Search Results (5,763)

Non-communicable diseases, particularly cardiovascular diseases (CVD) and metabolic syndrome (MS), remain a major challenge for primary health care (PHC). This study aimed to assess cardiometabolic risk and health behaviours in adult PHC patients using routine preventive screening. This prospective observational study included 506 adults attending routine consultations in an urban PHC centre in Poland. Preventive assessment included anthropometric measurements (body weight, height, BMI, and waist circumference), blood pressure, lipid profile, and fasting glucose levels. Health behaviours were recorded using the standardised NFZ CHUK questionnaire. The 10-year CVD risk was estimated using the SCORE2 algorithm. Multivariable logistic regression was used to identify independent factors associated with high cardiovascular risk (SCORE2 ≥ 5%) and of a composite endpoint defined as the presence of any non-optimal biochemical parameter. Nearly half of the participants had excess body weight (overweight or obesity), and more than half met criteria for central obesity. Borderline or elevated total cholesterol was found in 47% of patients, abnormal LDL in 27%, low HDL-C (<40 mg/dL) in 80% (84% when applying sex-specific cut-offs), and impaired fasting glucose or diabetes in about 12%. High SCORE2 risk (≥5%) was observed in approximately 9% of the cohort. In multivariable models, SCORE2 components (age, sex, and smoking) were, as expected, associated with high SCORE2 risk, and obesity (BMI ≥ 30 kg/m²)—a factor not included in SCORE2—was additionally associated with higher risk. Additionally, age, male sex, and obesity also predicted the presence of at least one non-optimal biochemical marker. The prevalence of high SCORE2 risk increased from 1.2% in patients with 0–1 modifiable risk factor to 25.7% in those with 4–5 factors. Lower educational attainment was associated with a higher proportion of high-risk individuals in univariate analysis. Routine preventive activities in PHC enable the identification of important lipid and glucose abnormalities and the clustering of modifiable risk factors, even in a relatively young, highly educated population. Systematic cardiovascular screening and a focus on patients with accumulated risk factors should remain a priority in PHC to enable early identification of high-risk patients and timely implementation of lifestyle and therapeutic interventions. Full article

In this paper, the authors survey and summarize the widely researched morbidities and their life expectancy results. A constant impaired mortality adjustment for each morbidity is defined so that life expectancy is consistent with current medical research. Impaired mortality factors are derived and used to evaluate morbidity’s impact on retirement benefits. A morbidity-based pension benefit evaluation algorithm is proposed. Popular pension payment options, such as single life payment and joint life, are evaluated. The authors found that the optimal decision is highly sensitive to health status: lump sums are preferred when health is impaired, whereas annuities dominate for healthier individuals. Full article

Pregnancy represents a period of heightened oxidative demand in which maternal metabolic adaptations are tightly regulated by redox-sensitive molecular pathways. Imbalances in these systems have been associated with gestational complications, impaired placental function, and long-term effects on offspring health. This review examines the molecular mechanisms through which adherence to the Mediterranean diet (MD) influences oxidative balance during pregnancy. We summarize evidence on how MD-derived bioactives regulate oxidative stress pathways and affect oxidative stress biomarkers, as well as the expression of antioxidant enzymes such as superoxide dismutase and glutathione peroxidase. At the same time, certain MD foods containing environmental contaminants may potentially attenuate its protective effects. In addition, the review explores molecular insights into how the MD may counteract oxidative stress induced by environmental pollutants through modulation of redox signaling and detoxification pathways. By integrating biochemical, molecular, and environmental perspectives, this review highlights the MD as a potential nutrigenomic intervention to optimize oxidative balance, support healthy pregnancy outcomes linked to environmental pollution. Full article

Background: Estrogen deficiency following human menopause or rodent ovariectomy (OVX) induces adverse alterations in body composition and metabolic function. This study investigated the combined effects of acetic acid supplementation and voluntary exercise on metabolic health and skeletal muscle mitochondrial function using an OVX mouse model. Methods: Forty female C57BL/6J mice (8 weeks old) were randomly assigned to 5 groups: sham (SHM), ovariectomized control (OVX), OVX with exercise (OVX-E), OVX with acetic acid (OVX-A), and OVX with both interventions (OVX-AE). Following a 1-week recovery from OVX, a 13-week intervention was initiated: 5% sodium acetate-supplemented chow and/or voluntary wheel running. Body composition, glucose tolerance, total energy expenditure, skeletal muscle mitochondrial function, and the contents of AMPKα, PGC-1α, and carbonyl protein were assessed. Results: OVX impaired whole-body metabolism and skeletal muscle mitochondrial function, specifically in the gastrocnemius muscle. While the exercise alone failed to mitigate the OVX-induced mitochondrial dysfunction, the combined treatment of exercise and acetic acid supplementation significantly rescued from the OVX-induced mitochondrial dysfunction. Conclusions: OVX resulted in detrimental changes in whole-body metabolism, but voluntary exercise and/or acetic acid supplementation had no rescuing effects on those parameters. In gastrocnemius muscle, acetic acid supplementation during exercise enhanced mitochondrial function in OVX mice. Full article

