Search Results (358)

Dietary fiber (DF) is one type of carbohydrate that cannot be digested by the gastrointestinal tract. It is widely recognized as an essential ingredient for health due to its remarkable prebiotic properties. Studies have shown that DF is important in the management of metabolic diseases, such as obesity and diabetes, by regulating the balance of gut microbiota and slowing down the absorption of glucose. It is worth noting that patients with metabolic diseases might suffer from intestinal dysfunction (such as constipation), which is triggered by factors such as the disease itself or medication. This increases the complexity of chronic disease treatment. Although medications are the most common treatment for chronic disease, long-term use might increase the financial and psychological burden. DF as a prebiotic has received significant attention not only in the therapy for constipation but also as an adjunctive treatment in metabolic disease. This review focuses on the application of DF in modulating metabolic diseases with special attention on the effect of DF on intestinal dysfunction. Furthermore, the molecular mechanisms through which DF alleviates intestinal disorders are discussed, including modulating the secretion of gastrointestinal neurotransmitters and hormones, the expression of aquaporins, and the production of short-chain fatty acids. Full article

Background and Objectives: The transition from pediatric to adult-oriented healthcare is challenging and data on parental involvement and perception regarding the transition of children with chronic digestive diseases are scarce. Materials and Methods: Legal guardians of adolescents with chronic digestive diseases receiving care at a North-Eastern Romanian tertiary center and private offices were administered a 30-item survey. Results: There were 124 responders; 73.4% lived in rural areas; 81.5% were patients’ mothers. Positive correlations were found between parents’ perception of the child’s readiness for health-related decisions and appreciation of the children’s preparedness for transition (0.544; p = 0.000), between parents encouraging their children to maintain healthcare records and their perception of the children’s knowledge about their disease (0.67; p = 0.000), between parents’ fear of therapeutic breaks during transition and their perception of the need for transition training (0.704; p = 0.000), between fears for children’s impropriate health-related choices, fears of therapeutic breaks (0.573; p = 0.00) and parental perception that the adult physicians would be more patient-oriented and less family-centered (0.453; p < 0.000) and between parents’ trust in their children’s self-management skills and encouraging them to make decisions on their own (0.673; p < 0.000). Conclusions: The results of our study highlight the importance of addressing parental fears during special parent–children counseling sessions and promoting a child’s independence, chronic disease knowledge, records and alone consultations. Full article

Inflammatory bowel disease (IBD), a heterogeneous group of recurring inflammatory conditions of the digestive system that encompass both ulcerative colitis (UC) and Crohn’s disease (CD), pose a significant public health challenge, currently lacking a definitive cure. The specific etiopathogenesis of IBD is not yet fully understood, but a multifactorial interplay of genetic and environmental factors is suspected. A growing body of evidence supports the involvement of intestinal dysbiosis in the development of IBD, including the effects of dysbiosis on the integrity of the intestinal epithelial barrier, modulation of the host immune system, alterations in the enteric nervous system, and the perpetuation of chronic inflammation. A comprehensive understanding of these mechanisms is important to define preventive measures, to develop new effective and lasting treatments, and to improve disease outcome. This review examines the complex tri-directional relationship between gut microbiota, mucosal immune system, and intestinal epithelium in IBD. In addition, nonpharmacological and behavioral strategies aimed at restoring a proper microbial–immune relationship will be suggested. Full article

Objectives: Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease with an unclear etiology. This study aimed to assess chronic heavy metal exposure in ALS patients in South Korea by comparing hair concentrations of common (Hg, Pb, Cd) and rare (U, Th, Pt) metals with healthy controls. Methods: Hair samples were collected from 66 ALS patients and 70 healthy individuals at Rodem Hospital between 2022 and 2025. Metal concentrations were measured using inductively coupled plasma mass spectrometry (ICP-MS) following standardized washing and digestion protocols. Results: ALS patients showed significantly higher levels of Hg, Pb, Cd, Al, As, and U than controls (p < 0.05). Notably, 40% of ALS patients had Hg levels exceeding 50% of the reference upper limit, compared to only 10% of controls. Elevated levels of uranium and other rare metals were also observed in specific ALS cases. Conclusions: These findings suggest a possible association between heavy metal exposure and ALS in South Korea. Hair analysis may serve as a useful tool for identifying environmental factors contributing to ALS pathogenesis. Full article

