Diseases

44 pages, 2571 KB

Open AccessReview

Research Progress on the Efficacy and Mechanism of Acupuncture in Treating Chronic Gastritis

by Jing He, Hongye Wang, Cong Che, Anjie Wang, Ru Nie, Jinghong Tan, Jialin Jia, Zijian Liu, Tie Li and Guojuan Dong

Diseases 2025, 13(11), 363; https://doi.org/10.3390/diseases13110363 (registering DOI) - 7 Nov 2025

Abstract

Chronic gastritis (CG) is a prevalent digestive disorder. It progresses through multiple stages, has an insidious onset, and can lead to severe complications if untreated. Modern treatments primarily aim to eradicate Helicobacter pylori and relieve symptoms. However, drug resistance and adverse effects often [...] Read more.

Chronic gastritis (CG) is a prevalent digestive disorder. It progresses through multiple stages, has an insidious onset, and can lead to severe complications if untreated. Modern treatments primarily aim to eradicate Helicobacter pylori and relieve symptoms. However, drug resistance and adverse effects often limit their effectiveness. As a primary traditional Chinese medicine (TCM) therapy, acupuncture treats CG through multi-target mechanisms. This review systematically outlines the classification and pathology of CG. It also comprehensively analyzes animal and clinical studies on acupuncture for CG from the past decade. The study summarizes the mechanisms of acupuncture and related therapies for CG, covering gastric mucosal function, metabolism, intestinal flora, gastrointestinal hormones, apoptosis, inflammation, and oxidative stress. It further explores the relationships among diseases, interventions, acupoints, and molecular pathways. Additionally, it compares the therapeutic profiles of different external therapies. The review also examines the current state of clinical research, including the selection of acupoints, treatment duration, and outcome assessment. The results demonstrate that external therapies effectively alleviate common CG symptoms such as abdominal distension, acid reflux, and stomach pain. These treatments also improve gastric mucosal health and modulate serum levels of inflammatory factors, oxidative stress markers, and gastrointestinal hormones. In vivo experiments using chronic non-atrophic gastritis (CNAG) and chronic atrophic gastritis (CAG) models confirm these benefits, showing changes in key biomarkers and elucidating potential mechanisms. Nevertheless, future high-quality, large-sample clinical trials are still needed to firmly establish efficacy. Further mechanistic studies are also needed to validate the interconnections among relevant signaling pathways. Full article

13 pages, 696 KB

Open AccessArticle

Blood Urea/Creatinine Ratio and Mortality in Ambulatory Patients with Heart Failure with Reduced Ejection Fraction

by Andrew S. Oswald, Muhammad S. Hussain, Mohsin H. K. Roshan, Filippo Pigazzani, Anna-Maria Choy, Faisel Khan, Ify R. Mordi and Chim C. Lang

Diseases 2025, 13(11), 362; https://doi.org/10.3390/diseases13110362 - 7 Nov 2025

Abstract

Background: Chronic heart failure with reduced ejection fraction (HFrEF) is associated with high mortality, and renal dysfunction is common in these patients. Blood urea/creatinine ratio (UCR) has been identified as a potential prognostic marker, reflecting both renal function and neurohormonal activity. We assessed [...] Read more.

Background: Chronic heart failure with reduced ejection fraction (HFrEF) is associated with high mortality, and renal dysfunction is common in these patients. Blood urea/creatinine ratio (UCR) has been identified as a potential prognostic marker, reflecting both renal function and neurohormonal activity. We assessed whether a UCR ≥ 95 at discharge from an outpatient service was associated with increased mortality. Methods: This retrospective study reviewed 337 patients (age 72.7 ± 14.3 years; 64.7% Male; Mean LVEF 33.2 ± 8.9%) with HFrEF referred to the Heart Failure Nurse Service at NHS Tayside for optimisation of heart failure medication. Cox proportional hazards models were used to assess the association between UCR and all-cause mortality. Results: Receiver operating characteristic (ROC) analysis identified a UCR threshold of 95 (area under the curve [AUC] 0.701) as predictive of mortality. Results demonstrated that a UCR ≥ 95 was independently associated with increased mortality (HR 1.85, 95% CI 1.09–3.14, p = 0.022). A high UCR was associated with increased mortality even in patients with preserved eGFR, a group typically considered at lower risk (HR 4.03, 95% CI 1.50–10.9, p = 0.006). Conclusions: These findings suggest that UCR could be a useful addition for identifying high-risk patients who may benefit from closer monitoring and more aggressive intervention following optimisation of heart failure medication. Full article

(This article belongs to the Special Issue Insights into the Management of Cardiovascular Disease Risk Factors)

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9 pages, 414 KB

Open AccessArticle

Psychiatric Comorbidities in Parkinson’s Disease: A Moroccan Perspective on Anxiety and Depression

by Khaoula Elcadi, Oussama Cherkaoui Rhazouani, Nissrine Louhab, Najib Kissani and Mohamed Chraa

Diseases 2025, 13(11), 361; https://doi.org/10.3390/diseases13110361 - 6 Nov 2025

Abstract

Background/Objectives: An individual’s quality of life is greatly impacted by the motor and non-motor symptoms of Parkinson’s disease (PD), which include anxiety and depression. Using the Hospital Anxiety and Depression Scale (HADS), this study sought to determine the prevalence of anxiety and depression [...] Read more.

