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Diseases, Volume 7, Issue 1 (March 2019)

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Cover Story (view full-size image) Myogenin–Cre-mediated deletion of the SET and MYND Domain 1 (SMYD1) lysine methyl transferase in [...] Read more.
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Open AccessArticle
Longitudinal Changes of Handgrip, Knee Extensor Muscle Strength, and the Disability of the Arm, Shoulder and Hand Score in Cardiac Patients During Phase II Cardiac Rehabilitation
Received: 12 February 2019 / Revised: 23 March 2019 / Accepted: 23 March 2019 / Published: 26 March 2019
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Abstract
Handgrip strength (HS) and knee extensor muscle strength (KEMS) showed a negative correlation with the Disabilities of the Arm, Shoulder, and Hand (DASH) score at one month following cardiac surgery. We performed a longitudinal study to examine changes in HS/KEMS and DASH score [...] Read more.
Handgrip strength (HS) and knee extensor muscle strength (KEMS) showed a negative correlation with the Disabilities of the Arm, Shoulder, and Hand (DASH) score at one month following cardiac surgery. We performed a longitudinal study to examine changes in HS/KEMS and DASH score during phase II cardiac rehabilitation (CR) in patients after cardiac surgery. We measured and assessed HS, KEMS, and DASH score in 41 consecutive patients at one and three months following cardiac surgery and examined the relation between these factors at three months following cardiac surgery. Wilcoxon signed-rank test and Spearman correlation coefficients were used to analyze the results. Finally, 26 patients (63.2 years, 73.1% male) were analyzed. There were significant differences from one month to three months following cardiac surgery in HS (26.78 ± 8.26 to 31.35 ± 9.41 kgf, p < 0.001), KEMS (1.53 ± 0.42 to 1.72 ± 0.46 Nm/kg, p = 0.001), and DASH score (14.76 ± 12.58 to 7.62 ± 9.29, p < 0.001). DASH score correlated negatively with HS (r = −0.41, p = 0.01) but not with KEMS (r = −0.32, p = 0.09) after three months of phase II CR. Although HS, KEMS, and DASH scores changed significantly from one to three months following cardiac surgery during phase II CR, only HS correlated negatively with DASH score at three months following cardiac surgery. Full article
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Open AccessCommunication
Dirt, Saliva and Leprosy: Anti-Inflammatory and Anti-Infectious Effects
Received: 4 March 2019 / Revised: 15 March 2019 / Accepted: 19 March 2019 / Published: 22 March 2019
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Abstract
Ancient Egyptians smeared a mixture of dark soil on their eyelids and believed it protected eyes from unknown forces (illness). Recent studies have proven that the dark soil across the Nile River is rich in natural compounds including lead sulfide, which in low [...] Read more.
Ancient Egyptians smeared a mixture of dark soil on their eyelids and believed it protected eyes from unknown forces (illness). Recent studies have proven that the dark soil across the Nile River is rich in natural compounds including lead sulfide, which in low levels, promotes the production of nitric oxide (240-fold) by keratinocytes, with strong immune stimulatory and antimicrobial properties. Current investigations reveal anti-inflammatory and anti-infectious activities—including cytokines and chemokines—in saliva, as well as its friendly microbiota, which lines the surface of the oral cavity, its protection against inflammatory and infectious organisms in the stoma and other organs, such as the cardiovascular and central nervous systems. In fact, saliva may soon become a safe and practical surrogate biomarker for genomic/proteomic evaluations and to replace painful blood drawing and its side effects. Another example is leprosy, or Hansen’s disease, a chronic inflammatory syndrome and neglected tropical disease, which affects the skin, and peripheral and trigeminal neurons causing a lack of sensation to heat and cold and loss of extremities. Leprosy has horrified humans for over 2000 years, as lepers were considered unclean sinners and were subsequently drawn out of towns. This communication scrutinizes the past and the present state of saliva and leprosy to encounter possible mystery and/or wisdom in ancient healing as the mixture of “sputum and dirt” as reported in the biblical time. Full article
(This article belongs to the Special Issue Chronic Inflammatory and Infectious Diseases)
Open AccessEditorial
Special Issue: Wine and Vine Components and Health
Received: 11 March 2019 / Revised: 11 March 2019 / Accepted: 12 March 2019 / Published: 19 March 2019
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Abstract
There is much literature on the topic of wine and health dating back to the days of Hippocrates, and it is believed that there are unlimited varieties of wine, allowing the association of senses, nutrition, and hedonism [...] Full article
(This article belongs to the Special Issue Wine and Vine Components and Health)
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Open AccessArticle
Keeping an Eye on Perimenopausal and Postmenopausal Endometriosis
Received: 19 January 2019 / Revised: 1 March 2019 / Accepted: 9 March 2019 / Published: 12 March 2019
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Abstract
Introduction: We aimed to describe and review the epidemiological aspect of the disease pattern of a series of perimenopausal and postmenopausal women with a histology confirmation of endometriosis. Material and Methods: We retrospectively examined the clinical records of 184 perimenopausal and [...] Read more.
Introduction: We aimed to describe and review the epidemiological aspect of the disease pattern of a series of perimenopausal and postmenopausal women with a histology confirmation of endometriosis. Material and Methods: We retrospectively examined the clinical records of 184 perimenopausal and 46 postmenopausal women with endometriosis. Data were collected and analyzed from 1100 patients’ charts with confirmed endometriosis and involved cases from two different geographical areas, New Haven (US) and Greece. The statistical methods included ×2 and the Mann-Whitney U test. In the perimenopausal group (age 45–54 years), there were 184 patients (16.7%) and the postmenopausal group (55–80 years) had 46 (4.2%). The average age of diagnosis was (49 ± 2.3) and (61.2 ± 5.1), respectively (p < 0.01). Results: Advanced endometriosis was more aggressive in the perimenopausal group (p < 0.05); in the same group, we observed a higher left-sided predisposition of endometriosis in comparison with the right side (p < 0.01). Endometrioma was the most common gynecological condition among patients with perimenopausal endometriosis in relation to the postmenopausal group (p < 0.001). Additionally, we found uterine leiomyomata more prominent in the perimenopausal group (p < 0.05). In contrast, adenomyosis was found higher in postmenopausal patients (p < 0.05); further, 24 cases with dry eye we observed. Conclusions: Postmenopausal endometriosis is an important underestimated condition. Although the reported situation is not common, various clinicopathological characteristics were observed in both groups. Clinicians should be aware that there is a correlation between endometriosis and endometriosis-associated ovarian cancer in perimenopausal and postmenopausal age. Full article
Open AccessReview
Salmonella Infection in Chronic Inflammation and Gastrointestinal Cancer
Received: 13 January 2019 / Revised: 16 February 2019 / Accepted: 6 March 2019 / Published: 10 March 2019
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Abstract
Salmonella not only causes acute infections, but can also cause patients to become chronic “asymptomatic” carriers. Salmonella has been verified as a pathogenic factor that contributes to chronic inflammation and carcinogenesis. This review summarizes the acute and chronic Salmonella infection and describes the [...] Read more.
