Search Results (82)

Background: Patients with mastocytosis may present with exacerbated respiratory symptoms and lung diseases resulting from mast cell mediator release. However, their prevalence and severity level remain under debate. The study aims to analyze the prevalence of respiratory symptoms and the usefulness of lung function tests like spirometry, diffusing capacity of the lung for carbon monoxide (DLCO), and high-resolution computed tomography (HRCT) of the chest in mastocytosis patients presenting with dyspnea, cough, and exercise intolerance. Methods: We included 104 patients with mastocytosis and 71 healthy controls. Data collection encompassed patient interview, clinical examination, spirometry, DLCO, and chest HRCT. Diagnosis of mastocytosis included bone marrow biopsies and serum tryptase measurements. Results: Compared to controls, patients with mastocytosis exhibited significantly lower values in FEV1/VC ratio, absolute DLCO/VA, predicted DLCO/VA, absolute DLCOcSB, and predicted DLCOcSB (p < 0.001). Commonly reported respiratory symptoms included dyspnea (36.5%), chest tightness (22.1%), and wheezing (9.6%). Airway obstruction was identified in 7.7% of patients; however, it appeared to be independent of the mastocytosis subtype. A decreased DLCO/VA ratio was observed in 4.8% of patients, but HRCT did not reveal any evidence of underlying lung disease. Conclusions: Mastocytosis appears to be a risk factor for the occurrence and exacerbation of respiratory symptoms. However, airway obstruction and impairment of the alveolar–capillary membrane seem to occur independently of the clinical subtype of mastocytosis. Additionally, the causal relationship between pulmonary involvement, mast cell infiltration of the alveolar–capillary membrane, and the systemic circulation of mast cell mediators remains unclear and requires further research. Full article

Shaken Baby Syndrome (SBS) is one of the primary causes of fatal head trauma in infants and young children, occurring in about 33 per 100,000 infants annually in the U.S., with mortality rates being between 15% and 38%. Survivors frequently endure long-term disabilities, such as cognitive deficits, visual impairments, and motor dysfunction. Diagnosing SBS remains difficult due to the lack of visible injuries and delayed symptom onset. Existing detection methods—such as neuroimaging, biomechanical modeling, and infant monitoring systems—cannot perform real-time detection and face ethical, technical, and accuracy limitations. This study proposes an inertial measurement unit (IMU)-based detection system enhanced with machine learning to identify aggressive shaking patterns. Findings indicate that wearable-based motion analysis is a promising method for recognizing high-risk shaking, offering a non-invasive, real-time solution that could minimize infant harm and support timely intervention. Full article

Short bowel syndrome (SBS) is a rare but complex medical condition that requires expertise in management. The etiology in adults is commonly surgical resection for Crohn’s disease or mesenteric ischemia and is classified based on the anatomy of the remaining bowel. An accurate assessment of the anatomy and nutritional and hydration status is necessary. Dietary therapy is essential to induce adaptation in SBS, provide adequate nutritional needs, and manage symptoms including stool burden. As general SBS guidelines on nutritional support and dietary interventions exist, SBS is unique to the individual and nutrition must also be personalized to the individual to improve quality of life. This review will highlight the principles of adaptation, dietary interventions in SBS, as well as future directions for this field. Full article

Short bowel syndrome (SBS) is a malabsorptive condition resulting from reduced functional small intestinal length. SBS is closely related to intestinal failure (IF), defined as the reduction of functional intestinal mass below that which can sustain life, resulting in parenteral nutrition (PN) support for 60 days or greater within a consecutive 74-day period. IF frequently results from intestinal resection necessitated by such diseases as necrotizing enterocolitis in children and Crohn’s disease in adults. Clinical manifestations of IF may include diarrhea, growth failure, bacterial overgrowth, and vitamin deficiencies. Nutritional rehabilitation is the cornerstone of IF management. Surgical interventions are aimed at preserving intestinal length and restoring continuity. Medical management involves individualized enteral and parenteral nutrition therapy, GLP-2 agonists (e.g., teduglutide) that promote mucosal growth, and drugs for symptom management such as antidiarrheals. Experimental therapies such as the use of devices to induce intestinal growth through distraction enterogenesis are under development for the treatment of IF. An interdisciplinary approach involving surgeons, gastroenterologists, dietitians, nurses, and social workers is crucial in the management of these complex patients. Ultimately, a combination of nutritional, medical, and surgical management may be necessary to improve clinical outcomes in patients with IF. Full article

