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Prevention and Treatment: Focus More on People with Chronic Illness

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A special issue of Healthcare (ISSN 2227-9032).

Deadline for manuscript submissions: 20 August 2026 | Viewed by 7909

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Dr. Liliana Streba

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Guest Editor

Department of Oncology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
Interests: medical oncology; chemotherapy; immunotherapy; radiotherapy; internal medicine; palliative care

Prof. Dr. Cristin Constantin Vere

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Gastroenterology and Internal Medicine, University of Medicine and Pharmacy of Craiova, Craova, Romania
Interests: neuroendocrine system; systemic immune response; liver; gut microbiota; neuro-immune-modulation
Special Issues, Collections and Topics in MDPI journals

Dr. Cosmin Vasile Obleaga

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Department of Surgery, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
Interests: digestive cancer; surgical oncology; surgical resection; liver cancer; laparoscopy

Special Issue Information

Dear Colleagues,

The Special Issue entitled “Prevention and Treatment: Focus More on People with Chronic Illness” aims to address the pressing need for comprehensive strategies in managing chronic diseases. Chronic illnesses, such as cancer, diabetes, cardiovascular diseases, and chronic respiratory conditions, represent a significant burden on global health systems, contributing to high morbidity and mortality rates.

We are pleased to invite you to present original, innovative research and case studies that align with the aims and scope of the journal.

This Special Issue aims to explore innovative approaches in regard to both prevention and treatment, emphasizing the importance of patient-centered care. By bringing together research from diverse disciplines, the publication aims to foster a holistic understanding of chronic illness management and to promote interdisciplinary collaboration.

Through this collection of articles, we hope to provide valuable insights and practical solutions that can be implemented in clinical practice and public health initiatives. Ultimately, our goal is to enhance the quality of life for people living with chronic illnesses and to reduce the overall burden of these conditions on society. It also highlights the role of healthcare policies and community-based interventions in improving health outcomes for individuals with chronic conditions.

In this Special Issue, original research articles and reviews are welcome. Research areas may include (but not limited to) the following: early detection and intervention strategies, lifestyle modifications, and the integration of technology in chronic disease management. We will also try to highlight the role of healthcare policies and community-based interventions in improving health outcomes for individuals with chronic conditions.

We look forward to receiving your contributions.

Dr. Liliana Streba
Prof. Dr. Cristin Constantin Constantin Vere
Dr. Cosmin Vasile Obleaga
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

chronic illness management
patient-centered care
prevention strategies
innovative treatments
health policy interventions
early detection
lifestyle modifications
technology integration
community-based interventions
quality of life improvement

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Published Papers (8 papers)

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Research

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20 pages, 3327 KB

Open AccessArticle

Chronic Implications of Bilateral Foot Pattern Variability in Schoolchildren

by Magdalena Rodica Traistaru, Mihai Cealicu, Daniela Matei, Miruna Andreiana Matei, Liliana Anghelina and Doru Stoica

Healthcare 2025, 13(20), 2586; https://doi.org/10.3390/healthcare13202586 - 14 Oct 2025

Abstract

Background: Foot morphology plays a central role in musculoskeletal development during childhood. Variations in the medial longitudinal arch may influence walking mechanics, and excess body weight can further affect plantar structure and gait. Objective: This study examined the relationship between foot type, body mass index (BMI), and gait function in school-aged children, with particular focus on gait symmetry as a sensitive marker. Methods: Ninety-eight children aged 8–16 years were evaluated. Foot type was classified using a pressure platform, and gait was assessed with a wearable sensor. Outcomes included gait symmetry, walking speed, cadence, Timed Up and Go (TUG), and Six-Minute Walk Distance (6MWD). Results: Mixed bilateral foot patterns were observed in 46 of the 98 participants (47%). Significant associations were found between foot type, BMI, and gait symmetry (p < 0.01), while other mobility measures (speed, cadence, TUG, 6MWD) remained stable across groups. Children with normal bilateral feet showed the best gait symmetry, whereas mixed patterns had the lowest. Conclusions: Gait symmetry is a sensitive indicator of functional imbalance in schoolchildren and is strongly influenced by both foot morphology and body weight. Incorporating plantar assessment and BMI monitoring into routine pediatric evaluations may help clinicians identify children at risk for long-term musculoskeletal problems at an early stage. Full article