Background/Objectives: An individual’s quality of life is greatly impacted by the motor and non-motor symptoms of Parkinson’s disease (PD), which include anxiety and depression. Using the Hospital Anxiety and Depression Scale (HADS), this study sought to determine the prevalence of anxiety and depression in Moroccan patients with Parkinson’s disease (PD) and investigate any possible associations with clinical characteristics and pharmacological treatment. Methods: The HADS was used to assess 100 PD patients in total. Clinical and demographic information, including prescription drug use, was gathered. The relationships between HADS scores and clinical factors were evaluated using Pearson’s correlation. Results: According to the HADS assessment, 20% of respondents had no anxiety symptoms, 17% had borderline symptoms, and 63% of patients reported definite anxiety symptoms. Of those with depression, 24% showed no symptoms, 14% were borderline, and 62% were certain. The average HADS-A and HADS-D scores were 2.34 and 2.43, respectively. L-DOPA alone was used to treat half of the patients, while combinations of Trivastal, Sifrol, anticholinergics, or antidepressants were given to the other half. There were no discernible correlations between HADS scores and clinical or demographic traits. Conclusions: The HADS is a useful instrument for assessing anxiety and depression in PD patients. Regardless of the method of treatment or stage of the disease, psychiatric symptoms are prevalent. For PD patients to benefit from early interventions and achieve an improved quality of life, routine screening is crucial. Full article

(This article belongs to the Special Issue Research Progress in Neurodegenerative Diseases)

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20 pages, 3826 KB

Open AccessArticle

MicroRNA Signatures in Serous Ovarian Cancer: A Comparison of Prognostic Marker Targets in African Americans and Caucasians

by Jane M. Muinde, Celina Romi Yamauchi, Joseph Cruz, Alena A. McQuarter, Kyah Miller, Umang Sharma, Skyler Schiff, Isaac Kremsky, Saied Mirshahidi, Cody S. Carter and Salma Khan

Diseases 2025, 13(11), 360; https://doi.org/10.3390/diseases13110360 - 6 Nov 2025

Abstract

Background: Ovarian cancer (OC) is the second most common gynecologic malignancy in the United States and remains the leading cause of death among cancers of the female reproductive system. Alarmingly, mortality rates have risen disproportionately among women of African ancestry compared to those [...] Read more.

Background: Ovarian cancer (OC) is the second most common gynecologic malignancy in the United States and remains the leading cause of death among cancers of the female reproductive system. Alarmingly, mortality rates have risen disproportionately among women of African ancestry compared to those of European or Asian descent. Identifying microRNA (miRNA) signatures that contribute to these disparities may enhance prognostic accuracy and inform personalized therapeutic strategies. Methods: In this study, we identified prognostic markers of overall survival in serous ovarian cancer (SOC) using data from The Cancer Genome Atlas (TCGA) and the Human Protein Atlas. Integrative bioinformatic analyses revealed three key prognostic genes—TIMP3 (Tissue Inhibitor of Metalloproteinases-3), BRAF (v-raf murine sarcoma viral oncogene homolog B), and ITGB1 (Integrin Beta-1)—as critical molecular determinants associated with survival in patients with SOC. Candidate miRNAs regulating these genes were predicted using TargetScanHuman v8.0, identifying a core regulatory set comprising miR-192, miR-30d, miR-16-5p, miR-143-3p, and miR-20a-5p. To validate their clinical relevance, formalin-fixed, paraffin-embedded (FFPE) and fresh SOC tumor samples were obtained from African American and Caucasian patients who underwent surgery at Loma Linda University (LLU) between 2010 and 2023. Results and Discussion: Among all these, ITGB1 (p = 0.00033), TIMP3 (p = 0.0035), and BRAF (p = 0.026) emerged as statistically significant predictors. Following total RNA extraction, cDNA synthesis, and quantitative reverse transcription PCR (qRT-PCR), the expression levels of these miRNAs and their target genes were quantified. In the LLU cohort, ITGB1 and TIMP3 were significantly upregulated in African American patients compared to Caucasian patients (p < 0.01 and p < 0.02, respectively). Among the miRNAs, miR-192-5p was particularly noteworthy, showing marginally differential expression in LLU samples (p = 0.0712) but strong statistical significance in the TCGA cohort (p = 0.00013), where elevated expression correlated with poorer overall survival (p = 0.021). Pathway enrichment and gene ontology analyses (miRTargetLink2.0, Enrichr) revealed interconnected regulatory networks linking miR-192, miR-16-5p, miR-143-3p, and miR-20a-5p to ITGB1; miR-143-3p/miR-145-5p to BRAF; and miR-16-5p and miR-30c/d to TIMP3. Conclusions: Collectively, these findings identify distinct miRNA–mRNA regulatory signatures—particularly the miR-192-5p–ITGB1/TIMP3 axis—as potential clinically relevant biomarkers that may contribute to racial disparities and disease progression in ovarian cancer. Full article

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27 pages, 1312 KB

Open AccessReview

Type 3 Diabetes: Linking Insulin Resistance to Cognitive Decline

by Brooke Chapple, Emily Bayliss, Seth Woodfin, Merritt Smith, Jeremiah Winter and William Moore

Diseases 2025, 13(11), 359; https://doi.org/10.3390/diseases13110359 - 5 Nov 2025

Abstract

Type 3 diabetes (T3D) is characterized by chronic insulin resistance and insulin deficiency in the brain, leading to neuronal death, inflammation, oxidative stress, apoptosis, and synaptic dysfunction. These pathological processes contribute to cognitive decline and neurodegenerative disorders such as Alzheimer’s disease. However, despite [...] Read more.

