Diseases

15 pages, 1983 KiB

Open AccessArticle

Cyclosporine A Causes Gingival Overgrowth by Promoting Entry into the S Phase at the G1/S Cell Cycle Checkpoint in Gingival Fibroblasts Exposed to Lipopolysaccharide

by Reiri Takeuchi, Noriko Kuwahara, Yuta Amino, Sachiyo Hayashi, Chieko Taguchi, Itaru Suzuki, Haruka Suzuki, Teruaki Nagashima, Kazumune Arikawa, Yuichiro Okada, Takato Nomoto and Koichi Hiratsuka

Diseases 2024, 12(12), 322; https://doi.org/10.3390/diseases12120322 - 10 Dec 2024

Abstract

Objectives: Cyclosporine A promotes gingival fibrosis by enhancing the proliferation of gingival fibroblasts, leading to gingival overgrowth. The population of gingival fibroblasts is regulated by cell cycle machinery, which balances cell growth and inhibition. Cells that detect DNA damage pause at the G1/S [...] Read more.

Objectives: Cyclosporine A promotes gingival fibrosis by enhancing the proliferation of gingival fibroblasts, leading to gingival overgrowth. The population of gingival fibroblasts is regulated by cell cycle machinery, which balances cell growth and inhibition. Cells that detect DNA damage pause at the G1/S checkpoint to repair the damage instead of progressing to the S phase. Previous studies have linked drug-induced gingival overgrowth to the response of fibroblasts to lipopolysaccharide (LPS) and cyclosporine A. This research investigates the effects of cyclosporine A on the G1/S checkpoint and its mediators in LPS-treated gingival fibroblasts to clarify the mechanisms behind cyclosporine-A-induced gingival overgrowth. Methods: Semi-confluent human gingival fibroblasts were treated with LPS or cyclosporine A in DMEM. Cell proliferation was evaluated by counting the total number of cells. The distribution of the cell cycle phases was analyzed using flow cytometry. Additionally, the expression levels of mRNAs and proteins related to cell cycle regulators were quantified by reverse-transcription quantitative PCR and Western blotting, respectively. Results: Cyclosporine A treatment significantly enhanced cell proliferation and the G1-S cell cycle transition. It increased the mRNA levels of CDC25A and CYCLIN D while decreasing those of RB1, SMAD3, and SMAD4. Additionally, it upregulated the protein levels of CDC25A, CYCLIN D, CDK4, CDK6, and pRB and downregulated the protein levels of SMAD3 and SMAD4. Conclusions: Gingival overgrowth induced by cyclosporine A could be attributed to these alterations. Full article

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12 pages, 1062 KiB

Open AccessArticle

Mid-Term Impact of Conduction System Pacing on Overall Cardiac Performance: A Non-Randomized, Prospective, Single-Center Echocardiographic Study

by Catalin Pestrea, Ecaterina Cicala, Roxana Enache, Marcela Rusu, Radu Gavrilescu, Adrian Vaduva, Madalina Ivascu, Florin Ortan and Dana Pop

Diseases 2024, 12(12), 321; https://doi.org/10.3390/diseases12120321 - 10 Dec 2024

Abstract

Introduction. Recently published data suggested significantly lower pacing-induced cardiomyopathy (PICM) incidence with conduction system pacing (CSP). Because most data evaluated only the impact on the left ventricle, this study aimed to assess changes in echocardiographic parameters of morphology and function for all heart [...] Read more.

Introduction. Recently published data suggested significantly lower pacing-induced cardiomyopathy (PICM) incidence with conduction system pacing (CSP). Because most data evaluated only the impact on the left ventricle, this study aimed to assess changes in echocardiographic parameters of morphology and function for all heart chambers in patients with baseline preserved and mid-range LVEF over a medium-term follow-up period after CSP. Methods. A total of 128 consecutive patients with LVEF > 40% and successful CSP for bradyarrhythmic indication were prospectively enrolled. A complete 2D echocardiographic examination was performed at baseline and the last follow-up. Results. In total, 38 patients received His bundle pacing (HBP) and 90 received left bundle branch area pacing (LBBAP). The mean follow-up period was 699.2 ± 177.2 days, with 23 patients lost during this period. The ventricular pacing burden for the entire group was 97.2 ± 4.2%. Only three patients (2.9%) met the criteria for PICM. CSP led to a significant increase in LVEF (from 54.2 ± 7.9 to 56.7 ± 7.8%, p = 0.01) and a significant decrease in LV diastolic (from 107.2 ± 41.8 to 91.3 ± 41.8 mL, p < 0.001) and systolic (from 49.7 ± 21.4 to 39.5 ± 18.2 mL, p < 0.001) volumes. There were no significant changes in E/e′, mitral regurgitation, atrial volumes, and right ventricle (RV) diameter. There was a significant improvement in RV function. Tricuspid regurgitation was the only parameter that worsened. There were no differences in evolution for each echocardiographic parameter between the HBP and the LBBAP groups. Conclusions. HBP and LBBAP are equally protective for harmful changes in both atria and ventricles. The prevalence of PICM, defined as a decrease in LVEF, is very low with CSP. Full article

(This article belongs to the Section Cardiology)

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24 pages, 905 KiB

Open AccessArticle

Gender-Specific Insights into Depression in Patients with Ischemic Heart Disease: Findings from a Pilot Study Using a Self-Developed Questionnaire

by Laura Ioana Bondar, Brigitte Osser, Caius Calin Miuța, Denis Petran, Alexandru Ioan Baltean, Denis Bogdan Butari, Mariana Adelina Mariș, Ligia Elisaveta Piroș, Robert Almășan, Mihaela Gavrila-Ardelean, Liviu Gavrila-Ardelean and Mircea Ioachim Popescu

Diseases 2024, 12(12), 320; https://doi.org/10.3390/diseases12120320 - 10 Dec 2024

Abstract

Background/Objectives: Ischemic heart disease (IHD) significantly affects mental health, with gender-specific differences being observed in psychological responses. This pilot study aimed to explore these differences in the demographic, clinical, psychological, psychiatric, and social profile of patients diagnosed with IHD. Methods: A descriptive, cross-sectional [...] Read more.

