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Search Results (965)

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Keywords = pre-hypertension

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20 pages, 1020 KB  
Article
Suboptimal Selenium Intake Produces Sex-Specific Alterations in Metabolic Profiles in Western Diet-Fed Obese Mice
by Sarah K. Walsh, Isabella Mezzani, Katy Pettigrew, John E. Hesketh and Giovanna Bermano
Int. J. Mol. Sci. 2026, 27(12), 5345; https://doi.org/10.3390/ijms27125345 (registering DOI) - 13 Jun 2026
Abstract
Selenium (Se) is an essential micronutrient required for redox regulation and metabolic homeostasis. Altered biomarkers of Se status have been linked with obesity and metabolic syndrome, yet its role in these conditions, particularly in a sex-specific context, is not well defined. This study [...] Read more.
Selenium (Se) is an essential micronutrient required for redox regulation and metabolic homeostasis. Altered biomarkers of Se status have been linked with obesity and metabolic syndrome, yet its role in these conditions, particularly in a sex-specific context, is not well defined. This study investigated the impact of suboptimal Se intake on metabolic risk profiles in male and female mice with pre-existing diet-induced obesity. C57BL/6N mice were fed either a standard diet with adequate Se (SD-ASe), a Western diet with adequate Se (WD-ASe), or WD-ASe followed by a Western diet containing suboptimal Se levels (WD-SOSe). Metabolic parameters, adipokine profiles, tissue Se distribution, and gene expression in visceral white adipose tissue (vWAT) were assessed. Both sexes exhibited increased weight gain and adiposity in response to a Western diet; however, only males developed hypertension and elevated non-fasted blood glucose levels. Suboptimal Se intake elicited marked sex-dependent effects. In females, it induced elevated non-fasted blood glucose levels and circulating leptin, and further dysregulated circulating adipokine profiles, accompanied by pronounced alterations in selenoprotein expression and redox-related pathways in vWAT. In contrast, male mice exhibited a partial adaptation, including reduced glucose levels and minimal alterations in gene expression. Tissue Se distribution also appeared to be influenced by biological sex. These findings demonstrate that suboptimal Se intake may exacerbate obesity-related metabolic dysfunction in a sex-specific manner, with females showing greater susceptibility, underscoring the importance of micronutrient status and sex differences in metabolic disorders. Full article
(This article belongs to the Special Issue New Insights and Research on Nutrition and Obesity)
12 pages, 641 KB  
Article
Clinical and Perioperative Determinants of Postoperative Pneumonia After Craniotomy for Tumor Resection
by Anatoli Pinchuk, Nikolay Tonchev, Anna Schaufler, Claudia A. Dumitru, Belal Neyazi, Klaus-Peter Stein, I. Erol Sandalcioglu and Ali Rashidi
J. Clin. Med. 2026, 15(12), 4437; https://doi.org/10.3390/jcm15124437 - 8 Jun 2026
Viewed by 108
Abstract
Background/Objectives: Postoperative pneumonia is a common complication in surgical patients. Despite its clinical significance, there is limited evidence regarding its occurrence following intracranial tumor resection, the most common procedure in neurosurgery. The objective of this study is to determine the incidence of [...] Read more.
Background/Objectives: Postoperative pneumonia is a common complication in surgical patients. Despite its clinical significance, there is limited evidence regarding its occurrence following intracranial tumor resection, the most common procedure in neurosurgery. The objective of this study is to determine the incidence of postoperative pneumonia, to examine its association with length of hospital stay, and to identify potential risk factors. Methods: A retrospective cohort study was conducted on 1481 patients who underwent intracranial tumor resection in our department over a ten-year period, excluding the influence of anticoagulant or antiplatelet medications. Results: Of the 1481 patients included in this study, postoperative pneumonia occurred in 1.48% of cases. Smoking status (p = 0.014) and prolonged hospital stay (p = 0.011) emerged as significant risk factors in the univariate analysis for postoperative pneumonia in patients undergoing brain tumor resection. In contrast, demographic factors (age, sex, body mass index), pre-existing comorbidities (hypertension, diabetes, cardiovascular disease, chronic inflammatory conditions), and laboratory parameters did not show significant associations with the development of postoperative pulmonary infection. Conclusions: This study identified pre- and postoperative risk factors associated with pneumonia following craniotomy for intracranial tumors. These findings may provide a valuable framework for pre- und postoperative risk assessment and guide strategies to mitigate the occurrence of postoperative pneumonia. Full article
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11 pages, 1225 KB  
Article
Risk Factors for Postoperative Complications in Different Fusion Surgical Approaches for Lumbar Degenerative Diseases
by Zhenbiao Zhu, Anwu Xuan, Cheng Xu, Chaofeng Wang, Qing He, Liang Tang and Dike Ruan
J. Clin. Med. 2026, 15(11), 4195; https://doi.org/10.3390/jcm15114195 - 29 May 2026
Viewed by 216
Abstract
Objective: Posterior lumbar interbody fusion (PLIF), posterolateral fusion (PLF), and Hybrid fusion are widely used fusion procedures for lumbar degenerative diseases (LDDs). Postoperative complications dominated by cage migration (CM) and adjacent segment degeneration (ASD) remain major challenges. This study aimed to identify and [...] Read more.