Background/Objectives: Skin photoaging represents a predominant form of extrinsic aging, characterized by structural and functional impairment of the skin barrier. In severe cases, it may precipitate dermatological diseases and even tumors. Given the prevalence and detrimental effects of skin photoaging, strategies for its effective prevention and mitigation have garnered significant research interest. Chrysanthemum morifolium Ramat cv. ‘Hangju’ contains diverse bioactive compounds, including flavonoids, phenylpropanoids, phenolic acids, and polysaccharides, which have been proven to exhibit antioxidant and anti-inflammatory effects. Methods: This study employed a UVB-induced mouse model of skin photoaging to evaluate the potential of dietary supplementation with Chrysanthemum morifolium Ramat cv. ‘Hangju’ flower extract (CME) in vivo. Results: In the photoaged skin of female SKH-1 hairless mice, dietary supplementation with CME significantly increased skin moisture content, reduced wrinkle formation, suppressed epidermal hyperplasia, enhanced collagen density, and suppressed the senescence marker expression and DNA damage marker expression. Analysis of the skin transcriptome suggested that CME could alter gene expression patterns and potentially modulate critical signaling pathways involved in skin homeostasis. Moreover, 16S rRNA sequencing indicated that CME mitigated UVB-induced gut microbiota dysbiosis. Conclusions: These preclinical findings reveal the anti-photoaging property of dietary CME supplementation and point to its potential application as a functional dietary supplement for promoting skin health. Full article

Background and Objectives: Long COVID-19 (LC) is a multifaceted condition characterized by persistent fatigue and impaired health-related quality of life (HRQoL). Exercise intolerance and post-exertional symptom exacerbation (PESE) pose challenges for rehabilitation. This study aimed to evaluate the effects of a 12-week core-focused plank exercise program on fatigue and HRQoL in women with LC, using validated patient-reported measures. Materials and Methods: A pilot quasi-experimental design was implemented, with non-randomized group allocation. Thirty-nine women with LC were recruited from the Madrid Long COVID Association. Participants were assigned to either an intervention group (n = 20), which completed a supervised plank-based motor control program, or a control group (n = 19), which maintained usual activity. Fatigue was assessed using the Modified Fatigue Impact Scale (MFIS), and HRQoL was measured using the EQ-5D-5L and EQ Visual Analog Scale (EQ-VAS). Body composition was evaluated via bioelectrical impedance analysis. Results: The intervention group showed significant reductions after intervention in the MFIS total scores compared to the control group, particularly in the physical (21.26 ± 6.76 vs. 25.21 ± 6.06; p < 0.001) and psychosocial domains (4.51 ± 0.41 vs. 5.21 ± 0.38; p < 0.001), without triggering PESE. EQ-VAS scores improved significantly (63.94 ± 15.33 vs. 46.31 ± 14.74; p = 0.034). No significant changes were found in body composition parameters, suggesting that benefits were driven by neuromuscular adaptations rather than morphological changes. Conclusions: A core-focused, non-aerobic exercise program effectively reduced fatigue and improved perceived health status in women with LC. These findings support the use of motor control-based interventions as a safe and feasible strategy for LC rehabilitation, particularly in populations vulnerable to PESE, suggesting clinical applicability for the rehabilitation of women with LC. Further randomized trials are warranted to confirm these results and explore long-term outcomes. Full article

