Search Results (2,026)

Maqui (Aristotelia chilensis) is a berry native to southern Chile, recognized for its high content of phenolic compounds, particularly delphinidin-type anthocyanins, which confer strong antioxidant and anti-inflammatory properties and have generated growing interest as a functional food. Its scientific relevance has increased due to advances in understanding its biological mechanisms, including the Nrf2 signaling pathway, modulation of systemic inflammation, improvement in mitochondrial function, and potential applications in cardiometabolic, renal, and vascular health. Objective: The objective of this study is to analyze the available evidence on maqui in relation to its nutritional composition, bioactive profile, antioxidant and anti-inflammatory mechanisms, bioavailability, and emerging clinical applications in the prevention and/or treatment of chronic non-communicable diseases. Main findings: Maqui is rich in delphinidins, dietary fiber, and antioxidant micronutrients and modulates key oxidative stress and inflammatory pathways, including Nrf2-HO-1 and NF-κB. Preclinical and early clinical evidence supports its cardiometabolic and nephroprotective effects, with improvements in glycemic control, lipid metabolism, oxidative stress, and endothelial function. Conclusions: Maqui shows considerable potential as a Chilean functional food with antioxidant and anti-inflammatory effects relevant to human health. However, robust clinical trials and formulations with enhanced bioavailability are required to consolidate its therapeutic application. Full article

Global health faces unprecedented challenges driven by communicable diseases, which are increasingly amplified by persistent health inequities, the impact of climate change, and the speed of emerging crises. Prevention is not merely a component but the foundational strategy for an effective, sustainable, and fiscally responsible public health response. This paper delves into the pivotal role of core prevention levers: robust vaccination programs, stringent hygiene standards, advanced epidemiological surveillance, and targeted health education. We detail how contemporary technological advancements, including Artificial Intelligence (AI), big data analytics, and genomics, are fundamentally reshaping infectious disease management, enabling superior predictive capabilities, faster early warning systems, and personalized prevention models. Furthermore, we thoroughly examine the imperative of integrating the One Health approach, which formally recognizes the close, interdependent links between human, animal, and environmental health as critical for combating complex threats like zoonoses and Antimicrobial Resistance (AMR). Despite significant scientific progress, persistent socio-economic disparities, the pervasive influence of health-related misinformation (infodemics), and structural weaknesses in global preparedness underscore the urgent need for decisive international cooperation and equitable financing models. We conclude that only through integrated, multidisciplinary, and resource-equitable strategies can the global community ensure effective prevention, mitigate severe socio-economic disruption, and successfully build resilient healthcare systems capable of withstanding future global health threats. Full article

Metabolic endotoxemia has been proposed as a possible mechanism to explain the strong link between inflammation, obesity, and obesity-associated disorders. Gut dysbiosis is a hallmark of obesity, and diet has been reported to regulate both inflammation and disease risk by affecting the composition of gut microbiota and gut barrier function. In the condition of microbial imbalance and impaired intestinal mucosa, bacterial endotoxins, specifically lipopolysaccharides, translocate from the gut into the bloodstream, where they can sustain a prolonged, sterile, low-grade inflammation, raising the risk of several non-communicable diseases. Increasing evidence indicates that the risk and incidence of obesity and several obesity-associated disorders are sex-specific, although the underlying mechanisms are only just emerging. Notably, most of the factors influencing metabolic endotoxemia exhibit sexual dimorphism. This review aims to summarize the human studies investigating the role of metabolic endotoxemia in obesity and associated diseases, with a focus on those highlighting sex differences. We also discuss the clinical relevance of circulating endotoxins in metabolic derangements and their potential role as sex-related and modifiable risk factors to consider in future prevention strategies. Full article