Objective: Posterior lumbar interbody fusion (PLIF), posterolateral fusion (PLF), and Hybrid fusion are widely used fusion procedures for lumbar degenerative diseases (LDDs). Postoperative complications dominated by cage migration (CM) and adjacent segment degeneration (ASD) remain major challenges. This study aimed to identify and compare the independent risk factors for CM and ASD in PLIF, PLF, and Hybrid fusion, so as to provide evidence-based references for preoperative evaluation, surgical selection, and complication prevention in clinical practice. Methods: A retrospective cohort study was conducted in patients who underwent PLIF, PLF, or Hybrid fusion for LDDs at our institution. Demographic data (age, gender, and body mass index [BMI]), lifestyle factors (smoking and insobriety), comorbidities (hypertension, diabetes, hyperuricemia, osteoporosis, and hypoalbuminemia), surgical parameters (operative time, intraoperative blood loss, fusion segments, and lumbar lordosis angle), radiological indices (Pfirrmann grading of intervertebral disc degeneration and relative disc height), and biological markers (C-reactive protein/lymphocyte ratio [CLR], procalcitonin [PCT], and serum amyloid A [SAA]) were collected. Patients were stratified into complication and non-complication groups based on the occurrence of CM or ASD. Univariate and binary logistic regression analyses were performed to determine independent risk factors for postoperative complications. Results: A total of 203 patients were enrolled, including 80 cases with complications in the PLIF group, 64 in the Hybrid group, and 59 in the PLF group. No significant differences were noted in the distribution of complication types among the three groups (p = 0.179). Univariate analysis revealed that BMI, osteoporosis, the Pfirrmann grading of superior adjacent disc degeneration, lumbar lordosis angle, operative time, and intraoperative blood loss were significantly associated with postoperative complications across all three surgical groups (p < 0.05). Binary logistic regression analysis confirmed that elevated BMI (PLIF: OR = 1.18, 95%CI: 1.05–4.38; PLF: OR = 1.19, 95%CI: 0.76–2.18; Hybrid: OR = 1.14, 95%CI: 1.07–2.54), osteoporosis (PLIF: OR = 6.86; PLF: OR = 7.62; Hybrid: OR = 5.62), advanced superior adjacent disc degeneration (PLIF: OR = 8.04; PLF: OR = 4.49; Hybrid: OR = 2.87), prolonged operative time, and increased intraoperative blood loss were independent risk factors for postoperative complications. In contrast, age, gender, smoking, insobriety, hypertension, diabetes, CLR, PCT, and SAA were not identified as risk factors (p* > 0.05). Conclusions: Elevated BMI, osteoporosis, pre-existing superior adjacent disc degeneration, prolonged operative time, and increased intraoperative blood loss are shared independent risk factors for CM and ASD following PLIF, PLF, and Hybrid fusion for LDDs. Targeted interventions addressing these factors may reduce postoperative complication rates and improve patient outcomes. Full article
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23 pages, 2945 KB  
Article
A Decade of Adolescent Pregnancy—Risk Assessment—A Tertiary Center Retrospective Analysis
by Daniela Roxana Matasariu, Demetra Gabriela Socolov, Iuliana-Elena Bujor, Maria Elena Nita, Gabriel-Ioan Anton, Alexandra Ursache, Carmen Pintilescu, Monica Titianu, Vasile Lucian Boiculese, Ecaterina Tomaziu-Todosia Anton and Alexandru Carauleanu
Diagnostics 2026, 16(11), 1666; https://doi.org/10.3390/diagnostics16111666 - 28 May 2026
Viewed by 288
Abstract
Background/Objectives: Adolescent pregnancy, defined as pregnancy occurring between ages 10 and 19, remains a pressing global health concern with significant disparities in prevalence and outcomes across countries. Early and systematic diagnostic screening may allow timely risk stratification and adequate management. Methods: We conducted [...] Read more.
Background/Objectives: Adolescent pregnancy, defined as pregnancy occurring between ages 10 and 19, remains a pressing global health concern with significant disparities in prevalence and outcomes across countries. Early and systematic diagnostic screening may allow timely risk stratification and adequate management. Methods: We conducted this retrospective cohort study at a tertiary referral center from January 2015 through December 2024, including all women who delivered live fetuses at our facility, analyzing adolescent pregnancy outcomes in our region and comparing them with adult pregnancy outcomes. Results: Younger adolescents have higher rates of vaginal infections (45.3% vs. 38.1%), chorioamnionitis, urinary tract infections (6% vs. 4.9%), preterm birth, higher cesarean section rates, SGA and FGR fetuses, with more frequent NICU admissions than older adolescents. Adolescent pregnancies more often resulted in vaginal births compared to adult pregnancies but also showed higher rates of operative vaginal delivery, episiotomy, perineal tears, vaginal tears, and cervical lacerations. Gestational diabetes and excessive gestational weight gain were overall less common in adolescents, but pre-pregnancy maternal obesity was significantly more prevalent in the older adolescent group than in the younger ones. Gestational hypertension was about twice as frequent in adult pregnancies, while HELLP syndrome was approximately six times more common in adults than in adolescents. Conclusions: In summary, adolescent pregnancy presents both potential biological advantages and notable disadvantages, with outcomes resulting from the complex interplay of biological immaturity and socioeconomic factors. These results highlight the critical importance of implementing comprehensive early diagnostic screening protocols and structured antenatal care to facilitate earlier identification and mitigation of modifiable risk factors to improve both maternal and fetal outcomes. Full article
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10 pages, 883 KB  
Article
Psychobehavioral Assessment and Brief Cognitive–Behavioral Therapy in Resistant Arterial Hypertension: A Feasibility-Oriented Pilot Study Within a Precision Medicine Framework
by Apoenna Marina Noronha Brito, Enilson Carmo Barbosa Dos Santos, Andre Rodrigues Duraes and Carla Daltro
J. Pers. Med. 2026, 16(6), 293; https://doi.org/10.3390/jpm16060293 - 28 May 2026
Viewed by 185
Abstract
Background: Resistant arterial hypertension (RAH) is a heterogeneous cardiovascular condition influenced by biological, behavioral, psychosocial, and neuroendocrine mechanisms. Within emerging precision medicine frameworks, psychobehavioral assessment may contribute to a more individualized characterization of patients with RAH and help identify modifiable dimensions associated with [...] Read more.