Salmonella not only causes acute infections, but can also cause patients to become chronic “asymptomatic” carriers. Salmonella has been verified as a pathogenic factor that contributes to chronic inflammation and carcinogenesis. This review summarizes the acute and chronic Salmonella infection and describes the current research progress of Salmonella infection contributing to inflammatory bowel disease and cancer. Furthermore, this review explores the underlying biological mechanism of the host signaling pathways manipulated by Salmonella effector molecules. Using experimental animal models, researchers have shown that Salmonella infection is related to host biological processes, such as host cell transformation, stem cell maintenance, and changes of the gut microbiota (dysbiosis). Finally, this review discusses the current challenges and future directions in studying Salmonella infection and its association with human diseases. Full article
(This article belongs to the Special Issue Role of Bacterial Infection in Cancer)
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Open AccessReview
The Therapeutic Implications of the Gut Microbiome and Probiotics in Patients with NAFLD
Received: 14 December 2018 / Revised: 21 February 2019 / Accepted: 24 February 2019 / Published: 25 February 2019
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Abstract
Recent breakthrough in our understanding pertaining to the pathogenesis of nonalcoholic fatty liver disease (NAFLD) has pointed to dysregulation or derangement of the gut microbiome, also known as dysbiosis. This has led to growing interest in probiotic supplementation as a potential treatment method [...] Read more.
Recent breakthrough in our understanding pertaining to the pathogenesis of nonalcoholic fatty liver disease (NAFLD) has pointed to dysregulation or derangement of the gut microbiome, also known as dysbiosis. This has led to growing interest in probiotic supplementation as a potential treatment method for NAFLD due to its ability to retard and/or reverse dysbiosis and restore normal gut flora. A thorough review of medical literature was completed from inception through July 10, 2018 on the PubMed database by searching for key terms such as NAFLD, probiotics, dysbiosis, synbiotics, and nonalcoholic steatohepatitis (NASH). All studies reviewed indicate that probiotics had a beneficial effect in patients with NAFLD and its subset NASH. Results varied between studies, but there was evidence demonstrating improvement in liver enzymes, hepatic inflammation, hepatic steatosis, and hepatic fibrosis. No major adverse effects were noted. Currently, there are no guidelines addressing the use of probiotics in the setting of NAFLD. In conclusion, probiotics appear to be a promising option in the treatment of NAFLD. Future research is necessary to assess the efficacy of probiotics in patients with NAFLD. Full article
(This article belongs to the Special Issue Gut Microbiome and Human Diseases)
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Open AccessFeature PaperArticle
Factors Influencing Quality of Life in Breast Cancer Patients Six Months after the Completion of Chemotherapy
Received: 3 November 2018 / Revised: 17 February 2019 / Accepted: 22 February 2019 / Published: 24 February 2019
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Abstract
Purpose: To assess breast cancer patients’ quality of life six months after the completion of adjuvant chemotherapy, and to investigate factors affecting this. Methods: The study was conducted in one large hospital located in a major Greek city. A convenience sample of 61 [...] Read more.
Purpose: To assess breast cancer patients’ quality of life six months after the completion of adjuvant chemotherapy, and to investigate factors affecting this. Methods: The study was conducted in one large hospital located in a major Greek city. A convenience sample of 61 breast cancer outpatients was recruited. A questionnaire, including the SF-36 scale and questions regarding demographic and clinical information, was used to collect data. Results: The mean age of the patients was 51.52 ± 12.10. The effect of age on the physical role was significant (p = 0.003). Τhe effect of menopausal status on physical role was also found to be significant (p = 0.003); this might be explained by age. Regarding the treatment type, patients who received hormone therapy in addition to surgery and chemotherapy reported a significantly higher quality of life in terms of bodily pain (p = 0.04) and vitality (p = 0.04) than patients who underwent only surgery and chemotherapy. Conclusions: Quality of life is affected by factors such as age, menopausal status, and previous therapy. Health care professionals should be more aware of the factors that influence the quality of life domains (physical role, bodily pain, vitality) within this group of cancer patients in order to meet their needs following acute treatment. Full article
(This article belongs to the Special Issue Neuro-psychiatric Disorders - from Diagnosis to Care)
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Open AccessArticle
Association of HCV Infection with C-Reactive Protein: National Health and Nutrition Examination Survey (NHANES), 2009–2010
Received: 31 December 2018 / Revised: 18 February 2019 / Accepted: 21 February 2019 / Published: 24 February 2019
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Abstract
The relationship between hepatitis C virus (HCV) infection and C-reactive protein (CRP), which is an inflammatory biomarker, is limited in studies with the general population. It was hypothesized that changes in CRP levels are genotype-dependent in the general population with HCV infection. Thus, [...] Read more.