(This article belongs to the Special Issue Prevention and Treatment: Focus More on People with Chronic Illness)

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17 pages, 554 KB

Open AccessArticle

Uptake, Willingness, and Determinants of Herpes Zoster Vaccination in Adults with Chronic Diseases in Riyadh, Saudi Arabia

by Haytham I. AlSaif, Lara AlMuaawi, Shaikhah Alsenani, Nouf Aldalaqan, Yara Mulia, Farah Alqazlan, Sara Alsheikh, Muath Alsaidan, Norah A. Alshehri and Abdullah A. Alrasheed

Healthcare 2025, 13(19), 2495; https://doi.org/10.3390/healthcare13192495 - 1 Oct 2025

Viewed by 274

Abstract

Background/Objectives: Herpes zoster (HZ) poses a substantial risk to adults aged ≥ 50, particularly those with chronic disease, and may lead to postherpetic neuralgia. Following Saudi Arabia’s introduction of the recombinant zoster vaccine (RZV), we assessed the RZV’s uptake among adults ≥ 50 and their willingness to receive it and examined how knowledge and attitudes influenced these outcomes. Methods: In 2024, we conducted a cross-sectional, interview-based study in the outpatient clinics of a Riyadh tertiary hospital using a structured questionnaire adapted from the literature to assess knowledge, attitudes, and practices regarding HZ and RZV. Results: Among 333 participants, HZ vaccine uptake was low (12%). Among the unvaccinated, 45.7% (134/293) were willing to be vaccinated, and knowledge of HZ and RZV was low (mean: 3.84/14). Uptake was most strongly associated with physician recommendation (OR: 7.5; 95% CI: 2.79–20.11), followed by greater knowledge (OR: 1.42; 95% CI: 1.19–1.67). Willingness was best predicted by higher attitude scores (OR: 1.28; 95% CI: 1.12–1.48). The most reported barrier was low perceived risk (27%; n = 79). Conclusions: Uptake among adults aged ≥50 with chronic disease was low due to poor knowledge and low perceived risk, yet many were willing to be vaccinated. Enhancing physician–patient counseling and targeted campaigns addressing HZ risk and RZV misconceptions could increase uptake. Full article

(This article belongs to the Special Issue Prevention and Treatment: Focus More on People with Chronic Illness)

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14 pages, 651 KB

Open AccessArticle

A Possible Missing Link Between Obstructive Sleep Apnea Syndrome (OSA) Associated with Tobacco Use and Inflammation Biomarkers

by Adriana-Loredana Pintilie, Andreea Zabara Antal, Bogdan-Mihnea Ciuntu, David Toma, Raluca Tiron, Ruxandra Stirbu, Mihai Lucian Zabara and Radu Crisan Dabija

Healthcare 2025, 13(10), 1177; https://doi.org/10.3390/healthcare13101177 - 19 May 2025

Viewed by 1098

Abstract

Background: Obstructive sleep apnea (OSA) is increasingly recognized as a chronic condition associated with systemic low-grade inflammation. Elevated levels of inflammatory markers such as C-reactive protein (CRP), fibrinogen, TNF-α, and IL-6 have been observed in OSA patients, independent of obesity. Tobacco use, a known pro-inflammatory factor, may further exacerbate this burden. This study aimed to evaluate whether smoking influences inflammatory markers and OSA severity in newly diagnosed patients. Methods: We conducted a retrospective, observational study on individuals newly diagnosed with OSA between 1 January 2024 and 31 December 2024 at the Clinical Hospital of Pulmonary Diseases Iași. All participants underwent overnight respiratory polygraphy using the SleepDoc Porti 9 system (Löwenstein Medical), with OSA severity classified according to the American Academy of Sleep Medicine (AASM) criteria. Inflammatory status was assessed using CRP and the erythrocyte sedimentation rate (ESR). Smokers were defined as individuals who had smoked within the past year; non-smokers had a lifetime history of fewer than 50 cigarettes. Statistical analysis was performed using IBM SPSS Statistics. Results: Smokers (n = 55) shoation Index (ODI) values, compared to non-smokers (n = 49): AHI 45.29 ± 20.94 vs. 38.40 ± 19.84 events/hour, ODI 45.69 ± 21.05 vs. 38.44 ± 19.40 events/hour (p < 0.05 for both). Mean CRP levels were approximately 3.5 times higher in smokers (10.32 ± 11.69 mg/dL) than in non-smokers (2.97 ± 2.45 mg/dL), indicating a significantly elevated inflammatory burden. Conclusions: The inflammatory burden and clinical severity of OSA may be influenced by smoking. Routine inflammatory marker screening, particularly CRP, may improve risk stratification and treatment planning in OSA patients, especially those who smoke or are obese. Routine assessment of CRP and other inflammatory markers may improve risk stratification and guide personalized treatment strategies, particularly in smokers and obese patients with OSA. Full article

