Journal Description
Medical Sciences
Medical Sciences
is an international, peer-reviewed, open access journal, providing a platform for advances in basic, translational and clinical research, published quarterly online by MDPI.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within ESCI (Web of Science), PubMed, PMC, MEDLINE, CAPlus / SciFinder, and other databases.
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 25.6 days after submission; acceptance to publication is undertaken in 5.1 days (median values for papers published in this journal in the first half of 2024).
- Recognition of Reviewers: reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.
- Sections: published in 12 topical sections.
Latest Articles
The Impact of Tumor Stage and Histopathology on Survival Outcomes in Esophageal Cancer Patients over the Past Decade
Med. Sci. 2024, 12(4), 70; https://doi.org/10.3390/medsci12040070 - 9 Dec 2024
Abstract
Background: Esophageal cancer (EC) is the sixth leading cause of cancer-related mortality worldwide, continuing to be a significant public health concern. The purpose of this study is to assess the impact of staging and histopathology of EC on associated mortality. The study also
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Background: Esophageal cancer (EC) is the sixth leading cause of cancer-related mortality worldwide, continuing to be a significant public health concern. The purpose of this study is to assess the impact of staging and histopathology of EC on associated mortality. The study also aims to further investigate clinical characteristics, prognostic factors, and survival outcomes in patients diagnosed with EC between 2010 and 2017. Furthermore, we analyzed the interaction between tumor histology and staging and the risk of mortality. Methods: A total of 24,011 patients diagnosed with EC between 2010 and 2017 in the United States were enrolled from the Surveillance, Epidemiology, and End Results (SEER) database. Demographic parameters, tumor stage, and histologic subtypes were analyzed and associated overall mortality (OM) and cancer-specific mortality (CSM) were measured across all subgroups. Covariates reaching the level of statistical significance, demonstrable by a p-value equal to or less than 0.01, were incorporated into a multivariate Cox proportional hazards model. A hazard ratio greater than 1 was indicative of an increased risk of mortality in the presence of the variable under discussion. Additionally, the study explores the interaction between histology and tumor stage on outcomes. Results: The majority of patients were male (80.13%) and non-Hispanic white (77.87%), with a predominant age at diagnosis of between 60 and 79 years (59.86%). Adenocarcinoma was the most common tumor subtype (68.17%), and most patients were diagnosed at a distant stage (41.29%). Multivariate analysis revealed higher mortality risks for males, older patients, unmarried individuals, and those with advanced-stage tumors. Higher income, receiving radiation or chemotherapy, and undergoing surgery were associated with lower mortality. Tumor subtype significantly influenced mortality, with squamous cell carcinoma and neuroendocrine tumors showing higher hazard ratios compared to adenocarcinoma. Adenocarcinoma is linked to a poorer prognosis at advanced stages, whereas the opposite trend is observed for SCC. Conclusions: The study identifies significant demographic and clinicopathologic factors influencing mortality in esophageal cancer patients, highlighting the importance of early diagnosis and treatment intervention. Future research should focus on tailored treatment strategies to improve survival outcomes in high-risk groups and to understand the interaction between tumor histology and tumor stage.
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(This article belongs to the Section Hepatic and Gastroenterology Diseases)
Open AccessArticle
Evaluating Self-Directed Rehabilitation for Knee and Hip Arthroplasty During the COVID-19 Pandemic: A Multicenter Study
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Todd M. Miner, Mike B. Anderson, David C. Van Andel, Robert E. Neher, Roberta E. Redfern and Paul J. Duwelius
Med. Sci. 2024, 12(4), 69; https://doi.org/10.3390/medsci12040069 - 26 Nov 2024
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The COVID-19 pandemic has triggered the adoption of new technologies to reduce the need for in-person physical therapy (PT). This study evaluated the impact of the COVID-19 pandemic on PT utilization and outcomes of patients prescribed a smartphone-based care management platform (sbCMP) for
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The COVID-19 pandemic has triggered the adoption of new technologies to reduce the need for in-person physical therapy (PT). This study evaluated the impact of the COVID-19 pandemic on PT utilization and outcomes of patients prescribed a smartphone-based care management platform (sbCMP) for self-directed rehabilitation (SDR). A secondary analysis of data collected in a multicenter, prospective cohort trial investigating a mobile platform to deliver SDR after arthroplasty was performed. Patients who used the sbCMP for 2 weeks prior to undergoing partial knee arthroplasty (PKA), total knee arthroplasty (TKA), or total hip arthroplasty (THA) and provided 3 months of post-operative data were included. Use of adjunct PT at 3 months, step counts, and KOOS JR and HOOS JR scores were compared during the early versus late pandemic period. The cohort data was available for 1665 patients. Use of SDR without adjunct PT was higher in the early period of the COVID-19 pandemic in TKA (35.3% vs. 27.6%, p = 0.03) and THA (72.5% vs. 59.3%, p < 0.001), but not in the PKA cohort (58.9% vs. 53.3%, p = 0.53). Post-operative step counts improved at 3 months compared to pre-operative levels in all procedure types. Change in HOOS JR and KOOS JR scores from pre-operative to post-operative levels were similar by pandemic period in all cohorts. Use of SDR increased early during the COVID-19 pandemic, corresponding to pandemic restrictions, without negatively impacting patient outcomes. SDR facilitated via a sbCMP may be beneficial for patients unable or unwilling to participate in traditional PT visits.