Background/Objectives: Ischemic heart disease (IHD) significantly affects mental health, with gender-specific differences being observed in psychological responses. This pilot study aimed to explore these differences in the demographic, clinical, psychological, psychiatric, and social profile of patients diagnosed with IHD. Methods: A descriptive, cross-sectional design was used, recruiting 183 adult patients diagnosed with coronary artery disease and depression at the Psychiatry Department of Arad County Emergency Hospital, Romania, between May 2021 and May 2024. Data were collected using a self-developed tool, named the Depression Assessment in Ischemic Heart Disease Questionnaire (DA-IHDQ), alongside standardized assessments. Statistical analysis was performed using JASP statistical software (Version 0.19.1, University of Amsterdam, Amsterdam, Netherlands), employing binomial and multinomial tests for categorical data, and Cronbach’s alpha was used to assess internal consistency. Results: This study found significant demographic differences, with female patients exhibiting higher levels of emotional distress and severe depression compared with the male subjects. Women reported greater social isolation and a stronger desire to seek for psychological or psychiatric support. Furthermore, a positive correlation between depression severity and physical symptoms was observed in both genders. Conclusions: These findings highlight the importance of recognizing gender-specific responses to IHD, emphasizing the need for tailored interventions in mental healthcare and cardiac rehabilitation. Future research should further explore these differences to enhance the understanding of the psychosocial/psychiatric aspects of IHD and improve patient outcomes. Full article

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11 pages, 456 KiB

Open AccessBrief Report

Serum 25-Hydroxyvitamin D Levels and Disease Activity in Patients with Systemic Lupus Erythematosus: An Exploratory Study in Western Mexico

by Daniela Deossa-Piedrahita, Berenice Vicente-Hernández, Sol Ramírez-Ochoa, Mauricio Alfredo Ambriz-Alarcón, Gabino Cervantes-Pérez, Gabino Cervantes-Guevara, Alejandro González-Ojeda, Clotilde Fuentes-Orozco, Francisco Javier Hernández-Mora, Luis Asdruval Zepeda-Gutiérrez, Jorge Isaac Michel-González, Janet Cristina Vázquez-Beltrán and Enrique Cervantes-Pérez

Diseases 2024, 12(12), 319; https://doi.org/10.3390/diseases12120319 - 8 Dec 2024

Abstract

Background and objectives: The correlation between diminished 25-hydroxyvitamin D (25-(OH)D) concentrations and heightened disease activity in systemic lupus erythematosus (SLE) patients remains contentious, as clinical studies have yielded conflicting outcomes—some propose a potential link, while others assert no relationship exists. Nonetheless, all studies [...] Read more.

Background and objectives: The correlation between diminished 25-hydroxyvitamin D (25-(OH)D) concentrations and heightened disease activity in systemic lupus erythematosus (SLE) patients remains contentious, as clinical studies have yielded conflicting outcomes—some propose a potential link, while others assert no relationship exists. Nonetheless, all studies report a significant prevalence of low 25-(OH)D levels among SLE patients. This study aimed to assess the frequency of low serum levels of 25-(OH)D in Mexican patients with SLE and to evaluate the correlation between 25-(OH)D deficiency or insufficiency and disease activity levels. Materials and Methods: This retrospective analysis comprised patients admitted to our hospital from November 2022 to October 2023, diagnosed with SLE, and had their serum 25-(OH)D levels tested upon admission. The frequency of low levels of 25-(OH)D was assessed, and clinical and demographic data were gathered to examine potential causes linked to 25-(OH)D deficiency or insufficiency. Results: A total of 61 patients were included, and 87% (n = 53) had low serum 25-(OH)D levels. Patients with 25-(OH)D deficiency (n = 21) were significantly younger (mean 23 vs. 39 years, p = 0.04) and had higher protein levels in 24 h urine protein (1.8 vs. 1.1 g/24 h, p = 0.006) than patients who presented only 25-(OH)D insufficiency, without significant differences in other indicators of disease activity. Conclusions: In this investigation, patients with SLE exhibited a high frequency of low serum levels of 25-(OH)D, consistent with existing literature; however, no significant correlations were identified between 25-(OH)D levels and indicators of disease activity. These findings require validation in subsequent research. Full article

(This article belongs to the Special Issue Treatment Strategies and Immune Responses in Rheumatic Diseases)

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10 pages, 263 KiB

Open AccessArticle

Health-Enhancing Physical Activity (HEPA) and Its Barriers Among Working Women at Mansoura University, Egypt

by Wael Ramadan, Mariam Abu Alim, Mohammed Khamis and Abdel-Hady El-Gilany

Diseases 2024, 12(12), 318; https://doi.org/10.3390/diseases12120318 - 7 Dec 2024

Abstract

Background: Identifying physical activity (PA) and its barriers among middle-aged women may aid in the development of age-specific health promotion interventions. In Egypt, women, particularly those in the workforce, typically face numerous barriers that result in low levels of PA. This research seeks [...] Read more.