Type 3 diabetes (T3D) is characterized by chronic insulin resistance and insulin deficiency in the brain, leading to neuronal death, inflammation, oxidative stress, apoptosis, and synaptic dysfunction. These pathological processes contribute to cognitive decline and neurodegenerative disorders such as Alzheimer’s disease. However, despite increasing evidence that links insulin resistance to cognitive impairment, the precise mechanisms that underly T3D remain largely unknown. This highlights a critical gap in research and potential therapeutic strategies. Given the significant impact of diet on metabolic health, investigating the correlation between the gut–brain axis may offer novel insights into the prevention and management of T3D. This review aims to elucidate the potential connections between insulin resistance and cognitive decline while also proposing interventions to slow aging and reduce the risk of early cognitive decline. At the same time, we acknowledge that the classification of type 3 diabetes is debatable and there is uncertainty as to whether insulin resistance is a primary driver or secondary manifestation of neurodegeneration. Full article

(This article belongs to the Special Issue Research Progress in Neurodegenerative Diseases)

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14 pages, 1146 KB

Open AccessCase Report

Intraoral Epidermoid Cyst: Case Report and Literature Review

by Ana Andabak Rogulj, Danica Vidović Juras, Božana Lončar Brzak, Ivana Škrinjar, Bruno Špiljak and Sven Seiwerth

Diseases 2025, 13(11), 358; https://doi.org/10.3390/diseases13110358 - 5 Nov 2025

Abstract

Background/Objectives: Epidermoid cysts are benign lesions originating from germinative epithelium, characterized by a keratin-filled cavity. They are histopathologically classified as epidermoid, dermoid, or teratoid. Intraoral cases are exceedingly rare, comprising less than 0.01% of all oral cystic lesions, most frequently affecting the floor [...] Read more.

Background/Objectives: Epidermoid cysts are benign lesions originating from germinative epithelium, characterized by a keratin-filled cavity. They are histopathologically classified as epidermoid, dermoid, or teratoid. Intraoral cases are exceedingly rare, comprising less than 0.01% of all oral cystic lesions, most frequently affecting the floor of the mouth. While usually asymptomatic, they may become painful due to infection or growth. Because of their rarity in sites such as the upper lip, they may be clinically misdiagnosed, making awareness crucial for accurate management. Methods: Diagnosis is primarily clinical and histopathological, with imaging reserved for complex or deep-seated lesions. Complete surgical excision is the standard treatment to prevent recurrence. In this case, diagnostic evaluation included careful clinical inspection, assessment of consistency and mobility, and excisional biopsy with subsequent histopathological confirmation. Results: We report a rare case of a 68-year-old female presenting with a painless, slow-growing swelling of the upper lip. Clinical examination revealed a solitary, whitish, mobile lesion. Histopathological analysis confirmed an epidermoid cyst. The lesion was surgically excised under local anesthesia, with no recurrence observed at six-month follow-up. The outcome highlights the success of surgical management and the importance of monitoring even when the lesion appears benign. Conclusions: Although uncommon in the upper lip, epidermoid cysts should be considered in the differential diagnosis of submucosal swellings. Complete surgical excision offers a favorable outcome and prevents recurrence. Reporting such rare presentations expands clinical awareness and assists in differentiating these lesions from other pathologies of the oral cavity. Full article

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9 pages, 679 KB

Open AccessCase Report

Radiation Recall Pneumonitis with Pneumocystis jirovecii Superinfection and Treatment Induced Hyponatremia in a Patient with Non-Small-Cell Lung Cancer

by Aleksandra Piórek, Adam Płużański, Dariusz M. Kowalski and Maciej Krzakowski

Diseases 2025, 13(11), 357; https://doi.org/10.3390/diseases13110357 - 4 Nov 2025

Abstract

Immune checkpoint inhibitors (ICIs) and thoracic radiotherapy are standard treatments for advanced non-small-cell lung cancer (NSCLC), especially in patients with high PD-L1 expression or symptoms such as superior vena cava syndrome (SVCS). Both therapies carry a risk of pulmonary toxicity, which may be [...] Read more.

Immune checkpoint inhibitors (ICIs) and thoracic radiotherapy are standard treatments for advanced non-small-cell lung cancer (NSCLC), especially in patients with high PD-L1 expression or symptoms such as superior vena cava syndrome (SVCS). Both therapies carry a risk of pulmonary toxicity, which may be exacerbated by opportunistic infections due to corticosteroid use. We report a unique case of a 65-year-old man with squamous-cell NSCLC and high PD-L1 expression (80%), who developed a rare complication: radiation recall pneumonitis (RRP), with superimposed Pneumocystis jirovecii pneumonia and severe symptomatic hyponatremia induced by trimethoprim/sulfamethoxazole (TMP-SMX). The coexistence of these three complications—radiotherapy- and immunotherapy-associated lung injury, opportunistic infection, and electrolyte imbalance—represents an exceptional clinical scenario not previously described in the literature. This report highlights the importance of differential diagnosis, early recognition of complications, and close monitoring of electrolytes in NSCLC patients undergoing complex treatment regimens. Full article

(This article belongs to the Section Oncology)

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15 pages, 2835 KB

Open AccessArticle

Global Epidemiology of Smoking and Liver Cancer from 1990 to 2021

by Jinguo Wang, Yang Ma, Aixu Duan and Xiaoming Fan

Diseases 2025, 13(11), 356; https://doi.org/10.3390/diseases13110356 - 3 Nov 2025

Abstract

Liver cancer is a prevalent and highly malignant tumor worldwide, and smoking has been suggested as a potentially significant risk factor, but this association remains understudied and not widely recognized. This study utilized global epidemiological data (1990–2021) from open access databases, analyzing smoking-related [...] Read more.