(This article belongs to the Special Issue Prevention and Treatment: Focus More on People with Chronic Illness)

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17 pages, 284 KB

Open AccessArticle

The Role of Direct-Acting Antivirals in Enhancing Quality of Life Among Individuals with Chronic Hepatitis C

by Mihail Cristian Pirlog, Claudia Monica Danilescu, Dragos Ovidiu Alexandru, Costin Teodor Streba and Ion Rogoveanu

Healthcare 2025, 13(8), 878; https://doi.org/10.3390/healthcare13080878 - 11 Apr 2025

Viewed by 736

Abstract

Background: Chronic hepatitis C virus (HCV) infection significantly impairs health-related quality of life (HRQoL) and poses a substantial global health concern. Direct-acting antiviral (DAA) therapies have revolutionized HCV treatment, but their impact on HRQoL, particularly considering clinical and psychological factors, requires further investigation. This study aimed to evaluate the influence of DAA therapy on HRQoL in Romanian patients with chronic HCV infection, analyzing the effects of treatment on HRQoL and the role of associated factors. Methods: A prospective, single-center study was conducted on 90 HCV-infected patients treated with a 12-week DAA regimen (Ombitasvir/Paritaprevir/Ritonavir/Dasabuvir). HRQoL was assessed at baseline (BSL), end of treatment (EOT), and 12 weeks post-treatment (SVR) using the WHOQOL BREF questionnaire. Clinical data, including fibrosis degree, prior PegIFN treatment, and psychological assessments (HADS, PSS), were collected. Statistical analyses examined HRQoL trends and associations with clinical and psychological parameters. Results: Significant improvements in HRQoL were observed across all domains over time (p < 0.0001). Gender and residence did not significantly influence HRQoL changes. Fibrosis severity and prior PegIFN treatment had no significant impact on HRQoL progression. However, comorbidities such as anemia and chronic kidney disease moderated improvements in specific HRQoL domains. Anxiety also affected HRQoL, while perceived stress and depression did not show significant effects. Conclusions: DAA therapy significantly enhances HRQoL in HCV-infected patients. While clinical and treatment-related factors had limited influence, comorbidities and anxiety played a moderating role. These findings underscore the importance of personalized care and integrated mental health assessments in HCV management. Full article

(This article belongs to the Special Issue Prevention and Treatment: Focus More on People with Chronic Illness)

20 pages, 1050 KB

Open AccessArticle

Impact of the COVID-19 Pandemic on Gut Cancer Admissions and Management: A Comparative Study of Two Pandemic Years to a Similar Pre-Pandemic Period

by Sergiu Marian Cazacu, Ion Rogoveanu, Adina Turcu-Stiolica, Alexandru Marian Vieru, Anca Gabroveanu, Petrică Popa, Mircea Pirscoveanu, Dan Cartu and Liliana Streba

Healthcare 2025, 13(7), 805; https://doi.org/10.3390/healthcare13070805 - 3 Apr 2025