The relationship between hepatitis C virus (HCV) infection and C-reactive protein (CRP), which is an inflammatory biomarker, is limited in studies with the general population. It was hypothesized that changes in CRP levels are genotype-dependent in the general population with HCV infection. Thus, this study aimed to assess the prevalence of HCV infection and compare CRP levels with an anti-HCV antibody, HCV-RNA status, and HCV genotypes. A total of 5611 adult participants from the National and Health Nutrition Examination (NHANES), 2009–2010 survey were analyzed. Proc survey frequency, means, and multivariate regression were used due to the complex survey design of NHANES. The prevalence of HCV infection among the study population was 1.6%. There were lower mean CRP levels among people with anti-HCV antibody positive status compared to those with antibody negative status (0.12 ± 0.08 vs. 0.24 ± 0.02, p = 0.08, 95% Confidence Intervals, CI: −1.12 to 0.07). Mean CRP levels were also lower in people with HCV-RNA positive status compared to those with HCV-RNA negative status (0.56 ± 0.03 vs. 0.48 ± 0.05, p = 0.62 and 95% CI: −1.37 to 0.86). However, these differences were non-significant. With respect to HCV genotypes, significantly higher CRP levels were noted among people infected with HCV genotype 2 vs. genotype 1 (0.53 ± 0.06 vs. 0.23 ± 0.05, p < 0.01, 95% CI: −0.58 to −0.02) and those with HCV genotype 2 vs. HCV genotype 3 (0.53 ± 0.06, 0.28 ± 0.04, p < 0.01, 95% CI: 0.02 to 0.48). Further studies are needed to confirm this finding. Full article
(This article belongs to the Special Issue Infectious Disease Epidemiology)
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Open AccessFeature PaperReview
Social Interaction Improved by Oxytocin in the Subclass of Autism with Comorbid Intellectual Disabilities
Received: 18 January 2019 / Revised: 14 February 2019 / Accepted: 15 February 2019 / Published: 22 February 2019
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Abstract
Approximately half of all autism spectrum disorder (ASD) individuals suffer from comorbid intellectual disabilities. Furthermore, the prevalence of epilepsy has been estimated to be 46% of patients with low intelligence quotient. It is important to investigate the therapeutic benefits and adverse effects of [...] Read more.
Approximately half of all autism spectrum disorder (ASD) individuals suffer from comorbid intellectual disabilities. Furthermore, the prevalence of epilepsy has been estimated to be 46% of patients with low intelligence quotient. It is important to investigate the therapeutic benefits and adverse effects of any recently developed drugs for this proportion of individuals with the so-called Kanner type of ASD. Therefore, we investigated the therapeutic and/or adverse effects of intranasal oxytocin (OT) administration, especially in adolescents and adults with ASD and comorbid intellectual disability and epilepsy, with regard to core symptoms of social deficits. We have already reported three randomized placebo-controlled trials (RCTs). However, we revisit results in our pilot studies from the view of comorbidity. Most of the intellectually disabled participants were found to be feasible participants of the RCT. We observed significantly more events regarded as reciprocal social interaction in the OT group compared with the placebo group. In the trial, no or little differences in adverse events were found between the OT and placebo arms, as found in some other reports. However, seizures were induced in three participants with medical history of epilepsy during or after OT treatment. In conclusion, we stress that behavioral changes in ASD patients with intellectual disabilities could be recognized not by the conventional measurements of ASD symptoms but by detailed evaluation of social interactions arising in daily-life situations. Full article
(This article belongs to the Section Neuro-psychiatric Disorders)
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Open AccessFeature PaperArticle
Inhibitory Effect of Ionizing Radiation on Echinococcus granulosus Hydatid Cyst
Received: 21 December 2018 / Revised: 16 February 2019 / Accepted: 17 February 2019 / Published: 18 February 2019
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Abstract
Background: Heavy ion radiation has more advantages than traditional radiation therapy in the treatment of cancer, mainly because of its superior biological effects. However, there is currently no reliable evidence that heavy ion radiation can induce cell death in hydatid cysts at the [...] Read more.
Background: Heavy ion radiation has more advantages than traditional radiation therapy in the treatment of cancer, mainly because of its superior biological effects. However, there is currently no reliable evidence that heavy ion radiation can induce cell death in hydatid cysts at the cellular and molecular level. In addition, we believe heavy ion therapy could be a potential alternative approach for the treatment of hydatid cysts. Methodology/Principal Finding: The hydatid cysts and protoscolices were obtained from an experimentally infected KunMing mice. LD50 was used to evaluate the death of the protoscolex. The cellular and ultrastructure of the parasites were observed under light and electron microscopes, the damage and copy numbers of mitochondrial DNA (mtDNA) were decided by QPCR. The apoptosis was evaluated by the expression and activity of caspase3. Dose-dependent ionizing radiation induced damage to the initial mtDNA. Echinococcosis cyst after ionizing radiation showed sparse cytoplasm, disorganized and clumped organelles, huge vacuoles, and villus deletions. The kinetic of DNA repair activity after X-ray irradiation was faster than those after carbon-ion irradiation. High doses of carbon ion radiation caused irreversible attenuation of mitochondrial DNA. Cysts showed obvious reduction in size after radiation. Carbon ion radiation was more effective than X-ray radiation in inhibiting hydatid cysts. Conclusions: These studies provide evidence that heavy-ion radiation can cause the extinction of hydatid cysts in vitro. The carbon-ion radiation is more advantageous than X-ray radiation in suppress hydatid cyst. Full article
(This article belongs to the Special Issue Chronic Inflammatory and Infectious Diseases)
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Open AccessReview
Roles of PI3K/AKT/GSK3 Pathway Involved in Psychiatric Illnesses
Received: 25 January 2019 / Revised: 10 February 2019 / Accepted: 11 February 2019 / Published: 13 February 2019
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Abstract
Psychiatric illnesses may be qualified to the cellular impairments of the function for survival or death in neurons, which may consequently appear as abnormalities in the neuroplasticity. The molecular mechanism has not been well understood, however, it seems that PI3K, AKT, GSK3, and [...] Read more.
Psychiatric illnesses may be qualified to the cellular impairments of the function for survival or death in neurons, which may consequently appear as abnormalities in the neuroplasticity. The molecular mechanism has not been well understood, however, it seems that PI3K, AKT, GSK3, and their downstream molecules have crucial roles in the pathogenesis. Through transducing cell surviving signal, the PI3K/AKT/GSK3 pathway may organize an intracellular central network for the action of the synaptic neuroplasticity. In addition, the pathways may also regulate cell proliferation, cell migration, and apoptosis. Several lines of evidence have supported a role for this signaling network underlying the development and treatment for psychiatric illnesses. Indeed, the discovery of molecular biochemical phenotypes would represent a breakthrough in the research for effective treatment. In this review, we summarize advances on the involvement of the PI3K/AKT/GSK3 pathways in cell signaling of neuronal cells. This study may provide novel insights on the mechanism of mental disorder involved in psychiatric illnesses and would open future opportunity for contributions suggesting new targets for diagnostic and/or therapeutic procedures. Full article
(This article belongs to the Special Issue Neuro-psychiatric Disorders - from Diagnosis to Care)
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Open AccessReview
Impact of Gut Dysbiosis on Neurohormonal Pathways in Chronic Kidney Disease
Received: 21 December 2018 / Revised: 29 January 2019 / Accepted: 8 February 2019 / Published: 13 February 2019
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Abstract
Chronic kidney disease (CKD) is a worldwide major health problem. Traditional risk factors for CKD are hypertension, obesity, and diabetes mellitus. Recent studies have identified gut dysbiosis as a novel risk factor for the progression CKD and its complications. Dysbiosis can worsen systemic [...] Read more.
