiB  
Review
The Role of Targeted Microbiota Therapy in the Prevention and Management of Puerperal Mastitis
by Mariarosaria Matera, Chiara Maria Palazzi, Alexander Bertuccioli, Francesco Di Pierro, Nicola Zerbinati, Massimiliano Cazzaniga, Aurora Gregoretti and Ilaria Cavecchia
Diseases 2025, 13(6), 176; https://doi.org/10.3390/diseases13060176 - 5 Jun 2025
Viewed by 672
Abstract
Mastitis, an inflammatory condition of the breast, significantly affects breastfeeding women and can lead to the early cessation of lactation. This article explores the pathophysiology of mastitis, distinguishing between acute mastitis (AM) and subacute mastitis (SAM), with a focus on the microbial dynamics [...] Read more.
Mastitis, an inflammatory condition of the breast, significantly affects breastfeeding women and can lead to the early cessation of lactation. This article explores the pathophysiology of mastitis, distinguishing between acute mastitis (AM) and subacute mastitis (SAM), with a focus on the microbial dynamics involved. AM is primarily associated with Staphylococcus aureus, while SAM is linked to a dysbiotic milk microbiota characterized by an imbalance of microbial species, including increased levels of opportunistic pathogens. The role of inflammation and the gut–breast axis in the development of mastitis are discussed, emphasizing the importance of maintaining a healthy microbiota. Recent studies highlight the potential of probiotics as a preventive and therapeutic measure against mastitis, showing promising results in reducing incidence and recurrence. However, further research is necessary to optimize probiotic strains, dosages, and treatment protocols. This review underscores the need for a comprehensive understanding of the microbiological, immunological, and inflammatory factors involved in mastitis to develop effective prevention and treatment strategies. Full article
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15 pages, 609 KiB  
Article
Association of Mitochondrial DNA Copy Number Variations with Triple-Negative Breast Cancer: A Potential Biomarker Study
by Karin Manto, Sevdican Ustun Yilmaz, Zeliha Pala Kara, Halil Kara, Fatma Tokat, Cemaliye B. Akyerli, Cihan Uras, Meltem Muftuoglu and Ugur Özbek
Diseases 2025, 13(6), 175; https://doi.org/10.3390/diseases13060175 - 1 Jun 2025
Viewed by 687
Abstract
Background/Objectives: Triple-negative breast cancer (TNBC) is a highly aggressive subtype with limited therapeutic options, and identifying reliable biomarkers for diagnosis and prognosis is crucial for improving patient outcomes. Mitochondrial DNA (mtDNA) copy number has been linked to an increased risk of developing various [...] Read more.
Background/Objectives: Triple-negative breast cancer (TNBC) is a highly aggressive subtype with limited therapeutic options, and identifying reliable biomarkers for diagnosis and prognosis is crucial for improving patient outcomes. Mitochondrial DNA (mtDNA) copy number has been linked to an increased risk of developing various types of cancer, including breast cancer. However, there is a lack of understanding regarding how mtDNA copy number variations may influence the development and progression of TNBC. Methods: This study investigated mtDNA copy number in TNBC tumors and corresponding normal breast tissues from 23 TNBC patients who received neoadjuvant chemotherapy. The relative mtDNA copy number was estimated using quantitative PCR for the NADH dehydrogenase subunit 1 (ND1) and subunit 5 (ND5) regions. Results: The results showed a significant decrease in mtDNA copy number in TNBC tumor tissues compared to corresponding normal breast tissue. However, no significant correlation was found between mtDNA content and clinical parameters such as age, tumor size, or chemotherapy response. Conclusions: These results suggest that while mtDNA content decreases in TNBC tumors, it may not directly influence these clinical characteristics. Despite some inconsistencies in the literature regarding mtDNA dynamics in cancer, this study supports the potential of mtDNA as a biomarker for TNBC. Larger cohort studies are needed to further validate these results and explore the role of mtDNA in guiding personalized treatment strategies for TNBC patients. Full article
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12 pages, 1270 KiB  
Article
The Relationship Between Non-Traumatic Fat Embolism and Fat Embolism Syndrome (FES) in Patients with Cancer
by Beáta Ágnes Borsay, Barbara Dóra Halasi, Zoltán Hendrik, Pórszász Kristóf Róbert, Katalin Károlyi, Teodóra Tóth and Péter Attila Gergely
Diseases 2025, 13(6), 174; https://doi.org/10.3390/diseases13060174 - 30 May 2025
Viewed by 559
Abstract
Background: Fat embolism and fat embolism syndrome are rare but well-known consequences of long bone fractures and orthopedic surgeries. These sources support the mechanical theory of their development. On the other hand, as an alternative pathway suggested by the biochemical theory, lipase activation [...] Read more.