Background: Late-life depression is a critical public health concern, particularly among older adults with chronic multimorbidity. Existing studies often focus on single-disease associations, neglecting the complex interplay of coexisting conditions. Understanding how multimorbidity patterns contribute to depression risk and identifying high-risk subgroups through integrated statistical and machine learning approaches remain underexplored, limiting targeted prevention strategies. Methods: Using data from the China Health and Retirement Longitudinal Study (CHARLS), latent class analysis (LCA) was employed to cluster multimorbidity patterns. Associations between these patterns and depression were analyzed using multivariable logistic regression, while predictive performance and interaction effects were evaluated via an XGBoost machine learning model. Results: Four distinct multimorbidity patterns were identified: cardio-metabolic, digestive–joint, respiratory, and cardiovascular–digestive pattern. All clusters showed significant independent associations with depression, with the cardiovascular–digestive pattern exhibiting the strongest association (OR = 4.56). However, the digestive–joint pattern demonstrated the highest predictive effects for depression. Sociodemographic factors—low income, limited education, female gender, and rural residence—emerged as robust predictors, amplifying depression risk in older adults with multimorbidity. Conclusions: This study bridges epidemiological insights with predictive analytics to inform depression risk stratification. We recommend routine depression screening for all individuals with cardiovascular–digestive diseases and prioritize screening for women with digestive–joint diseases. Additionally, low-income and rural-dwelling older adults with chronic conditions warrant heightened clinical vigilance. These findings provide a framework for integrating multimorbidity profiling into depression prevention protocols, addressing both biological and socioeconomic determinants. Full article

This retrospective cohort study aimed to assess clinical and epidemiological characteristics, treatment outcomes, and predictors of serological cure in patients with chronic Chagas disease in a non-endemic setting. All individuals aged ≥16 years with confirmed infection and evaluated at a tertiary hospital in Spain from 2008 to 2023 were included. Most of the 107 participants were women (78.5%) and Bolivian-born (99.1%). Digestive and cardiac involvement were identified in 32.7% and 17.8% of cases, respectively. Cardiac symptoms were significantly associated with the diagnostic findings of cardiac involvement (odds ratio [OR] 3.0, 95% confidence interval [CI] 1.1–8.2), whereas digestive symptoms did not correlate with imaging abnormalities (OR 0.7, 95% CI 0.3–1.6). Antiparasitic treatment, usually benznidazole, was initiated in 69% of patients and led to adverse events in 66.2%, with treatment discontinuation in 25.7%. Only 8.1% of treated patients achieved serological cure after a median 26 months, with obesity emerging as the only independent predictor (adjusted OR 31.0, 95% CI 3.7–261.2). Cardiac progression occurred in 9.3% of patients despite treatment. Although 59.8% were lost to follow-up, the cohort maintained a median follow-up of 27 months. These findings underscore the need for improved treatment strategies and sustained clinical monitoring in non-endemic settings. Full article

Background/Objectives: Anxiety disorders are the most prevalent mental illnesses worldwide and in Portugal, often resulting in chronicity and disability. The objective of this study is to evaluate the sociodemographic and health-related factors associated with anxiety in the Portuguese adult population. Methods: This study included participants aged 18 to 65 years from the nationwide, population-based EpiDoC cohort, who were followed from 2011 to 2021 (n = 2927). Anxiety was assessed using the Hospital Anxiety and Depression Scale (HADS). A mixed logistic regression analysis was performed using a prospective analytical approach. Two strategies were used to adjust the mixed models: (i) model with only complete observations (n = 1950) and (ii) model with imputation of the category “No” in missing self-reported diseases (n = 2554). Results: The proportion of anxiety symptoms decreased from 2011–2013 to 2021 (12.5% vs. 8.5%). Experienced anxiety symptoms were positively associated (OR > 1, p < 0.05) with being female; having a high school, 2nd and 3rd cycle (6–9 years of studies), or primary/no education; being unemployed; seeking the first job; and not working or being temporarily unable to work. Additionally, anxiety symptoms were positively associated (OR > 1, p < 0.05) with smoking daily, lack of physical exercise, and medication use. Digestive diseases, multimorbidity, and region were also positively associated (OR > 1, p < 0.05) with anxiety symptoms. Moreover, age was negatively associated (OR < 1, p < 0.05) with experiencing anxiety symptoms. Conclusions: Some determinants are modifiable and preventable through economic, social, and health policies. Measures to promote healthy lifestyles, like physical exercise, reduce substance abuse, prevent chronic diseases, increase employability, and increase schooling and health literacy, are necessary to reduce the anxiety rate in Portugal. Full article