Objective: To evaluate the prevalence of systemic chronic diseases among patients undergoing endodontic therapy in a University Department of Endodontology and to assess their potential implications for treatment planning and prognosis. Methods: A retrospective cross-sectional study analysis was performed on clinical records of patients aged > 18 years treated at the Department of Endodontics, University of Bologna. Data collected included demographic information, presence of chronic systemic diseases, endodontic disease and medication history. Descriptive statistics were used to estimate prevalence rates. Results: More than one third of patients (35%) presented with at least one systemic chronic disease or multiple comorbidities. Cardiovascular diseases (19.8%) were the most prevalent. Polypharmacy was observed in 32% of patients. Patients aged 40 years and older showed a significantly higher prevalence of systemic conditions compared to younger individuals. Conclusions: The study supports the finding that a high percentage of patients undergoing endodontic therapies present systemic chronic diseases, multiple comorbid conditions and polypharmacy. It is important to assess these factors and to customize endodontic treatment and decision-making. These realities are likely to become even more pronounced in the coming years, as global population aging continues apace. Full article

Introduction: Dysmorphic RBC (DysRBC) as a marker of glomerular abnormalities is expected to have added value in screening for glomerular abnormalities along with other examinations, including renal tubular epithelial cells (RTECs) and pathological casts (PathCasts) that indicate tubular abnormalities in lupus nephritis (LN). Therefore, this study intended to assess the diagnostic performance of urinary cell and cast characteristics, including DysRBC, RTECs, and PathCast, as measured by the urine flow cytometry in lupus nephritic children. Methods: Urine samples from 317 patients (50.47% female and 49.53% male) were collected. The diagnostic value was evaluated using receiver operating characteristic (ROC) analysis. Results: The ROC analysis demonstrated that all parameters exhibited acceptable discriminatory performance, including %DysRBC (AUC = 0.954, p < 0.001), RTEC (AUC = 0.580, p = 0.001), and PathCast (AUC = 0.664, p = 0.001). Conclusions: DysRBC, RTECs, and PathCast may have added value in the diagnosis of LN in children, notably with excellent diagnostic value in distinguishing LN in %DysRBC. This promising result warrants evaluation with a large-scale site study. Full article

Background/Objectives: Adolescence represents a critical period for the formation of lifestyle habits that often persist into adulthood, significantly shaping long-term health outcomes and contributing to the development of non-communicable diseases. This study aims to assess the impact of Food Game, a secondary school-based programme, delivered throughout the academic year, to promote healthy eating, physical activity, and sustainability awareness among students. Methods: As part of the Food Game programme, 184 adolescents aged 14–16 years from the Milan area (Italy) completed two questionnaires, administered before and after the intervention (November 2024, April 2025), evaluating dietary habits, lifestyle behaviours, and attitudes toward sustainability. This uncontrolled intervention study assessed dietary changes using a composite score [0–14], with higher scores indicating healthier eating patterns. Pre–post intervention differences were analysed using paired t-tests for continuous variables and McNemar’s test for categorical variables. Results: After participation in Food Game, a significant improvement in mean dietary score from 7.6 to 8.2 (p < 0.001) occurred. Overall, 28.3% of the students worsened their score and 53.2% improved (≥1-point increase), including a significant improvement (≥2-point increase) in 29.4%. Fruit, vegetable, and fish intake increased, while consumption of meat, processed meat, and snacks decreased (p < 0.05). Waste recycling did not change (94.6%), and tap water non-significantly increased. No significant changes were observed in water intake, physical activity, screen time, or addictive behaviours. Conclusions: These findings support the potential of peer-led gamified interventions to promote healthier eating in youth. Future controlled studies are required to rigorously evaluate the Food Game programme’s effectiveness in relation to adolescents’ diet, lifestyle, and sustainability habits. Full article