Background: Fat embolism and fat embolism syndrome are rare but well-known consequences of long bone fractures and orthopedic surgeries. These sources support the mechanical theory of their development. On the other hand, as an alternative pathway suggested by the biochemical theory, lipase activation and fat breakdown are also a possible background for lipid droplets appearing in the vasculature. According to Hulman’s theory, elevated C-reactive protein levels can facilitate calcium-dependent agglutination of very low-density proteins and chylomicrons forming fat globules. The level of this acute-phase protein can increase mainly in advanced-stage cancers but also has predictive or indicative value in treatment success. Methods: This study focused on strictly selected patients with different histological types and origins of cancer, as well as advanced cancer in approximately 90% of the deceased. After collecting the tissue samples, the frozen sections were stained with Oil Red O to detect fat emboli. Results: Less than 50% of the cases showed punctiform, non-clinically relevant pulmonary fat embolism, and fat embolism syndrome was identified in none of the cases. In one, non-advanced cancer case, punctiform kidney fat embolism was observed. Conclusions: The end-of-life anergic state of patients may influence the procedure. In the case of osseous metastases, since the intramedullary sinuses are affected, both the mechanical and the biochemical backgrounds may prevail and mediate fat embolism formation. Full article
(This article belongs to the Section Oncology)
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9 pages, 505 KiB  
Article
Prevalence and Associated Factors of Latent Tuberculosis Infection Among Healthcare Workers in a Mexican Tertiary Care Hospital
by José Ángel Hernández-Mariano, Mónica Alethia Cureño-Díaz, Verónica Fernández-Sánchez, Estibeyesbo Said Plascencia-Nieto, Dulce Milagros Razo-Blanco-Hernández, Claudia Vázquez-Zamora, Víctor Hugo Gutiérrez-Muñoz, Beatriz Leal-Escobar, Erika Gómez-Zamora and Yanelly Estrella Morales-Vargas
Diseases 2025, 13(6), 173; https://doi.org/10.3390/diseases13060173 - 30 May 2025
Viewed by 734
Abstract
Background/Objectives: Healthcare workers (HCWs) are globally recognized as a high-risk group for tuberculosis (TB) infection. However, limited data exist on the prevalence of latent TB infection (LTBI) and associated occupational risk factors in the Mexican context. Identifying the burden of LTBI is essential [...] Read more.
Background/Objectives: Healthcare workers (HCWs) are globally recognized as a high-risk group for tuberculosis (TB) infection. However, limited data exist on the prevalence of latent TB infection (LTBI) and associated occupational risk factors in the Mexican context. Identifying the burden of LTBI is essential for effective prevention. This study aimed to estimate the prevalence of LTBI among HCWs in a tertiary care hospital in Mexico and to explore associated risk factors. Methods: An analytical cross-sectional study was conducted among 300 HCWs (including physicians, nurses, and stretcher-bearers) at a tertiary-level hospital in Mexico. Sociodemographic and occupational data were collected through a structured questionnaire. LTBI screening was performed using the tuberculin skin test (TST), with positive results confirmed via the QuantiFERON-TB Gold assay. Associations between relevant variables and LTBI were assessed using logistic regression models, adjusted for potential confounders. Results: The prevalence of LTBI was 16.7%. After adjusting for confounders, male HCWs had significantly higher odds of LTBI compared to females (adjusted odds ratio [aOR] = 2.02; 95% confidence interval [CI]: 1.06–3.80). Although elevated odds of LTBI were also observed among physicians, stretcher-bearers, and those with direct contact with TB patients, these associations were not statistically significant. Conclusion: LTBI represents a relevant occupational health issue among HCWs, with nearly one in six workers affected. Early detection and prevention of TB in healthcare settings are critical to protecting individual workers and public health. These findings highlight the need to strengthen occupational TB surveillance and prevention strategies in similar healthcare environments. Full article
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17 pages, 1040 KiB  
Article
The Overlapping Burdens of Fatigue and Daytime Sleepiness: Gender-Specific Impacts on Life Quality in Patients with Sleep Disorders
by Bianca Temporini, Dario Bottignole, Giulia Balella, Giorgio Ughetti, Irene Pollara, Margherita Soglia, Francesco Rausa, Ylenia Ciuro, Christian Franceschini, Marcello Giuseppe Maggio, Liborio Parrino and Carlotta Mutti
Diseases 2025, 13(6), 172; https://doi.org/10.3390/diseases13060172 - 29 May 2025
Viewed by 414
Abstract
Background: Excessive daytime sleepiness (EDS) and fatigue are two impactful symptoms, frequently associated with sleep disorders, which can worsen the quality of life. Due to overlapping features and patient-report ambiguity a clear-cut distinction between EDS and fatigue can become a challenging issue. We [...] Read more.