Chronic kidney disease (CKD) is a worldwide major health problem. Traditional risk factors for CKD are hypertension, obesity, and diabetes mellitus. Recent studies have identified gut dysbiosis as a novel risk factor for the progression CKD and its complications. Dysbiosis can worsen systemic inflammation, which plays an important role in the progression of CKD and its complications such as cardiovascular diseases. In this review, we discuss the beneficial effects of the normal gut microbiota, and then elaborate on how alterations in the biochemical environment of the gastrointestinal tract in CKD can affect gut microbiota. External factors such as dietary restrictions, medications, and dialysis further promote dysbiosis. We discuss the impact of an altered gut microbiota on neuroendocrine pathways such as the hypothalamus–pituitary–adrenal axis, the production of neurotransmitters and neuroactive compounds, tryptophan metabolism, and the cholinergic anti-inflammatory pathway. Finally, therapeutic strategies including diet modification, intestinal alpha-glucosidase inhibitors, prebiotics, probiotics and synbiotics are reviewed. Full article
(This article belongs to the Special Issue Gut Microbiome and Human Diseases)
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Open AccessFeature PaperArticle
Timely Interventions for Children with ADHD through Web-Based Monitoring Algorithms
Received: 20 December 2018 / Revised: 30 January 2019 / Accepted: 1 February 2019 / Published: 7 February 2019
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Abstract
The aim of this study was to evaluate an automated trigger algorithm designed to detect potentially adverse events in children with Attention-Deficit/Hyperactivity Disorder (ADHD), who were monitored remotely between visits. We embedded a trigger algorithm derived from parent-reported ADHD rating scales within an [...] Read more.
The aim of this study was to evaluate an automated trigger algorithm designed to detect potentially adverse events in children with Attention-Deficit/Hyperactivity Disorder (ADHD), who were monitored remotely between visits. We embedded a trigger algorithm derived from parent-reported ADHD rating scales within an electronic patient monitoring system. We categorized clinicians’ alert resolution outcomes and compared Vanderbilt ADHD rating scale scores between patients who did or did not have triggered alerts. A total of 146 out of 1738 parent reports (8%) triggered alerts for 98 patients. One hundred and eleven alerts (76%) required immediate clinician review. Nurses successfully contacted parents for 68 (61%) of actionable alerts; 46% (31/68) led to a change in care plan prior to the next scheduled appointment. Compared to patients without alerts, patients with alerts demonstrated worsened ADHD severity (β = 5.8, 95% CI: 3.5–8.1 [p < 0.001] within 90 days prior to an alert. The trigger algorithm facilitated timely changes in the care plan in between face-to-face visits. Full article
(This article belongs to the Special Issue Attention Deficit Hyperactivity Disorder (ADHD))
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Open AccessArticle
Quantitative Risk Assessment Model of Human Salmonellosis Resulting from Consumption of Broiler Chicken
Received: 30 December 2018 / Revised: 29 January 2019 / Accepted: 5 February 2019 / Published: 7 February 2019
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Abstract
(1) Background: Salmonella infections are a major cause of illnesses in the United States. Each year around 450 people die from the disease and more than 23,000 people are hospitalized. Salmonella outbreaks are commonly associated with eggs, meat and poultry. In this study, [...] Read more.
(1) Background: Salmonella infections are a major cause of illnesses in the United States. Each year around 450 people die from the disease and more than 23,000 people are hospitalized. Salmonella outbreaks are commonly associated with eggs, meat and poultry. In this study, a quantitative risk assessment model (QRAM) was developed to determine Salmonella infections in broiler chicken. (2) Methods: Data of positive Salmonella infections were obtained from the United States Department of Agriculture (USDA) and the Centers for Disease Control and Prevention (CDC) Foodborne Disease Outbreak Surveillance System, in addition to published literature. The Decision Tools @RISK add-in software was used for various analyses and to develop the QRAM. The farm-to-fork pathway was modeled as a series of unit operations and associated pathogen events that included initial contamination at the broiler house (node 1), contamination at the slaughter house (node 2), contamination at retail (node 3), cross-contamination during serving and cooking (node 4), and finally the dose–response model after consumption. (3) Results: QRAM of Salmonella infections from broiler meat showed highest contribution of infection from the retail node (33.5%). (4) Conclusions: This QRAM that predicts the risk of Salmonella infections could be used as a guiding tool to manage the Salmonella control programs Full article
(This article belongs to the Special Issue Infectious Disease Epidemiology)
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Open AccessReview
Assessing Gait in Parkinson’s Disease Using Wearable Motion Sensors: A Systematic Review
Received: 28 November 2018 / Revised: 31 January 2019 / Accepted: 1 February 2019 / Published: 5 February 2019
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Abstract
Abstract: Parkinson’s disease (PD) is a progressive neurodegenerative disorder. Gait impairments are common among people with PD. Wearable sensor systems can be used for gait analysis by providing spatio-temporal parameters useful to investigate the progression of gait problems in Parkinson disease. However, various [...] Read more.