Background/Objectives: Sugar-sweetened beverage (SSB) consumption has been linked to obesity, metabolic diseases, and rising healthcare costs. This study aimed to assess the impact of a 20% excise tax on SSBs in Brazil on obesity/overweight prevalence, seven musculoskeletal and cardiovascular diseases, and related healthcare costs, with their associated impacts on health inequalities. Methods: Using 2017/2018 Brazilian Household Budget Survey data for baseline consumption and own- and cross-price elasticities for taxed beverages, we estimated changes in caloric consumption for the entire population and for lower- and upper-income quartiles. The PRIMEtime dynamic individual-level simulation model projected body weight changes, lifetime Quality-Adjusted Life-Years (QALYs), healthcare costs (discounted at 5%), and disease cases (20-year horizon). Results: A 20% excise SSB tax was projected to reduce obesity prevalence by 1.7 percentage points in men and 1.5 percentage points in women, from baseline rates of 19.8% and 23.6%, respectively. Lifetime gains were estimated at 17,878 QALYs per million men and 12,181 per million women, alongside healthcare cost savings of Int$520 million. Impacts varied by income, with smaller health gains in the lowest quartile and higher among the wealthiest. Over 20 years, the tax could avert 1784 cases of type 2 diabetes mellitus/100,000 adults (52% in men) and 1070 cases of ischemic heart disease/100,000 adults (80% in men). Conclusions: A 20% excise SSB tax in Brazil could yield large health and cost benefits. With the recent approval of the Selective Tax under Complementary Law 214/2025, Brazil has a timely opportunity to translate these projected benefits into effective public health policy. Full article

Background/Objectives: It is well documented that people with human immunodeficiency virus (HIV) have nearly twice the risk of incident acute myocardial infarction compared to the general population. The elevated risk stems from a multi-layered interplay of factors such as persistent immune activation inherent to HIV infection and higher prevalence of traditional risk factors associated with nutritional needs. A large proportion of people living with HIV (PWH) reside in Sub-Saharan African countries such as Tanzania; however, there is a dearth of data on nutrition, particularly fruit and vegetable (F&V) intake, a key factor in the prevention of cardiovascular disease (CVD). This study aimed to contribute to the growing literature on CVD prevention for PWH globally. Methods: We conducted secondary analyses of original data collected from a study using the World Health Organization (WHO) STEPS survey among PWH and the general population in Mwanza City between December 2018 and May 2019. Approval for the parent study was obtained from Bugando Medical Center. Multinomial logistic regression analysis examined F&V intake and associated factors between PWH and people living without HIV (PWoH) using sex, employment, and BMI. Results: A total of 537 participants (277 PWoH and 260 PWH) were included in the analysis. PWH were more likely to consume fruits ≥ 4 days per week than PWoH (38% vs. 25%, p = 0.002), whereas vegetable intake did not differ significantly between groups. Fruit intake was higher in males (OR = 5.63; 95% CI: 2.48–12.79) and employed individuals (OR = 3.85; 95% CI: 1.82–8.14). Conclusions: PWH were more likely to consume more fruits than PWoH in this study, a phenomenon that is more novel than previous research. These findings are encouraging to support nutrition-based interventions for PWH who are at a higher risk of CVD. Full article

Background/Objectives: Self-care is a cornerstone of healthy aging and chronic disease management; however, evidence on the most effective intervention models for improving quality of life in older adults with chronic non-communicable diseases (NCDs) remains fragmented. This review aimed to evaluate the effectiveness of self-care interventions in promoting quality of life and health outcomes in older adults with NCDs. Methods: A systematic review was conducted in accordance with PRISMA 2020 guidelines and registered in PROSPERO (CRD420251040613). Randomized and non-randomized clinical trials published between 2019 and 2024 were retrieved from Scopus, Web of Science, and EBSCOhost. Eligible studies included adults aged ≥60 years with NCDs receiving self-care interventions. Data extraction and risk of bias assessment were independently performed using Joanna Briggs Institute tools. Results: Twenty-nine studies involving 7241 older adults were included. Self-care interventions comprised nurse-led educational programs, digital health strategies, community- and peer-based approaches, and person-centered care models. Multicomponent and continuous interventions demonstrated consistent improvements in physical and psychological domains of quality of life, self-efficacy, autonomy, symptom management, and treatment adherence. Digital interventions enhanced monitoring and engagement, although their effectiveness varied according to sensory and health literacy limitations. Conclusions: Structured, person-centered, and nurse-led self-care interventions are effective in improving quality of life and autonomy among older adults with NCDs. These findings support their integration into primary and community-based care, reinforcing their relevance for clinical practice, care planning, and the development of assistive and educational strategies in aging care. Full article