Atrial fibrillation (AF) is the most common sustained heart rhythm disorder. It is estimated that AF affects over 52 million people worldwide, with its prevalence expected to double in the next four decades. AF significantly increases the risk of stroke and heart failure, contributing to 340,000 excess deaths annually. Beyond these life-threatening complications, AF results in limitations in physical, emotional, and social well-being causing significant reductions in quality of life and resulting in 8.4 million disability-adjusted life-years per year, highlighting the wide-ranging impact of AF on public health. Moreover, AF is increasingly recognized for its association with cognitive decline and dementia. AF is a chronic and progressive disease characterized by rapid and erratic electrical activity in the atria, often in association with structural changes in the heart tissue. AF is often initiated by triggered activity, often from ectopic foci in the pulmonary veins. These triggered impulses may initiate AF via: (1) sustained rapid firing with secondary disorganization into fibrillatory waves, or (2) by triggering micro re-entrant circuits around the pulmonary venous-LA junction and within the atrial body. In each instance, AF perpetuation necessitates the presence of a vulnerable atrial substrate, which perpetuates and stabilizes re-entrant circuits through a combination of slowed and heterogeneous conduction, as well as functional conduction abnormalities (e.g., fibrosis disrupting tissue integrity, and abnormalities in the intercalated disks disrupting effective cell-to-cell coupling). The re-entry wavelength, determined by conduction velocity and refractory period, is shortened by slowed conduction, favoring AF maintenance. One major factor contributing to these changes is the disruption of the extracellular matrix (ECM), which is induced by atrial fibrosis. Fibrosis-driven disruption of the ECM, especially in the heart and blood vessels, is commonly caused by conditions such as aging, hypertension, diabetes, smoking, and chronic inflammatory or autoimmune diseases. These factors lead to excessive collagen and protein deposition by activated fibroblasts (i.e., myofibroblasts), resulting in increased tissue stiffness, maladaptive remodeling, and impaired organ function. Fibrosis typically occurs when cardiac fibroblasts are activated to myofibroblasts, resulting in the deposition of excessive collagen and other proteins. This change in ECM interferes with the normal electrical function of the heart by creating irregular, fibrotic regions. AF and atrial fibrosis have a reciprocal relationship: AF promotes fibrosis through fibroblast activation and extracellular matrix buildup, while atrial fibrosis can sustain and perpetuate AF, contributing to higher rates of AF recurrence after treatments such as catheter ablation or cardioversion. Full article

Background: Age-related declines in respiratory muscle strength and ventilatory efficiency can impair functional capacity and metabolic health in older adults. Inspiratory muscle training (IMT) has been proposed as a practical intervention to counteract these changes, yet its systemic effects remain unclear. This study aimed to examine the effects of short-term IMT on functional capacity, diaphragm thickness, and liver tissue characteristics in healthy elderly men. Methods: Thirty community-dwelling men aged 60–80 years were randomly assigned to an IMT or control group. The IMT group performed four weeks of breathing exercises using a POWERbreathe^® device at 40% of maximal inspiratory pressure, with a weekly 10% increase in pressure. Pre- and post-intervention assessments included the six-minute walk test (6MWT), diaphragm thickness and liver density via computed tomography, and quality of life (QoL; SF-12). Results: Four weeks of inspiratory muscle training significantly improved diaphragm thickness (11.7%), fatty liver density (FLD) (+16.7%), and six-minute walk performance (+5.3%), with large time × group effects favoring the IMT group. While the physical quality of life showed modest, comparable improvements, mental health outcomes demonstrated a moderate, time-dependent improvement without a significant group-by-time interaction. Conclusions: Short-term IMT improved diaphragmatic function and functional capacity in older men and was associated with favorable changes in a liver-related biomarker; however, given that only a single liver-related metric was assessed, these findings should not be interpreted as evidence of overall improvements in liver health. Full article

Pulmonary embolism (PE) is a potentially life-threatening cardiopulmonary condition that frequently requires hospitalization and is often accompanied by reduced mobility, systemic inflammation, and nutritional impairment. These factors may contribute to the development or worsening of sarcopenia, a condition associated with adverse outcomes in hospitalized patients. However, its clinical relevance in patients with PE has not been sufficiently explored. This longitudinal observational cohort study evaluated the association between sarcopenia and clinical outcomes in patients hospitalized with confirmed PE. Participants were classified according to the presence of sarcopenia based on muscle mass and muscle strength criteria. Symptom severity, functional status, and health-related quality of life were assessed at hospital admission, at discharge, and three months after discharge. A total of 162 patients were included. Patients with sarcopenia exhibited a greater symptom burden, poorer functional status, and worse self-perceived health compared with non-sarcopenic patients. At discharge, sarcopenic patients reported higher levels of dyspnea and fatigue, poorer health-related quality of life, and experienced longer hospital stays. At the three-month follow-up, these patients continued to show significantly worse symptoms, reduced functionality, and lower quality of life. Sarcopenia was therefore associated with a persistently worse clinical and functional profile in patients hospitalized for PE. Early identification of sarcopenia may help identify patients at higher risk of poor recovery and support the implementation of targeted interventions aimed at improving functional outcomes and quality of life. Full article