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Open AccessArticle
The Impact of Telemonitoring and Telehealth Coaching on General Nutrition Knowledge in Overweight and Obese Individuals: A Pilot Randomized Controlled Trial
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Noura M. S. Eid, Ebtisam A. Al-Ofi, Sumia Enani, Rana H. Mosli, Raneem R. Saqr, Karimah M. Qutah and Sara M. S. Eid
Med. Sci. 2024, 12(4), 68; https://doi.org/10.3390/medsci12040068 - 22 Nov 2024
Abstract
(1) Background: General nutrition knowledge is a fundamental pillar of well-being and healthy lifestyles. This study aimed to measure the general nutrition knowledge questionnaire (GNKQ) scores of overweight and obese participants who joined a pilot randomized controlled trial (RCT) and the association between
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(1) Background: General nutrition knowledge is a fundamental pillar of well-being and healthy lifestyles. This study aimed to measure the general nutrition knowledge questionnaire (GNKQ) scores of overweight and obese participants who joined a pilot randomized controlled trial (RCT) and the association between changes in GNKQ scores and changes in anthropometric measures. (2) Methods: A total of 30 and 25 participants had completed the trial at the 3- and 6-month visits, respectively. All participants enrolled in a randomized controlled trial (RCT) and received a hypocaloric-tailored diet and three online nutrition education sessions over 6 months. The participants were randomly divided into two groups: an intervention group supported with weekly telemonitoring and monthly telehealth coaching vs. a control group. The Arabic-validated GNKQ was used, covering four sections: dietary recommendations; food groups and nutrient sources; healthy food choices; and associations between the diet–disease relationship and weight. (3) Results: The findings show that both the intervention and control groups showed improvements in GNKQ scores over time, with the intervention group demonstrating significant increases in overall nutrition knowledge and specific areas, such as the diet–disease relationship and weight management, at 3 months. In addition, changes in GNKQ scores had a significant negative association with BMI and visceral fat percentage. The findings underline the benefits of supporting dietary weight loss interventions with telemonitoring and telehealth coaching, suggesting that an increase in nutrition knowledge may relate to lower body fat metrics. Nevertheless, the small sample size and high attrition rate of participants were the main limitations of this study, such that large populations are required to confirm the reliability of the obtained findings.
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Open AccessReview
Quantum Computing in Medicine
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James C. L. Chow
Med. Sci. 2024, 12(4), 67; https://doi.org/10.3390/medsci12040067 - 17 Nov 2024
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Quantum computing (QC) represents a paradigm shift in computational power, offering unique capabilities for addressing complex problems that are infeasible for classical computers. This review paper provides a detailed account of the current state of QC, with a particular focus on its applications
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Quantum computing (QC) represents a paradigm shift in computational power, offering unique capabilities for addressing complex problems that are infeasible for classical computers. This review paper provides a detailed account of the current state of QC, with a particular focus on its applications within medicine. It explores fundamental concepts such as qubits, superposition, and entanglement, as well as the evolution of QC from theoretical foundations to practical advancements. The paper covers significant milestones where QC has intersected with medical research, including breakthroughs in drug discovery, molecular modeling, genomics, and medical diagnostics. Additionally, key quantum techniques such as quantum algorithms, quantum machine learning (QML), and quantum-enhanced imaging are explained, highlighting their relevance in healthcare. The paper also addresses challenges in the field, including hardware limitations, scalability, and integration within clinical environments. Looking forward, the paper discusses the potential for quantum–classical hybrid systems and emerging innovations in quantum hardware, suggesting how these advancements may accelerate the adoption of QC in medical research and clinical practice. By synthesizing reliable knowledge and presenting it through a comprehensive lens, this paper serves as a valuable reference for researchers interested in the transformative potential of QC in medicine.
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Open AccessArticle
Hemin Promotes Higher Effectiveness of Aminolevulinic-Photodynamic Therapy (ALA-PDT) in A549 Lung Cancer Cell Line by Interrupting ABCG2 Expression
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Anantya Pustimbara, Rahma Wirdatul Umami, Nurul Muhammad Prakoso, Anna Rozaliyani, Jamal Zaini, Astari Dwiranti, Shun-ichiro Ogura and Anom Bowolaksono
Med. Sci. 2024, 12(4), 66; https://doi.org/10.3390/medsci12040066 - 17 Nov 2024
Abstract
Background/Objectives: Due to concerns about drug resistance and side effects, the discovery of improved drugs for lung cancer has attracted studies to find an effective and safe treatment. Aminolevulinic acid-mediated photodynamic therapy (ALA-PDT) is a cancer treatment with minimal side effects. However, ALA-PDT
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Background/Objectives: Due to concerns about drug resistance and side effects, the discovery of improved drugs for lung cancer has attracted studies to find an effective and safe treatment. Aminolevulinic acid-mediated photodynamic therapy (ALA-PDT) is a cancer treatment with minimal side effects. However, ALA-PDT effectiveness can be hindered by ABCG2 and ABCB1 transporters impeding PpIX accumulation. Combining ALA with other substances can enhance PpIX accumulation. Hemin is a potential substance due to its antitumor properties and may be involved in regulating the ABCG2 and ABCB1 expressions. Methods: The objective of this report is to analyze the effects of administering a combination of hemin and ALA after 48 h on A549 lung cancer cells by quantifying cell viability, intracellular PpIX, and ROS accumulation, completed by ABCG2 and ABCB1 expressions. Results: Our data indicate that the combination of hemin and ALA followed by photoirradiation decreased the viability of A549 cells, which was due to increased intracellular PpIX and ROS. The expression of ABCG2 mRNA was significantly decreased after ALA-hemin treatment, while the ABCB1 mRNA expression increased. This result might suggest that ABCG2 plays a greater role than ABCB1 in regulating the PpIX accumulation in A549 lung cancer cells. Conclusions: The combination of ALA and hemin followed by photoirradiation offers a promising novel treatment for lung cancer, and further evaluations of this therapy are required.