Abstract: Parkinson’s disease (PD) is a progressive neurodegenerative disorder. Gait impairments are common among people with PD. Wearable sensor systems can be used for gait analysis by providing spatio-temporal parameters useful to investigate the progression of gait problems in Parkinson disease. However, various methods and tools with very high variability have been developed. The aim of this study is to review published articles of the last 10 years (from 2008 to 2018) concerning the application of wearable sensors to assess spatio-temporal parameters of gait in patients with PD. We focus on inertial sensors used for gait analysis in the clinical environment (i.e., we do not cover the use of inertial sensors to monitor walking or general activities at home, in unsupervised environments). Materials and Methods: Relevant articles were searched in the Medline database using Pubmed. Results and Discussion: Two hundred ninety-four articles were initially identified while searching the scientific literature regarding this topic. Thirty-six articles were selected and included in this review. Conclusion: Wearable motion sensors are useful, non-invasive, low-cost, and objective tools that are being extensively used to perform gait analysis on PD patients. Being able to diagnose and monitor the progression of PD patients makes wearable sensors very useful to evaluate clinical efficacy before and after therapeutic interventions. However, there is no uniformity in the use of wearable sensors in terms of: number of sensors, positioning, chosen parameters, and other characteristics. Future research should focus on standardizing the measurement setup and selecting which spatio-temporal parameters are the most informative to analyze gait in PD. These parameters should be provided as standard assessments in all studies to increase replicability and comparability of results. Full article
(This article belongs to the Special Issue Neuro-psychiatric Disorders - from Diagnosis to Care)
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Open AccessArticle
The Relationship between Walking Speed and Step Length in Older Aged Patients
Received: 26 December 2018 / Revised: 28 January 2019 / Accepted: 31 January 2019 / Published: 2 February 2019
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Abstract
Compared with elderly people who have not experienced falls, those who have were reported to have a shortened step length, large fluctuations in their pace, and a slow walking speed. The purpose of this study was to elucidate the step length required to [...] Read more.
Compared with elderly people who have not experienced falls, those who have were reported to have a shortened step length, large fluctuations in their pace, and a slow walking speed. The purpose of this study was to elucidate the step length required to maintain a walking speed of 1.0 m/s in patients aged 75 years or older. We measured the 10 m maximum walking speed in patients aged 75 years or older and divided them into the following two groups: Those who could walk 1.0 m/s or faster (fast group) and those who could not (slow group). Step length was determined from the number of steps taken during the 10 m-maximum walking speed test, and the step length-to-height ratio was calculated. Isometric knee extension muscle force (kgf), modified functional reach (cm), and one-leg standing time (s) were also measured. We included 261 patients (average age: 82.1 years, 50.6% men) in this study. The fast group included 119 participants, and the slow group included 142 participants. In a regression logistic analysis, knee extension muscle force (p = 0.03) and step length-to-height ratio (p < 0.01) were determined as factors significantly related to the fast group. As a result of ROC curve analysis, a step length-to-height ratio of 31.0% could discriminate between the two walking speed groups. The results suggest that the step length-to-height ratio required to maintain a walking speed of 1.0 m/s is 31.0% in patients aged 75 years or older. Full article
(This article belongs to the Special Issue Neuro-psychiatric Disorders - from Diagnosis to Care)
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Open AccessArticle
The Presence of Gut Microbial Genes Encoding Bacterial Genotoxins or Pro-Inflammatory Factors in Stool Samples from Individuals with Colorectal Neoplasia
Received: 22 December 2018 / Revised: 23 January 2019 / Accepted: 28 January 2019 / Published: 1 February 2019
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Abstract
Gut bacterial toxins are thought to contribute to the development of colorectal cancer (CRC). This study examines the presence of specific gut bacterial toxin genes in stool samples from individuals with colorectal neoplasia (adenomas and/or CRC). The presence of bacterial genes encoding genotoxic [...] Read more.
Gut bacterial toxins are thought to contribute to the development of colorectal cancer (CRC). This study examines the presence of specific gut bacterial toxin genes in stool samples from individuals with colorectal neoplasia (adenomas and/or CRC). The presence of bacterial genes encoding genotoxic or pro-inflammatory factors (pks, tcpC, gelE, cnf-1, AMmurB, and usp) was established by PCR of stool samples from individuals from mainland US (n = 30; controls = 10, adenoma = 10, CRC = 10) and from Puerto Rico (PR) (n = 33; controls = 13; adenomas = 8; CRC = 12). Logistic regression models and multinomial logistic regression models were used to estimate the magnitude of association. Distinct bacterial gene profiles were observed in each sample cohort. In individuals with CRC, AMmurB was detected more frequently in samples from the US and gelE in samples from PR. In samples from PR, individuals with ≥2 gut bacterial toxin genes in stool had higher odds of having colorectal neoplasia (OR = 11.0, 95%: CI 1.0–637.1): however, no significant association between bacterial genes and colorectal neoplasia was observed in the US cohort. Further analyses are warranted in a larger cohort to validate these preliminary findings, but these encouraging results highlight the importance of developing bacterial markers as tools for CRC diagnosis or risk stratification. Full article
(This article belongs to the Special Issue Role of Bacterial Infection in Cancer)
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Open AccessReview
Autophagy Intertwines with Different Diseases—Recent Strategies for Therapeutic Approaches
Received: 6 December 2018 / Revised: 22 January 2019 / Accepted: 28 January 2019 / Published: 1 February 2019
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Abstract
Autophagy is a regular and substantial “clear-out process” that occurs within the cell and that gets rid of debris that accumulates in membrane-enclosed vacuoles by using enzyme-rich lysosomes, which are filled with acids that degrade the contents of the vacuoles. This machinery is [...] Read more.
Autophagy is a regular and substantial “clear-out process” that occurs within the cell and that gets rid of debris that accumulates in membrane-enclosed vacuoles by using enzyme-rich lysosomes, which are filled with acids that degrade the contents of the vacuoles. This machinery is well-connected with many prevalent diseases, including cancer, HIV, and Parkinson’s disease. Considering that autophagy is well-known for its significant connections with a number of well-known fatal diseases, a thorough knowledge of the current findings in the field is essential in developing therapies to control the progression rate of diseases. Thus, this review summarizes the critical events comprising autophagy in the cellular system and the significance of its key molecules in manifesting this pathway in various diseases for down- or upregulation. We collectively reviewed the role of autophagy in various diseases, mainly neurodegenerative diseases, cancer, inflammatory diseases, and renal disorders. Here, some collective reports on autophagy showed that this process might serve as a dual performer: either protector or contributor to certain diseases. The aim of this review is to help researchers to understand the role of autophagy-regulating genes encoding functional open reading frames (ORFs) and its connection with diseases, which will eventually drive better understanding of both the progression and suppression of different diseases at various stages. This review also focuses on certain novel therapeutic strategies which have been published in the recent years based on targeting autophagy key proteins and its interconnecting signaling cascades. Full article
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Open AccessReview
Delirium Assessment in Older People in Emergency Departments. A Literature Review
Received: 22 November 2018 / Revised: 27 January 2019 / Accepted: 28 January 2019 / Published: 30 January 2019
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Abstract
Delirium is a neuropsychiatric syndrome often manifesting in acute disease conditions, and with a greater prevalence in the older generation. Delirium in the Emergency Department (ED) is a highly prevalent problem that typically goes unnoticed by healthcare providers. The onset of a delirium [...] Read more.