Introduction: Mounting evidence indicates that the p53 Pro72Arg single-nucleotide polymorphisms (SNPs) may play a role in modulating hepatocarcinogenesis in the setting of chronic HBV infection. However, there is currently a lack of studies focusing on this genetic variant in Indonesia, a country characterized by its diverse genetic landscape comprising over 1300 distinct ethnic groups. We aimed to investigate the association between the p53 Pro72Arg polymorphism and the risk of hepatocellular carcinoma (HCC) among Indonesian patients with chronic HBV infection. Methods: A total of 140 patients with chronic hepatitis B (CHB) were recruited, including 79 with HCC and 61 without HCC serving as controls. We used direct sequencing of DNA extracted from peripheral blood to analyze the SNPs of p53 codon 72. Results: The distribution of p53 Pro72Arg genotypes among Indonesian CHB patients was 12.9% for proline homozygotes (Pro/Pro), 31.4% for arginine homozygotes (Arg/Arg), and 55.7% for proline/arginine heterozygotes (Pro/Arg). Despite the lack of association between the SNPs and HCC risk in the overall population, both the Pro/Arg and Arg/Arg genotypes demonstrate an increased susceptibility to HCC compared to Pro/Pro genotypes exclusively in the Madurese ethnic group. Additionally, we discovered that in those with decompensated cirrhosis, the heterozygote Pro/Arg was more likely to develop HCC than the homozygous Pro/Pro. No significant association was found between the SNPs of p53 Pro72Arg and the clinicopathological characteristics of HCC. Conclusions: The p53 Pro72Arg polymorphism might contribute to hepatocarcinogenesis in Indonesian chronic hepatitis B patients, particularly Madurese and those with liver decompensation. Full article

Kidney aging is receiving growing attention in middle- to high-income societies due to increasing longevity in general population. Chronic Kidney Disease (CKD) has been widely accepted as a major non-communicable human disease affecting over 10% of the adult population in industrialized countries. CKD is mainly caused by metabolic and cardiovascular disorders such as diabetes mellitus and hypertension, disproportionally affecting older people, whereas natural kidney aging is driven by age-dependent systemic and renal low-grade inflammation. Interleukin-6 (IL-6) is the key cytokine mediating age-related inflammation. At the same time, IL-6 has been implicated in the pathophysiology of cardiovascular and renal disorders as a major pro-inflammatory cytokine. Thereby, IL-6 is placed at the intersection between natural and pathophysiological kidney aging, and the latter accelerates systemic aging and substantially limits life quality and expectancy. Growing clinical availability of IL-6 inhibitors for treatment of autoimmune and autoinflammatory disorders demands clarification of potential renal consequences as well. Available data suggests that IL-6 inhibition may be renoprotective in some kidney disorders, but the setting of kidney aging has received only minor attention. The present review focuses on the known effects of IL-6 associated with natural or pathophysiological renal aging. Full article

