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Life
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Conservative Management of Chronic Disease
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Conservative Management of Chronic Disease

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Medical Research".

Deadline for manuscript submissions: 26 May 2025 | Viewed by 14829

Special Issue Editor

Dr. Jonathan Sinclair

E-Mail Website
Guest Editor
School of Sport and Health Sciences, University of Central Lancashire, Preston PR1 2HE, UK
Interests: biomechanics; finite element analysis; statistical analyses; randomized controlled trials
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Chronic conditions are representative of various health-related states of the human body, such as syndromes, physical impairments, disabilities as well as diseases. People of all age groups, regions and countries are affected by chronic disease. Conservative management is a type of medical treatment defined by the avoidance of invasive measures such as surgery, usually with the intent to preserve function. The aims of conservative management are as follows:

  1. Preventing the symptoms of disease;
  2. Treating the symptoms of disease;
  3. Protecting and maintaining functions.

This Special Issue ‘Conservative Management of Chronic Disease’ invites submissions from researchers on a wide spectrum of topics related to improving and enhancing chronic disease management.

Dr. Jonathan Sinclair
Guest Editor

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. Life is an international peer-reviewed open access monthly 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 2600 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 disease 
  • conservative management
  • trial protocol
  • clinical research
  • interventions

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Published Papers (5 papers)