Background: Resistant arterial hypertension (RAH) is a heterogeneous cardiovascular condition influenced by biological, behavioral, psychosocial, and neuroendocrine mechanisms. Within emerging precision medicine frameworks, psychobehavioral assessment may contribute to a more individualized characterization of patients with RAH and help identify modifiable dimensions associated with therapeutic resistance. This study evaluated the feasibility and preliminary outcomes of a brief psychobehavioral intervention in patients with RAH. Methods: This feasibility-oriented exploratory pre–post pilot study included 20 adults with RAH recruited from a tertiary outpatient clinic specialized in resistant hypertension. Participants underwent psychobehavioral assessment using the Hospital Anxiety and Depression Scale (HADS). Individuals presenting clinically significant anxiety and/or depressive symptoms (scores ≥ 8) received an individualized semi-structured brief cognitive–behavioral therapy (CBT) intervention consisting of 8–9 weekly sessions. Feasibility indicators included intervention adherence, completion of the protocol, operational flexibility, and absence of symptom worsening. Pre- and post-intervention emotional symptoms were compared using nonparametric analyses. Results: High baseline emotional burden was observed, with 90% of participants presenting anxiety symptoms and 60% depressive symptoms. Following the intervention, reductions in anxiety [median 11 (IQR 8–13) vs. 6 (4–8); p < 0.001] and depressive symptoms [10 (8–11) vs. 5 (3–8); p < 0.001] were identified. No worsening of symptoms occurred. The intervention demonstrated satisfactory feasibility and acceptability, including flexibility for remote and in-person delivery. Conclusions: These preliminary findings suggest that psychobehavioral phenotyping combined with individualized brief CBT may represent a feasible complementary strategy within precision-oriented cardiovascular care for resistant hypertension. Although causal inference cannot be established due to the pilot design and absence of a control group, the findings support further investigation of psychobehavioral dimensions as potentially relevant components of personalized hypertension management. Full article
(This article belongs to the Section Personalized Therapy in Clinical Medicine)
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14 pages, 5860 KB  
Case Report
Spontaneous Resolution of a Bilateral Barrow Type D Indirect Carotid–Cavernous Fistula: A Rare Case Report and Literature Review
by Madalina Totir, Ana Maria Dascalu, Ece Ergin, Bogdan Dorobat and Daniela Stana
Diagnostics 2026, 16(11), 1594; https://doi.org/10.3390/diagnostics16111594 - 23 May 2026
Viewed by 297
Abstract
Background and Clinical Significance: Bilateral carotid-cavernous fistulas are rare clinical entities characterized by heterogeneous clinical presentations and variable outcomes. Case presentation: We report the case of a 69-year-old woman with a three-month history of progressive bilateral conjunctival hyperemia, proptosis, intermittent diplopia, [...] Read more.
Background and Clinical Significance: Bilateral carotid-cavernous fistulas are rare clinical entities characterized by heterogeneous clinical presentations and variable outcomes. Case presentation: We report the case of a 69-year-old woman with a three-month history of progressive bilateral conjunctival hyperemia, proptosis, intermittent diplopia, and a left eye abduction deficit. Her systemic history included long-standing arterial hypertension and previous thyroidectomy with stable substitutive therapy. Comprehensive ophthalmologic, neurologic, and endocrine evaluations excluded more common causes of orbital congestion, including thyroid eye disease, orbital cellulitis, cavernous sinus thrombosis, and idiopathic orbital inflammation. The patient denied any history of recent trauma. Digital subtraction angiography (DSA) confirmed a bilateral, low-flow, indirect Barrow type D carotid–cavernous fistula (CCF) supplied by dural branches of both the internal and external carotid arteries, with marked reflux into dilated superior ophthalmic veins. DSA was essential, as prior CT and MRI studies did not identify any vascular abnormalities. The patient was scheduled for transvenous embolization; however, during the follow-up she noted gradual improvement in her condition. Repeat pre-procedural angiography performed approximately two months later demonstrated complete spontaneous closure of all shunts, accompanied by full clinical resolution. Conclusions: Owing to the exceptional rarity of bilateral indirect CCFs and the added occurrence of spontaneous closure, this case expands the limited existing literature and emphasizes the diagnostic challenges and the need for individualized treatment timing supported by multidisciplinary evaluation in low-flow dural carotid–cavernous fistulas. Full article
(This article belongs to the Special Issue Diagnosing, Treating, and Preventing Eye Diseases)
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13 pages, 937 KB  
Article
Recognition of Obstructive Sleep Apnea: An Exploratory Bayesian Modeling Analysis
by Maria Perifanou-Sotiri, Evaggelia Anyfanti, Eleftherios Meletis, Olympia Lioupi, Chaido Pastaka, Polychronis Kostoulas, Konstantinos I. Gourgoulianis and Garyfallia Perlepe
J. Pers. Med. 2026, 16(5), 273; https://doi.org/10.3390/jpm16050273 - 19 May 2026
Viewed by 810
Abstract
Background/Objectives: Two diagnostic approaches for sleep studies are commonly used worldwide: in-laboratory polysomnography [PSG] and home sleep apnea testing [HSAT]. Although HSAT has gained increasing acceptance due to its convenience and lower cost, clinical criteria for HSAT use remain complex and cannot [...] Read more.