Delirium is a neuropsychiatric syndrome often manifesting in acute disease conditions, and with a greater prevalence in the older generation. Delirium in the Emergency Department (ED) is a highly prevalent problem that typically goes unnoticed by healthcare providers. The onset of a delirium episode in the ED is associated with an increase in morbidity and mortality. Because delirium is a preventable syndrome, these statistics are unacceptable. Emergency Department staff therefore should strive to perform systematic screening in order to detect delirium. Different tools have been developed for the assessment of delirium by healthcare professionals other than psychiatrists or geriatricians. Emergency Departments require delirium assessment scales of high sensitivity and specificity, suited to the characteristics of the Department, since the time available is scarce. In addition, the presence of dementia in the assessment of delirium may induce sensitivity bias. Despite the existence of numerous delirium rating scales, scales taking less than three minutes to complete are recommended. The choice of the tool depends on the characteristics of the ED. The only scale affording high sensitivity and specificity in older people with and without dementia is the Four “A”s Test (4AT); it requires no training on the part of the rater, and can be performed in under two minutes. Full article
(This article belongs to the Special Issue Neuro-psychiatric Disorders - from Diagnosis to Care)
Open AccessArticle
Prevalence of Tinea Capitis among Children in Osogbo, Nigeria, and the Associated Risk Factors
Received: 31 December 2018 / Revised: 20 January 2019 / Accepted: 23 January 2019 / Published: 27 January 2019
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Abstract
Tinea capitis is a fungi infection of the scalp that disproportionately affects children in rural and underserved communities in Nigeria. A case-control study was conducted to identify the causative agents and factors that predispose school pupils to tinea capitis in two selected government-owned [...] Read more.
Tinea capitis is a fungi infection of the scalp that disproportionately affects children in rural and underserved communities in Nigeria. A case-control study was conducted to identify the causative agents and factors that predispose school pupils to tinea capitis in two selected government-owned public primary schools in Osogbo, Southwestern Nigeria. A total of 230 participants were included in the study: 115 cases and 115 controls. Head scrapings were collected from pupils with suspected T. capitis lesions, viewed under Potassium Hydroxide smear microscopy and cultured in Sabouraud’s Dextrose Agar (SDA) for characteristic fungal elements. A total of 105 (91%) samples were successfully cultured, of which 56% (59/105) were from male pupils. Tricophyton rubrum (34%), Tricophyton mentagrophyte (31%) and Microsporum canis (18%) were the most prevalent organisms. Other dermatophytes obtained include Microsporum nanuum (3%), Epidermophyton floccusum (6%), Tricophyton verucosum (1%), and Microsporum gypseum (8%). Pupils between the ages of 4 and 7 years had the highest distribution (67%) followed by those between the ages of 8 and 11 years (39%). Playing with animals, the sharing of combs and not bathing with soap were significantly associated with tinea capitis infection (P < 0.05) in each case. This study showed a high prevalence of tinea capitis caused by the identified dermatophytes in the area. Full article
(This article belongs to the Special Issue Infectious Disease Epidemiology)
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Open AccessReview
Modulating Effect of Diet on Alzheimer’s Disease
Received: 7 December 2018 / Revised: 17 January 2019 / Accepted: 21 January 2019 / Published: 26 January 2019
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Abstract
As life expectancy is growing, neurodegenerative disorders, such as Alzheimer’s disease, are increasing. This disease is characterised by the accumulation of intracellular neurofibrillary tangles formed by hyperphosphorylated tau protein, senile plaques composed of an extracellular deposit of β-amyloid peptide (Aβ), and neuronal loss. [...] Read more.
As life expectancy is growing, neurodegenerative disorders, such as Alzheimer’s disease, are increasing. This disease is characterised by the accumulation of intracellular neurofibrillary tangles formed by hyperphosphorylated tau protein, senile plaques composed of an extracellular deposit of β-amyloid peptide (Aβ), and neuronal loss. This is accompanied by deficient mitochondrial function, increased oxidative stress, altered inflammatory response, and autophagy process impairment. The present study gathers scientific evidence that demonstrates that specific nutrients exert a direct effect on both Aβ production and Tau processing and their elimination by autophagy activation. Likewise, certain nutrients can modulate the inflammatory response and the oxidative stress related to the disease. However, the extent to which these effects come with beneficial clinical outcomes remains unclear. Even so, several studies have shown the benefits of the Mediterranean diet on Alzheimer’s disease, due to its richness in many of these compounds, to which can be attributed their neuroprotective properties due to the pleiotropic effect they show on the aforementioned processes. These indications highlight the potential role of adequate dietary recommendations for clinical management of both Alzheimer’s diagnosed patients and those in risk of developing it, emphasising once again the importance of diet on health. Full article
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Open AccessFeature PaperReview
The Effects of Exercise on IL-6 Levels and Cognitive Performance in Patients with Schizophrenia
Received: 27 December 2018 / Revised: 18 January 2019 / Accepted: 18 January 2019 / Published: 22 January 2019
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Abstract
Exercise plays an important role in brain plasticity, leading to improvements in cognitive function and delaying the cognitive deterioration of healthy people. These effects can be observed in individuals with schizophrenia through improvements in their performance in cognitive tasks and a decrease in [...] Read more.