Liver cancer is a prevalent and highly malignant tumor worldwide, and smoking has been suggested as a potentially significant risk factor, but this association remains understudied and not widely recognized. This study utilized global epidemiological data (1990–2021) from open access databases, analyzing smoking-related liver cancer burden and trends by age, sex, region, and country using mortality, disability-adjusted life years (DALYs), and age-standardized rates (ASRs), with projections for disease burden in 2040. The results show that from 1990 to 2021, the global number of smoking-attributable liver cancer deaths increased (cumulative growth: 67.10%; annual growth rate: 1.63%), while the age-standardized mortality rate (ASMR) declined. Similarly, global DALYs rose (cumulative growth: 49.5%; annual growth rate: 1.32%), yet age-standardized DALY rates (ASDRs) decreased. Significant disparities were observed across gender, age groups, regions, and countries, with higher burdens in males and in regions such as East Asia. Projections indicate that by 2040, both the ASMR and ASDR for smoking-associated liver cancer will decline significantly, particularly among the male population. In conclusion, although the burden of liver cancer related to smoking is on a downward trend, there are still significant demographic and regional differences. Future efforts should prioritize strengthened public health policies, targeted interventions, and further research into the smoking–liver cancer relationship to enhance prevention and control strategies. Full article

(This article belongs to the Topic Dietary Habits in Liver Health and Disease: Preclinical and Clinical Studies)

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18 pages, 373 KB

Open AccessReview

Navigating the Latest Hepatitis B Virus Reactivation Guidelines

by Zeyad Elharabi, Jowana Saba and Hakan Akin

Diseases 2025, 13(11), 355; https://doi.org/10.3390/diseases13110355 - 1 Nov 2025

Abstract

Hepatitis B virus (HBV) infection is a global health concern with an estimated 254 million people with chronic HBV infection. The utilization of immunosuppressive therapies (ISTs) is increasing and expanding continuously with new agents being implemented across multiple medical disciplines. The occurrence of [...] Read more.

Hepatitis B virus (HBV) infection is a global health concern with an estimated 254 million people with chronic HBV infection. The utilization of immunosuppressive therapies (ISTs) is increasing and expanding continuously with new agents being implemented across multiple medical disciplines. The occurrence of HBV reactivation (HBVr) during or after IST varies from 15% to 50% in HBsAg-positive individuals and can be higher than 75% after stem cell transplantation. HBVr is gaining increasing significance in contemporary clinical practice. The American Gastroenterological Association (AGA) in 2025, the European Association for the Study of the Liver (EASL) in 2025, and the Asian Pacific Association for the Study of the Liver (APASL) in 2021, published their most recent clinical guidelines as major societies in the area, which enables us to better predict and manage HBVr. This narrative review focuses on comparing these three current guidelines, highlighting key similarities and differences to provide valuable guidance for practitioners navigating the complex, sometimes conflicting recommendations, thereby aiding clinicians in their decision-making. The risk of HBVr during IST has been stratified into three categories in all three guidelines: high (>10%), moderate (1–10%), and low (<1%). The effectiveness of prophylaxis scales with baseline risk for HBV reactivation. Prophylaxis is clearly cost-effective for high-risk patients, potentially beneficial for those at moderate risk, and generally may not be justified for low-risk individuals. Entecavir (ETV), tenofovir disoproxil fumarate (TDF), and tenofovir alafenamide (TAF) are all highly effective in preventing HBV reactivation during immunosuppression and all are considered to be economically viable options for HBVr high risk patients. When selecting among these agents, safety considerations—particularly renal and bone toxicity—and insurance coverage remain the primary factors directing clinical decision-making. Full article

(This article belongs to the Special Issue Viral Hepatitis: Diagnosis, Treatment and Management)

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20 pages, 1161 KB

Open AccessReview

The Systemic Link Between Oral Health and Cardiovascular Disease: Contemporary Evidence, Mechanisms, and Risk Factor Implications

by Florinel Cosmin Bida, Florin Razvan Curca, Raoul-Vasile Lupusoru, Dragos Ioan Virvescu, Mihaela Scurtu, Gabriel Rotundu, Oana Maria Butnaru, Teona Tudorici, Ionut Luchian and Dana Gabriela Budala

Diseases 2025, 13(11), 354; https://doi.org/10.3390/diseases13110354 - 31 Oct 2025

Abstract

Background: Oral health plays a critical role in systemic wellbeing, with growing evidence supporting strong associations between oral conditions and cardiovascular disease (CVD). These connections extend beyond periodontal disease and involve oral microbiota imbalance, systemic inflammation, and oral side effects of cardiovascular pharmacotherapy. [...] Read more.

Background: Oral health plays a critical role in systemic wellbeing, with growing evidence supporting strong associations between oral conditions and cardiovascular disease (CVD). These connections extend beyond periodontal disease and involve oral microbiota imbalance, systemic inflammation, and oral side effects of cardiovascular pharmacotherapy. Objective: To explore these links, a narrative literature review was performed using PubMed, Scopus, and ScienceDirect, covering studies published between 2000 and 2025. Methods: A comprehensive literature search was conducted in PubMed, Scopus, and ScienceDirect for studies published between January 2000 and May 2025. Both MeSH and free-text terms related to oral health, periodontal disease, systemic inflammation, endothelial dysfunction, and atherosclerosis were used. Eligible studies included observational and interventional research, systematic reviews, and meta-analyses. Key findings: The evidence consistently supports an association between chronic periodontal inflammation and cardiovascular risk, mediated by systemic dissemination of proinflammatory cytokines (IL-6, TNF-α, CRP) and microbial products that promote endothelial activation and atherogenesis. Interventional data indicate that periodontal therapy may reduce systemic inflammatory burden and improve vascular parameters, though heterogeneity across studies limits causal inference. Conclusions: Current findings highlight a significant oral–systemic connection through inflammatory and endothelial mechanisms. Strengthening interdisciplinary collaboration between dental and cardiovascular care providers is essential to translate this evidence into preventive and therapeutic practice. Further longitudinal and mechanistic studies are required to confirm causality and guide clinical integration. Full article