Background/Objectives: Two diagnostic approaches for sleep studies are commonly used worldwide: in-laboratory polysomnography [PSG] and home sleep apnea testing [HSAT]. Although HSAT has gained increasing acceptance due to its convenience and lower cost, clinical criteria for HSAT use remain complex and cannot be inferred directly from AHI/ODI severity indices alone. The aim of the present exploratory study was to examine associations between routinely collected demographic, clinical, and symptom-related variables and objective indices of disease severity, namely the apnea–hypopnea index [AHI] and oxygen desaturation index [ODI] as an initial, hypothesis-generating step toward future patient-level model development and validation. Methods: A retrospective observational analysis was conducted in 1100 individuals who previously underwent in lab-polysomnography [PSG] at the University Hospital of Thessaly, Greece, between 2006 and 2023. Specific demographic, clinical and symptom-related variables were included in this study [six continuous and fifteen categorical], which were analyzed in relation to AHI and ODI values. A three-step process was carried out: variable selection followed a screening and backward elimination process. Multivariable linear regression models were subsequently estimated within a Bayesian framework using Hamiltonian Monte Carlo methods. Results: Out of 1100 individuals, the mean age was 51.9 years with the predominant gender being male [76%]. Obesity [65.6%] and hypertension [40.5%] were the most common comorbidities. For AHI, male gender, body mass index [BMI], Epworth Sleepiness Scale [ESS] score, reported breathing interruptions during sleep, and chronic obstructive pulmonary disease [COPD] were significant predictors. For ODI, significant predictors included male gender, BMI, ESS score, breathing interruptions during sleep, daytime sleepiness, obesity, and COPD. COPD showed an inverse association with both indices. Conclusions: These findings support the feasibility of integrating routinely available clinical variables within a Bayesian probabilistic framework to estimate disease severity pre-test probability. The current analysis may not constitute a validated tool for HSAT versus PSG selection; however, it is an initial, hypothesis-generating step toward future model development. Full article
(This article belongs to the Special Issue Advancing Respiratory Care Through Personalized Medicine)
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11 pages, 1356 KB  
Review
Asymmetric Optic Disc Edema in Astronauts: A Narrative Review Proposing an Interplay Between Ocular Venous Congestion and Glymphatic Transport
by Peter Wostyn, Maiken Nedergaard, C. Robert Gibson and Thomas H. Mader
Life 2026, 16(5), 831; https://doi.org/10.3390/life16050831 - 18 May 2026
Viewed by 325
Abstract
Spaceflight associated neuro-ocular syndrome (SANS) is a significant ophthalmic complication observed in astronauts during and after long-duration missions, characterized by optic disc edema, globe flattening, choroidal folds, and hyperopic shifts. Unlike papilledema in terrestrial idiopathic intracranial hypertension, optic disc edema in SANS is [...] Read more.
Spaceflight associated neuro-ocular syndrome (SANS) is a significant ophthalmic complication observed in astronauts during and after long-duration missions, characterized by optic disc edema, globe flattening, choroidal folds, and hyperopic shifts. Unlike papilledema in terrestrial idiopathic intracranial hypertension, optic disc edema in SANS is often asymmetric. The mechanisms underlying this asymmetry remain poorly understood. In this narrative review, we synthesize and critically interpret existing clinical observations, anatomical studies, neuroimaging findings, and experimental evidence, and propose that uneven ocular venous congestion, arising from microgravity-induced cephalad fluid shifts, pre-existing transverse sinus asymmetry, and orbital venous overload, leads to asymmetric optic disc edema by differentially disrupting anterograde ocular glymphatic transport between the eyes. This mechanistic framework highlights the interplay between venous hemodynamics and ocular glymphatic flow as a key factor in SANS pathophysiology. Targeted in-flight monitoring and ground-based analog studies will be essential to rigorously test this hypothesis. To this end, we outline a feasible experimental approach that prospectively integrates preflight cerebral magnetic resonance venography, providing data on transverse sinus dominance, with serial in-flight ophthalmic imaging on the International Space Station. This combined strategy could directly determine whether dural venous sinus anatomy predisposes to uneven ocular venous congestion and asymmetric optic disc edema in microgravity. Insights gained from this work may guide the development of effective countermeasures against SANS and broaden our understanding of ocular fluid dynamics under conditions of altered venous physiology on Earth. Full article
(This article belongs to the Section Medical Research)
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9 pages, 397 KB  
Article
Clinical and Metabolic Predictors of Hypertensive Disorders in Pregnancies Complicated by Gestational Diabetes Mellitus: A Retrospective Cohort Study
by Laura La Fauci, Rosario D’Anna, Ferdinando Antonio Gulino, Cristina Barracato, Eliana Zangla, Chiara Conti Nibali, Antonino Di Benedetto and Francesco Corrado
J. Clin. Med. 2026, 15(10), 3835; https://doi.org/10.3390/jcm15103835 - 15 May 2026
Viewed by 267
Abstract
Introduction: Hypertensive disorders in pregnancy (HDP) and gestational diabetes mellitus (GDM) represent two significant maternal cardiometabolic disorders closely related to each other. This study aims to identify predictive risk factors for gestational hypertension in patients with GDM within our population. Methods: This cohort [...] Read more.