Berries are an excellent source of bioactive compounds, particularly polyphenols, and have been widely used in folk medicine by the Mapuche people of southern Chile. In this study, a hydroalcoholic extract of Berberis congestiflora Gay (BE) was analyzed to determine its phytochemical composition and to evaluate its antioxidant capacity, vasorelaxant effects in rat aortas, and inhibitory activity on enzymes related to chronic non-communicable diseases, including exploration of a possible vasodilatory mechanism in isolated rat aortas. Antioxidant activity was assessed using Oxygen Radical Absorbance Capacity (ORAC), DPPH (2,2-diphenyl-1-picrylhydrazyl), and ABTS (2,2-azinobis-(3-ethylbenzothiazolin-6-sulfonic acid)) radical scavenging assays, as well as ferric reducing antioxidant power (FRAP). Vascular responses to the Berberis extract were studied using isometric tension recordings in an ex vivo rat thoracic aortic ring model, and the chemical constituents of BE were identified for the first time by HPLC-DAD-MS. The extract itself produced a dose-dependent contraction at 100 and 1000 µg/mL and induced relaxation in phenylephrine-precontracted aortas at the same concentrations, with a maximum contraction of 71% and maximum relaxation of 70% at 1000 µg/mL. Mechanistically, the extract triggered calcium-mediated contraction primarily through calcium release from the sarcoplasmic reticulum and, to a lesser degree, via extracellular Ca²⁺ influx, while its relaxant effect depended on an intact endothelium and activation of the NO/cGMP pathway. In addition, the extract showed inhibitory activity against cholinesterase, glucosidase, and amylase, with IC₅₀ values of 7.33 ± 0.32, 243.23 ± 0.3, and 27.21 ± 0.03 µg/mL, respectively, and docking studies were carried out for selected berry compounds. Overall, these findings indicate that these berries are a rich source of bioactive constituents with antioxidant properties and endothelium-dependent vasodilator effects, supporting their traditional use and highlighting their potential as enzyme inhibitors and as promising candidates for the development of phytotherapeutic products, particularly as supplements for chronic disease management. Full article

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

Non-communicable diseases (NCDs) impose an overwhelming burden on global health systems. Prevailing healthcare for NCDs remains largely hospital-centered, episodic, and reactive, rendering them poorly suited to address the long-term, heterogeneous, and multifactorial nature of NCDs. Rapid advances in digital technologies, artificial intelligence (AI), and precision medicine have catalyzed the development of an integrative framework for digital-intelligent precision health management, characterized by the functional integration of data, models, and decision support. It is best understood as an integrated health management framework operating across three interdependent dimensions. First, it is grounded in multidimensional health-related phenotyping, enabled by continuous digital sensing, wearable and ambient devices, and multi-omics profiling, which together allow for comprehensive, longitudinal characterization of individual health states in real-world settings. Second, it leverages intelligent risk warning and early diagnosis, whereby multimodal data are fused using advanced machine learning algorithms to generate dynamic risk prediction, detect early pathological deviations, and refine disease stratification beyond conventional static models. Third, it culminates in health management under intelligent decision-making, integrating digital twins and AI health agents to support personalized intervention planning, virtual simulation, adaptive optimization, and closed-loop management across the disease continuum. Framed in this way, digital-intelligent precision health management enables a fundamental shift from passive care towards proactive, anticipatory, and individual-centered health management. This Perspectives article synthesizes recent literature from the past three years, critically examines translational and ethical challenges, and outlines future directions for embedding this framework within population health and healthcare systems. Full article

Background: Dementia is an increasing public health challenge in Mexico, yet recent national data on mortality patterns remain limited. This study examines temporal trends in dementia-related mortality and its sociodemographic and ecological characteristics among adults aged ≥65 years from 2017 to 2023. Methods: National mortality records from the General Directorate of Health Information were analyzed. Annual dementia-related mortality rates were calculated based on mid-year population estimates from CONAPO. Trends were assessed with regression analysis, including population offsets, and individual- and state-level characteristics were evaluated. Results: Between 2017 and 2023, dementia-related deaths increased from 761 to 1425, corresponding to an observed rise from 7.9 to 14.6 deaths per 100,000 inhabitants aged ≥65 years. Period trend indicated an average annual expected increase of 18.6% in dementia related mortality. A transient decline occurred in 2020–2021, coinciding with the COVID-19 pandemic. At the individual level, higher education was associated with greater odds of dementia certification, whereas Indigenous ethnicity appeared protective, which may reflect patterns consistent with diagnostic and reporting disparities. Higher state-level life expectancy correlated with higher dementia mortality, while greater population aging was inversely associated. Conclusions: Dementia-related mortality in Mexico shows a sustained upward trend with regional heterogeneity and apparent inequities in diagnosis and reporting. Strengthening mortality surveillance, improving certification quality, and integrating dementia indicators into national non-communicable disease registries are essential to guide equitable policy responses. Full article