(This article belongs to the Special Issue Insights into the Management of Cardiovascular Disease Risk Factors)

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15 pages, 2449 KB

Open AccessArticle

Impact of Becoming a Certified Oncologic Center of Pancreatic Surgery: Evaluation of Single-Center Perioperative Results and Quality of Life Before and After Implementation of a Certified Center

by Jan-Paul Gundlach, Thorben Fedders, Steffen Markus Heckl, Thomas Becker and Julius Pochhammer

Diseases 2025, 13(11), 353; https://doi.org/10.3390/diseases13110353 - 31 Oct 2025

Abstract

Background: Centralization and certification mark constant processes in everyday clinical routine. Despite the continuously rising number of certified pancreatic cancer (PAC) centers in recent years, fewer than 40% of PAC resections are still performed in certified institutions nationwide. The main objective of the [...] Read more.

Background: Centralization and certification mark constant processes in everyday clinical routine. Despite the continuously rising number of certified pancreatic cancer (PAC) centers in recent years, fewer than 40% of PAC resections are still performed in certified institutions nationwide. The main objective of the certification is the enhancement of patient survival. Furthermore, certification is intended to improve structural quality, multidisciplinary cooperation, and the transparency of treatment pathways. In addition, it should have a positive effect on patient satisfaction. However, it requires the substantial effort of all partners involved. We aim to illustrate both advantages and limitations of the certification process. Methods: We analyzed perioperative outcomes of patients undergoing pancreatic resection for PAC (ICD C25) before and after our center’s first certification, and benchmarked these results against national data from the German Cancer Society. In addition, we analyzed quality of life (QoL) longitudinally using the validated QLQ-C30 questionnaire administered preoperatively and at 1, 4, and 18 months postoperatively. Results: The study cohort included 47 patients treated in the three years prior to certification and 130 patients during the subsequent seven years as a certified center. The mean annual number of PAC resections increased from 15 (ranged 14–18) to 19 (ranged 10–26). In-hospital mortality, length of stay, and rate of exploration-only procedures remained unchanged. Indicators of procedural quality, such as the number of harvested lymph nodes (p = 0.1485) and the precision of histopathological assessment, improved slightly but not significantly. QoL scores generally improved after discharge in both groups; however, functional scales and symptom measures demonstrated unexpectedly inferior values following certification, possibly reflecting higher case complexity. Conclusion: Achieving and maintaining certification requires substantial and continuous effort from all disciplines involved. While major improvements in morbidity, mortality, and long-term QoL were not observed, certification ensured clearer delegation of responsibilities, standardized documentation, and structured quality control. We therefore consider the certification process valuable for promoting multidisciplinary collaboration, maintaining high treatment volumes, and ensuring transparent oncological care pathways. Full article

(This article belongs to the Section Oncology)

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14 pages, 253 KB

Open AccessArticle

Quantitative Analysis of Selected Circulating Hematological Biomarkers, Essential Minerals, Vitamins, and Thyroid Hormones in Females Affected by Hair Loss

by Saad Al-Fawaeir and Ibrahim Al-Odat

Diseases 2025, 13(11), 352; https://doi.org/10.3390/diseases13110352 - 29 Oct 2025

Abstract

Purpose: To assess the association between hair loss in females and various biomarkers including hemoglobin, iron, ferritin, zinc, selenium, calcium, vitamin D, vitamin B12, folic acid, and thyroid hormones. Patients and methods: This study enrolled 100 women presenting with hair loss and 100 [...] Read more.

Purpose: To assess the association between hair loss in females and various biomarkers including hemoglobin, iron, ferritin, zinc, selenium, calcium, vitamin D, vitamin B12, folic acid, and thyroid hormones. Patients and methods: This study enrolled 100 women presenting with hair loss and 100 age-matched healthy controls. Venous blood samples were collected for analysis of hematological, hormonal and biochemical parameters. Results: The mean age of participants was comparable between groups (43.06 ± 10.76 vs. 41.39 ± 7.94 years; p = 0.88). Hair loss in females had significantly lower mean levels of Hb (11.45 ± 0.39 vs. 13.09 ± 0.46 g/dL; p < 0.001), iron (70.14 ± 7.85 vs. 94.42 ± 5.61 µg/dL; p < 0.001) and ferritin (39.34 ± 3.71 vs. 48.09 ± 5.31 ng/mL), all with p < 0.001. Serum levels of selenium (67.11 ± 5.53 vs. 71.45 ± 4.05 µg/L), zinc (86.07 ± 3.98 vs. 88.87 ± 2.03 µg/L), copper (90.71 ± 3.48 vs. 104.84 ± 5.38 µg/L), and calcium (8.61 ± 0.28 vs. 9.11 ± 0.27 mg/dL) were significantly reduced in women with hair loss (p < 0.001). Thyroid hormones were also significantly lower in the hair loss group, including TSH (1.74 ± 0.25 vs. 2.35 ± 0.39 µIU/mL) and FREE T4 (1.11 ± 0.11 vs. 1.32 ± 0.12 ng/dL), despite remaining within the normal reference ranges. Patients also showed lower serum folate (6.17 ± 0.63 vs. 6.96 ± 0.41 ng/mL), vitamin B12 (185.52 ± 35.27 vs. 258.30 ± 52.84 pg/mL), and vitamin D (26.32 ± 2.98 vs. 32.20 ± 3.76 ng/dL) levels (p < 0.001). Conclusions: Hair loss in females is significantly associated with reduced levels of circulating hemoglobin, iron, copper, selenium, vitamin D, vitamin B12, folate, thyroid-stimulating hormone and FREE T4 hormone. Full article