Canine chronic enteropathy (CE) is a gastrointestinal disorder characterized by persistent or recurrent digestive symptoms lasting more than three weeks. It shares similarities with human inflammatory bowel disease but its immunopathogenesis remains poorly characterized in dogs. The aim of this study was to characterize the local and systemic immune profile of dogs with CE by assessing cytokine and chemokine expression in serum and intestinal tissue, as well as the mRNA expression of immune-related receptors such as integrins, chemokine receptors, and cytokines. Duodenal biopsies and blood samples were collected from five dogs diagnosed with a CE and five healthy controls. Serum concentrations of cytokines and chemokines were determined by multiplex ELISA, and mRNA expression in the intestinal mucosa was analyzed by quantitative PCR. Dogs with a CE showed increased expression of pro-inflammatory cytokines, including TNF-α and IFN-γ, and increased concentrations of chemokines such as CXCL10 and CCL2 in both serum and tissue samples. Increased mRNA expression of the chemokine receptor CCR9 and the adhesion molecule MAdCAM-1 were also observed in intestinal samples. These findings provide new insights into the immune response involved in CE and may aid the development of future diagnostic biomarkers and targeted therapies for canine chronic enteropathies. Full article

Background: Sarcopenia is a progressive muscle disorder commonly associated with aging and chronic diseases. It has been linked to worse clinical outcomes and increased vulnerability during acute illness. However, its prevalence in emergency department (ED) populations remains underexplored. This study aimed to evaluate the presence of sarcopenia among ED patients using ultrasound, determine its relationship with underlying comorbidities, and assess its association with in-hospital complications. Methods: We conducted a prospective, observational, cross-sectional study at the Infanta Cristina University Hospital (Madrid, Spain) from January to May 2024. A total of 150 patients aged 18 years and older who presented to the ED were assessed for sarcopenia using rectus femoris ultrasound. Sociodemographic, clinical, and laboratory variables were collected. A multivariate logistic regression model was used to identify independent predictors of in-hospital complications. Patients were followed for 30 days to evaluate outcomes. Comparisons were made between diagnostic groups and sarcopenia indices. Results: The mean age of the cohort was 70.7 years (SD 18.15), and 52% were male. Neurological diseases were associated with the highest degree of sarcopenia (mean Y-axis: 0.93 cm), followed by digestive (1.05 cm), hematological (1.05 cm), and cardiovascular diseases (1.08 cm). Patients who developed in-hospital complications had lower mean muscle thickness values compared to those without complications (1.08 cm vs. 1.24 cm; p < 0.05). Sarcopenia was significantly correlated with the presence of comorbidities and poor clinical outcomes. Conclusions: These findings support the integration of sarcopenia screening protocols into emergency care and highlight the need for studies exploring early nutritional or rehabilitation interventions targeted at high-risk patients. Full article