Background: Identifying physical activity (PA) and its barriers among middle-aged women may aid in the development of age-specific health promotion interventions. In Egypt, women, particularly those in the workforce, typically face numerous barriers that result in low levels of PA. This research seeks to assess the prevalence of health-enhancing physical activity (HEPA) among working women at Mansoura University and identify the associated barriers. Methods: This cross-sectional study employs a quantitative methodology that includes an analytic component. We studied a non-random sample of 760 Egyptian women employed at Mansoura University. Sociodemographic data were collected, and the international physical activity questionnaire (IPAQ) short form was used to assess the level of PA. Additionally, the Barriers to Being Active Quiz (BBAQ) was used to assess barriers to PA. Results: One-fourth of women engage in HEPA; 44.9% are classified as minimally active, while 30.1% are inactive. Multivariable logistic regression analysis showed the type of job is an independent predictor of HEPA, with ARR of 1.7 for manager and administrative roles. The total BBAQ score significantly predicts HEPA (ARR = 0.94). Social influences and lack of willpower scores are significant independent predictors of HEPA (ARR = 0.9 and 0.8, respectively). Most individuals encounter two to five barriers, with only 11.3% experiencing no PA barriers. The most frequently reported barrier is the lack of energy (80.4%), followed by the lack of resources, willpower, and time (74.04%, 69.6%, and 69.4%, respectively). Conclusions: The prevalence of HEPA is low among working women at Mansoura University. Policymakers can utilize findings to promote engagement with and adherence to physical activity. Full article

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

10 pages, 17792 KiB

Open AccessCommunication

Dasatinib and Quercetin as Senolytic Drugs Improve Fat Deposition and Exhibit Antifibrotic Effects in the Medaka Metabolic Dysfunction-Associated Steatotic Liver Disease Model

by Shunta Yakubo, Hiroyuki Abe, Yawen Li, Marina Kudo, Atsushi Kimura, Takuya Wakabayashi, Yusuke Watanabe, Naruhiro Kimura, Toru Setsu, Takeshi Yokoo, Akira Sakamaki, Hiroteru Kamimura, Atsunori Tsuchiya, Kenya Kamimura and Shuji Terai

Diseases 2024, 12(12), 317; https://doi.org/10.3390/diseases12120317 - 4 Dec 2024

Abstract

Metabolic dysfunction-associated steatotic liver disease (MASLD) causes cellular senescence due to oxidative stress, endoplasmic reticulum stress, and ectopic fat deposition in the liver. Recently, dasatinib, an antitumor agent, and quercetin, a dietary supplement, were combined as a senolytic drug to eliminate senescent cells. [...] Read more.

Metabolic dysfunction-associated steatotic liver disease (MASLD) causes cellular senescence due to oxidative stress, endoplasmic reticulum stress, and ectopic fat deposition in the liver. Recently, dasatinib, an antitumor agent, and quercetin, a dietary supplement, were combined as a senolytic drug to eliminate senescent cells. Thus, this study aimed to examine the effects of dasatinib and quercetin administration on removing senescent cells and their therapeutic effects on MASLD in a medaka MASLD model. Dasatinib and quercetin were administered to a medaka MASLD model, which was fed a high-fat diet by dissolving them in aquarium water. The results revealed that senescent cells in the liver were increased in the HFD group but improved in the treatment group. Hematoxylin and eosin staining also showed that treatment improved fat deposition in hepatocytes. In addition, TGFβ1, a driver factor of fibrosis, was reduced in the treatment group. Dasatinib and quercetin eliminated senescent cells in MASLD, attenuated fat deposition, and suppressed fibrosis gene expression. The results indicate that dasatinib and quercetin as senolytic drugs are novel therapeutic agents that reduce MASLD. Full article

(This article belongs to the Section Gastroenterology)

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11 pages, 2224 KiB

Open AccessReview

ECMO in the Management of Noncardiogenic Pulmonary Edema with Increased Inflammatory Reaction After Cardiac Surgery: A Case Report and Literature Review

by Raluca Elisabeta Staicu, Ana Lascu, Petru Deutsch, Horea Bogdan Feier, Aniko Mornos, Gabriel Oprisan, Flavia Bijan and Elena Cecilia Rosca

Diseases 2024, 12(12), 316; https://doi.org/10.3390/diseases12120316 - 4 Dec 2024

Abstract

Noncardiogenic pulmonary edema after cardiac surgery is a rare but severe complication. The etiology remains poorly understood; however, the issue may arise from multiple sources. Possible causes include a significant inflammatory response or an autoimmune process. Pulmonary edema resulting from noncardiac etiologies can [...] Read more.

Noncardiogenic pulmonary edema after cardiac surgery is a rare but severe complication. The etiology remains poorly understood; however, the issue may arise from multiple sources. Possible causes include a significant inflammatory response or an autoimmune process. Pulmonary edema resulting from noncardiac etiologies can necessitate extracorporeal membrane oxygenation (ECMO) because most of the cases present a substantial volume of fluid expelled from the lungs and the medical team must manage the inability to achieve effective ventilation. A 64-year-old patient with known heart disease was admitted to our clinic with acute pulmonary edema. His medical history included Barlow’s disease, severe mitral regurgitation (IIP2), moderate–severe tricuspid regurgitation, and moderate pulmonary hypertension. The patient had a coronary angiography performed in a prior hospitalization before the surgical intervention which indicated the absence of coronary lesions. Preoperative screening (nasal, pharyngeal exudate, inguinal pouch culture, and urine culture) was negative, with no active dental infections. The patient was stabilized, and 14 days post-admission, mitral and tricuspid valve repair was performed via a thoracoscopic approach. After being admitted to intensive care post-surgery, the patient quickly developed pulmonary edema, producing a large volume (4.5 L) of yellow secretions through the intubation tube followed by hemodynamic instability necessitating high doses of medications to support circulation but no cardiorespiratory arrest. Due to his worsening condition, the patient was urgently taken back to the operating room, where veno-venous extracorporeal membrane oxygenation (VV-ECMO) was initiated to support oxygenation and stabilize the patient. Full article

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14 pages, 276 KiB

Open AccessReview

Immune Checkpoint Inhibitor-Associated Celiac Disease: A Retrospective Analysis and Literature Review

by Malvika Gupta, Christopher Graham and Supriya Gupta

Diseases 2024, 12(12), 315; https://doi.org/10.3390/diseases12120315 - 3 Dec 2024

Abstract

Introduction: Immune checkpoint inhibitors (ICI) are used to treat various malignancies. They block the inhibitory signals of tumor cells and enhance the inflammatory cascade, which results in tumor killing. However, this can lead to unchecked inflammation throughout the body, leading to various adverse [...] Read more.