Introduction: Hypertensive disorders in pregnancy (HDP) and gestational diabetes mellitus (GDM) represent two significant maternal cardiometabolic disorders closely related to each other. This study aims to identify predictive risk factors for gestational hypertension in patients with GDM within our population. Methods: This cohort study was conducted at the Department of Obstetrics and Gynecology, Policlinico “G. Martino” of Messina from January 2012 to December 2019. It included 684 pregnant women diagnosed with GDM by Oral Glucose Tolerance Test (OGTT) according to Italian guidelines. A detailed medical history was taken for each patient to identify potential predictive risk factors for HDP. Patients with pre-existing hypertension or diabetes were excluded. Results: Among 684 women with GDM, 69 (10.1%) developed hypertensive disorders of pregnancy (HDP). Women with HDP had a significantly higher pregestational BMI (30.1 ± 7.7 vs. 26.5 ± 5.6 kg/m2, p = 0.001) and a higher prevalence of obesity (51% vs. 34%, p = 0.0001). Post-load glucose at 60 min was higher in the HDP group (178 ± 34 vs. 164 ± 32 mg/dL, p = 0.0001), with more women exceeding the diagnostic threshold (>180 mg/dL: 56% vs. 35%, p = 0.001). Multivariate analysis confirmed that pregestational obesity and higher 60-min glucose levels during OGTT were the strongest independent predictors of HDP. Conclusions: Obesity and glycemia above the cut-off after 1 h during OGTT are predictive risk factors for hypertensive disorders in patients with GDM. Full article
(This article belongs to the Section Obstetrics & Gynecology)
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14 pages, 4197 KB  
Article
The Effect of Renal Artery Stent Implantation on Clinical Outcomes in Patients with Early-Stage (Non-Atrophic Kidney) and Clinically Overt Severe Atherosclerotic Renal Artery Stenosis (ARAS-TR)
by Mehmet Kış, Fatih Levent, Mehmet Altunova, Sadık Volkan Emren, Mustafa Doğduş, Beytullah Çakal, Oktay Şenöz, Tuncay Güzel, Çisem Oktay, Ömer Faruk Kahraman, Sezgin Atmaca, Yunus Emre Erata, Tumarzat Ulanbekova and Mehmet Birhan Yılmaz
J. Clin. Med. 2026, 15(10), 3825; https://doi.org/10.3390/jcm15103825 - 15 May 2026
Viewed by 429
Abstract
Objective: Atherosclerotic renal artery stenosis (ARAS) is increasingly prevalent among aging populations and in patients with diabetes, hyperlipidemia, aortoiliac obstructive disease, coronary artery disease, and/or hypertension. Patients with severe ARAS are at a substantially elevated risk of cardiovascular disease, recurrent congestive heart failure, [...] Read more.