Background: Excessive daytime sleepiness (EDS) and fatigue are two impactful symptoms, frequently associated with sleep disorders, which can worsen the quality of life. Due to overlapping features and patient-report ambiguity a clear-cut distinction between EDS and fatigue can become a challenging issue. We aimed to investigate the prevalence and consequences of these two conditions in several sleep pathologies, examining their social, psychological, and dietary impact, with a focus on gender-related differences and occupational status. Methods: We prospectively recruited for an online survey 136 adult outpatients (60 females) affected by various sleep disorders and admitted to our Sleep Disorders Center in Parma, Italy. Patients were asked to complete the following tests: Epworth Sleepiness Scale, Fatigue Severity Scale, Pittsburgh Sleep Quality Index, Difficulties in Emotion Regulation Scale, Depression Anxiety Stress Scale-21, Hyperarousal Scale, the Addiction-like Eating Behaviors Scale, Work Productivity and Activity Impairment Questionnaire, MEDI-Lite, and EQ-5D Health Questionnaire. Results:Fatigue was the primary daily symptom leading to serious repercussions on social/emotional and psychological well-being, while daytime sleepiness showed a less relevant role. Women reported higher levels of fatigue, sleep disturbances, emotional dysregulation, hyperarousal, and work productivity impairments. Unemployed people experienced a higher degree of fatigue, with multi-level negative consequences. Conclusions: We suggest sleep clinicians place a greater emphasis on the assessment of fatigue during clinical interviews, keeping in mind the greater vulnerability of females, experiencing disproportionate consequences. Further studies should expand our findings, exploring a wider range of gender identities and recruiting larger samples of patients. Full article
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12 pages, 2753 KiB  
Article
Plasma Matrix Metalloproteinases Signature as Biomarkers for Pediatric Tuberculosis Diagnosis: A Prospective Case–Control Study
by Nathella Pavan Kumar, Syed Hissar, Arul Nancy, Kannan Thiruvengadam, Velayuthum V. Banurekha, Sarath Balaji, S. Elilarasi, N. S. Gomathi, J. Ganesh, M. A. Aravind, Dhanaraj Baskaran, Soumya Swaminathan and Subash Babu
Diseases 2025, 13(6), 171; https://doi.org/10.3390/diseases13060171 - 27 May 2025
Viewed by 364
Abstract
Diagnosing tuberculosis (TB) in children presents significant challenges, necessitating the identification of reliable biomarkers for accurate diagnosis. In this study, we investigated plasma matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) as potential diagnostic markers. A prospective case–control study involved 167 children [...] Read more.