14 pages, 832 KB

Open AccessArticle

Risk Factors for Recurrent Hip Fractures Following Surgical Treatment of Primary Osteoporotic Hip Fractures in Chinese Older Adults

by Yuzhu Wang, Wenhui Shen, Jiayi Jiang, Lin Wang, Qing Xia, Yunchao Shao and Lu Cao

Diseases 2025, 13(11), 351; https://doi.org/10.3390/diseases13110351 - 27 Oct 2025

Abstract

Objectives: Hip fractures associated with osteoporosis are indicative of high rates of both disability and mortality. The objective of this study was to analyze the risk factors for recurrent hip fractures following primary osteoporotic hip fracture surgery in older adult patients. Methods: A [...] Read more.

Objectives: Hip fractures associated with osteoporosis are indicative of high rates of both disability and mortality. The objective of this study was to analyze the risk factors for recurrent hip fractures following primary osteoporotic hip fracture surgery in older adult patients. Methods: A single-center, retrospective cohort study was conducted on 376 patients suffering from primary osteoporotic hip fractures from 1 January 2020 to 31 December 2021. Multivariate logistic regression was used to identify risk factors for recurrent hip fractures. Results: The study observed 376 patients over a period of three years. The incidence of recurrent hip fractures was 20.5% (77/376). Multiple logistic regression analysis revealed that age ≥ 85 years (odd ratios [OR] = 3.127, 95% confidence interval [CI] = 1.672–5.849, p < 0.001), chronic obstructive pulmonary disease (COPD) (OR = 3.794, 95%CI = 1.747–8.236, p < 0.001), and Parkinson’s disease (PD) (OR = 2.744, 95%CI = 1.249–6.028, p = 0.012) were independent risk factors for recurrent hip fractures; antiosteoporosis drugs (OR = 0.243, 95%CI = 0.131–0.451, p < 0.001), duration of antiosteoporosis drug therapy (OR = 0.564, 95%CI = 0.283–0.830, p = 0.003) and serum albumin ≥ 35 g·L⁻¹ (OR = 0.413, 95%CI = 0.194–0.881, p = 0.022) were independent protective factors for recurrent hip fractures. The receiver operating characteristic (ROC) curve demonstrated that the AUC was 0.802, the sensitivity was 77.8%, and the specificity was 75.5%. A significantly higher three-year mortality rate was observed among patients with recurrent hip fractures (26.0% vs. 15.4%, p = 0.029). Conclusions: Older patients with advanced age, COPD and PD were at greater risk of recurrent hip fractures. Early nutrition intervention and antiosteoporosis drug therapy may decrease the incidence of recurrent hip fractures in older patients, thereby reducing mortality. Full article

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17 pages, 736 KB

Open AccessArticle

Proportion and Correlates of Psychiatric Morbidity Among Psychiatry-Assessed Oncology Inpatients

by Ana-Maria Paslaru, Iulian Bounegru, Catalin Plesea-Condratovici, Moroianu Marius and Anamaria Ciubară

Diseases 2025, 13(11), 350; https://doi.org/10.3390/diseases13110350 - 24 Oct 2025

Abstract

Background/Objectives: Psychiatric morbidity is frequent in oncology, yet prevalence and correlates differ across tumour sites. Urogenital cancers, in particular, involve psychosocial stressors related to sexuality, fertility, continence, and body image, which may intensify anxiety and depression. This study aimed to estimate the proportion [...] Read more.

Background/Objectives: Psychiatric morbidity is frequent in oncology, yet prevalence and correlates differ across tumour sites. Urogenital cancers, in particular, involve psychosocial stressors related to sexuality, fertility, continence, and body image, which may intensify anxiety and depression. This study aimed to estimate the proportion of psychiatric morbidity among psychiatry-assessed oncology inpatients in a real-world hospital setting to compare urogenital with non-urogenital malignancies and to examine clinical correlates and hospitalisation outcomes. Methods: We conducted a retrospective analysis of 174 oncology inpatients who were evaluated by liaison psychiatry and completed the Hospital Anxiety and Depression Scale (HADS) during admission to a tertiary hospital in Galați, Romania, between 2019 and 2022. All patients completed the Hospital Anxiety and Depression Scale (HADS) and underwent liaison psychiatry evaluation. Mixed anxiety–depressive disorder (ICD-10 F41.2) was the primary psychiatric outcome. Demographic, clinical, and functional data—including Eastern Cooperative Oncology Group (ECOG) performance status—were extracted from medical records. Comparative and multivariable analyses were performed to identify predictors of severe depressive symptoms (primary outcome, HADS-D ≥ 11) and to explore associations with length of stay and costs. Results: Overall, 59% of patients had elevated HADS-Anxiety and 62% elevated HADS-Depression, while 40% received a psychiatric diagnosis. Mixed anxiety–depressive disorder predominated, especially in cervical (95%), bladder (100%), and prostate (≈70–75%) cancers. Urogenital cancers showed significantly higher rates of anxiety/depression than non-urogenital cancers (85% vs. 46%, p < 0.01). Poorer ECOG status independently predicted severe depressive symptoms (OR 3.6, 95% CI 2.1–6.2, p < 0.001). Psychiatric morbidity was associated with a trend toward longer LOS (median 12 vs. 9 days, p ≈ 0.08) and ≈10% higher hospital costs. Conclusions: Anxiety and depression were highly frequent among psychiatry-assessed oncology inpatients, particularly in urogenital malignancies. Functional impairment strongly correlates with psychiatric morbidity. These findings underscore the need for systematic screening and risk-stratified psycho-oncologic interventions to improve patient outcomes and resource utilisation. Full article