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Research

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11 pages, 577 KiB  
Article
The Impact of Postoperative Albumin Levels on Furosemide Efficacy in Infants with Congenital Heart Disease
by Ayşegül Aşır, Bedri Aldudak and Nilüfer Matur Okur
Life 2024, 14(12), 1679; https://doi.org/10.3390/life14121679 - 18 Dec 2024
Viewed by 1062
Abstract
Postoperative fluid overload is associated with increased mortality and morbidity in infants with congenital heart disease (CHD). Loop diuretics, such as furosemide, are commonly used to prevent fluid overload in the postoperative period. This study aimed to investigate the effect of postoperative albumin [...] Read more.
Postoperative fluid overload is associated with increased mortality and morbidity in infants with congenital heart disease (CHD). Loop diuretics, such as furosemide, are commonly used to prevent fluid overload in the postoperative period. This study aimed to investigate the effect of postoperative albumin levels on the efficacy of furosemide after surgery in infants with CHD. From 1 January 2017 to 31 December 2022, postoperative albumin levels, total furosemide doses, and three-day postoperative diuresis levels were retrospectively analyzed in 186 patients aged 0–1 years who underwent cardiopulmonary bypass at the Pediatric Intensive Care Unit, Diyarbakır Gazi Yaşargil Training and Research Hospital. Demographic and clinical parameters, along with urine output in the first 6 h, first 24 h, 24–48 h, and 48–72 h postoperatively, were recorded. Patients were divided into two groups based on their albumin levels: normal albumin (≥30 g/dL) and hypoalbuminemia (<30 g/dL). A common protein interaction network for albumin and furosemide was constructed using Cytoscape software (version 3.10.2). Of the 186 patients, 79 (42.5%) were male and 107 (57.5%) were female, with a median age of 97.5 days (range 1–360 days). Furosemide doses were higher in hypoalbuminemic patients on postoperative days 1 and 2 compared to normoalbuminemic patients. On postoperative day 1, hypoalbuminemia was more prevalent in patients with oliguria, whereas normoalbuminemia was significantly higher in patients with normouria and polyuria. Furosemide doses were significantly higher in patients with oliguria than in those with normouria in the first 6 h and lower in patients with polyuria compared to those with normouria. A positive correlation was observed between albumin levels and furosemide efficacy on postoperative day 2. Additionally, a positive correlation existed between albumin levels on postoperative day 1 and urine output in the first 6 and 24 h postoperatively. Furosemide efficacy and urine output were positively correlated in the postoperative period. Mortality risk was significantly higher in hypoalbuminemic patients on postoperative days 1 and 2, as well as in patients with oliguria in the first 6 and 24 h postoperatively. Network analysis revealed that albumin was directly involved in furosemide’s target network, along with six other proteins within the common interaction network. Diuresis levels were significantly lower in hypoalbuminemic patients. We suggest that the effectiveness of furosemide is reduced because it cannot bind to albumin at sufficient levels. The effective management of albumin levels may enhance furosemide efficacy and improve postoperative outcomes in infants with CHD. Full article
(This article belongs to the Special Issue Conservative Management of Chronic Disease)
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14 pages, 8909 KiB  
Article
Diet Supplementation with Ketoanalogues, Inulin, and Calcium Citrate in Chronic Kidney Disease: A Retrospective Cohort
by Martín Calderón-Juárez, Nadia Saavedra-Fuentes, Karla Guadalupe Del Castillo-Loreto, Juan Carlos Castillo-Salinas and Claudia Lerma
Life 2024, 14(12), 1638; https://doi.org/10.3390/life14121638 - 10 Dec 2024
Viewed by 1058
Abstract
The addition of ketoanalogues (KAs) to a low-protein diet has been shown to mitigate the progression of pre-dialysis chronic kidney disease (CKD). The addition of inulin and calcium citrate may add further benefits, given their nephroprotective effects. In this study, we tested the [...] Read more.
The addition of ketoanalogues (KAs) to a low-protein diet has been shown to mitigate the progression of pre-dialysis chronic kidney disease (CKD). The addition of inulin and calcium citrate may add further benefits, given their nephroprotective effects. In this study, we tested the changes in estimated glomerular filtration rate (eGFR), CKD symptoms, body composition, and biochemical parameters after 6 months of diet supplementation with Cetolán III, a combination of KA, inulin, and calcium citrate. We included 76 adult patients diagnosed with CKD stages 3 and 4 and not treated with renal replacement therapy in a retrospective cohort. In this cohort, participants were followed through two clinic visits at 3 and 6 months after diet supplementation. We found a slight increase in eGFR at 3 and 6 months compared with baseline, as well as a decrease in the severity of CDK-related symptoms, fat mass, and muscle mass. We observed only a slight decrease in creatinine and uric acid after 6 months of follow-up. We did not find a remarkable change in anthropometric parameters (e.g., body mass index, waist circumference, and arm muscle area). This observational study suggests that addition of KA, inulin, and calcium citrate to a low protein- diet could be associated with an improvement in eGFR and symptom severity in CKD pre-dialysis. Full article
(This article belongs to the Special Issue Conservative Management of Chronic Disease)
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14 pages, 1033 KiB  
Article
Effects of a Nutrition Education Programme in Stage IV Cardiac Rehabilitation Patients: A 3-Arm Randomised Controlled Trial
by Jonathan Sinclair, Stephanie Dillon, Nicola M. Lowe and April Melia
Life 2024, 14(1), 63; https://doi.org/10.3390/life14010063 - 29 Dec 2023
Cited by 3 | Viewed by 1815
Abstract
This trial examined the influence of two nutrition intervention programmes on health-related and nutritional intake indices pertinent to cardiovascular disease compared to usual care in stage IV cardiac rehabilitation patients. Sixty-six patients were recruited from the Heartbeat North-West cardiac rehabilitation centre in Preston [...] Read more.
This trial examined the influence of two nutrition intervention programmes on health-related and nutritional intake indices pertinent to cardiovascular disease compared to usual care in stage IV cardiac rehabilitation patients. Sixty-six patients were recruited from the Heartbeat North-West cardiac rehabilitation centre in Preston (United Kingdom). Patients were randomly assigned to Usual care, Biggest loser or Nutrition education arms. Usual care undertook their usual two exercise classes per week without nutritional support, Biggest loser underwent weekly education sessions focussing on weight loss using the themes within the British Heart Foundation ‘So You Want to Lose Weight for Good’ guidelines, and Nutrition education followed the same themes as Biggest loser but in a more focussed manner informed by patient focus groups. In total, this was a 12-week trial in which patients spent 6 weeks engaged in their allocated intervention arm, after which all participants switched to Usual care. The primary outcome was systolic blood pressure, and secondary measures of anthropometric, blood biomarker, nutritional knowledge (via the Mediterranean Diet Assessment Tool) and nutritional intake indices were measured at baseline, 6 weeks, and 12 weeks (follow-up). Intention-to-treat analyses revealed no significant alterations in the primary outcome (Usual care: baseline = 130.45 mmHg, 6 weeks = 127.83 mmHg, and follow-up = 126.35 mmHg, Biggest loser: baseline = 133.50 mmHg, 6 weeks = 123.06 mmHg, and follow-up = 135.22 mmHg, or Nutrition education: baseline = 135.23 mmHg, 6 weeks = 129.20 mmHg, and follow-up = 126.26 mmHg) between arms. However, at 6 weeks, improvements in triglycerides were significantly greater in Usual care (baseline = 1.61 mmol/L and 6 weeks = 1.43 mmol/L) group compared to Nutrition education (baseline = 1.70 mmol/L and 6 weeks = 2.21 mmol/L). Improvements in nutrition knowledge were significantly greater in Nutrition education (baseline = 8.48, 6 weeks = 9.77, and follow-up = 10.07) compared to Usual care (baseline = 7.71, 6 weeks = 8.00, and follow-up = 8.00) and Biggest loser (baseline = 7.71, 6 weeks = 8.73, and follow-up = 8.36). At 6 weeks, the Biggest loser group (baseline = 4.75 g and 6 weeks = 3.83 g) exhibited significantly greater improvements in salt intake compared to Usual care (baseline = 4.87 g and 6 weeks = 4.28 g) and Nutrition education (baseline = 19.25 g and 6 weeks = 16.78 g) in saturated fatty acids compared to Usual care (baseline = 20.26 g and 6 weeks = 21.34 g). This trial shows the effectiveness of nutritional interventions for improving nutritional knowledge and dietary practices in stage IV cardiac rehabilitation, but the mechanisms and longer-term effects of increased triglyceride levels in the Nutrition education group requires further exploration. Full article
(This article belongs to the Special Issue Conservative Management of Chronic Disease)
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Review