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(This article belongs to the Section Cancer and Cancer-Related Research)
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Open AccessArticle
The Correlation of Bile Duct Dilatation in Postmortem Computed Tomography of Lethal Intoxication Cases for Different Drug Types—A Retrospective Study
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Barbara Fliss, Kirththanan Krishnarajah, Lars Ebert, Cora Wunder and Sabine Franckenberg
Med. Sci. 2024, 12(4), 65; https://doi.org/10.3390/medsci12040065 - 12 Nov 2024
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Purpose: To assess (I) whether, in autopsy-proven lethal intoxications with opiates/opioids, a dilatation of the common bile duct (CBD) is still visible in postmortem computed tomography (PMCT) and (II) if a dilatation of the CBD might also be measurable for other substance groups
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Purpose: To assess (I) whether, in autopsy-proven lethal intoxications with opiates/opioids, a dilatation of the common bile duct (CBD) is still visible in postmortem computed tomography (PMCT) and (II) if a dilatation of the CBD might also be measurable for other substance groups (e.g., stimulants, hypnotics, antipsychotics, etc.). Methods: We retrospectively measured the CBD using PMCT in cases with lethal intoxication (n = 125) and as a control group in cases with a negative toxicological analysis (n = 88). Intoxicating substances were classified into the subgroups (opiates, opioids, stimulants, hypnotics, antipsychotics, gasses, and others). Significance between the study and control groups was tested with the Mann–Whitney U test, and correlations were examined by using crosstables. Results: There was a statistically significant difference between the CBD diameters in the intoxication group overall, when compared to the CBD diameter in the control group (p < 0.001). For both subgroups of “opiates” and “opioids”, there was a strong statistically significant difference between the CBD diameter (being wider) in those groups compared to the control group (both p = 0.001). For the three subgroups “hypnotics”, “stimulants”, and “psychotropic drugs”, there was no statistically significant difference between the CBD diameters in the intoxication subgroups when compared with the control group. The other subgroups were too small for statistical analysis. Conclusion: A dilated common bile duct in postmortem computed tomography might be used as an indication for a lethal opioid or opiate intoxication only in regard to the specific case circumstances or together with other indicative findings in a postmortem investigation.
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Open AccessSystematic Review
Beta-Blocker Use in Patients Undergoing Non-Cardiac Surgery: A Systematic Review and Meta-Analysis
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Doménica Herrera Hernández, Bárbara Abreu, Tania Siu Xiao, Andreina Rojas, Kevin López Romero, Valentina Contreras, Sol Villa Nogueyra, Zulma Sosa, Samantha M. Alvarez, Camila Sánchez Cruz and Ernesto Calderón Martinez
Med. Sci. 2024, 12(4), 64; https://doi.org/10.3390/medsci12040064 - 11 Nov 2024
Abstract
Background: The use of beta-blockers in the perioperative period has been widely investigated due to their potential to reduce the risk of major adverse cardiovascular and cerebrovascular events (MACCE) and mortality; yet their overall impact on various postoperative outcomes remains debated. This study
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Background: The use of beta-blockers in the perioperative period has been widely investigated due to their potential to reduce the risk of major adverse cardiovascular and cerebrovascular events (MACCE) and mortality; yet their overall impact on various postoperative outcomes remains debated. This study constitutes a systematic review and meta-analysis of the impact of beta-blockers on mortality, MI, stroke, and other adverse effects such as hypotension and bradycardia in patients undergoing non-cardiac surgery. Methods: A comprehensive systematic review and meta-analysis were conducted according to PRISMA 2020 guidelines. Searches were performed across PubMed, Cochrane, Web of Science, Scopus, EMBASE, and CINAHL databases; we included randomized controlled trials and cohort and case-control studies published from 1999 to 2024. Results: This meta-analysis included data from 28 studies encompassing 1,342,430 patients. Perioperative beta-blockers were associated with a significant increase in stroke risk (RR 1.42, 95% CI: 1.03 to 1.97, p = 0.03, I2 = 62%). However, no statistically significant association was found between beta-blocker use and mortality (RR 0.62, 95% CI: 0.38 to 1.01, p = 0.05, I2 = 100%). Subgroup analyses revealed a protective effect on mortality for patients with high risks, such as patients with a history of atrial fibrillation, chronic heart failure, and other arrhythmias. For myocardial infarction (RR 0.82, 95% CI: 0.53 to 1.28, p = 0.36, I2 = 86%), a reduction in events was observed in the subgroup of randomized controlled trials. Beta-blockers significantly increased the risk of hypotension (RR 1.46, 95% CI: 1.26 to 1.70, p < 0.01, I2 = 25%) and bradycardia (RR 2.26, 95% CI: 1.37 to 3.74, p < 0.01, I2 = 64%). Conclusions: Perioperative beta-blockers show increasing rates of stroke events following non-cardiac surgery but do not significantly impact the incidence of MI or mortality. The increased risks of hypotension and bradycardia necessitate careful patient selection and monitoring. Future research should aim to refine patient selection criteria and optimize perioperative management to balance the benefits and risks of beta-blocker use in surgical settings.