Objective: Atherosclerotic renal artery stenosis (ARAS) is increasingly prevalent among aging populations and in patients with diabetes, hyperlipidemia, aortoiliac obstructive disease, coronary artery disease, and/or hypertension. Patients with severe ARAS are at a substantially elevated risk of cardiovascular disease, recurrent congestive heart failure, stroke, ischemic nephropathy, and chronic kidney disease. Therefore, the ARAS-TR study aims to evaluate the effect of renal artery stenting on the clinical outcomes in patients with severe ARAS and renovascular hypertension. Materials: This study was conducted as a multicenter, prospective study between July 2024 and September 2025. It encompassed 278 patients with angiographically confirmed severe ARAS who underwent renal artery stent implantation. Patients were subsequently monitored for 6 months. A paired-samples t-test was used to compare continuous variables pre- and post-intervention, while categorical variables were analyzed using the Pearson chi-square test and Fisher’s exact test. Results: The mean age of the patients was 63.6 [±13.4] years, and the male gender ratio was 52.5%. After renal artery stenting, systolic and diastolic blood pressures decreased significantly at the 6-month follow-up compared with the pre-procedure levels (SBP 166.99 [21.24] vs. 135.40 [15.69], p < 0.001; DBP 96.28 [13.03] vs. 80.39 [11.03], p < 0.001, respectively). GFR (61.23 [28.33] vs. 63.35 [26.36], p = 0.029) and creatinine (1.40 [0.93] vs. 1.29 [0.66], p = 0.004) levels improved compared to baseline. The mean number of antihypertensive drugs required for patients to remain normotensive decreased significantly (3.19 [1.04] vs. 2.48 [1.13], p < 0.001) during the follow-up period. Conclusions: Percutaneous renal artery intervention appears to be a promising and safe strategy for carefully selected high-risk patients presenting with severe ARAS, renovascular hypertension, and non-atrophic kidneys. In this specific clinical context, restoring renal artery patency through percutaneous stenting was associated with improved renal function and observed reduction in the burden of antihypertensive drugs required to sustain normotension. Full article
(This article belongs to the Section Cardiovascular Medicine)
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16 pages, 1011 KB  
Article
Beyond Wall Thickness: Clinical Predictors of Genotype Positivity in Hypertrophic Cardiomyopathy
by Filippo Angelini, Veronica Dusi, Amedeo Maria Feneziani, Rossella Manai, Matteo Bianco, Enrica Lonni, Giulia Margherita Brach Del Prever, Pier Paolo Bocchino, Giuseppe Giannino, Daniele Melis, Giulia Gobello, Francesco Ravera, Lucia Elena Laiso, Federico Juvenal, Guglielmo Gallone, Stefano Pidello, Barbara Mabritto, Daniela Giachino, Giuseppe Musumeci, Alessandra Chinaglia, Walter Grosso Marra, Silvia Deaglio, Gaetano Maria De Ferrari and Claudia Raineriadd Show full author list remove Hide full author list
Cardiogenetics 2026, 16(2), 10; https://doi.org/10.3390/cardiogenetics16020010 - 11 May 2026
Viewed by 521
Abstract
Background: Genetic testing in hypertrophic cardiomyopathy (HCM) yields variable positivity rates. Identifying clinical predictors of positive genetic tests could improve pre-test counseling and refine expectations about diagnostic yield. Methods: We analyzed consecutive genotyped HCM probands from a contemporary multicenter cohort across four Italian [...] Read more.
Background: Genetic testing in hypertrophic cardiomyopathy (HCM) yields variable positivity rates. Identifying clinical predictors of positive genetic tests could improve pre-test counseling and refine expectations about diagnostic yield. Methods: We analyzed consecutive genotyped HCM probands from a contemporary multicenter cohort across four Italian tertiary centers. Genotype positivity was defined as the presence of ≥1 pathogenic or likely pathogenic variant (ACMG classes 4–5). Multivariable logistic regression identified predictors of genotype positivity. Sensitivity analyses assessed the incremental value of left atrial volume index (LAVI) ≥ 34 mL/m2 and the mode of first clinical presentation. Results: Among 274 genotyped probands (median age at diagnosis 54 years; 62% male), 86 (31%) were genotype-positive (38% MYBPC3, 29% MYH7). Age at diagnosis <40 years (OR 2.38, 95%CI 1.26–4.51, p = 0.008), family history of sudden cardiac death/major ventricular arrhythmias (OR 2.34, 95%CI 1.16–4.84, p = 0.019) and family history of non-ischemic cardiomyopathy (OR 1.92, 95%CI 1.04–3.54, p = 0.038), were independently associated with genotype positivity whereas arterial hypertension was inversely associated (OR 0.42, 95%CI 0.23–0.77). Maximal left ventricular wall thickness > 20 mm and gender were not predictive of genotype positivity. Inclusion of LAVI modestly improved the model performance (AUC 0.769, p = 0.016, ΔAUC +0.024; DeLong p = 0.016) but without leading to meaningful patient reclassification. Conclusions: Genotype positivity in HCM links to earlier onset and family history; traditional severity markers and initial presentation may not independently suggest genetic causality. These findings may help shape a personalized approach to genetic counseling in HCM. Full article
(This article belongs to the Special Issue Contemporary and Future Approaches to Inherited Cardiomyopathies)
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13 pages, 3652 KB  
Article
C-Reactive Protein-to-Albumin Ratio as a Prognostic Marker in ICU Patients with Pre-Existing Hypertension and Diabetes
by Sultan Almuntashiri, Eissa A. Jafari, Abdullah Alhumaid, Abdulaziz H. Alanazi, Moaddey Alfarhan and Abdulkarim Alshammari
J. Clin. Med. 2026, 15(10), 3683; https://doi.org/10.3390/jcm15103683 - 11 May 2026
Viewed by 394
Abstract
Background/Objective: The C-reactive protein-to-albumin ratio (CAR) reflects both systemic inflammation and nutritional status and has been proposed as a prognostic marker in critical illness, yet its value in intensive care unit (ICU) patients with pre-existing hypertension is not well defined. Methods: [...] Read more.