Cited by 1 | Viewed by 1111

Abstract

Background/Objective: Gastrointestinal tract cancers may have been severely affected by the COVID-19 pandemic. The limitations of digestive endoscopy, the fear effect, and restrictions on hospital admissions during the pandemic may have delayed the presentation of patients to hospitals and surgical procedures and may have impacted overall survival. Methods: We conducted an observational, cross-sectional study of esophageal, gastric, small bowel, and colorectal cancer patients admitted to our hospital between 1 January 2018 and 31 December 2021. We analyzed the hospitalization rates, pathological type, the onset by complications, staging, and surgery during the pandemic compared to a pre-pandemic period (January 2018–December 2019). Results: During 2018–2021, 1613 patients with malignant gut tumors were admitted to our hospital (112 esophageal and eso-cardial tumors, 419 gastric tumors, 34 small bowel tumors, and 1058 colorectal tumors). Admission was reduced by 30.3% for esophageal and eso-cardial malignant tumors, 27.6% for gastric tumors, and 17.3% for malignant colorectal tumors. For esophageal and eso-cardial tumors, a higher frequency of stenosing tumors and palliative gastrostomies was noted. More stage III gastric cancers and a lower rate of vascular invasion were recorded during the pandemic. No differences regarding small bowel tumors were noted. In colorectal tumors, slightly more stage II cancers and more stenosing tumors were recorded, but occlusive, bleeding, and perforated tumors were similar; also, surgical rates were similar, with a two-fold higher perioperative mortality. The overall survival of gastric and colorectal carcinoma was higher during the pandemic (but with no statistical significance), although a clear explanation has not emerged. Conclusions: The impact of the COVID-19 pandemic on gut cancer included a significantly lower rate of newly diagnosed admissions, more stage II colorectal and stage III gastric carcinomas, a two-fold higher perioperative mortality for colorectal carcinoma, and a trend for a surprisingly higher overall survival for gastric and colorectal tumors (but without statistical significance). Future research is necessary for assessing long-term impact. Full article

(This article belongs to the Special Issue Prevention and Treatment: Focus More on People with Chronic Illness)

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Review

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14 pages, 527 KB

Open AccessReview

Field Tests for Assessing Functional Capacity in Children with Chronic Lung Diseases Other than Asthma: A Scoping Review

by Panagiotis Dalamarinis, Eleni A. Kortianou, Aspasia Mavronasou, Vaia Sapouna, Dafni Moriki and Konstantinos Douros

Healthcare 2025, 13(19), 2417; https://doi.org/10.3390/healthcare13192417 - 24 Sep 2025

Viewed by 331

Abstract

Objective: To synthesize the available evidence on field tests used to assess functional capacity in children with CLDs other than asthma, such as cystic fibrosis (CF), and non-CF bronchiectasis (NCFB). Still, the application and reliability of the field tests in non-asthmatic pediatric CLDs populations is scarce. Methods: Three databases (PubMed, Medline via EBSCOhost, and Web of Science) were searched from inception to 20 May 2025. Two researchers independently screened the retrieved articles and rated the methodological quality using the NIH Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Information was extracted about study design, field test used, outcomes measured, and methodological quality. Results: Out of 784 records, 8 studies met the inclusion criteria. Most studies focused on CF. Five different field tests were identified: six-minute walk test (6MWT), modified shuttle walk test (mSWT), one-minute sit-to-stand test (1mSTS), three-minute step test (3mST), and TGlittre-P test. The 6MWT (n = 3) and mSWT (n = 2) were the most frequently used and demonstrated good reliability and clinical applicability. Reported outcomes included distance walked, total steps, task’ repetitions, and cardiopulmonary parameters, such as heart rate and perceived exertion of dyspnea/leg fatigue. Conclusions: Field exercise tests appear to be feasible in children with CLDs other than asthma, with most data available in CF. They can be used to monitor functional capacity over time, to assess the effectiveness of rehabilitation programs, and to complement symptom assessment with tools such as the Borg scale. Evidence in NCFB and PCD is still limited, and additional pediatric studies are needed. Full article

(This article belongs to the Special Issue Prevention and Treatment: Focus More on People with Chronic Illness)