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(This article belongs to the Section Cardiovascular Disease)
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Open AccessArticle
The Impact of Adverse Childhood Experiences on Asthma Severity in US Adults
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Chukwuemeka E. Ogbu, Ioannis Stouras, Chisa O. Oparanma, Stella C. Ogbu and Chinazor Umerah
Med. Sci. 2024, 12(4), 63; https://doi.org/10.3390/medsci12040063 - 11 Nov 2024
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Background/objectives: The association between adverse childhood experiences (ACEs) and asthma severity among United States (US) adults with asthma has not been well documented. In addition, whether gender differences exist in this association has been underexplored. We aimed to examine the prevalence of
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Background/objectives: The association between adverse childhood experiences (ACEs) and asthma severity among United States (US) adults with asthma has not been well documented. In addition, whether gender differences exist in this association has been underexplored. We aimed to examine the prevalence of asthma severity in the US adult population with asthma and investigate the association between ACEs and asthma severity by using data from non-institutionalized US adults with asthma. Methods: This cross-sectional study used data from the Adult 2019 and 2020 Behavioral Risk Factor Surveillance System (BRFSS) Asthma Call-Back Survey (ACBS), a survey of US adults aged 18 years or older in 31 US states and Puerto Rico. A total of 22934 adults with asthma participated in 2019 and 2020 ACBS. The 11 BRFSS ACE variables encompassing abuse and household dysfunction were used as ACE measures. ACE measures were summed up as cumulative ACE scores (continuous) and categorized (zero, one ACE, two ACEs, ≥ three ACEs). Asthma severity was categorized as intermittent or persistent. Weighted logistic regression models were used to assess associations of the cumulative ACE score, categorical ACE measures, and the 11 individual ACE responses with asthma severity controlling confounders. Gender differences were explored by stratifying by gender. Results: The prevalence of persistent asthma among US adults with asthma was 45.3%. The mean cumulative ACE score in adults with intermittent vs. persistent asthma was (2.43 vs. 2.70, p-value < 0.05). About 22% of adults with asthma had no ACEs, 19% had one ACE, 14% had two ACEs, and 45% had three or more ACEs. A one-unit increase in ACEs score was associated with a 5.4% increase in the odds of persistent asthma (adjusted odds ratio, aOR = 1.054 (95% confidence interval, CI = 1.01–1.10). Experiencing ≥ three ACEs compared to no ACEs was associated with 31% increased odds of persistent asthma (aOR = 1.31, 95% CI = 1.01–1.70). Individual ACE items significantly associated with persistent asthma include parent/adult ever touched you sexually (aOR = 1.33, 95% CI = 1.03–1.74), adult tried to make you touch them (aOR = 1.34, 95% CI = 1.01–1.79), any adult forced you to have sex (aOR = 1.44, 95% CI = 1.04–1.20), parental separation/divorce (aOR = 1.31, 95% CI = 1.05–1.63), and household alcohol abuse (aOR = 1.24, 95% CI = 1.01–1.53). In women, experiencing one ACE and ≥ three ACEs (compared to no ACEs) was associated with 51% and 60% increased odds of persistent asthma, respectively (aOR = 1.51, 95% CI = 1.02–2.23; aOR = 1.60, 95% CI = 1.12–2.27). No significant association was observed between ACEs and asthma severity in men; however, experiencing household physical violence (compared to no household physical violence) was associated with persistent asthma in men (aOR = 1.69, 95% CI = 1.18–2.42). Conclusions: In this cross-sectional study of US adults with asthma, exposure to ACEs was associated with higher odds of asthma overall and in women. These findings highlight the importance of preventive strategies and early interventions to reduce ACEs, potentially mitigating asthma’s severity in adulthood.
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Open AccessArticle
Association Between Asian Flush and Satisfaction of Sleep via Alcohol Consumption Status in a Sample of Japanese Participants
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Yuji Shimizu, Tomokatsu Yoshida, Keiko Ito, Kumiko Terada, Nagisa Sasaki, Eiko Honda and Kazushi Motomura
Med. Sci. 2024, 12(4), 62; https://doi.org/10.3390/medsci12040062 - 8 Nov 2024
Abstract
Background: The reddening of the face and neck following alcohol consumption is known as Asian flush. Although genetic factors related to Asian flush have been reported to be inversely associated with duration of sleep, no study has reported an association between Asian flush
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Background: The reddening of the face and neck following alcohol consumption is known as Asian flush. Although genetic factors related to Asian flush have been reported to be inversely associated with duration of sleep, no study has reported an association between Asian flush and sleep satisfaction. Methods: A cross-sectional study of 3823 Japanese people, aged 20 to 64 years was conducted. The target population comprised general public resident monitors of Osaka Prefecture who were registered with an internet research company. Results: A significant inverse association was observed between Asian flush and satisfaction of sleep. The potential confounder-adjusted odds ratio (OR) and 95% confidence interval (CI) of satisfied sleep was 0.81 (0.69–0.96). The alcohol consumption status-specific analysis revealed essentially the same associations between consumers and non-consumers of alcohol. The adjusted ORs (95% CIs) were 0.81 (0.65–0.997) for non-consumers and 0.80 (0.61–1.05) for consumers of alcohol. Conclusion: The genetic characteristics of physical reactions to alcohol exposure may influence sleep quality. One’s alcohol consumption status may not influence the effects of having a lower tolerance to alcohol on sleep quality.