Sick building syndrome (SBS) poses a significant challenge in hospital settings, adversely affecting staff health, operational efficiency, and environmental quality. This study aims to investigate the prevalence and risk factors of SBS among medical staff in Chinese hospitals, advancing the literature by pinpointing actionable environmental and psychological factors tailored to this occupational group within China’s distinct regional context. A survey questionnaire was administered to 615 medical staff members across seven private hospitals located in the eastern coastal region of China. Data were collected using structured questionnaires. The survey encompassed 27 factors across four aspects, with respondents being asked to self-assess the severity of four types of SBS symptoms (never, rarely, occasionally, often). Multivariable binary logistic regression analysis was carried out to identify factors associated with SBS, based on odds ratios (OR) with a significance level of p < 0.05. The prevalence rates for skin symptoms, mucosal symptoms, and general symptoms were 32.8%, 61%, and 71.1%, respectively. Gender, psychological mood, visibility of water systems and greenery from the workspace, outdoor noise environment, indoor air quality, indoor natural lighting, department of occupancy, design of workspace, cleanliness, and control over the indoor environment (temperature, lighting) were identified as risk factors related to SBS symptoms. These findings underscore the critical role of modifiable building design and psychological factors in SBS occurrence, offering a novel perspective on hospital-specific risks in China compared to global studies. Enhancing indoor and outdoor environments—through increased greenery, noise reduction, improved air quality, better lighting, and greater environmental control—emerges as a vital strategy to mitigate SBS, with implications for hospital management and staff well-being. Full article

Background/Objectives: Sedentary behavior (SB) and physical activity (PA) are key determinants of health in occupational settings. This study aimed to analyze the levels of SB, PA, and their associations with health outcomes among Chilean workers using data from the National Health Survey-2017. Methods: A secondary analysis of 2042 workers aged ≥18 years was conducted. Occupations were classified using ISCO-08, and SB/PA were assessed using the Global Physical Activity Questionnaire (GPAQ). Health outcomes included musculoskeletal symptoms, hypertension, diabetes mellitus, metabolic syndrome, and cardiovascular risk. Results: Of the participants, 49.8% were women, and the mean age was 45 years (±13.7). The median SB was 120 min/day, with 32.6% accumulating ≥4 h/day. “Managers” exhibited the highest SB (median: 270 min/day). The median total PA was 123 min/day, and “Skilled agricultural, forestry, and fishery workers” reported the highest PA (median: 330 min/day). The SB (≥4 h/day) was significantly associated with musculoskeletal symptoms (OR: 1.61, 95% CI: 1.21–2.14) and hypertension (OR: 1.53, 95% CI: 1.07–2.18). PA showed no significant protective effect. Conclusions: SB and PA vary significantly across occupational groups. SB is associated with musculoskeletal symptoms. Health promotion programs should be tailored to specific occupational groups. Full article

Background: Children with short bowel syndrome (SBS) have abnormal intestinal anatomy, secretion, or motility, which can lead to small intestinal bacterial overgrowth (SIBO). In this paper, we describe our experience with SIBO in children with SBS, focusing on potential risk factors, clinical presentation, and antibiotic treatment. Methods: A single-center retrospective descriptive cohort study of all episodes of clinically suspected SIBO in 16 children with SBS on home parenteral nutrition (HPN) between January 2018 and December 2022 was performed. Results: The mean small bowel remnant was 47 cm (SD = 31.5), with an absent ileocecal valve in 61.5% (8/13). Five children (31.2%) had at least 1 episode of clinically suspected SIBO, with a total of 25 episodes. The most common clinical presentation was diarrhea (76%), followed by meteorism (56%), loss of appetite (48%), flatulence (48%), weight loss (36%), abdominal pain (25%), and vomiting (12%). Fifty-six percent (16/25) of SIBO episodes were treated with one type of antibiotic, 36% (9/25) with two types, and 8% (2/25) with three types. Symptom resolution was achieved in 56% (14/25) of SIBO episodes after one course of antibiotic therapy. Two children (12.5%) had refractory and recurrent SIBO episodes treated with cyclic antibiotic regimens. Conclusions: SIBO can affect the ability of children with SBS to successfully wean off HPN. Diagnostic tests have innate challenges, and early clinical suspicion is paramount. Antibiotic therapy should be individualized considering the child’s age, gastrointestinal anatomy, and the risk of SIBO recurrence. Full article