Background/Objective: The C-reactive protein-to-albumin ratio (CAR) reflects both systemic inflammation and nutritional status and has been proposed as a prognostic marker in critical illness, yet its value in intensive care unit (ICU) patients with pre-existing hypertension is not well defined. Methods: This was a retrospective single-center study of 341 critically ill adults with pre-existing hypertension (June 2001–October 2012) from the Medical Information Mart for Intensive Care III database. CAR was calculated from the first C-reactive protein (CRP) and albumin measurements after ICU admission. Using adjusted Cox proportional hazard models, we examined the association of CAR with 30-day mortality in the overall hypertensive cohort, across hypertension groups, and in patients with coexisting diabetes. Results: Non-survivors had higher CAR than survivors (35.5 vs. 18.1, p = 0.008). CAR showed moderate discriminative ability in the overall hypertensive cohort (AUC = 0.637, 95% CI: 0.543–0.732), with better discrimination in patients with normal/elevated blood pressure (BP) (AUC = 0.748, 95% CI: 0.637–0.858) and a relatively higher AUC in the subgroup with diabetes and normal/elevated BP (0.833, 95% CI: 0.671–0.995). In univariable Cox analysis, high CAR was associated with increased 30-day mortality in the overall hypertensive cohort (HR: 3.02, 95% CI: 1.48–6.17, p = 0.0024), in patients with normal/elevated BP (HR: 8.90, 95% CI: 2.00–39.17, p = 0.0038), and in patients with diabetes and normal/elevated BP (HR: 10.00, 95% CI: 1.20–83.10, p = 0.0331). These associations remained significant after multivariable adjustment in the overall hypertensive cohort (adjusted HR: 3.01, 95% CI: 1.45–6.21, p = 0.0030), in patients with normal/elevated BP (adjusted HR: 10.12, 95% CI: 2.20–46.59, p = 0.0030), and in patients with diabetes and normal/elevated BP (adjusted: HR: 19.41, 95% CI: 1.37–275.28, p = 0.0284). Conclusions: These results suggest that CAR measured early after ICU admission may serve as a practical tool for mortality risk stratification in ICU patients with pre-existing hypertension, particularly those with diabetes. Full article
(This article belongs to the Section Intensive Care)
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15 pages, 873 KB  
Article
Metabolic Syndrome Is Associated with Increased Plasma Fibroblast Growth Factor 21 (FGF21) in Postmenopausal Breast Cancer Survivors: Implications for Therapy and Diagnosis
by Pedro Céspedes, Cristina Buigues, María Dolores Torregrosa, Francisco M. Martínez-Arnau, Omar Cauli and Isabel Trapero
Pathophysiology 2026, 33(2), 31; https://doi.org/10.3390/pathophysiology33020031 - 5 May 2026
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Abstract
Background: Fibroblast growth factor 21 (FGF21) is a peptide hormone that is synthesized by several organs and regulates energy homeostasis, including reducing fat mass and lowering hyperglycemia, insulin resistance and dyslipidemia. It also increased metabolic syndrome (MS) and cardiovascular risk in breast cancer [...] Read more.
Background: Fibroblast growth factor 21 (FGF21) is a peptide hormone that is synthesized by several organs and regulates energy homeostasis, including reducing fat mass and lowering hyperglycemia, insulin resistance and dyslipidemia. It also increased metabolic syndrome (MS) and cardiovascular risk in breast cancer (BC) survivors treated with aromatase inhibitors (AIs) aimed at reducing cancer recurrence. We evaluated whether blood FGF21 concentration is associated with MS and its five criteria in postmenopausal women treated with AIs, and whether this persists after multimodal interventions that reduce MS. Methods: A quasi-experimental longitudinal study in 31 postmenopausal women with localized BC on Ais, assessed via a 12-week multimodal program. Their MS was evaluated per the NCEP-ATP III guidelines (waist circumference, blood pressure, fasting glucose, triglycerides, HDL-cholesterol). Plasma FGF21 was measured pre/post-intervention via fasting blood samples, centrifugation, and ELISA assay. Results: Pre-intervention FGF21 median: 377.62 pg/mL (38.40–1616.42). Plasma FGF21 concentrations positively correlated with MS criteria number pre- and post-intervention (all p < 0.05). Linear regression confirmed pre-intervention MS criteria (β = 127.262, p = 0.006) and antihypertensive drugs as predictors of post-FGF21 levels. Analysis of individual MS criteria revealed significant associations with blood pressure (p = 0.028 and p = 0.022 for systolic and diastolic pressure, respectively) and fasting glucose changes (p = 0.008). Conclusions: Plasma FGF21 may act as a biomarker for monitoring exercise-based interventions which reduce MSs, particularly hypertension and hyperglycemia, in AI-treated BC survivors. Full article
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21 pages, 580 KB  
Article
Maternal Diet, Lifestyle Factors, and Gestational Weight Gain: A Single-Center Case–Control Study in Hungary
by Edit Paulik, Anita Sisák, Anna Szolnoki, Evelin Olteán-Polanek, Márió Gajdács, Regina Molnár, Andrea Szabó, Gábor Németh and Hajnalka Orvos
Nutrients 2026, 18(9), 1403; https://doi.org/10.3390/nu18091403 - 29 Apr 2026
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Abstract
Background/Objectives: Preterm birth (PTB) is a major public health concern worldwide, which may lead to detrimental maternal and neonatal outcomes. Maternal nutritional status, gestational weight gain (GWG), and lifestyle factors are potentially modifiable determinants of adverse pregnancy outcomes. This study examined the association [...] Read more.