Diagnosing tuberculosis (TB) in children presents significant challenges, necessitating the identification of reliable biomarkers for accurate diagnosis. In this study, we investigated plasma matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) as potential diagnostic markers. A prospective case–control study involved 167 children classified into confirmed TB, unconfirmed TB, and unlikely TB control groups. Plasma levels of MMPs (MMP 1, 2, 3, 7, 8, 9, 12, and 13) and TIMPs (TIMP 1, 2, 3, and 4) were measured using multiplex assays. Elevated baseline levels of MMP-1, MMP-2, MMP-7, MMP-9, TIMP-1, TIMP-2, TIMP-3, and TIMP-4 were observed in active TB cases compared to unlikely TB controls. Receiver operating characteristics (ROC) analysis identified MMP-1, MMP-2, MMP-9, and TIMP-1 as potential biomarkers with over 80% sensitivity and specificity. A three-MMP signature (MMP-1, MMP-2, and MMP-9) demonstrated 100% sensitivity and specificity. The findings suggest that a baseline MMP signature could serve as an accurate biomarker for diagnosing pediatric TB, enabling early intervention and effective management. Full article
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9 pages, 4305 KiB  
Case Report
Intraosseous Pneumatocysts of the Scapula Mimicking Bone Tumors: A Report of Two Rare Cases Along with Elucidation of Their Etiology
by Jiro Ichikawa, Masanori Wako, Tomonori Kawasaki, Satoshi Ochiai, Tetsuo Hagino, Naofumi Taniguchi, Kouhei Mitsui and Kojiro Onohara
Diseases 2025, 13(6), 170; https://doi.org/10.3390/diseases13060170 - 27 May 2025
Viewed by 406
Abstract
Background/Objectives: Pneumatocysts, characterized by gas-filled cavities, are commonly found in the spine and pelvis but are rarely observed in the scapula. In this report, we describe two rare cases of scapular pneumatocysts mimicking bone tumors and exhibiting different image findings. Case Report: Case [...] Read more.
Background/Objectives: Pneumatocysts, characterized by gas-filled cavities, are commonly found in the spine and pelvis but are rarely observed in the scapula. In this report, we describe two rare cases of scapular pneumatocysts mimicking bone tumors and exhibiting different image findings. Case Report: Case 1. A 47-year-old man who presented with neck pain underwent radiography, followed by magnetic resonance imaging (MRI). MRI showed heterogeneity with low and high signals on fat-suppressed T2-weighted images, suggestive of enchondroma or fibrous dysplasia (FD). However, preoperative computed tomography (CT) revealed gas-filled cavities within the tumor, in continuity with the shoulder joint, confirming the diagnosis of a pneumatocyst. Case 2. A 58-year-old woman who presented with neck pain underwent similar examinations to Case 1. MRI showed homogeneity with high signals on fat-suppressed T2-weighted images, leading to a suspicion of solitary bone cysts and FD. Preoperative CT revealed gas-filled cavities within the tumor, but no continuity with the joint, leading to the diagnosis of a pneumatocyst. While the exact etiology of pneumatocysts remains unclear, two potential causes are as follows: (i) gas migration from the joint to the bone, and (ii) gas replacement in cystic tumors. Thus, CT is particularly valuable in confirming the presence of gas-filled cavities and aiding in diagnosis. Conclusions: This report highlights two extremely rare cases of scapular pneumatocysts, reflecting two potential etiologies. The utility of CT in the diagnosis of pneumatocyst has been clarified. Full article
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21 pages, 2133 KiB  
Article
A Study of Adrenal Incidentaloma-Related Hormonal Assays After First Integration of the Diagnosis Within Primary Healthcare
by Oana-Claudia Sima, Mihai Costachescu, Ana Valea, Mihaela Stanciu, Ioana Codruta Lebada, Tiberiu Vasile Ioan Nistor, Mihai-Lucian Ciobica, Claudiu Nistor and Mara Carsote
Diseases 2025, 13(6), 169; https://doi.org/10.3390/diseases13060169 - 26 May 2025
Viewed by 405
Abstract
Background: Adrenal incidentalomas are detected in various medical and surgical healthcare departments, including primary healthcare. One up to three out of ten individuals confirmed with nonfunctioning adrenal incidentalomas (NFAs) actually present a mild autonomous cortisol secretion (MACS), which is distinct from Cushing’s syndrome. [...] Read more.