Complete or partial loss of smell (anosmia), sometimes in association with distorted olfactory perceptions (parosmia), is a common neurological symptom affecting nearly 60% of patients suffering from post-acute neurological sequelae of COronaVIrus Disease of 2019 (COVID-19) syndrome, called long COVID. Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV-2) may gain access from the nasal cavity to the brain (neurotropism), and the olfactory route has been proposed as a peripheral site of virus entry. COVID-19 is a risk factor for developing Alzheimer’s Disease (AD), an age-dependent and progressive neurodegenerative disorder characterized in affected patients by early olfaction dysfunction that precedes signs of cognitive decline associated with neurodegeneration in vulnerable brain regions of their limbic system. Here, we summarize the recent literature data supporting the causal correlation between the persistent olfactory deterioration following SARS-CoV-2 infection and the long-delayed manifestation of AD-like memory impairment. SARS-CoV-2 infection of the olfactory neuroepithelium is likely to trigger a pattern of detrimental events that, directly and/or indirectly, affect the anatomically interconnected hippocampal and cortical areas, thus resulting in tardive clinical dementia. We also delineate future advancement on pharmacological and rehabilitative treatments to improve the olfactory dysfunction in patients recovering even from the acute/mild phase of COVID-19. Collectively, the present review aims at highlighting the physiopathological nexus between COVID-19 anosmia and post-pandemic mental health to favor the development of best-targeted and more effective therapeutic strategies in the fight against the long-term neurological complications associated with SARS-CoV-2 infection. Full article

People with intellectual disabilities are disproportionately affected by diet-related health inequalities. This Perspective outlines a dual challenge: (1) intrinsic vulnerabilities—cognitive limitations, health-literacy constraints, and comorbidities—that impair individuals’ ability to make healthy dietary choices, and (2) extrinsic neglect—insufficient support in care environments, inadequate nutrition-related training among informal caregivers and support staff, and structural gaps in policy and services. We argue that this “double jeopardy” undermines nutritional equity and proposes strategies for person-centered nutrition education, caregiver empowerment, supportive food environments, and inclusive policy frameworks. Greater interdisciplinary collaboration and tailored research are urgently needed to ensure nutritional health as a right for people with intellectual disabilities. Full article

Obesity is a systemic metabolic disorder characterized by chronic low-grade inflammation and insulin resistance, with growing evidence indicating that the brain represents a primary and particularly vulnerable target organ. Beyond peripheral metabolic consequences, obesity induces region-specific structural, functional, and biochemical alterations within the central nervous system, contributing to cognitive impairment, dysregulated energy homeostasis, and increased susceptibility to neurodegenerative diseases. This narrative review examines key neurometabolic and neuroinflammatory mechanisms underlying obesity-related brain vulnerability, including downstream neuroinflammation, impaired insulin signaling, mitochondrial dysfunction, oxidative stress, blood–brain barrier disruption, and impaired brain clearance mechanisms. These processes preferentially affect frontal and limbic networks involved in executive control, reward processing, salience detection, and appetite regulation. Advanced neuroimaging has substantially refined our understanding of these mechanisms. Magnetic resonance spectroscopy provides unique in vivo insight into early neurometabolic alterations that may precede irreversible structural damage and is complemented by diffusion imaging, volumetric MRI, functional MRI, cerebral perfusion imaging, and positron emission tomography. Together, these complementary modalities reveal microstructural, network-level, structural, hemodynamic, and molecular alterations associated with obesity-related brain vulnerability and support the concept that such brain dysfunction is dynamic and potentially modifiable. Integrating neurometabolic and multimodal neuroimaging biomarkers with metabolic and clinical profiling may improve early risk stratification and guide preventive and therapeutic strategies aimed at preserving long-term brain health in obesity. Full article