Diabetes is a metabolic disorder characterized by chronic hyperglycemia, affecting between 0.21% and 1.24% of cats. While gastrointestinal complications are well-documented in human diabetic patients—affecting up to 75%—similar data in cats remain scarce. This study explores gastrointestinal alterations in diabetic cats using ultrasound and histopathological evaluations, alongside assessing owners’ perceptions of digestive issues. A brief survey was conducted with the owners of diabetic cats to document diabetes symptoms and any gastrointestinal changes. Following the survey, each cat underwent abdominal US, focusing on the digestive tract including the stomach, duodenum, jejunum, ileum, and colon. Additionally, histopathological analysis was conducted on necropsied diabetic cats. Thirteen domestic spayed diabetic cats with no prior gastrointestinal disease were included, with 83% showing at least one gastrointestinal issue reported by owners. All cats exhibited increased gastric, duodenal, and jejunal wall thickness, while the ileum and colon showed normal thickness. Histopathological evaluation revealed increased thickness of the muscular layers, inflammatory infiltrate, and collagen deposits in the whole length of the gastrointestinal tract. These findings suggest that diabetic cats may experience gastrointestinal remodeling, a phenomenon that, while well recognized in human diabetes, has not been adequately studied in feline patients. Full article

Background: Microvascular complications in type 2 diabetes (T2D) and cancer share biological pathways, including chronic inflammation, dysregulated angiogenesis, and endothelial dysfunction, yet their impact on cancer risk and mortality remains unclear. This study evaluated whether T2D patients with microvascular complications face increased cancer incidence or cancer-related mortality. Methods: Using the Taiwan National Health Insurance Research Database, we identified individuals newly diagnosed with T2D (2008–2021) and assessed the outcomes with multivariable Cox proportional hazards models. Results: Our findings indicate that T2D patients with diabetic neuropathy, retinopathy, or chronic kidney disease do not have a significantly increased risk of major cancers, including those of the oral cavity, thyroid, breast, respiratory tract, digestive system, or lymphoid tissues. Similarly, microvascular complications were not associated with higher cancer-related mortality. However, microvascular complications significantly increased all-cause mortality in a dose-dependent manner: adjusted hazard ratio (aHR) 1.16 [95% CI: 1.15–1.17] for one complication, aHR 1.42 [1.38–1.45] for two, and aHR 1.71 [1.60–1.83] for three. Conclusions: In this nationwide cohort study, we demonstrate that while microvascular complications are associated with increased all-cause mortality in T2D, they do not appear to elevate cancer risk or cancer-specific mortality. These findings provide crucial epidemiological insights into the relationship between diabetes complications and cancer. Full article

Background/Objectives: Chronic pancreatitis (CP) is a progressive inflammatory condition of the pancreas that leads to irreversible changes in pancreatic structure. The pancreatic α and β cells secrete hormones such as insulin and glucagon into the bloodstream. The pancreatic acinar cells secrete digestive enzymes that break down macromolecules. When these digestive enzymes do not function properly, maldigestion, malabsorption, and malnutrition may result. Presented here is a case study of an individual newly diagnosed with chronic pancreatitis, along with a genetic analysis of his son and an in-silico analysis of two of the variant proteins. Methods: This study was conducted using human subjects, namely, the proband (father) and his son. Medical genetic testing of the proband (father) identified the presence of two variants in the cystic fibrosis transmembrane receptor gene (CFTR): variant rs213950, resulting in a single amino acid change (p. Val470Met), and variant rs74767530, a nonsense variant (Arg1162Ter) with known pathogenicity for cystic fibrosis. Medical testing also revealed an additional missense variant, rs515726209 (Ala73Thr), in the CTRC gene. Cheek cell DNA was collected from both the proband and his son to determine the inheritance pattern and identify any additional variants. A variant in the human leukocyte antigen (rs7454108), which results in the HLA-DQ8 haplotype, was examined in both the proband and his son due to its known association with autoimmune disease, a condition also linked to chronic pancreatitis. In silico tools were subsequently used to examine the impact of the identified variants on protein function. Results: Heterozygosity for all variants originally identified through medical genetic testing was confirmed in the proband and was absent in the son. Both the proband and his son were found to have the DRB1*0301 (common) haplotype for the HLA locus. However, the proband was also found to carry a linked noncoding variant, rs2647088, which was absent in the son. In silico analysis of variant rs213950 (Val470Met) in CFTR and rs515726209 (Ala73Thr) in CTRC revealed distinct changes in predicted ligand binding for both proteins, which may affect protein function and contribute to the development of CP. Conclusions: This case study of a proband and his son provides additional evidence for a polygenic inheritance pattern in CP. The results also highlight new information on the role of the variants on protein function, suggesting additional testing of ligand binding for these variants should be done to confirm the functional impairments. Full article