Exercise plays an important role in brain plasticity, leading to improvements in cognitive function and delaying the cognitive deterioration of healthy people. These effects can be observed in individuals with schizophrenia through improvements in their performance in cognitive tasks and a decrease in the symptomology of the disease. In this review we examine the current evidence for the roles that exercise and the immune system play in patients with schizophrenia, and specifically analyze the interleukin-6 (IL-6) pathway as a potential mechanism resulting in these positive effects. Inflammation and high levels of IL-6 are associated with both the severity of schizophrenia and the cognitive impairment suffered throughout the disease. Performing regular exercise can modulate IL-6 by lowering its basal levels and by causing lower acute increases in the plasma levels of this cytokine in response to exercise (an anti-inflammatory response to physical exertion). Although there is evidence for the positive effects of physical exercise on schizophrenia, more studies will be required to better understand how variation in different exercise parameters affects both the acute and chronic plasma levels of IL-6. Full article
(This article belongs to the Special Issue Neuro-psychiatric Disorders - from Diagnosis to Care)
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Open AccessArticle
PAOT-Liquid® Technology: An Easy Electrochemical Method for Evaluating Antioxidant Capacity of Wines
Received: 5 December 2018 / Revised: 15 January 2019 / Accepted: 17 January 2019 / Published: 21 January 2019
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Abstract
Polyphenol compounds present in high quantity in wines are well-known to have potent cardio-protective properties through several biological mechanisms including antioxidant activity. A large number of methods have been developed for evaluating the antioxidant capacity of food matrices. Most of them have, however, [...] Read more.
Polyphenol compounds present in high quantity in wines are well-known to have potent cardio-protective properties through several biological mechanisms including antioxidant activity. A large number of methods have been developed for evaluating the antioxidant capacity of food matrices. Most of them have, however, the disadvantage of being time consuming and require specific analytical protocols and devices. In the present study, we present the electrochemical PAOT (Pouvoir Antioxydant Total)-Liquid® Technology which can be easily used by winemakers for evaluating antioxidant activity of wine during all steps of making process. The methodology is based on the measurement of electric potential variation resulting from chemical reactions between wine polyphenols and a free radical mediator M as source of oxidants. Total antioxidant activity as estimated by the PAOT-Liquid® activity was 6.8 fold higher in red wines (n = 14) when compared to rosé (n = 3) and white (n = 3) wines bought in a commercial market. Moreover, PAOT-Liquid® activity was highly correlated with total polyphenols content (TPC) of all wines (r = 0.9540, p < 0.0001) and the classical DPPH (2,2-diphenyl-1-picryhydrazyl) assay which is often used for evaluating antioxidant capacity of food matrices (r = 0.9102, p < 0.0001). Full article
(This article belongs to the Special Issue Wine and Vine Components and Health)
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Open AccessReview
The MAPK Signaling Pathways as a Novel Way in Regulation and Treatment of Parasitic Diseases
Received: 3 December 2018 / Revised: 10 January 2019 / Accepted: 15 January 2019 / Published: 17 January 2019
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Abstract
Few major advances in fighting parasitic diseases have been made in China since the development of new methods for prevention, control, and elimination. However, the proportion of immunocompromised individuals has increased due to the growth of chronic diseases, population aging, and more frequent [...] Read more.
Few major advances in fighting parasitic diseases have been made in China since the development of new methods for prevention, control, and elimination. However, the proportion of immunocompromised individuals has increased due to the growth of chronic diseases, population aging, and more frequent cases of patients with AIDS and cancer. All these problems can promote development of parasitic infections, which is commonly associated with manipulation of host signaling pathways and the innate immune system. Mitogen-activated protein kinase (MAPK) signaling pathways are evolutionarily conserved in metazoan organisms, which play critical roles in the cell cycle, gene expression, growth, differentiation, apoptosis, and parasite–host interactions. Recent discoveries of the MAPK components involved in activation, regulation, and signal transduction appeared to be promising for the diagnosis, prevention, and treatment of parasitic diseases in the future. This review summarizes the involvement and critical role of the MAPK family in parasitic disease development and maintenance in the host. Moreover, it highlights recent studies concerning the mechanisms and novel drug development for inhibition and regulation of MAPK pathways in order to prevent parasitic disease. In addition, we discuss some antigenic proteins as prospective inhibitory molecules or vaccines for the regulation and control of MAPK signaling involved in parasite physiological activity. Full article
(This article belongs to the Special Issue Chronic Inflammatory and Infectious Diseases)
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Open AccessReview
Potential Beneficial Effects of Wine Flavonoids on Allergic Diseases
Received: 2 November 2018 / Revised: 7 January 2019 / Accepted: 9 January 2019 / Published: 15 January 2019
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Abstract
Wine, a widely consumed beverage, comprises several biophenols that promote health. Flavonoids, majorly present in red wine, have been shown to have antioxidant, anti-inflammatory, anticancer, and immunomodulatory activities. Regular consumption of red wine (100 mL/day) is estimated to provide an average of 88 [...] Read more.
Wine, a widely consumed beverage, comprises several biophenols that promote health. Flavonoids, majorly present in red wine, have been shown to have antioxidant, anti-inflammatory, anticancer, and immunomodulatory activities. Regular consumption of red wine (100 mL/day) is estimated to provide an average of 88 mg of flavonoids, whereas recent epidemiological studies indicate that wine is one of the major sources of flavonoid intake amongst wine lovers in European countries (providing an average intake of 291–374 mg/day of flavonoids). In addition to being antioxidants, in vitro studies suggest that flavonoids also have anti-allergic activities that inhibit IgE synthesis, activation of mast cells and basophils or other inflammatory cells, and production of inflammatory mediators, including cytokines. Furthermore, they affect the differentiation of naïve CD4+ T cells into effector T cell subsets. Moreover, several studies have reported the benefits of flavonoids in allergic models such as atopic dermatitis, asthma, anaphylaxis, and food allergy; however, evidence in humans is limited to allergic rhinitis and respiratory allergy. Although further evaluation is required, it is expected that an appropriate intake of flavonoids may be beneficial in preventing, and eventually managing, allergic diseases. Full article
(This article belongs to the Special Issue Wine and Vine Components and Health)
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Open AccessReview
Immunological Features in the Process of Blood Platelet-Induced Alloimmunisation, with a Focus on Platelet Component Transfusion
Received: 22 November 2018 / Revised: 6 January 2019 / Accepted: 9 January 2019 / Published: 14 January 2019
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Abstract
Alloimmunisation to platelet antigens is not uncommon; a large number of females, having had pregnancies, developed antibodies to Human Leukocyte Antigen (HLA) moieties harboured on their foetuses’ cells (inherited from the father(s)) that may conflict with further pregnancies and transfused Platelet Components occasionally. [...] Read more.