Background: Adrenal incidentalomas are detected in various medical and surgical healthcare departments, including primary healthcare. One up to three out of ten individuals confirmed with nonfunctioning adrenal incidentalomas (NFAs) actually present a mild autonomous cortisol secretion (MACS), which is distinct from Cushing’s syndrome. Objective: We aimed to assess the cortisol secretion in newly detected adrenal incidentalomas in patients who were referred by their primary healthcare physician upon accidental detection of an adrenal tumor at abdominal computed tomography (CT) scan that was performed for unrelated (non-endocrine) purposes. Methods: This retrospective study included adults diagnosed with an adrenal incidentaloma via CT during the previous 3 months. Inclusion criteria: age ≥ 40 years (y). A triple stratification of exclusion criteria involved: (1) Clinical aspects and medical records such as active malignancies or malignancies under surveillance protocols, subjects under exogenous glucocorticoid exposure (current or during the previous year), or suggestive endocrine phenotypes for any hormonal ailment; (2) Radiological appearance of suspected/confirmed (primary or secondary) adrenal malignancy, adrenal cysts, or myelolipomas; (3) Endocrine assays consistent with active endocrine tumors. Protocol of assessment included baseline ACTH, morning plasma cortisol (C-B), cortisol at 6 p.m. (C-6 pm), and after 1 mg dexamethasone suppression testing (C-1 mg-DST), 24-h urinary free cortisol (UFC), and a second opinion for all CT scans. MACS were defined based on C-1 mg-DST ≥ 1.8 and <5 µg/dL (non-MACS: C-1 mg-DST < 1.8 µg/dL). Results: The cohort (N = 60, 78.33% female; 60.72 ± 10.62 y) associated high blood pressure (HBP) in 66.67%, respectively, type 2 diabetes (T2D) in 28.37% of the patients. Females were statistically significantly older than males (62.40 ± 10.47 vs. 54.62 ± 9.11 y, p = 0.018), while subjects with unilateral vs. bilateral tumors (affecting 26.67% of the individuals) and those with MACS-positive vs. MACS-negative profile had a similar age. Body mass index (BMI) was similar between patients with unilateral vs. bilateral incidentalomas, regardless of MACS. Patients were divided into five age groups (decades); most of them were found between 60 and 69 years (40%). Left-gland involvement was found in 43.33% of all cases. The mean largest tumor diameter was 26.08 ± 8.78 mm. The highest rate of bilateral tumors was 46.67% in the 50–59 y decade. The rate of unilateral/bilateral and tumor diameters was similar in females vs. males. The MACS-positive rate was similar in females vs. males (23.40% vs. 23.08%). A statistically significant negative correlation (N = 60) was found between BMI and C-B (r = −0.193, p = 0.03) and BMI and UFC (r = −0.185, p = 0.038), and a positive correlation was found between C-B and C-6 pm (r = 0.32, p < 0.001), C-B and UFC (r = 0.226, p = 0.011), and C-6 pm and C-1 mg-DST (r = 0.229, p = 0.010), and the largest tumor diameter and C-1 mg-DST (r = 0.241, p = 0.007). Conclusions: Adrenal incidentalomas belong to a complex scenario of detection in the modern medical era, requiring a multidisciplinary collaboration since the patients might be initially detected in different departments (as seen in the current study) and then referred to primary healthcare for further decision. In these consecutive patients, we found a higher female prevalence, a MACS rate of 23.33%, regardless of uni/bilateral involvement or gender distribution, and a relatively high rate (than expected from general data) of bilateral involvement of 26.67%. The MACS-positive profile adds to the disease burden and might require additional assessments during follow-up and a protocol of surveillance, including a tailored decision of tumor removal. The identification of an adrenal incidentaloma at CT and its hormonal characterization needs to be integrated into the panel of various chronic disorders of one patient. The collaboration between endocrinologists and primary healthcare physicians might improve the overall long-term outcomes. Full article
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17 pages, 1022 KiB  
Article
HBV, HCV, and HDV Triple-Infection—A Therapeutic Challenge
by Alexia Anastasia Stefania Balta, Mariana Daniela Ignat, Raisa Eloise Barbu, Liliana Baroiu, Lavinia Alexandra Moroianu, Valerii Lutenco, Valentin Bulza, Mihaela Patriciu, Caterina Dumitru and Mihaela Debita
Diseases 2025, 13(6), 168; https://doi.org/10.3390/diseases13060168 - 26 May 2025
Viewed by 468
Abstract
Purpose: This article aims to harmonize the current data from the literature, describe baseline severity, and discuss potential treatment considerations for cases of triple infection. Patients and Methods: We undertook a retrospective, observational study on 1244 patients with viral hepatitis study subgroups: chronic [...] Read more.