Introduction: Immune checkpoint inhibitors (ICI) are used to treat various malignancies. They block the inhibitory signals of tumor cells and enhance the inflammatory cascade, which results in tumor killing. However, this can lead to unchecked inflammation throughout the body, leading to various adverse effects. A rare gastrointestinal adverse effect of ICI therapy is the development of immune-mediated celiac disease. This entity has a similar clinical presentation to the more common ICI-induced enterocolitis. Our study aims to determine the clinical characteristics and optimal treatment strategies for this rare ICI toxicity and differentiate it from ICI-induced enterocolitis. Methods and Material: We conducted a retrospective analysis of eight cases of ICI-induced celiac disease and 24 cases of ICI-induced enterocolitis from the literature. Data on patient demographics, clinical history, therapeutic interventions and outcomes were collected. A comparative analysis was performed to identify the key differences between the two groups. Results: Patients with ICI-induced celiac disease were more likely to have a pre-existing autoimmune condition and HLA-DQ2 positivity. Significant differences in clinical manifestations, histological findings, and treatment outcomes were observed. Notably, weight loss, nutritional deficiencies and electrolyte abnormalities were more commonly associated with ICI-induced celiac disease. Regarding pathology, duodenal villous blunting was noted more commonly with ICI-induced celiac disease. Initiating a gluten-free diet led to a rapid improvement in patients with ICI-induced celiac disease, while immunosuppressive therapy did not have an impact. Conclusion: ICI-induced celiac disease is a rare and underrecognized gastrointestinal adverse effect of ICI therapy, often misdiagnosed as ICI-induced enterocolitis. Early recognition and treatment with a gluten-free diet can lead to rapid symptom resolution, sparing patients from unnecessary systemic immunosuppression and the discontinuation of antineoplastic immunotherapy. Full article

10 pages, 1039 KiB

Open AccessArticle

Sex Differences in Pain Scores and Medication Consumption for Chronic Non-Cancer Pain

by Alvaro Guerra Branger, Stefania Diaz Morales, Fabiola Adkisson and Nebojsa Nick Knezevic

Diseases 2024, 12(12), 314; https://doi.org/10.3390/diseases12120314 - 3 Dec 2024

Abstract

Background: Chronic pain is defined as any persistent or recurring pain lasting longer than 3 months that significantly affects a person’s quality of life. Millions worldwide are impacted by chronic pain, but its subjective nature makes it difficult to quantify and compare between [...] Read more.

Background: Chronic pain is defined as any persistent or recurring pain lasting longer than 3 months that significantly affects a person’s quality of life. Millions worldwide are impacted by chronic pain, but its subjective nature makes it difficult to quantify and compare between individuals. Methods: This retrospective analysis aimed to examine the differences in pain perception and reporting between male and female patients, as well as how their pain was managed. Data from 1995 patients who met the inclusion criteria were selected from the Advocate Illinois Masonic Pain Clinic database. The types of pain assessed in this study included lower back pain, neck pain, and osteoarthritis. Results: The findings indicate that females suffer more from chronic pain conditions than males, where lower back pain had the highest prevalence in both sexes (63.7% reported). Baseline Numeric Rating Scale (NRS) scores at the first inpatient visit were statistically higher in females than males (7.95 ± 1.35 vs. 7.72 ± 1.46, p = 0.006). After 1 year of treatment, both sexes reported a clinical improvement in their symptoms. With regards to medication, females reported a higher use of medications such as muscle relaxants, benzodiazepines, and tricyclic antidepressants, while males reported a higher use of opioids (measured in MMEs). Conclusions: This study reveals a significant sex difference in the reporting of non-cancer-related chronic pain, with females reporting higher pain intensity than males. Full article

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14 pages, 265 KiB

Open AccessArticle

Association Between Left Ventricular Diastolic Dysfunction, Systemic Inflammation, and Gastrointestinal Symptoms in HIV-Positive Patients on Antiretroviral Therapy

by Madalina-Ianca Suba, Bogdan Hogea, Ahmed Abu-Awwad, Voichita Elena Lazureanu, Ovidiu Rosca, Daniela Gurgus, Sorina Maria Denisa Laitin and Alina Abu-Awwad

Diseases 2024, 12(12), 313; https://doi.org/10.3390/diseases12120313 - 3 Dec 2024

Abstract

Background/Objectives: Despite advancements in antiretroviral therapy (ART), HIV-positive individuals face heightened risks of cardiovascular and gastrointestinal (GI) complications, often linked to persistent systemic inflammation. Left ventricular diastolic dysfunction (LVDD), prevalent in HIV patients, exacerbates this inflammatory state and may contribute to worsened GI [...] Read more.

Background/Objectives: Despite advancements in antiretroviral therapy (ART), HIV-positive individuals face heightened risks of cardiovascular and gastrointestinal (GI) complications, often linked to persistent systemic inflammation. Left ventricular diastolic dysfunction (LVDD), prevalent in HIV patients, exacerbates this inflammatory state and may contribute to worsened GI symptoms. This study aims to explore the association between LVDD, systemic inflammation, and gastrointestinal symptoms in HIV-positive patients undergoing ART. The primary objective is to analyze how LVDD contributes to the inflammatory burden and its impact on gastrointestinal health in this population. Methods: This cross-sectional study included 320 participants divided into three groups: HIV-positive with LVDD (n = 80), HIV-positive without LVDD (n = 120), and HIV-negative controls (n = 120). Levels of inflammatory biomarkers—CRP, IL-6, TNF-α, fibrinogen, IL-1β, IFN-γ, and D-dimer—were measured, and GI symptoms were assessed. Echocardiographic evaluations were performed to determine LVDD presence and severity, while multivariate logistic regression identified predictors of GI complications. Results: Patients in the HIV + LVDD group exhibited significantly elevated levels of TNF-α, CRP, and D-dimer compared to other groups, correlating with higher incidences of nausea, diarrhea, and abdominal pain. TNF-α emerged as the strongest predictor of GI symptoms, underscoring its role in the pathophysiology linking cardiovascular and GI distress in this population. Persistent inflammation and coagulation abnormalities in the ART + LVDD group suggest that ART alone may not fully mitigate these complications. Conclusions: Our findings emphasize the compounded inflammatory burden in HIV patients with LVDD, highlighting the need for integrated approaches that address both cardiovascular and GI symptoms. Anti-inflammatory therapies targeting specific biomarkers like TNF-α could improve clinical outcomes, supporting a more comprehensive strategy to managing HIV-related comorbidities beyond viral suppression. Full article