Alloimmunisation to platelet antigens is not uncommon; a large number of females, having had pregnancies, developed antibodies to Human Leukocyte Antigen (HLA) moieties harboured on their foetuses’ cells (inherited from the father(s)) that may conflict with further pregnancies and transfused Platelet Components occasionally. This is possible since platelets constitutionally express HLA class I molecules (though in copy numbers that consistently differ among individuals). Platelets also express HPA moieties that are variants of naturally expressed adhesion and aggregation molecules; HPA differences between mothers and foetuses and between donors and recipients explain alloimmune conflicts and consequences. Lastly, platelets express ABO blood group antigens, which are rarely immunising, however transfusion mismatches in ABO groups seem to be related to immunisation in other blood and tissue groups. Transfusion also brings residual leukocytes that may also immunise through their copious copy numbers of HLA class I (rarely class II on activated T lymphocytes, B cells, and dendritic cells). In addition, residual red blood cells in platelet concentrates may induce anti-red blood cell allo-antibodies. This short review aims to present the main mechanisms that are commonly reported in alloimmunisation. It also critically endeavours to examine paths to either dampen alloimmunisation occurrences or to prevent them. Full article
(This article belongs to the Section Immunology)
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Open AccessEditorial
Acknowledgement to Reviewers of Diseases in 2018
Published: 11 January 2019
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Abstract
Rigorous peer-review is the corner-stone of high-quality academic publishing [...] Full article
Open AccessFeature PaperArticle
Prevalence, Wellbeing, and Symptoms of Dysmenorrhea among University Nursing Students in Greece
Received: 30 November 2018 / Revised: 1 January 2019 / Accepted: 2 January 2019 / Published: 8 January 2019
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Abstract
Dysmenorrhea (pain during menstruation) is one of the most common medical conditions among women of reproductive age. Dysmenorrhea has been studied around the world but not yet in Greece. The aim of the present study was to investigate the prevalence, characteristics, and impact [...] Read more.
Dysmenorrhea (pain during menstruation) is one of the most common medical conditions among women of reproductive age. Dysmenorrhea has been studied around the world but not yet in Greece. The aim of the present study was to investigate the prevalence, characteristics, and impact of dysmenorrhea on the wellbeing (exercising, and social and academic functioning) among nursing students in Greece. A cross-sectional study of 637 nursing students was conducted by administering a questionnaire at a university in Athens. The prevalence of dysmenorrhea was 89.2% and the rate of severe intensity was 52.5%. Factors that were associated with severe dysmenorrhea were family history (p = 0.02), early menarche (p = 0.05) and menstruation duration (p = 0.05). Women with moderate and severe pain reported using pain relievers (non-steroidal anti-inflammatory drugs (NSAIDs), paracetamol etc., p < 0.0005). Finally, activities affected by severe pain were class attendance (p = 0.01), personal studying (p < 0.0005), exercising (p < 0.0005), and socializing (p < 0.0005). Exam attendance (p = 0.27) and clinical placement attendance (p = 0.48) were not affected by severe dysmenorrhea. Dysmenorrhea has a high prevalence among nursing students and seems to affect important aspects of wellbeing and academic performance when the pain intensity is severe. The present findings lay the foundation for further investigation of dysmenorrhea both in the Greek population and cross-culturally. Full article
(This article belongs to the Special Issue Neuro-psychiatric Disorders - from Diagnosis to Care)
Open AccessArticle
Neglected Zoonoses and the Missing Opportunities for One Health Education: The Case of Cystic Echinococcosis among Surgically Operated Patients in Basrah, Southern Iraq
Received: 14 November 2018 / Revised: 24 December 2018 / Accepted: 4 January 2019 / Published: 7 January 2019
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Abstract
Cystic echinococcosis (CE) is recognized as a neglected disease of public health significance throughout the world, particularly in low and middle-income countries. The objectives of this study were to describe the characteristics, attitudes, knowledge, and practices of some Basrah province residents diagnosed with [...] Read more.
Cystic echinococcosis (CE) is recognized as a neglected disease of public health significance throughout the world, particularly in low and middle-income countries. The objectives of this study were to describe the characteristics, attitudes, knowledge, and practices of some Basrah province residents diagnosed with CE. Using a questionnaire survey, we interviewed 50 surgically operated cases of CE from Basrah, south Iraq. The cases comprised of 31 females and 19 males, of which 74% originated from rural areas. The questionnaire contained 30 questions and focused on gathering the demographic characteristics of the patients and capturing their overall knowledge, attitudes, and practices toward CE. Approximately half of the participants reported slaughtering livestock at home for their families’ consumption, 78% indicated the presence of a large number of stray dogs roaming freely about their village, 86% reported that they never boiled water before drinking it, and 26% reported not washing vegetables before eating them. Although a large proportion of the participants (72%) had heard of hydatid disease before becoming sick, over half (57%) were not aware of how the disease can be transmitted from animals to humans. This study highlights a gap in One Health education efforts regarding CE in southern Iraq, with a lack of counselling of patients on how to prevent reinfection. An intensive One Health education program should be implemented in Basrah to reduce CE at the human–animal interface. Lack of awareness on zoonoses among medical professionals, who are supposed to disseminate advice on preventative measures to their patients, is a challenge to the public health system. Full article
(This article belongs to the Special Issue Infectious Disease Epidemiology)
Open AccessReview
Infected with Scabies Again? Focus in Management in Long-Term Care Facilities
Received: 28 November 2018 / Revised: 11 December 2018 / Accepted: 22 December 2018 / Published: 29 December 2018
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Abstract
Scabies is a significant public health condition in long-term care facilities, plaguing even developed countries. Although treatments are available, eradication and control of scabies cases still remain a challenge due to delays in diagnosis and difficulties in maintaining preventive and surveillance measures. Prompt [...] Read more.
Scabies is a significant public health condition in long-term care facilities, plaguing even developed countries. Although treatments are available, eradication and control of scabies cases still remain a challenge due to delays in diagnosis and difficulties in maintaining preventive and surveillance measures. Prompt treatment of patients and their contacts that are affected, along with concomitant education of health staff and family members, are paramount. Environmental disinfestation is also a concern. Full article
(This article belongs to the Section Infectious Disease)
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