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(This article belongs to the Section Cardiovascular Disease)
Open AccessArticle
Investigating the Matrix of Factor V Leiden (G1691A), Factor II Prothrombin (G2021A), MTHFR C677T and A1298G Polymorphisms in Greek Population: A Preliminary Study
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Maria Spanoudaki, Aikaterini Itziou, Antonios Cheimaras, Orestis Tsiripidis, Grigoris Risvas, Naysika Tsitlakidou and Vasileios Balis
Med. Sci. 2024, 12(4), 61; https://doi.org/10.3390/medsci12040061 - 5 Nov 2024
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Background: Thrombophilia, characterized by an increased risk of thrombosis, can result from genetic polymorphisms in clotting factors. This study aims to investigate the prevalence of factor V Leiden (G1691A), factor II prothrombin (G20210A), and MTHFR (C677T and A1298C) polymorphisms in a Greek population,
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Background: Thrombophilia, characterized by an increased risk of thrombosis, can result from genetic polymorphisms in clotting factors. This study aims to investigate the prevalence of factor V Leiden (G1691A), factor II prothrombin (G20210A), and MTHFR (C677T and A1298C) polymorphisms in a Greek population, evaluating not only their association with thrombophilia, but also broader health implications. Methods: We conducted a cross-sectional study involving one hundred apparently healthy adults from Thessaloniki, Greece. After obtaining informed consent, DNA was isolated and analyzed using real-time PCR to detect the frequencies of the aforementioned polymorphisms. Results: The genetic distribution of the examined polymorphisms aligns closely with that observed in Northern Europe. Factor V Leiden (FVL) and prothrombin G20210A mutations were predominantly wild types, with a small percentage showing heterozygous mutations. The MTHFR C677T and A1298C polymorphisms showed a higher variation in allele frequency. Certain lifestyle factors such as smoking and high body mass index were significantly associated with the occurrence of combined MTHFR genotypes, suggesting an interaction between genetic and environmental risk factors. Family cancer and cardiovascular history was significantly associated with combined FVL and prothrombin G20210A and MTHFR polymorphism heterozygous carriers. Conclusions: Our findings indicate that these genetic polymorphisms are not only pivotal in understanding thrombophilia but also have broader implications for cardiovascular disease and cancer. This study highlights the need for further research into the combined effects of genetic and epigenetic factors on health, which could lead to improved screening and personalized preventive healthcare strategies.
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Open AccessArticle
Survival Outcomes of U.S. Patients with CMML: A Two-Decade Analysis from the SEER Database
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Ayrton Bangolo, Behzad Amoozgar, Abhishek Thapa, Wardah Bajwa, Vignesh K. Nagesh, Yaryna Nyzhnyk, Rakshanda Banu, Tirth Bhavsar, Lili Zhang, Olga Velichko, Challa Mani Shankar Reddy, Edwina Essuman, Amal M. Ibrahim, Ramkumar Krishnasamy, Achint Jethi, Arun Ram, Abdullah A. Haq, Abdulla Ahmad Al hashm, Parna Pathak, Shafia Naeem, Rachana R. Gavva, Prajakta H. Ratnaparkhi, Paula Samaha, Cynthia Elizabeth Armendariz Espinoza, Prasansa Dhakal, Frantz Ricot Martine, Mogahid Elkhidir, Jay Mehta and Simcha Weissmanadd
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Med. Sci. 2024, 12(4), 60; https://doi.org/10.3390/medsci12040060 - 31 Oct 2024
Abstract
Background: Chronic Myelomonocytic Leukemia (CMML) is a rare and aggressive form of leukemia with characteristics of both myeloproliferative neoplasms (MPNs) and myelodysplastic syndromes (MDSs). This study aims to explore the clinical features, survival outcomes, and prognostic factors in CMML patients over the past
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Background: Chronic Myelomonocytic Leukemia (CMML) is a rare and aggressive form of leukemia with characteristics of both myeloproliferative neoplasms (MPNs) and myelodysplastic syndromes (MDSs). This study aims to explore the clinical features, survival outcomes, and prognostic factors in CMML patients over the past 20 years using a large sample. Methods: The study data from 4124 patients diagnosed with CMML between 2000 and 2017 were sourced from the SEER database. Demographic and clinical characteristics, along with overall and cancer-specific mortality, were examined. Factors with a p-value < 0.01 in univariate Cox regression were included in the multivariate Cox model to identify independent prognostic factors, with hazard ratios (HRs) greater than one indicating adverse outcomes. Results: The majority of the cohort were male (61.57%), and most diagnoses occurred between ages 60–79 (55.16%), with a small percentage under 40 (1.41%). Non-Hispanic whites represented the largest racial group (79.03%). Multivariate analysis showed higher mortality in males, those aged 80+, residents in metropolitan areas with populations between 250,000 and 1 million, single or widowed individuals, and those who underwent chemotherapy. Conversely, lower mortality was associated with an annual income of $75,000+. Conclusions: CMML remains a rare and highly aggressive hematologic disorder. This U.S.-based retrospective cohort study identified male gender, advanced age, single or widowed status, and chemotherapy as independent poor prognostic factors. While it is expected that older patients and those requiring chemotherapy would have a poorer prognosis, the higher mortality risk in single or widowed patients, as well as males, warrants further investigation. The early involvement of family and community support may help reduce mortality in these groups, suggesting a need for larger prospective studies to explore these associations further.