(This article belongs to the Special Issue Mental Health—Management and Care, Multidisciplinary Approaches and Perspectives)

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10 pages, 250 KB

Open AccessArticle

Exploring the Role of Presepsin in the Prediction of Atrial Fibrillation Recurrence: Results from the PLACEBO Study

by Aristi Boulmpou, Christodoulos Papadopoulos, Theocharis Koufakis, Kalliopi Kotsa, Dimitrios Kouroupis, Georgios Dimakopoulos, Aikaterini Balaska, Georgios Zormpas, Michael Doumas and Vassilios Vassilikos

Diseases 2025, 13(10), 349; https://doi.org/10.3390/diseases13100349 - 20 Oct 2025

Abstract

Background: Presepsin, a soluble CD14 subtype released during immune activation, has emerged as a marker of inflammation in cardiometabolic disorders. Given the links between inflammation, metabolic dysregulation, and atrial fibrillation (AF), presepsin may represent a novel biomarker for predicting AF recurrence. Aims: To [...] Read more.

Background: Presepsin, a soluble CD14 subtype released during immune activation, has emerged as a marker of inflammation in cardiometabolic disorders. Given the links between inflammation, metabolic dysregulation, and atrial fibrillation (AF), presepsin may represent a novel biomarker for predicting AF recurrence. Aims: To evaluate whether presepsin levels, alone or in combination with other biomarkers and clinical parameters, are associated with paroxysmal AF (PAF) recurrence in a well-characterized cohort from the PLACEBO trial. Methods: This was a retrospective exploratory substudy of 62 patients from the PLACEBO cohort with available baseline presepsin measurements. All patients had a history of PAF and were in sinus rhythm at inclusion. Presepsin and other biomarkers were measured at baseline. Reduced multivariable Cox regression models, limited to two or three predictors, were constructed to avoid overfitting. Results: During 12 months of follow-up, 27 patients (43.5%) experienced AF recurrence. Across the reduced multivariable models, each containing a limited number of predictors, obstructive sleep apnea (OSA) consistently emerged as an independent predictor (HR 3.13–3.36, p < 0.05). The use of HR ranges reflects the inclusion of these variables in more than one model. Galectin-3 (GAL3) and standard deviation of R-R intervals (SDRR) did not retain statistical significance, and presepsin was not independently associated with recurrence (HR 1.00, 95% CI 0.92–1.10, p = 0.94). Conclusions: In this exploratory study, OSA emerged as the only independent predictor of AF recurrence. Presepsin was not significantly associated with recurrence in the present cohort; however, given the limited sample size and exploratory design, these results do not exclude a potential association. Larger, adequately powered studies are needed to clarify the role of presepsin in AF recurrence risk. Full article

16 pages, 8480 KB

Open AccessReview

The Radiologists’ Guide to Spinal Separation Surgery: What Does the Surgeon Want to Know?

by Mohsin Khan, Labeeba Haq, Sai Niharika Gavvala, Petr Rehousek, Simon Hughes and Rajesh Botchu

Diseases 2025, 13(10), 348; https://doi.org/10.3390/diseases13100348 - 18 Oct 2025

Abstract

Spinal tumours are an uncommon but significant cause of pain, fractures, instability, and cord compression, leading to poor quality of life and mortality. Separation surgery is a rapidly advancing technique that has seen increased utilisation in the field of spinal oncology surgery. Separation [...] Read more.

Spinal tumours are an uncommon but significant cause of pain, fractures, instability, and cord compression, leading to poor quality of life and mortality. Separation surgery is a rapidly advancing technique that has seen increased utilisation in the field of spinal oncology surgery. Separation surgery can be described as a resection technique that decompresses the spinal cord whilst creating an ablative target for high-dose stereotactic radiotherapy to achieve durable local control while minimising the risk of radiation myelopathy. This has facilitated the delivery of stereotactic radiotherapy, as well as created potential for use in managing primary bone tumours of the spine. From a radiology standpoint, optimal outcomes depend on meticulous preoperative characterisation of tumour volume and stability (e.g., ESCC grade and SINS), clear communication of anatomic constraints relevant to approach and fixation, and systematic postoperative surveillance to distinguish expected postoperative appearances from early recurrence or complications. We present our radiological experience and report recommendations while evaluating spinal oncology separation surgery. Full article

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21 pages, 734 KB

Open AccessReview

Diabetic Ketoacidosis in Young Adults with Type 1 Diabetes: The Impact of the Ketogenic Diet—A Narrative Literature Review

by Joanna Cielecka, Zuzanna Szkamruk, Maciej Walędziak and Anna Różańska-Walędziak

Diseases 2025, 13(10), 347; https://doi.org/10.3390/diseases13100347 - 17 Oct 2025

Abstract

(1) Background: diabetic ketoacidosis (DKA) remains one of the most serious acute complications of type 1 diabetes, especially among young adults. At the same time the ketogenic diet, characterized by high fat and very low carbohydrate intake, is becoming increasingly popular, raising concerns [...] Read more.