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25 pages, 444 KiB  
Review
Chemotherapy-Induced Peripheral Neuropathy: A Recent Update on Pathophysiology and Treatment
by Marina Mattar, Florence Umutoni, Marwa A. Hassan, M. Wambui Wamburu, Reagan Turner, James S. Patton, Xin Chen and Wei Lei
Life 2024, 14(8), 991; https://doi.org/10.3390/life14080991 - 9 Aug 2024
Cited by 7 | Viewed by 7910
Abstract
Chemotherapy-induced peripheral neuropathy (CIPN) is a major long-lasting side effect of some chemotherapy drugs, which threatens cancer survival rate. CIPN mostly affects sensory neurons and occasionally motor neurons, causing numbness, tingling, discomfort, and burning pain in the upper and lower extremities. The pathophysiology [...] Read more.
Chemotherapy-induced peripheral neuropathy (CIPN) is a major long-lasting side effect of some chemotherapy drugs, which threatens cancer survival rate. CIPN mostly affects sensory neurons and occasionally motor neurons, causing numbness, tingling, discomfort, and burning pain in the upper and lower extremities. The pathophysiology of CIPN is not completely understood; however, it is believed that chemotherapies induce peripheral neuropathy via directly damaging mitochondria, impairing the function of ion channels, triggering immunological mechanisms, and disrupting microtubules. The treatment of CIPN is a medical challenge, and there are no approved pharmacological options. Currently, duloxetine and other antidepressants, antioxidant, anti-inflammatory, and ion-channel targeted therapies are commonly used in clinics to relieve the symptoms of CIPN. Several other types of drugs, such as cannabinoids, sigma−1 receptor antagonists, and nicotinamides ribose, are being evaluated in preclinical and clinical studies. This paper summarizes the information related to the physiology of CIPN and medicines that could be used for treating this condition. Full article
(This article belongs to the Special Issue Conservative Management of Chronic Disease)

Other

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12 pages, 1089 KiB  
Protocol
Pilot Study of Home-Based Virtual Reality Fitness Training in Post-Discharge Rehabilitation for Patients with Spinal Cord Injury: A Randomized Double-Blind Multicenter Trial
by Dongheon Kang, Seon-Deok Eun and Jiyoung Park
Life 2024, 14(7), 859; https://doi.org/10.3390/life14070859 - 9 Jul 2024
Viewed by 1752
Abstract
Spinal cord injury (SCI) patients require continuous rehabilitation post-discharge to ensure optimal recovery. This study investigates the effectiveness of home-based virtual reality fitness training (VRFT) as a convenient and accessible rehabilitation method for SCI patients. This randomized, double-blind, multicenter trial will enroll 120 [...] Read more.
Spinal cord injury (SCI) patients require continuous rehabilitation post-discharge to ensure optimal recovery. This study investigates the effectiveness of home-based virtual reality fitness training (VRFT) as a convenient and accessible rehabilitation method for SCI patients. This randomized, double-blind, multicenter trial will enroll 120 participants, assigning them to either an 8-week VRFT program (exercise group) or a control group engaging in regular daily activities. The outcomes measured include muscle function, cardiopulmonary fitness, body composition, and physical performance. Our study will determine the safety and feasibility of VRFT in a home setting for SCI patients and evaluate whether these patients can effectively participate in such a program post-discharge. The results of this study are expected to inform future exercise protocols for SCI rehabilitation, offering valuable insights into the utility of VRFT as a therapeutic tool. Full article
(This article belongs to the Special Issue Conservative Management of Chronic Disease)
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