Background: The role of the indoor microbiome in sick building syndrome (SBS) is well-recognized, yet prior studies have been limited to single-center analyses, limiting a broader understanding and applicability of their findings. Methods: We conducted a multicenter indoor microbiome and metabolome investigation for SBS, involving 1139 middle school students across three regions in Malaysia (Johor Bahru, Terengganu, and Penang). Using high-throughput amplicon sequencing and untargeted LC-MS, indoor microbiome and metabolites were characterized from classroom dust samples. Results: The study found that the prevalence of SBS symptoms was high across all three centers (51.0% to 54.6%). Environmental characteristics, including indoor NO₂ and CO₂ concentrations and total weight of indoor dust, were positively associated with SBS (p < 0.01, linear regression). Curtobacterium in Terengganu was negatively associated with SBS, and Clostridium perfringens in Johor Bahru was positively associated with SBS (p < 0.01, FDR < 0.05). Whereas all identified fungal taxa, including an uncharacterized uc_f_Auriculariaceae_sp., Duportella kuehneroides, and Wallemia mellicola, were positively associated with SBS (p < 0.01, FDR < 0.05) in Johor Bahru and Terengganu. Mediation analysis revealed that the adverse health effects of NO₂ on SBS were partially mediated by the increased abundance of uc_f_Auriculariaceae_sp. (p < 0.05, total effect mediated 51.40%). Additionally, potential protective metabolites (S-adenosylmethionine, N-acetylserotonin, sphinganine, 4-hydroxy-2-quinolone, and (2E,4Z,8E)-Colneleic acid) were mainly derived from environmental microorganisms, conferring protective effects against nasal symptoms and tiredness. In contrast, synthetic chemicals were associated with higher SBS symptoms, inducing eye and nasal symptoms. Conclusions: This study emphasizes both the significance of fostering a balanced indoor microbiome/metabolite and the necessity to reduce exposure to deleterious substances, providing new insights for future targeted intervention strategies. Full article

Background/Objectives: Patients with spina bifida (SB) commonly experience neurogenic bowel dysfunction, characterized by defecation-related symptoms. While anorectal dysfunction and slow transit constipation (STC) have been implicated, the role of colonic motility in SB remains unclear. This study aimed to evaluate colonic motility in SB patients with refractory bowel dysfunction. Methods: This retrospective cohort study included SB patients who failed the repeated optimization of a bowel regimen including stimulant laxatives and subsequently underwent anorectal manometry (ARM), colonic transit time (CTT) studies, or colonic manometry (CM). Diagnostic findings were analyzed alongside treatment outcomes. Results: A total of 13 patients with myelomeningocele were included; one declined further treatment, and 12 underwent treatment optimization, with four achieving bowel continence. Of the five patients who proceeded with advanced motility testing, two had abnormal ARM findings, one of three had abnormal CTT results, and all five had normal CM findings. Conclusions: These findings suggest that anorectal dysfunction or STC may play a larger role in refractory bowel symptoms, while colonic motility appears to be preserved, and this highlights the importance of maximizing conservative therapies, particularly with stimulant laxatives, before pursuing invasive tests or surgical interventions for bowel dysfunction in this population. Full article