Purpose: This article aims to harmonize the current data from the literature, describe baseline severity, and discuss potential treatment considerations for cases of triple infection. Patients and Methods: We undertook a retrospective, observational study on 1244 patients with viral hepatitis study subgroups: chronic replicative hepatitis with HCV—679 patients, HBV—98 patients, HBV/HCV—25 patients, HBV/HDV—14 patients, and 2 patients with triple-infection (HBV, HCV, and HDV), hospitalized in the Second Department of “Sf. Cuv. Parascheva” Infectious Diseases Clinical Hospital of Galați, Romania, between 1 April 2017 and 1 March 2025. Results: Comparative analysis of biochemical parameters and liver fibrosis—at the initial testing—i.e., at the beginning of the specific antiviral therapy—with direct-acting antivirals on HCV (DAAs) or nucleos(t)ide analogues (NUCs): Entecavir (ETV) or Tenofovir Disoproxyl fumarate (TDF), for HBV, Bulevirtide (BLV) for HDV—revealed clinical forms with higher severity in the case of triple and double infections, in comparison to individuals who have had only one hepatotropic virus infection. Conclusions: Compared to patients with a single hepatotropic viral infection, those with a double or triple infection had more severe hepatic damage. Concomitant therapy with Bulevirtide, DAAs, and NUCs is possible and the therapeutic results from clinical studies, with single-infection patients showing great potential for improving the prognosis of these patients. Full article
(This article belongs to the Section Infectious Disease)
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28 pages, 3279 KiB  
Review
Overdiagnosis and Overtreatment in Prostate Cancer
by Zaure Dushimova, Yerbolat Iztleuov, Gulnar Chingayeva, Abay Shepetov, Nagima Mustapayeva, Oxana Shatkovskaya, Marat Pashimov and Timur Saliev
Diseases 2025, 13(6), 167; https://doi.org/10.3390/diseases13060167 - 24 May 2025
Viewed by 1239
Abstract
Prostate cancer (PCa) is one of the most common malignancies among men worldwide. While prostate-specific antigen (PSA) screening has improved early detection, it has also led to significant challenges regarding overdiagnosis and overtreatment. Overdiagnosis involves identifying indolent tumors unlikely to affect a patient’s [...] Read more.
Prostate cancer (PCa) is one of the most common malignancies among men worldwide. While prostate-specific antigen (PSA) screening has improved early detection, it has also led to significant challenges regarding overdiagnosis and overtreatment. Overdiagnosis involves identifying indolent tumors unlikely to affect a patient’s lifespan, while overtreatment refers to unnecessary interventions that can cause adverse effects such as urinary incontinence, erectile dysfunction, and a reduced quality of life. This review highlights contributing factors, including the limitations of PSA testing, advanced imaging techniques like multi-parametric MRI (mpMRI), medical culture, and patient expectations. The analysis emphasizes the need for refining screening protocols, integrating novel biomarkers (e.g., PCA3, TMPRSS2-ERG), and adopting conservative management strategies such as active surveillance to minimize harm. Risk-based screening and shared decision-making are critical to balancing the benefits of early detection with the risks of unnecessary treatment. Additionally, systemic healthcare factors like financial incentives and malpractice concerns exacerbate overuse. This review advocates for updated clinical guidelines and personalized approaches to optimizing patient outcomes while reducing the strain on healthcare resources. Addressing overdiagnosis and overtreatment through targeted interventions will improve the quality of life for PCa patients and enhance the efficiency of healthcare systems. Full article
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19 pages, 859 KiB  
Systematic Review
Iodine Intake from Universal Salt Iodization Programs and Hashimoto’s Thyroiditis: A Systematic Review
by Hernando Vargas-Uricoechea, Alejandro Castellanos-Pinedo, Ivonne A. Meza-Cabrera, María V. Pinzón-Fernández, Karen Urrego-Noguera and Hernando Vargas-Sierra
Diseases 2025, 13(6), 166; https://doi.org/10.3390/diseases13060166 - 23 May 2025
Viewed by 1143
Abstract
Background: Hashimoto’s thyroiditis (HT) is characterized by the loss of tolerance to thyroid autoantigens [thyroid peroxidase (TPO) and thyroglobulin (Tg)], usually identifying circulating antibodies (Abs) against these thyroid autoantigens (TPOAb and/or TgAb), together with a significant lymphocytic infiltration, causing an increased risk of [...] Read more.