(This article belongs to the Section Infectious Disease)

15 pages, 2235 KiB

Open AccessArticle

Maternal Supplementation with Lacticaseibacillus rhamnosus GG Improves Glucose Tolerance and Modulates the Intestinal Microbiota of Offspring

by Dayane Correia Gomes, José Enrique Meza Alvarado, Jesus Alejandro Zamora Briseño, Cynthia Cano Sarmiento, Alberto Camacho Morales and Rubi Viveros Contreras

Diseases 2024, 12(12), 312; https://doi.org/10.3390/diseases12120312 - 3 Dec 2024

Abstract

Introduction: Consuming hypercaloric diets during pregnancy induces metabolic, immune, and maternal intestinal dysbiosis disorders. These conditions are transferred to the offspring through the placenta and breastfeeding, increasing susceptibility to metabolic diseases. We investigated the effect of L. rhamnosus GG supplementation on offspring maternally [...] Read more.

Introduction: Consuming hypercaloric diets during pregnancy induces metabolic, immune, and maternal intestinal dysbiosis disorders. These conditions are transferred to the offspring through the placenta and breastfeeding, increasing susceptibility to metabolic diseases. We investigated the effect of L. rhamnosus GG supplementation on offspring maternally programmed with a hypercaloric diet. Methods: Our study involved sixteen female Wistar rats aged ten weeks, which were divided into four groups based on their diets: control (Ctrl), cafeteria (CAF), control + probiotic (PRO), and cafeteria + probiotic (CPRO). The control + probiotic and cafeteria + probiotic groups received a daily oral administration of 250 μL of L. rhamnosus GG cell suspension (equivalent to 10⁹ UFC) for nine weeks. The body weight of the animals was recorded weekly, and their food intake was monitored every 24 h. An oral glucose tolerance test was conducted on the offspring at seven weeks of age. At the ninth week of age, animals were euthanized, and blood, tissues, and organs were collected. Results: Maternal supplementation with L. rhamnosus GG decreased food intake and the average birth weight, improved glucose sensitivity, and lowered the levels of LDL, cholesterol, triglycerides, and mesenteric adipose tissue in offspring compared with the control and cafeteria groups. Conclusions: Our findings indicate that supplementing with LGG during maternal programming could protect offspring from metabolic disruptions caused by a hypercaloric maternal diet. Full article

(This article belongs to the Special Issue Recent Advances in Gastroenterology and Nutrition)

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31 pages, 3640 KiB

Open AccessReview

Helicobacter pylori: Routes of Infection, Antimicrobial Resistance, and Alternative Therapies as a Means to Develop Infection Control

by Ayman Elbehiry, Adil Abalkhail, Nuha Anajirih, Fahad Alkhamisi, Mohammed Aldamegh, Abdullah Alramzi, Riyad AlShaqi, Naif Alotaibi, Abdullah Aljuaid, Hilal Alzahrani, Feras Alzaben, Mohammed Rawway, Mai Ibrahem, Moustafa H. Abdelsalam, Nermin I. Rizk, Mohamed E. A. Mostafa, Moneef Rohail Alfaqir, Husam M. Edrees and Mubarak Alqahtani

Diseases 2024, 12(12), 311; https://doi.org/10.3390/diseases12120311 - 3 Dec 2024

Abstract

Helicobacter pylori (H. pylori) is a Gram-negative, spiral-shaped bacterium that colonizes the gastric epithelium and is associated with a range of gastrointestinal disorders, exhibiting a global prevalence of approximately 50%. Despite the availability of treatment options, H. pylori frequently reemerges and [...] Read more.

Helicobacter pylori (H. pylori) is a Gram-negative, spiral-shaped bacterium that colonizes the gastric epithelium and is associated with a range of gastrointestinal disorders, exhibiting a global prevalence of approximately 50%. Despite the availability of treatment options, H. pylori frequently reemerges and demonstrates increasing antibiotic resistance, which diminishes the efficacy of conventional therapies. Consequently, it is imperative to explore non-antibiotic treatment alternatives to mitigate the inappropriate use of antibiotics. This review examines H. pylori infection, encompassing transmission pathways, treatment modalities, antibiotic resistance, and eradication strategies. Additionally, it discusses alternative therapeutic approaches such as probiotics, anti-biofilm agents, phytotherapy, phototherapy, phage therapy, lactoferrin therapy, and vaccine development. These strategies aim to reduce antimicrobial resistance and enhance treatment outcomes for H. pylori infections. While alternative therapies can maintain low bacterial levels, they do not achieve complete eradication of H. pylori. These therapies are designed to bolster the immune response, minimize side effects, and provide gastroprotective benefits, rendering them suitable for adjunctive use alongside conventional treatments. Probiotics may serve as adjunctive therapy for H. pylori; however, their effectiveness as a monotherapy is limited. Photodynamic and phage therapies exhibit potential in targeting H. pylori infections, including those caused by drug-resistant strains, without the use of antibiotics. The development of a reliable vaccine is also critical for the eradication of H. pylori. This review identifies candidate antigens such as VacA, CagA, and HspA, along with various vaccine formulations, including vector-based and subunit vaccines. Some vaccines have demonstrated efficacy in clinical trials, while others have shown robust immune protection in preclinical studies. Nevertheless, each of the aforementioned alternative therapies requires thorough preclinical and clinical evaluation to ascertain their efficacy, side effects, cost-effectiveness, and patient compliance. Full article