Background: Chronic postoperative pain (CPOP) is among the main consequences of surgical procedures, directly affecting the quality of life. Although many strategies have been used to treat this symptom, they are often ineffective. Thus, studies investigating CPOP-associated mechanisms may help to develop more effective treatment strategies. Therefore, the present study investigated the spinal participation of the transient potential receptor vanilloid type 1 (TRPV1) and PI3K/AKT/mTOR pathway activation during CPOP. Methods: In this study C57BL/6 male mice were used, and CPOP was induced by muscle retraction and incision. The nociceptive threshold was measured by the von Frey filament test. For pharmacological evaluation, TRPV1 and PI3K/AKT/mTOR inhibitors were administered intrathecally. TRPV1 and PI3K/AKT/mTOR protein levels were evaluated by Western blotting. Results: The results showed that CPOP increased TRPV1 and mTOR protein levels, and pretreatment with the specific inhibitors alleviated CPOP. In addition, pretreatment with the TRPV1 antagonist SB-366791 attenuated mTOR protein levels. Conclusions: The results suggest that TRPV1 and the PI3K/AKT/mTOR pathway are involved in CPOP at the spinal level, and TRPV1 may activate mTOR during this process. Full article

Objectives: This study aimed to evaluate the correlations between optical coherence tomography angiography (OCTA), best corrected visual acuity (BCVA), and macular integrity assessment (MAIA) microperimetry (MP) in both a control group and patients with rhegmatogenous retinal detachment (RRD). Additionally, it assessed differences between the groups and examined whether the time from symptom onset to surgery influenced microvascular or functional changes in the RRD group. Methods: A cross-sectional study was conducted involving 47 patients who had undergone successful RRD surgery with pars plana vitrectomy (PPV) and sulfur-hexafluoride (SF6) gas injection, with or without scleral buckling (SB), and a control group of 136 healthy eyes. All participants underwent comprehensive ophthalmologic examinations, including BCVA, OCTA, and MAIA. In the RRD group, additional data on symptom duration, time from symptom onset to surgery, and time from surgery to testing were collected. Results: The RRD group exhibited significantly worse BCVA (p < 0.001) compared to the control group. Significant differences were found in all MAIA sectors, with controls showing superior macular integrity and average threshold values (p < 0.001). OCTA analysis revealed differences in the superficial capillary plexus (SCP) and deep capillary plexus (DCP) across various sectors, particularly in the foveal avascular zone (FAZ). In the control group, the vertical diameter of the FAZ in the SCP was positively correlated with most MAIA sectors, while in the DCP, correlations were seen in nearly all sectors. The RRD group showed fewer correlations between OCTA and MAIA, and no significant correlations were found between OCTA parameters and BCVA. However, there were correlations between the time from surgery to testing and MAIA outcomes, indicating improved results with longer intervals. Earlier surgical intervention after symptom onset was associated with better microvascular outcomes. Conclusions: RRD group exhibited significant impairments in BCVA, retinal sensitivity, and microvascular parameters compared to healthy controls. Correlations between OCTA findings and microperimetry were stronger in the control group, whereas the RRD group showed fewer and weaker associations. Full article

Sleep bruxism (SB) and sleep-disordered breathing (SDB) are two prevalent conditions that significantly impact overall health. Studies suggest that up to 49.7% of individuals with SDB also exhibit symptoms of SB. This review aims to provide a comprehensive analysis of the role of genetic background and neurotransmission in the pathogenesis of the co-occurrence of SB and SDB. It seeks to synthesize current knowledge, highlight gaps in the existing literature, and propose a new perspective that integrates genetic and neurobiological factors. This review shows that both SB and SDB may be influenced by a combination of genetic, neurochemical, and environmental factors that contribute to their shared pathophysiology. The key neurotransmitters—dopamine, serotonin, and GABA—may play a significant role in their co-occurrence by regulating motor activity, sleep architecture, and respiratory control. Understanding genetic and neurochemical mechanisms may allow for more precise diagnostic tools and more personalized treatment approaches regarding SB and SDB. Clinically, there is a need for interdisciplinary collaboration between sleep specialists, dentists, neurologists, and geneticists. There is also a need to conduct large-scale genetic studies, coupled with neuroimaging and neurophysiological research, uncovering additional insights into the shared mechanisms of SB and SDB. Full article