Background: Hashimoto’s thyroiditis (HT) is characterized by the loss of tolerance to thyroid autoantigens [thyroid peroxidase (TPO) and thyroglobulin (Tg)], usually identifying circulating antibodies (Abs) against these thyroid autoantigens (TPOAb and/or TgAb), together with a significant lymphocytic infiltration, causing an increased risk of hypothyroidism. Among the multiple mechanisms described for the development of HT is the nutritional status of several micronutrients, including iodine. Iodine deficiency or excess is associated with thyroid function disorders and, likely, thyroid autoimmunity. Thus, iodized salt intake [especially through universal salt iodization (USI) programs] may be influencing the prevalence of HT. The objectives of this systematic review are to describe and analyze changes over time in the prevalence of HT following the implementation of USI programs. Methods and results: The following databases were consulted for articles published from January 1965 to January 2025: Pubmed/Medline; ProQuest; Scopus; Biosis; Web of Science; and Google Scholar. The search terms were as follows: “iodine”, “salt”, “intake”, “prevalence”, AND Hashimoto’s thyroiditis. Only English language articles were taken into account, and each of them was scrutinized according to the JBI Critical Appraisal Checklist. Only those studies in which the design, study population, number of participants, country, evaluation post-USI (years), and the prevalence of thyroid Abs positivity were described were included. In total, 74 studies were identified, of which 31 evaluated thyroid Abs values post-USI. Conclusions: Excess iodine intake, mediated by USI programs without an adequate follow-up and monitoring plan, may explain (at least in part) the prevalence and distribution of HT; therefore, it is a real challenge to establish a balance between healthy salt intake, USI program strategies, and possible functional outcomes and thyroid autoimmunity in the population. Registration number: INPLASY202540074. Full article
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13 pages, 792 KiB  
Article
Relationships Among Childhood Bullying, Academic Satisfaction, and Mental Health Outcomes in Adults with Disabilities
by Bryan R. Christ, Bani Malhotra, Ghizlane Moustaid, Olivia Chapman and Paul B. Perrin
Diseases 2025, 13(6), 165; https://doi.org/10.3390/diseases13060165 - 23 May 2025
Viewed by 507
Abstract
Purpose/Objective: Children with disabilities are at a greater risk of being bullied and experience mental health and academic problems that may persist in adulthood. This study examined the association of childhood bullying experiences with current mental health (anxiety and depression) among adults with [...] Read more.