(1) Background: diabetic ketoacidosis (DKA) remains one of the most serious acute complications of type 1 diabetes, especially among young adults. At the same time the ketogenic diet, characterized by high fat and very low carbohydrate intake, is becoming increasingly popular, raising concerns about its appropriateness and safety for individuals with type 1 diabetes, (2) Methods: a literature review was conducted using MEDLINE and SCOPUS databases, complemented by additional searches in Embase, Cochrane Library, and Web of Science to ensure broad coverage of both international and European studies with the focus on keywords including “diabetic ketoacidosis”, “type 1 diabetes”, and “ketogenic diet”. The most relevant and up-to-date studies were selected to evaluate both risks and potential clinical applications of this diet in T1D in young adults, (3) Results and Conclusions: While nutritional ketosis under controlled conditions is typically safe, individuals with T1D, especially young adults, may be more vulnerable to DKA due to factors such as inconsistent insulin administration, lack of ketone monitoring, and lifestyle changes. Reports of euglycemic DKA further highlight the importance of regular ketone tracking, even when blood glucose appears within target ranges. Although low-carbohydrate diets may offer improved glycemic profiles, their use in young adults with T1D must be carefully evaluated, emphasizing individualized care plans, close metabolic monitoring, and comprehensive patient education. Ongoing research is essential to clarify whether ketogenic diet can be safely integrated into diabetes management in this population. Full article

(This article belongs to the Special Issue From Monitoring to Management: Addressing Challenges in Type 1 and Type 2 Diabetes Care)

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21 pages, 586 KB

Open AccessReview

Management and Clinical Outcomes of Scleredema Diabeticorum: A Scoping Review

by Weeratian Tawanwongsri and Chime Eden

Diseases 2025, 13(10), 346; https://doi.org/10.3390/diseases13100346 - 17 Oct 2025

Abstract

Background/Objectives: The objective of this scoping review was to systematically map the available evidence for the management of scleredema diabeticorum (SD) to summarize the documented clinical outcomes with the aim to inform clinical practice and identify research gaps. Methods: We conducted a scoping [...] Read more.

Background/Objectives: The objective of this scoping review was to systematically map the available evidence for the management of scleredema diabeticorum (SD) to summarize the documented clinical outcomes with the aim to inform clinical practice and identify research gaps. Methods: We conducted a scoping review identifying studies published in English from January 2005 to July 2025 through a comprehensive search of Scopus, MEDLINE, and the Cochrane Library. Eligible studies included randomized controlled trials, observational studies, case series, and case reports on treatment interventions and clinical outcomes. Two reviewers independently screened records, extracted data, and narratively and descriptively synthesized data. Results: Forty-five studies met the inclusion criteria: 39 single-patient case reports, five case series, and one multicenter observational study. The most common interventions were PUVA (8 studies, 14 patients; 12/14 improved, 85.7%), methotrexate (8 studies, 22 patients; 8/22 improved, 36.4%), and improved glycemic control (9 studies, 12 patients; mixed responses). Across small case reports/series, PUVA, UVA-1, and IVIG were most frequently reported as beneficial. Methotrexate monotherapy showed low and inconsistent effectiveness, with higher responses when combined with other agents. Other reported therapies included colchicine, electron-beam radiation, tranilast, and topical hyaluronidase. Conclusions: PUVA, UVA-1, and IVIG may offer benefit, while methotrexate alone is often ineffective. Evidence is predominantly from case reports and small series, which makes it difficult to generalize. Multicenter trials with standardized protocols are needed to develop evidence-based treatment recommendations. Full article

(This article belongs to the Special Issue ‘Rare Syndromes: Diagnosis and Treatment’ in 2024–2026)

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25 pages, 3355 KB

Open AccessReview

Application and Challenges of Using Probiotic Lactobacillus and Bifidobacterium to Enhance Overall Health and Manage Diseases

by Kawaljit Kaur

Diseases 2025, 13(10), 345; https://doi.org/10.3390/diseases13100345 - 17 Oct 2025

Abstract

Probiotics are known for their health benefits, and new studies suggest they could help with various conditions. However, the specific formulations and mechanisms of probiotics in addressing these issues are still being explored. This review focuses on four key areas: cancer, aging, autoimmune [...] Read more.

Probiotics are known for their health benefits, and new studies suggest they could help with various conditions. However, the specific formulations and mechanisms of probiotics in addressing these issues are still being explored. This review focuses on four key areas: cancer, aging, autoimmune diseases, and neurodegenerative disorders, highlighting the potential benefits of Lactobacillus and Bifidobacterium probiotics. Their interaction with the immune system plays a crucial role in offering protection and therapeutic effects, particularly in enhancing immunity in older adults. The review sheds light on how these probiotics affect the immune system, gut microbiome, and related processes to manage or combat these health problems. It emphasizes the importance of customizing probiotic formulations for specific conditions, as different combinations of Lactobacillus and Bifidobacterium uniquely activate immune cells. Some combinations work as effective treatments for diseases, while others boost immunity in aging. While the potential of these probiotics is significant, challenges remain in using them for cancer, age-related diseases, autoimmune diseases neurodegenerative disorder treatments. Limited evidence calls for further research to define their role and establish guidelines. Future approaches like strain engineering, nanoencapsulation, synbiotics, and personalized microbiome analysis aim to overcome these challenges, making probiotics a more viable option for disease prevention and care. Additionally, there is an urgent need for clinical trials to ensure patients can benefit from these probiotics. Full article

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