Quarantine policies during the coronavirus disease 2019 (COVID-19) pandemic prolonged time spent at home, leading to an unintended occurrence of sick building syndrome (SBS) symptoms. The aim of this study was to investigate the prevalence of SBS symptoms among residents in Suzhou, China, during the COVID-19 pandemic. A questionnaire survey was conducted online from February to May 2022. A total of 442 adults were included in this study. The prevalence of SBS symptoms was much higher during the COVID-19 pandemic, and the proportions of general, mucosal, and skin symptoms were 59.3%, 45.5% and 49.1%, respectively. The influences of building characteristics, occupant lifestyle, indoor environment and perception of indoor environment were analysed using a multivariate logistic regression model. Neighbourhood pollutant sources, older residences, non-ownership and humidity indicators were significant risk factors for SBS symptoms. Frequent use of air fresheners was significantly associated with general (adjusted odds ratio (AOR): 4.9, 95% confidence interval (CI: 2.4–10.0), mucosal (AOR: 5.3, 95% CI: 2.4–11.5), and skin symptoms (AOR: 4.6, 95% CI: 1.6–13.1), while the use of disinfectants was significantly correlated with skin symptoms (AOR: 4.0, 95% CI: 1.5–10.7). Residents’ perception of an uncomfortable indoor environment was a significant predictor of general (AOR: 2.2, 95% CI: 1.2–4.0) and mucosal symptoms (AOR: 3.1, 95% CI: 1.6–6.0). The use of air cleaners can reduce the prevalence of general symptoms. An important finding of this study is that the psychological impact of staying at home for a long time was associated with general symptoms (AOR: 1.3, 95% CI: 1.1–1.7), which means that attention should also be paid to the mental health of residents during the COVID-19 pandemic. Although the quarantine period has now ended, our results can still serve as a reference for the impact of the indoor environment on the health of people with SBS, especially for those who stay at home for a long time, such as the elderly. Full article

Background: Less than 25% of gastric cancers (GC) are discovered early, leading to limited treatment options and poor outcomes (27.8% mortality, 3.7% 5-year survival). Screening programs have improved cure rates, yet post-diagnosis treatment guidelines remain unclear (systemic chemotherapy versus surgery). The optimal type of palliative surgery (palliative gastrectomy (PG), surgical bypass (SB), endoscopic stenting (ES)) for long-term outcomes is also debated. Methods: A literature review was conducted using PubMed, MEDLINE, and EMBASE databases along with Google Scholar with the search terms “gastric cancer” and “palliative surgery” for studies post-1985. From the initial 1018 articles, multiple screenings narrowed it to 92 articles meeting criteria such as “metastatic, stage IV GC”, and intervention (surgery or chemotherapy). Data regarding survival and other long-term outcomes were recorded. Results: Overall, there was significant variation between studies but there were similarities of the conclusions reached. ES provided quick symptom relief, while PG showed improved overall survival (OS) only with adjuvant chemotherapy in a selective population. PG had higher mortality rates compared to SB, with ES having a reported 0% mortality, but OS improved with chemotherapy across both SB and PG. Conclusions: Less frail patients may experience an improvement in OS with palliative resection under limited circumstances. However, operative intervention without systemic chemotherapy is unlikely to demonstrate a survival benefit. Further research is needed to explore any correlations. Full article

Background/Objectives: Neuropsychological, neurodevelopmental, or minimal cerebral dysfunctions (MCD) can be found in many patients with mental disorders. They can be masked by other symptoms, impair the course of the illness, and impair work and social participation. Despite a long history of research, there is still a lack of data on the spectrum, prevalence, and consequences of these dysfunctions in patients with chronic illness. In this study, we compared patients with and without a history of neurocognitive problems in childhood for present neuropsychological dysfunctions. Methods: A convenience sample of 1453 psychosomatic inpatients completed the MCD scale, assessing neurodevelopmental issues in childhood and current neuropsychological dysfunctions. Additional assessments were the Attention Deficit Hyperactivity Self Rating Scale (ADHS-SB) and the Symptom Checklist 90 (SCL-90). Results: Significant early neurodevelopmental problems were reported by 8.87% of the patients. This group also reported a significantly higher rate of MCD symptoms and general psychosomatic symptoms (SCL-90) as compared with other patients. Conclusions: There is a notable prevalence of neuropsychological dysfunctions in psychosomatic patients in general, and especially in those with early neurodevelopmental problems. To adequately address specific potentially participation-relevant impairments, a broader diagnostic approach is necessary, including exploration of MCD history and present neuropsychological dysfunctions. Full article