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(This article belongs to the Section Cancer and Cancer-Related Research)
Open AccessArticle
Comparing NIRS and Pulse Oximetry for Cerebral Oxygen Saturation During Hypoxia Testing
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Vasilios Alevizakos, Andreas Werner, Lisa-Marie Schiller, Constantin von See and Marcus Schiller
Med. Sci. 2024, 12(4), 59; https://doi.org/10.3390/medsci12040059 - 24 Oct 2024
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Objective: This study evaluates the suitability of cerebral oximetry using near-infrared spectroscopy (NIRS) compared to traditional pulse oximetry (SpO2) for measuring cerebral oxygen saturation during hypoxia testing, aiming to enhance safety during flight operations and training. Material and Methods: The study included 106
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Objective: This study evaluates the suitability of cerebral oximetry using near-infrared spectroscopy (NIRS) compared to traditional pulse oximetry (SpO2) for measuring cerebral oxygen saturation during hypoxia testing, aiming to enhance safety during flight operations and training. Material and Methods: The study included 106 participants aged 18–60 years at the Aerospace Medicine Training Center in Königsbrück. Cerebral oxygen saturation (rSO2) and peripheral oxygen saturation (SpO2) were measured using the INVOS™ 5100C cerebral oximeter and Masimo™ MS5 pulse oximeter, respectively. Measurements were taken at baseline, during hypoxia at 25,000 feet, and post recovery. Data analysis included regression analysis, Bland–Altman plots, and concordance correlation coefficients (CCC). Ethical approval was obtained from the Hannover Medical School. Data from 100 participants were analyzed. Results: Baseline SpO2 was 97.5 ± 1.5%, and baseline rSO2 was 77.25 ± 6.4%. During hypoxia, SpO2 dropped significantly, while rSO2 showed higher values. SpO2 recovered faster than rSO2. Deviations in rSO2 between the right and left sides during hypoxia were minimal. Lin’s CCC indicated moderate to substantial concordance. NIRS measurements were more stable and less prone to disturbances, with 95 disruptions in pulse oximetry, 25 of which were potentially critical. Conclusions: NIRS is a reliable method for detecting cerebral oxygen saturation, offering significant advantages over traditional pulse oximetry in stability and reliability during hypoxia testing. NIRS is less error-prone, supporting its use for continuous monitoring in aviation settings and enhancing flight safety by providing more accurate hypoxia detection.
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Open AccessCase Report
Experience of Hereditary Amyloidosis with Rare Variant in Ecuador: Case Reports
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Diana Elizabeth Luzuriaga Carpio, Borys Roberto Abrigo Maldonado and Humberto Villacorta
Med. Sci. 2024, 12(4), 58; https://doi.org/10.3390/medsci12040058 - 21 Oct 2024
Abstract
More than approximately 120 transthyretin mutations are known. Their clinical presentation is heterogeneous, as the course of disease onset depends on genetic variation and level of penetrance. They are little known in Ecuador, and some of the reported cases suggest—given analysis of family
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More than approximately 120 transthyretin mutations are known. Their clinical presentation is heterogeneous, as the course of disease onset depends on genetic variation and level of penetrance. They are little known in Ecuador, and some of the reported cases suggest—given analysis of family trees—that they come from a province that is possibly considered endemic. The main objective of this study is to perform a descriptive observational analysis on the presentation of transthyretin amyloidosis in families carrying the p.Ser43Asn gene of the identified index case.
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(This article belongs to the Section Cardiovascular Disease)
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Open AccessArticle
Predicting Invasiveness in Lepidic Pattern Adenocarcinoma of Lung: Analysis of Visual Semantic and Radiomic Features
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Sean F. Johnson, Seyed Mohammad Hossein Tabatabaei, Grace Hyun J. Kim, Bianca E. Villegas, Matthew Brown, Scott Genshaft, Robert D. Suh, Igor Barjaktarevic, William Dean Wallace and Fereidoun Abtin
Med. Sci. 2024, 12(4), 57; https://doi.org/10.3390/medsci12040057 - 18 Oct 2024
Abstract
Objectives: To differentiate invasive lepidic predominant adenocarcinoma (iLPA) from adenocarcinoma in situ (AIS)/minimally invasive adenocarcinoma (MIA) of lung utilizing visual semantic and computer-aided detection (CAD)-based texture features on subjects initially diagnosed as AIS or MIA with CT-guided biopsy. Materials and Methods: From 2011
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Objectives: To differentiate invasive lepidic predominant adenocarcinoma (iLPA) from adenocarcinoma in situ (AIS)/minimally invasive adenocarcinoma (MIA) of lung utilizing visual semantic and computer-aided detection (CAD)-based texture features on subjects initially diagnosed as AIS or MIA with CT-guided biopsy. Materials and Methods: From 2011 to 2017, all patients with CT-guided biopsy results of AIS or MIA who subsequently underwent resection were identified. CT scan before the biopsy was used to assess visual semantic and CAD texture features, totaling 23 semantic and 95 CAD-based quantitative texture variables. The least absolute shrinkage and selection operator (LASSO) method or forward selection was used to select the most predictive feature and combination of semantic and texture features for detection of invasive lung adenocarcinoma. Results: Among the 33 core needle-biopsied patients with AIS/MIA pathology, 24 (72.7%) had invasive LPA and 9 (27.3%) had AIS/MIA on resection. On CT, visual semantic features included 21 (63.6%) part-solid, 5 (15.2%) pure ground glass, and 7 (21.2%) solid nodules. LASSO selected seven variables for the model, but all were not statistically significant. “Volume” was found to be statistically significant when assessing the correlation between independent variables using the backward selection technique. The LASSO selected “tumor_Perc95”, “nodule surround”, “small cyst-like spaces”, and “volume” when assessing the correlation between independent variables. Conclusions: Lung biopsy results showing noninvasive LPA underestimate invasiveness. Although statistically non-significant, some semantic features showed potential for predicting invasiveness, with septal stretching absent in all noninvasive cases, and solid consistency present in a significant portion of invasive cases.