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35 pages, 2154 KiB

Open AccessReview

A Review on Risk Factors, Traditional Diagnostic Techniques, and Biomarkers for Pneumonia Prognostication and Management in Diabetic Patients

by Shehwaz Anwar, Fahad A. Alhumaydhi, Arshad Husain Rahmani, Vikalp Kumar and Faris Alrumaihi

Diseases 2024, 12(12), 310; https://doi.org/10.3390/diseases12120310 - 2 Dec 2024

Abstract

People of all ages can contract pneumonia, and it can cause mild to severe disease and even death. In addition to being a major cause of death for elderly people and those with prior medical conditions such as diabetes, it isthe world’s biggest [...] Read more.

People of all ages can contract pneumonia, and it can cause mild to severe disease and even death. In addition to being a major cause of death for elderly people and those with prior medical conditions such as diabetes, it isthe world’s biggest infectious cause of death for children. Diabetes mellitus is a metabolic condition with a high glucose level and is a leading cause of lower limb amputation, heart attacks, strokes, blindness, and renal failure. Hyperglycemia is known to impair neutrophil activity, damage antioxidant status, and weaken the humoral immune system. Therefore, diabetic patients are more susceptible to pneumonia than people without diabetes and linked fatalities. The absence of quick, precise, simple, and affordable ways to identify the etiologic agents of community-acquired pneumonia has made diagnostic studies’ usefulness contentious. Improvements in biological markers and molecular testing techniques have significantly increased the ability to diagnose pneumonia and other related respiratory infections. Identifying the risk factors for developing severe pneumonia and early testing in diabetic patients might lead to a significant decrease in the mortality of diabetic patients with pneumonia. In this regard, various risk factors, traditional testing techniques, and pathomechanisms are discussed in this review. Further, biomarkers and next-generation sequencing are briefly summarized. Finding biomarkers with the ability to distinguish between bacterial and viral pneumonia could be crucial because identifying the precise pathogen would stop the unnecessary use of antibiotics and effectively save the patient’s life. Full article

(This article belongs to the Special Issue Epidemiological Trends and Risk Factors in Geriatric and Infectious Diseases)

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11 pages, 1191 KiB

Open AccessCommentary

Evidence-Based Guidance for One Health Preparedness, Prevention, and Response Strategies to Marburg Virus Disease Outbreaks

by Claude Mambo Muvunyi, Jean Claude Semuto Ngabonziza, Noella Bigirimana, Nicaise Ndembi, Emmanuel Edwar Siddig, Jean Kaseya and Ayman Ahmed

Diseases 2024, 12(12), 309; https://doi.org/10.3390/diseases12120309 - 2 Dec 2024

Abstract

Objectives: Marburg virus disease (MVD) is on the WHO list for pandemic-prone pathogens. The current outbreak in Rwanda provides an opportunity to map outbreaks and generate information to inform policymaking, resource mobilization, and guide the implementation of cost-effective response strategies. Methods: We synthesized [...] Read more.

Objectives: Marburg virus disease (MVD) is on the WHO list for pandemic-prone pathogens. The current outbreak in Rwanda provides an opportunity to map outbreaks and generate information to inform policymaking, resource mobilization, and guide the implementation of cost-effective response strategies. Methods: We synthesized available information about MVD to build holistic, up-to-date evidence to inform policymakers, public health leaders, and healthcare and public health services providers in their development and implementation of cost-effective preparedness, prevention, and control measures. Results: We have identified 20 outbreaks of MVD that occurred in 14 countries between 1967 and 2024; these outbreaks led to 580 confirmed cases and 423 deaths in total. We summarize the available information about the main clinical signs, diagnostic tools, primary reservoir, transmission dynamics, and case management protocol. We also document the best practices in the prevention and control of MVD outbreaks, including the implementation of a multisectoral One Health strategy for preparedness, prevention, and response to MVD outbreaks that incorporates the strict implementation of WASH and infection prevention measures, contact tracing, and the isolation of infected and suspected humans and animals, and enhances the implementation of the International Health Regulations, particularly efficient cross-country coordination. Conclusions: In the absence of a licensed treatment or vaccine for MVD, the response strategy to MVD should focus on preventive measures, including community engagement to promote the reduction in contact between humans and reservoirs, the supportive care and isolation of patients, and proper waste management. High risk populations such as frontline responders, including healthcare providers and community health workers, should be prioritized so that they can access all currently available protection measures. Full article

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10 pages, 8730 KiB

Open AccessArticle

Differentiating Benign from Malignant Causes of Splenomegaly: Is Acoustic Radiation Force Impulse Elastography Helpful?

by Amjad Alhyari, Oussama Dob, Ehsan Safai Zadeh, Christoph Frank Dietrich, Corrina Trenker, Thomas M. Gress and Christian Görg

Diseases 2024, 12(12), 308; https://doi.org/10.3390/diseases12120308 - 30 Nov 2024

Abstract

Purpose: To evaluate the ability of acoustic radiation force impulse (ARFI) elastography in differentiating benign from malignant etiologies of splenomegaly based on differences in splenic stiffness. Materials and Methods: Between September 2020 and November 2022, we evaluated 40 patients with splenomegaly—defined by a [...] Read more.