Cannabis is one of the most common intoxicants used worldwide. Cannabis is widely consumed worldwide and can lead to visual alterations. However, most of the available information on its effects comes from studies conducted in developed countries, while data remain limited in developing regions such as Morocco, despite its significant role in cannabis cultivation. The aim of this study was to explore multiple visual parameters and self-perceived eyesight in cannabis users in Morocco. A cross-sectional study was conducted between March 2022 and April 2023 in Marrakesh, Morocco, in cannabis consumers. Data collection was performed in two phases. First a hetero-administrated questionnaire was used to collect socio-demographics, intoxicant consumption habit information, and eye health information. Then, several visual acuity tests were performed, including a preliminary examination, a visual function assessment, and an eye health assessment. Ninety-five cannabis users participated in this study. The majority were single (62.1%) males (87.4%). All lived in the Marrakesh-Safi region (100%), and most had daily activities such as having a job or being a student (77.9%). Most had vision conditions like astigmatism or myopia (83.4%). The majority had multiple addictions (66.5%), mainly to tobacco (43.7%). Hashish was the main cannabis type used (57.9%), and smoked cannabis was the principal mode of consumption (94.7%). Many had a family history of cannabis addiction (58.9%). Day light sensitivity (66.3%) and appearance of eye symptoms after cannabis use (90.5%) were declared by the majority. In most cases, no impact on far or near vision or vision impairment due to cannabis use were declared. Our results showed that using cannabis could have significant adverse effects on visual functions. Full article

Background/Objectives: Heel pressure ulcers are a relevant complication in critically ill patients and may negatively affect recovery after ICU discharge. This study investigated health-related quality of life (HRQoL) and mobility levels one year after ICU discharge in survivors who developed heel pressure ulcers. Methods: A prospective observational study was conducted in the ICU of an academic tertiary-level hospital in Milan (Italy) from 1 January 2023 to 31 December 2024. Adult survivors were enrolled, and HRQoL was assessed using the EQ-5D-5L questionnaire. Functional status at ICU discharge was evaluated using the Manchester Mobility Score and Barthel Index. This study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Results: Among 3144 ICU admissions, 52 survivors were enrolled. At ICU discharge, functional status was markedly impaired: only 15 patients (28.9%) were able to stand upright according to the Manchester Mobility Score, and none achieved even moderate levels of independence. At one year, 47 patients (90.4%) completed the follow-up, and 15 of them (31.9%) continued to report moderate-to-severe mobility limitations. The mean EQ-5D index value was 0.75 (SD 0.27), representing a significant reduction compared with Italian population norms (p < 0.001). Conclusions: ICU survivors who developed heel pressure ulcers exhibit reduced HRQoL at one year after discharge. These findings emphasize the need for structured post-ICU rehabilitation and targeted follow-up. Full article

Obesity is a major global health concern, being associated with insulin resistance and multiple metabolic disorders. Gremlin 1 (GREM1), a bone morphogenetic protein (BMP) antagonist, is increasingly recognized as a key regulator of adipose tissue dysfunction and impaired thermogenesis in obesity. Orlistat, a lipase inhibitor that reduces dietary fat absorption, is one of the most commonly used pharmacological agents for obesity management. White tea has demonstrated antioxidant and anti-obesity properties in experimental models. The aim of this study was to evaluate the effects of white tea on metabolic parameters (HOMA-IR, BMP4, Gremlin1) and GREM1 expression in rats made obese by a high-fat diet (HFD). A total of 40 male Sprague-Dawley rats were randomized into five groups: a standard diet group (STD); a high-fat diet group (HFD); an HFD + orlistat group (ORL); an HFD + 50 mg/kg white tea group (WT50); and an HFD + 150 mg/kg white tea group (WT150). Obesity was induced by feeding the rats a 45% high-fat diet for 3 weeks. Serum insulin, glucose and HOMA-IR levels were measured. Levels of GREM1 and BMP4 in serum and retroperitoneal adipose tissue were assessed. White tea supplementation significantly reduced weight gain and HOMA-IR compared to the HFD group. GREM1 mRNA expression in visceral adipose tissue decreased markedly in the WT50 and WT150 groups (p = 0.002 and p = 0.017, respectively). Serum GREM1 levels were significantly lower in the white tea-treated groups than in the HFD group (p = 0.011). Tissue BMP4 levels were only significantly reduced in the WT50 group (p = 0.005), indicating a non-linear dose–response pattern. There was a negative correlation between serum BMP4 levels and weight gain (rho = −0.440, p = 0.015). White tea was associated with improvements in metabolic parameters in an HFD-induced obesity model. These observations suggest a potential association between white tea bioactives and adipose tissue-related molecular pathways implicated in obesity. Given the short intervention duration and the exploratory design of this animal study, the findings should be interpreted with caution. Full article