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(This article belongs to the Section Cancer and Cancer-Related Research)
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Open AccessArticle
Impact of Neutropenia on Clinical Outcomes after Lung Transplantation
by
Raquel Sanabrias Fernández de Sevilla, Ana Concepción Sánchez Cerviño, Rosalía Laporta Hernández, Myriam Aguilar Pérez, Christian García Fadul, Sarela García-Masedo Fernández, Amelia Sánchez Guerrero and María Piedad Ussetti Gil
Med. Sci. 2024, 12(4), 56; https://doi.org/10.3390/medsci12040056 - 16 Oct 2024
Abstract
Background/Objectives: Neutropenia is a frequent complication among solid organ transplant (SOT) recipients receiving immunosuppressive therapy and antimicrobial prophylaxis. However, there are limited studies analysing the frequency and impact of neutropenia in lung transplant recipients (LTRs). Our aim was to analyse the frequency of
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Background/Objectives: Neutropenia is a frequent complication among solid organ transplant (SOT) recipients receiving immunosuppressive therapy and antimicrobial prophylaxis. However, there are limited studies analysing the frequency and impact of neutropenia in lung transplant recipients (LTRs). Our aim was to analyse the frequency of neutropenia, the need for granulocyte colony-stimulating factor (GCSF) treatment within the first 18 months post-transplant and its association with acute rejection, chronic lung allograft dysfunction (CLAD), overall survival and the development of infections. Methods: This observational and retrospective study recruited 305 patients who underwent lung transplantation between 2009 and 2019, with outpatient quarterly follow-up during the first 18 months post-surgery.Results: During this period, 51.8% of patients experienced at least one episode of neutropenia. Neutropenia was classified as mild in 50.57% of cases, moderate in 36.88% and severe in 12.54%. GCSF treatment was indicated in 23.28% of patients, with a mean dose of 3.53 units. No statistically significant association was observed between neutropenia or its severity and the development of acute rejection, CLAD or overall survival. However, the patients who received GCSF treatment had a higher mortality rate compared to those who did not. Sixteen patients (5.25%) developed infections during neutropenia, with bacterial infections being the most common. Conclusions: Neutropenia is common in the first 18 months after lung transplantation and most episodes are mild. We did not find an association between neutropenia and acute rejection, CLAD, or mortality. However, the use of GCSF were associated with worse post-transplant survival.
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(This article belongs to the Section Pneumology and Respiratory Diseases)
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Open AccessReview
Novel Therapeutic Approach for Obesity: Seaweeds as an Alternative Medicine with the Latest Conventional Therapy
by
Rajesh Yadav, Ankita Nigam, Richa Mishra, Saurabh Gupta, Anis Ahmad Chaudhary, Salah-Ud-Din Khan, Eman Abdullah almuqri, Zakir Hassain Ahmed, Sarvesh Rustagi, Deependra Pratap Singh and Sanjay Kumar
Med. Sci. 2024, 12(4), 55; https://doi.org/10.3390/medsci12040055 - 13 Oct 2024
Abstract
The prevalence of overweight and obesity is increasing worldwide. Common comorbidities related to obesity, significantly polygenic disorders, cardiovascular disease, and heart conditions affect social and monetary systems. Over the past decade, research in drug discovery and development has opened new paths for alternative
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The prevalence of overweight and obesity is increasing worldwide. Common comorbidities related to obesity, significantly polygenic disorders, cardiovascular disease, and heart conditions affect social and monetary systems. Over the past decade, research in drug discovery and development has opened new paths for alternative and conventional medicine. With a deeper comprehension of its underlying mechanisms, obesity is now recognized more as a chronic condition rather than merely a result of lifestyle choices. Nonetheless, addressing it solely through lifestyle changes is challenging due to the intricate nature of energy regulation dysfunction. The Federal Drug Administration (FDA) has approved six medications for the management of overweight and obesity. Seaweed are plants and algae that grow in oceans, rivers, and lakes. Studies have shown that seaweed has therapeutic potential in the management of body weight and obesity. Seaweed compounds such as carotenoids, xanthophyll, astaxanthin, fucoidans, and fucoxanthin have been demonstrated as potential bioactive components in the treatment of obesity. The abundance of natural seaweed bioactive compounds has been explored for their therapeutic potential for treating obesity worldwide. Keeping this view, this review covered the latest developments in the discovery of varied anti-obese seaweed and its bioactive components for the management of obesity.
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(This article belongs to the Section Endocrinology and Metabolic Diseases)
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Open AccessTechnical Note
One-Step Cannulation and Distance Measurement during Aortic Branched Endograft Repair: The Neuron Catheter Trick
by
Gioele Simonte, Gianluigi Fino, Gianbattista Parlani, Rachele Simonte and Giacomo Isernia
Med. Sci. 2024, 12(4), 54; https://doi.org/10.3390/medsci12040054 - 6 Oct 2024
Abstract
Purpose: This paper aims to describe a straightforward, efficient, and reliable technique to simplify cannulation maneuvers during aortic branched endograft repair. Technique: The suggested approach utilizes the Penumbra Neuron Select catheter, which combines diagnostic, sizing, and support capabilities in one. This has the
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Purpose: This paper aims to describe a straightforward, efficient, and reliable technique to simplify cannulation maneuvers during aortic branched endograft repair. Technique: The suggested approach utilizes the Penumbra Neuron Select catheter, which combines diagnostic, sizing, and support capabilities in one. This has the potential to reduce procedural time and minimize the need for serial catheter and guidewire exchanges. Conclusions: The proposed technique offers a simple yet effective tool to mitigate the risk of vessel loss and injury, and to streamline complex aortic repair procedures.