Purpose/Objective: Children with disabilities are at a greater risk of being bullied and experience mental health and academic problems that may persist in adulthood. This study examined the association of childhood bullying experiences with current mental health (anxiety and depression) among adults with disabilities, and whether academic satisfaction mediated the relationship between childhood bullying and adult mental health outcomes. Research Method/Design: A sample of 409 adult participants with disabilities who had had their disabilities while attending school, and currently, completed an online survey assessing bullying experiences (California Bullying Victimization Scale-Retrospective), academic satisfaction (Academic Satisfaction Scale), depression (Patient Health Questionnaire-9), and anxiety (Generalized Anxiety Disorder-7). Bivariate correlations and two mediation analyses were conducted to identify the direct and indirect effects of school bullying experiences on current mental health outcomes, via academic satisfaction. Results: Participants reported a moderate amount of childhood bullying and relatively high levels of depression and anxiety symptomology (with averages close to or exceeding clinical cutoffs of 10). Bivariate correlations among the four variables were all significantly moderately or strongly correlated. Bullying and academic satisfaction had direct associations with depression and anxiety. Academic satisfaction partially mediated the relationships between bullying and both mental health outcomes. Conclusions/Implications: Bullying prevention interventions and programs, especially geared toward preventing bullying in students with disabilities, are critical to stop the likely long-term impacts of bullying on mental health outcomes in disabled communities. Full article
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11 pages, 400 KiB  
Article
The Effectiveness of Patient Education Interventions to Oncological Entero-Urostomy Patients and Caregivers: A Small Sample Size Pilot Study
by Alessandro Spano, Fabrizio Petrone, Emanuele Di Simone, Aurora De Leo, Paolo Basili, Irene Terrenato, Maria Antonietta Picano, Marco Piergentili, Albina Paterniani, Laura Iacorossi and Nicolò Panattoni
Diseases 2025, 13(6), 164; https://doi.org/10.3390/diseases13060164 - 22 May 2025
Viewed by 368
Abstract
Background: Patient education (PE) is an integral part of treatment from taking charge to the care, assistance, and rehabilitation of the patient, and consists of structured, organised actions, the orientation of which is aimed at finding solutions supported by scientific evidence. Aim: This [...] Read more.
Background: Patient education (PE) is an integral part of treatment from taking charge to the care, assistance, and rehabilitation of the patient, and consists of structured, organised actions, the orientation of which is aimed at finding solutions supported by scientific evidence. Aim: This prospective, descriptive, exploratory, single-centre pilot study aimed to evaluate the effectiveness of a PE intervention for oncological patients with entero-urostomies and their caregivers through the measurement of quality of life, perceived needs, and caregiver burden. Methods: This study was conducted in a National Cancer Institute between 22 December 2022 and 31 March 2023, and it was organised into three specific therapeutic education event days relative to the real needs measured by the patients and caregivers before it. Results: Our results seem to suggest that the PE intervention in entero-urostomy patients improves their quality-of-life levels, while caregivers’ perceived emotional burden levels are reduced. Conclusions: Targeted and individualised PE interventions positively affect self-care and quality of life in patients with an entero-urostomy and the emotional burden perceived by caregivers. Full article
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13 pages, 5798 KiB  
Review
Recent Developments in Rare Ovarian Carcinosarcoma: Literature Review and Case Report
by Alexandra Nienhaus and Elena Bernad
Diseases 2025, 13(6), 163; https://doi.org/10.3390/diseases13060163 - 22 May 2025
Viewed by 525
Abstract
Background and Objectives: Ovarian carcinosarcoma (OCS) is a rare gynecologic malignancy defined by both epithelial and mesenchymal components, generally associated with advanced clinical stage and poor outcomes. We present a 66-year-old patient initially presenting with right iliac vein thrombosis, ultimately diagnosed with OCS, [...] Read more.
Background and Objectives: Ovarian carcinosarcoma (OCS) is a rare gynecologic malignancy defined by both epithelial and mesenchymal components, generally associated with advanced clinical stage and poor outcomes. We present a 66-year-old patient initially presenting with right iliac vein thrombosis, ultimately diagnosed with OCS, and place these findings in context with a focused literature review from 2000 through to 2024. Methods: A comprehensive account of the patient’s clinical course—spanning diagnostic imaging, surgical pathology, neoadjuvant chemotherapy, and interval debulking—was combined with a review of the current data on OCS pathogenesis, treatment protocols, and outcomes. Results: The patient’s tumor showed predominantly sarcomatous histology (approximately 90%) with high-grade serous features, responded to platinum/taxane chemotherapy, and was resected to no visible residual disease. The updated literature indicates that the majority of OCS cases present at advanced stages (often exceeding 60%), with suboptimal cytoreduction closely tied to worse prognosis. Up to 64% of tumors may harbor homologous recombination deficiency, offering a rationale for PARP inhibitor therapy; nonetheless, five-year survival rarely surpasses 45% in most series. Conclusions: Despite its aggressive course, optimal debulking surgery plus platinum-based chemotherapy remain central in treating OCS. Emerging molecular insights highlight homologous recombination deficiency and BRCA mutations as potential therapeutic targets. Multidisciplinary care and future prospective studies are key to improving long-term outcomes in this challenging malignancy. Full article
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