Purpose: To evaluate the ability of acoustic radiation force impulse (ARFI) elastography in differentiating benign from malignant etiologies of splenomegaly based on differences in splenic stiffness. Materials and Methods: Between September 2020 and November 2022, we evaluated 40 patients with splenomegaly—defined by a splenic long axis greater than 13 cm and/or a short axis greater than 6 cm, without visible focal or infiltrative mass lesions—using abdominal ultrasound at our university hospital. Each patient also underwent a standardized ARFI elastographic assessment of the enlarged spleen, with data collected prospectively. We then retrospectively analyzed the cases with confirmed etiologies of splenomegaly from their final medical reports. Mean ARFI velocities (MAV) were compared across patients with splenomegaly due to malignant infiltration (MIS) from hematological malignancy, congestive splenomegaly (CS) due to portal or splenic vein congestion/occlusion, and immune-related splenomegaly (IRS) associated with systemic infectious or autoimmune diseases. Results: Among the 40 patients with splenomegaly, 21 (52.5%) were diagnosed with malignant infiltrative splenomegaly (MIS), 11 (27.5%) with congestive splenomegaly (CS), and 8 (20%) with immune-related splenomegaly (IRS). The mean ARFI velocities (MAV) for the MIS, CS, and IRS groups were 3.25 ± 0.68 m/s, 3.52 ± 0.47 m/s, and 2.84 ± 0.92 m/s, respectively. No significant differences were observed in splenic stiffness (MAV) among these groups. Conclusions: Differentiating between benign and malignant etiologies of splenomegaly based on stiffness differences observed in ARFI elastography is not feasible. Larger prospective studies are necessary to validate these findings. Full article

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11 pages, 520 KiB

Open AccessArticle

Quality of Life Evaluation Before and After Pulmonary Lobe Resection for Benign Diseases: A Comparative Study Among Patients with Tuberculosis, Bronchiectasis, and Benign Lung Nodules

by Alin Nicola, Tamara Mirela Porosnicu, Sorina Maria Denisa Laitin, Cristian Oancea and Emanuela Tudorache

Diseases 2024, 12(12), 307; https://doi.org/10.3390/diseases12120307 - 30 Nov 2024

Abstract

Background: Pulmonary lobe resection is a common surgical intervention for various benign lung diseases, including tuberculosis (TB), bronchiectasis, and benign lung nodules. While immediate clinical outcomes are well documented, the impact on patients’ quality of life (QoL) remains less explored. This study aims [...] Read more.

Background: Pulmonary lobe resection is a common surgical intervention for various benign lung diseases, including tuberculosis (TB), bronchiectasis, and benign lung nodules. While immediate clinical outcomes are well documented, the impact on patients’ quality of life (QoL) remains less explored. This study aims to evaluate QoL before and after pulmonary lobe resection over a 6-month period among patients with benign lung diseases. Objectives: To assess and compare changes in QoL among patients undergoing pulmonary lobe resection for TB, bronchiectasis, and benign lung nodules, and to identify factors influencing QoL outcomes. Methods: This prospective study included 84 patients who underwent pulmonary lobe resection for benign lung diseases, divided into three groups: TB (n = 22), bronchiectasis (n = 31), and benign lung nodules (n = 31). QoL was assessed using the SF-36 and WHOQOL-BREF questionnaires preoperatively and at 6 months postoperatively. Anxiety and depression were evaluated using the Hospital Anxiety and Depression Scale (HADS), and perceived stress was measured using the Perceived Stress Scale (PSS-10). Statistical analyses included paired t-tests, ANOVA, and Pearson’s correlation, with p-values < 0.05 considered significant. Results: At 6 months postoperatively, all groups showed significant improvements in physical and mental QoL scores (p < 0.05). The TB group exhibited the greatest improvement in physical health domains, while the bronchiectasis group showed significant enhancement in social functioning. Anxiety and depression scores decreased significantly in all groups, with the TB group showing the most substantial reduction (p < 0.01). Perceived stress levels also decreased across all groups. Comparisons revealed that the TB group had significantly higher QoL improvement compared to the other groups (p < 0.05). Conclusions: Pulmonary lobe resection for benign diseases significantly improves QoL over a 6-month period, particularly in patients with TB. The findings suggest that surgical intervention not only alleviates physical symptoms but also enhances psychological well-being. These results underscore the importance of considering QoL outcomes in the management of benign lung diseases requiring surgical intervention. Full article

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14 pages, 756 KiB

Open AccessArticle

Bioelectrical Impedance Analysis of Body Composition in Male Childhood Brain Tumor Survivors

by Alberto Romano, Fabrizio Sollazzo, Fabio Corbo, Giorgio Attinà, Stefano Mastrangelo, Simona Cordaro, Gloria Modica, Isabella Carlotta Zovatto, Riccardo Monti, Massimiliano Bianco, Palma Maurizi, Vincenzo Palmieri and Antonio Ruggiero

Diseases 2024, 12(12), 306; https://doi.org/10.3390/diseases12120306 - 28 Nov 2024

Abstract

Background. Childhood brain tumor survivors (CCSs) are at high risk of developing metabolic syndrome (MetS) and sarcopenia. To date, a tool able to predict any body composition changes or detect them early and increased adiposity (and, therefore, increased likelihood of MetS onset) [...] Read more.