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(This article belongs to the Section Cardiovascular Disease)
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Open AccessReview
The Increasing Problem of Resistant Hypertension: We’ll Manage till Help Comes!
by
Francesco Natale, Rosa Franzese, Ettore Luisi, Noemi Mollo, Luigi Marotta, Achille Solimene, Saverio D’Elia, Paolo Golino and Giovanni Cimmino
Med. Sci. 2024, 12(4), 53; https://doi.org/10.3390/medsci12040053 - 4 Oct 2024
Abstract
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Arterial hypertension remains the major cardiovascular risk worldwide. It is estimated that under 50 years of age one in every three adults is hypertensive while beyond the age of 50 the prevalence is almost 50% globally. The latest World Health Organization (WHO) Global
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Arterial hypertension remains the major cardiovascular risk worldwide. It is estimated that under 50 years of age one in every three adults is hypertensive while beyond the age of 50 the prevalence is almost 50% globally. The latest World Health Organization (WHO) Global Report on Hypertension indicated that the global number of hypertensive patients almost doubled in the last three decades, with related increasing deaths, disability, and costs annually. Because of this global increase, early diagnosis and timely treatment is of great importance. However, based on the WHO Global Report, it is estimated that up to 46% of individuals were never diagnosed. Of those diagnosed, less than 50% were on treatment, with nearly half among these at target according to the current guidelines. It is also important to note that an increasing number of hypertensive patients, despite the use of three or more drugs, still do not achieve a blood pressure normalization, thus defining the clinical scenario of resistant hypertension (RH). This condition is associated to a higher risk of hypertension-mediated organ damage and hospitalization due to acute cardiovascular events. Current guidelines recommend a triple combination therapy (renin angiotensin system blocking agent + a thiazide or thiazide-like diuretic + a dihydropyridinic calcium-channel blocker) to all patients with RH. Beta-blockers and mineralocorticoid receptor antagonists, alone or in combination, should be also considered based on concomitant conditions and potential contraindications. Finally, the renal denervation is also proposed in patients with preserved kidney function that remain hypertensive despite the use of maximum tolerated medical treatment. However, the failure of this procedure in the long term and the contraindication in patients with kidney failure is a strong call for a new therapeutic approach. In the present review, we will discuss the pharmacological novelties to come for the management of hypertension and RH in the next future.
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Open AccessArticle
Fractional Exhaled Nitric Oxide (FeNO) in Biomass Smoke-Associated Chronic Obstructive Pulmonary Disease
by
Juan Silva-Gallardo, Raúl H. Sansores, Alejandra Ramírez-Venegas, Robinson E. Robles Hernández, Gustavo I. Centeno-Saenz and Rafael J. Hernández-Zenteno
Med. Sci. 2024, 12(4), 52; https://doi.org/10.3390/medsci12040052 - 4 Oct 2024
Abstract
Chronic Obstructive Pulmonary Disease (COPD) is a disease characterized by local and systemic inflammation independently of the risk factor; during the exacerbations, such inflammation is accentuated and amplified. A practical inflammatory marker and one with an applicable predictive value in the follow-up has
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Chronic Obstructive Pulmonary Disease (COPD) is a disease characterized by local and systemic inflammation independently of the risk factor; during the exacerbations, such inflammation is accentuated and amplified. A practical inflammatory marker and one with an applicable predictive value in the follow-up has been sought. FeNO has shown an excellent performance in that respect within the context of asthma and has also been studied in tobacco-smoke COPD (COPD-TS). In Biomass-smoke COPD (COPD-BS), this, to our knowledge, has not been evaluated. Objective: To measure FeNO levels in patients with COPD-BS and to compare these with those of patients with stable COPD-TS and in healthy controls. Methods: Transversal, observational, descriptive, comparative, and analytical study. A total of 57 patients, including 23 with COPD-BS, 17 with COPD-TS, and 17 healthy control subjects. The measurement of FeNO was carried out on all of these by means of the on-line chemiluminescence technique; the values were expressed in parts per billion (ppb) for their analysis. Results: It was observed that the FeNO values were similar between COPD-BS and COPD-TS and were significantly different between the healthy and stable COPD (both groups). No correlation was found between pulmonary function and symptoms with FeNO in any of the groups. Conclusions: The level of FeNO in stable COPD is found to be increased in a similar manner in COPD-BS and COPD-TS, with a significant difference on comparing it with that of the healthy subjects.
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(This article belongs to the Section Pneumology and Respiratory Diseases)
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Combined Effects of Environmental Metals and Physiological Stress on Lipid Dysregulation
by
Emmanuel Obeng-Gyasi and Yvonne R. Ford
Med. Sci. 2024, 12(4), 51; https://doi.org/10.3390/medsci12040051 - 2 Oct 2024
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Background: Cardiovascular diseases (CVD) are a leading cause of mortality worldwide, influenced by genetic, environmental, and behavioral factors. This study examines the relationship between heavy metal exposure, chronic physiological stress (allostatic load), and lipid profiles, which are markers of CVD risk, using data
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Background: Cardiovascular diseases (CVD) are a leading cause of mortality worldwide, influenced by genetic, environmental, and behavioral factors. This study examines the relationship between heavy metal exposure, chronic physiological stress (allostatic load), and lipid profiles, which are markers of CVD risk, using data from the National Health and Nutrition Examination Survey (NHANES) 2017–2018. Methods: We utilized structural equation modeling (SEM) to explore the associations between blood levels of lead, cadmium, allostatic load (AL), and lipid measures (low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides). The AL index was derived from cardiovascular, inflammatory, and metabolic biomarkers and categorized into quartiles to identify high-risk individuals, with an index out of 10 subsequently developed. Results: The SEM analysis revealed that both heavy metal exposure and allostatic load are significantly associated with lipid profiles. Higher levels of lead and cadmium were associated with increased LDL and triglycerides, while higher AL scores were linked to increased LDL and triglycerides and decreased HDL levels. Age was also a significant factor, showing positive correlations with LDL and triglycerides, and a negative correlation with HDL. Conclusions: This study underscores the multifactorial nature of CVD, highlighting the combined impact of environmental pollutants and physiological stress on lipid dysregulation. These findings suggest the need for integrated public health strategies that address both environmental exposures and chronic stress to mitigate cardiovascular risk. Further research is warranted to explore the underlying mechanisms and develop targeted interventions.
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