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26 pages, 1312 KB

Open AccessReview

Depression and Anxiety as Comorbidities in Chronic Obstructive Pulmonary Disease: A Comprehensive Narrative Review

by Iulian-Laurențiu Buican, Alina-Cătălina Buican-Chirea, Mădălina Iuliana Mușat and Costin Teodor Streba

Healthcare 2025, 13(18), 2344; https://doi.org/10.3390/healthcare13182344 - 18 Sep 2025

Viewed by 979

Abstract

Background: Chronic Obstructive Pulmonary Disease (COPD) is a prevalent, progressive condition often associated with psychiatric comorbidities such as depression and anxiety, which negatively affect disease progression, treatment adherence, and quality of life. Methods: A narrative review was conducted by searching PubMed and Google Scholar for English-language publications from January 2015 to July 2025. This type of review was selected to allow for a broad and integrative analysis of the current evidence on the association between COPD and psychiatric comorbidities, particularly depression and anxiety. To increase comprehensiveness, the reference lists of the included articles and systematic reviews were manually screened, and data extraction and evaluation were conducted independently by two reviewers. Results: Reported prevalence rates vary widely in COPD patients with depression ranging from 10 to 57% and anxiety from 7 to 50%, largely due to differences in patient populations, diagnostic tools, and disease severity. Identified risk factors include female gender, social isolation, smoking, low BMI, comorbidities, and systemic inflammation. These comorbidities are associated with increased exacerbations, higher hospitalization rates, and poorer clinical outcomes. While inhaled therapies may have limited impact on psychiatric symptoms, antidepressants must be used cautiously. Non-pharmacological interventions, including pulmonary rehabilitation, cognitive-behavioral therapy, physical activity, and social support, demonstrate clear benefits. Conclusions: Effective management of COPD requires integrated approaches that address both pulmonary and psychiatric components. Tailored interventions can improve clinical outcomes and quality of life. This review explores the bidirectional relationship between COPD and psychiatric disorders, aiming to highlight risk factors, diagnostic tools, and both pharmacological and non-pharmacological treatment strategies. Full article

(This article belongs to the Special Issue Prevention and Treatment: Focus More on People with Chronic Illness)

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18 pages, 1033 KB

Open AccessReview

Chronic Obstructive Pulmonary Disease and Depression—The Vicious Mental Cycle

by Alexandru Corlateanu, Serghei Covantsev, Olga Iasabash, Liliana Lupu, Mihaela Avadanii and Nikos Siafakas

Healthcare 2025, 13(14), 1699; https://doi.org/10.3390/healthcare13141699 - 15 Jul 2025

Cited by 2 | Viewed by 2768

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is a heterogeneous lung condition marked by persistent airflow limitation and is currently the fourth leading cause of death worldwide, accounting for 3.5 million deaths in 2021. While its physical manifestations such as dyspnea, chronic cough, and sputum production are well known, its psychological impact, particularly the high prevalence of depression among patients, remains under-recognized. Objectives: This narrative review aims to summarize the existing data on the association between COPD and depression, analyze their pathophysiological connections, explore treatment possibilities, and highlight the interrelationships between these conditions. Methods: A non-systematic literature search was conducted using PubMed, Scopus, and Google Scholar. Studies, reviews, and key publications addressing the relationship between COPD and depression were selected based on clinical relevance. Findings were synthesized thematically to provide a comprehensive and critical overview. Results: Depression in patients with COPD is linked to worse quality of life, increased functional impairment, higher suicide risk, and poorer adherence to treatment. Contributing mechanisms include chronic systemic inflammation, hypoxemia, oxidative stress, and psychosocial risk factors such as low educational level, socioeconomic disadvantage, and comorbidities. Despite evidence of this strong association, treatment strategies remain limited and underutilized, and no unified approach has yet been established. Conclusions: Depression represents a major comorbidity in COPD that exacerbates both disease burden and patient suffering. Further research is essential to clarify the underlying mechanisms and to develop integrated therapeutic approaches. Enhancing our understanding and management of this comorbidity holds promise for significantly improving patient outcomes and overall quality of life. Full article

(This article belongs to the Special Issue Prevention and Treatment: Focus More on People with Chronic Illness)

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