α-Mangostin, a bioactive xanthone derived from the Garcinia mangostana L. Clusiaceae (G. mangostana) fruit, has demonstrated significant anti-inflammatory and immunomodulatory properties. Chronic inflammation plays a critical role in the pathogenesis of various diseases, including metabolic disorders, autoimmune conditions, and cancer. Conventional anti-inflammatory therapies, such as non-steroidal anti-inflammatory drugs (NSAIDs), often carry undesirable side effects, prompting the need for safer, natural alternatives. This review consolidates the existing literature on the mechanisms by which α-mangostin exerts its anti-inflammatory effects, including the suppression of pro-inflammatory cytokines, modulation of immune cell activity, and inhibition of key signaling pathways such as nuclear factor-kappa B (NF-κB) and mitogen-activated protein kinase (MAPK). Additionally, α-mangostin exhibits immunomodulatory properties by influencing both innate and adaptive immune responses, affecting macrophage polarization, T cell differentiation, and cytokine production. Its efficacy has been observed in numerous disease models, including joint disorders, digestive and metabolic conditions, hepatic diseases, neurological disorders, and respiratory ailments. The potential therapeutic applications of α-mangostin as an anti-inflammatory agent warrant further investigation through preclinical and clinical studies to validate its efficacy and safety. Full article

Background/Objectives: In short bowel syndrome adults (SBS), about 50% of patients on parenteral support (PS) are weaned off. However, micronutrient deficiency prevalence has never been studied in weaned patients. We aimed to assess the prevalence of micronutrient depletions and potential risk factors, more than a year after PS weaning. Methods: A retrospective study was conducted on our 161 weaned SBS patients between January 2011 and December 2021. Only 42 of them had an assessment of their plasma micronutrient status more than a year after PS weaning. Results: 40/42 patients had at least one micronutrient depletion, with an average of 4.0 ± 1.9 depletions per patient. Depletions in vitamins D, E, selenium, copper, and zinc were the most frequent, present for >50% of patients. In 75% of cases, patients depleted in vitamin B12 and D were already supplemented. Long-term proton pump inhibitor (PPI) use and duration on PS was associated with ≥ three depletions (p = 0.02). A daily mean of the total energy infused per week > 20 kcal/kg/day at the time of weaning was associated with more depletions (5.8 ± 1.6 vs. 3.7 ± 1.7 depletions, p = 0.02). Other factors (digestive anatomy, particularly SBS type, or associated chronic disease) were not predictive of depletion. Conclusions: Nearly all patients with SBS have at least one micronutrient depletion after PS withdrawal. This study suggests that a long-term monitoring of micronutrients status is needed for SBS patients weaned off PS. A larger-scale study would be necessary to generalize these results. Full article

Animal models are an essential part of translational research for the purpose of improving human health. The pig is a potential human research model that can be used to assess the effects of dietary interventions, pathologies, and drugs on gut health and the microbiome, due to its anatomical and physiological similarity to humans. It is recognised that a healthy gut is closely linked to the prevention of several chronic diseases, including obesity, diabetes, gastrointestinal inflammation, as well as neurological and cardiovascular diseases. The use of prebiotics and probiotics plays an important role in maintaining a healthy digestive system, which is responsible for modulating all other body functions. The present review focuses on the applications of prebiotics and probiotics in the pig as an animal model in healthy and diseased conditions, in order to highlight the efficacy of these molecules in the perspective of human health outcomes. The data support the use of prebiotics to improve intestinal health in both healthy and diseased states. In addition, the use of human microbiota-associated (HMA) gnotobiotic pigs provided a good model to study the intestinal and systemic immune response and microbiota composition following probiotic supplementation after a vaccine or virus challenge. Full article