Background. Childhood brain tumor survivors (CCSs) are at high risk of developing metabolic syndrome (MetS) and sarcopenia. To date, a tool able to predict any body composition changes or detect them early and increased adiposity (and, therefore, increased likelihood of MetS onset) is still lacking in this population. Objective. The objective was to analyze differences in a bioelectrical impedance analysis (BIA) of body composition between male childhood brain tumor cancer survivors and healthy controls. Methods. In this pilot, prospective, observational study, 14 male CCSs were compared to 14 healthy controls matched for sex and age. Results. CCSs showed statistically significant lower mean values in terms of their body metabolic rate (BMR), body cell mass index (BCMI), fat-free mass (FFM), skeleton muscle mass (SM), skeletal muscle mass index (SMI), and appendicular skeletal muscular mass (ASMM). CCSs also showed a statistically significantly higher mean value of resistance when compared with controls. The BMR, BCM, FFM, and ASMM were significantly correlated with total doses of carboplatin (Tau = −0.601; p = 0.018; Tau = −0.599, p = 0.025; Tau = −0.601, p = 0.018; Tau = −0.509, p = 0.045, respectively). Conclusion. A BIA allows for the detection of changes in body composition in survivors of childhood brain tumors, revealing either the presence of central obesity correlated with the risk of MetS or signs of sarcopenia that deserve early treatment. Full article

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10 pages, 230 KiB

Open AccessArticle

Impact of Autism on the Relation Between Sleep and Life Satisfaction in Japanese Adults

by Yuji Shimizu, Tomokatsu Yoshida, Keiko Ito, Kumiko Terada, Nagisa Sasaki, Eiko Honda and Kazushi Motomura

Diseases 2024, 12(12), 305; https://doi.org/10.3390/diseases12120305 - 28 Nov 2024

Abstract

Background/Objectives: Sleep disorders, such as short sleep, are common comorbidities in individuals with autism spectrum disorder (ASD). Sleep quality and duration are directly associated with quality of life (QOL). Clarifying the influence of ASD on the association between short sleep duration and life [...] Read more.

Background/Objectives: Sleep disorders, such as short sleep, are common comorbidities in individuals with autism spectrum disorder (ASD). Sleep quality and duration are directly associated with quality of life (QOL). Clarifying the influence of ASD on the association between short sleep duration and life satisfaction is an efficient way to improve the QOL of patients with ASD. Methods: To clarify the influence of ASD on the association between short sleep duration and life satisfaction scale scores, we conducted a web-based cross-sectional study involving 3823 Japanese adults aged 20–64 years. Results: In all the participants, a significant inverse association was observed between short sleep duration and life satisfaction. The adjusted odds ratio (OR) and 95% confidence interval (CI) of short sleep for one standard deviation (SD), the increment of life satisfaction scale (2.5 for men and 2.4 for women), was 0.76 (0.70, 0.82). When the analyses were stratified by ASD status, a significant inverse association was observed only among participants without ASD. The corresponding ORs (95% CIs) were 0.73 (0.67, 0.80) and 1.08 (0.85, 1.39) for those with and without ASD. Patients with ASD also showed a significant interaction effect on the association between short sleep duration and life satisfaction. Conclusions: Only participants without ASD showed a significant inverse association between short sleep duration and life satisfaction. Although further investigations are necessary, these results can help clarify the mechanism underlying the association between QOL, short sleep duration, and ASD. Full article

13 pages, 852 KiB

Open AccessArticle

Comparative Analysis of qSOFA, PRIEST, PAINT, and ISARIC4C Scores in Predicting Severe COVID-19 Outcomes Among Patients Aged over 75 Years

by Daniela Rosca, Vamsi Krishna, Chandramouli Chetarajupalli, Adelina Maria Jianu, Ilona Emoke Deak, Claudia Raluca Balasa Virzob, Sorina Maria Denisa Laitin, Madalina Boruga and Rodica Lighezan

Diseases 2024, 12(12), 304; https://doi.org/10.3390/diseases12120304 - 28 Nov 2024

Abstract

Background: Elderly patients, particularly those over 75 years old, have been disproportionately affected by COVID-19, exhibiting higher rates of severe outcomes, such as ICU admissions and mortality. This study aimed to evaluate and compare the effectiveness of various clinical scoring systems—qSOFA, PRIEST, PAINT, [...] Read more.

Background: Elderly patients, particularly those over 75 years old, have been disproportionately affected by COVID-19, exhibiting higher rates of severe outcomes, such as ICU admissions and mortality. This study aimed to evaluate and compare the effectiveness of various clinical scoring systems—qSOFA, PRIEST, PAINT, and ISARIC4C—in predicting ICU admission, the need for mechanical ventilation, and mortality among elderly COVID-19 patients. Methods: In this retrospective cohort study conducted at two tertiary care hospitals, 131 elderly patients (aged ≥ 75) and 226 younger controls (aged < 65) with confirmed COVID-19 were included. Clinical scores were computed at admission and five days after symptom onset. Kaplan–Meier survival analysis and Receiver Operating Characteristic (ROC) curve analysis were performed to assess the predictive performance of the scores regarding severe outcomes. Results: Kaplan–Meier analysis indicated significantly lower survival probabilities for elderly patients with high scores at admission. Those with an ISARIC4C score above 11.8 had a survival probability of 25% compared to 74% for those below this threshold (p < 0.001). Similarly, elderly patients with a qSOFA score above 2.1 had a survival probability of 36% compared to 72% for those with lower scores (p < 0.001). The PRIEST and PAINT scores also demonstrated predictive validity; patients with a PRIEST score above 6.3 and a PAINT score above 6.5 at admission showed comparable decreases in survival probabilities. ROC analysis at five days post-symptom onset revealed that the ISARIC4C score had the highest area under the curve (AUC) of 0.772, suggesting excellent predictive validity for severe outcomes, including mortality. The optimal cutoffs identified were 11.2 for ISARIC4C, 6.3 for PRIEST, and 6.5 for PAINT, each displaying high sensitivity and specificity. Conclusions: The ISARIC4C, qSOFA, PRIEST, and PAINT scores are robust predictors of severe outcomes in elderly COVID-19 patients over 75 years old, as confirmed by Kaplan–Meier and ROC analyses. These tools can be crucial for early identification of patients at high risk of adverse outcomes, guiding clinical decision making, and optimizing resource allocation. The use of these scoring systems should be encouraged in clinical settings to enhance the management of elderly COVID-19 patients. Further research is necessary to validate these findings across different populations and settings. Full article

(This article belongs to the Special Issue COVID-19 and Global Chronic Disease 2024: The Post-pandemic Era)

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