Background/Objectives: Preterm birth (PTB) is a major public health concern worldwide, which may lead to detrimental maternal and neonatal outcomes. Maternal nutritional status, gestational weight gain (GWG), and lifestyle factors are potentially modifiable determinants of adverse pregnancy outcomes. This study examined the association between PTB and maternal GWG and assessed whether maternal dietary habits and lifestyle factors were related to GWG in women delivering preterm versus at term. Methods: A retrospective case–control study was conducted at a tertiary center in Hungary (MANOR Study, 2019). The case group included n = 100 women with PTB, while n = 200 matched term deliveries served as controls (1:2 ratio). Data were collected using a self-administered questionnaire and medical records. Pre-pregnancy body mass index (BMI) was categorized using standard definitions, while GWG was classified as inadequate, recommended, or excessive according to the US 2009 Institute of Medicine guidelines. A 7-item dietary index score was calculated based on gestational dietary habits. Results: Pre-pregnancy BMI distribution did not considerably differ between groups (p > 0.05); over one-third of women in both groups were overweight or had obesity (38.7% vs. 36.7%). Previous PTB (p < 0.001) and gestational hypertension (GHT) (p = 0.003) were more common among current PTB cases, while smoking, alcohol consumption, and gestational diabetes mellitus (GDM) showed negligible differences (p > 0.05)—28.0% of cases, and 34.5% of controls were classified as having healthy dietary habits, based on the dietary index score calculated. Inadequate GWG was more prevalent among PTB cases (49.0% vs. 26.8%), whereas excessive GWG was less frequent among cases (21.9% vs. 38.4%). Being within the recommended GWG range and the manifestation of gestational hypertension were associated with lower (aOR: 0.39; 95% CI: 0.18–0.87; p = 0.020) and higher (aOR: 3.43; 95% CI: 1.44–8.19; p = 0.005) odds of PTB, respectively. Conclusions: Inadequate GWG was more common in PTB, while excessive GWG was more frequent in term pregnancies. Fast-food consumption was associated with excessive GWG among term births. Optimizing GWG and improving maternal diet quality should be included as key, cross-cutting interventions targeting the improvement of antenatal care. Full article
(This article belongs to the Special Issue Effects of Nutrition and BMI on Obstetric–Gynecological Pathologies)
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15 pages, 608 KB  
Article
Comorbidity Burden in Lung Cancer and Malignant Pleural Mesothelioma: Nationwide Database Results of Turkey
by Çiğdem Özdilekcan, Tarkan Özdemir, Mustafa Hamidullah Türkkanı, Naim Ata, Mesut Akyol, Mevlüt Karataş, Aslıhan Gürün Kaya, Aydın Yılmaz, Akın Kaya and Şuayip Birinci
Medicina 2026, 62(5), 845; https://doi.org/10.3390/medicina62050845 - 29 Apr 2026
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Abstract
Background and Objectives: The presence of comorbidities in both the pre- and post-diagnostic periods is a critical consideration in the diagnosis and management of patients with cancer. This study aimed to investigate the prevalence and burden of pulmonary and extrapulmonary comorbidities in patients [...] Read more.
Background and Objectives: The presence of comorbidities in both the pre- and post-diagnostic periods is a critical consideration in the diagnosis and management of patients with cancer. This study aimed to investigate the prevalence and burden of pulmonary and extrapulmonary comorbidities in patients diagnosed with lung cancer (LC) and malignant pleural mesothelioma (MPM). Materials and Methods: The data were obtained from official patient records of the Turkish Ministry of Health. Patients diagnosed with either lung cancer (LC) or malignant pleural mesothelioma (MPM) between 2015 and 2018 were included in the study. Comorbidities were classified as pulmonary or extrapulmonary. Results: A total of 74,835 patients with LC and 1678 patients with MPM were included. The burden of comorbid conditions increased significantly in the post-diagnostic period in both males and females across both cancer types. When the two cancer groups were compared with respect to diagnostic periods, comorbidities such as hypertension (HT), phlebitis/venous thrombosis/thrombophlebitis, pulmonary embolism, pneumothorax, and pleural effusion were significantly more prevalent in the MPM group (p < 0.05). Compared with the pre-diagnostic period, the comorbidity risk in LC was highest for pulmonary embolism, ARF, and pneumonia in the post-diagnostic period, whereas renal failure was the most frequent comorbidity in the MPM group (p < 0.001 and p = 0.024). When comparing changes in comorbidity burden between sexes in the lung cancer group, male patients had higher frequencies of pulmonary embolism, pneumonia, pneumothorax, and coronary artery disease than females. In contrast, in the female lung cancer group, the prevalence of chronic renal failure was higher than in males (OR = 2.14 vs. 2.00), whereas acute renal failure was more prominent in the male patient group (OR = 2.64 vs. 1.94). In gender-based comparison of comorbid conditions among patients with MPM, the risk of renal failure was higher in females than in males (CRF and ARF respectively: OR = 2.63 vs. 2.16 and OR = 6.80 vs. 5.44). Additionally, increased rates of COPD were observed in male patients within this group (OR = 1.93 vs. 1.81). Conclusions: Patients with LC and MPM are burdened not only by their primary malignancies but also by a wide spectrum of comorbidities, particularly in the post-diagnostic period. Comprehensive knowledge of comorbid conditions is essential for clinicians to guide clinical decision-making, anticipate disease progression, and optimize treatment strategies, thereby informing national healthcare policies. Future studies incorporating matched control groups or longitudinal designs with standardized surveillance protocols may help conduct better research. Full article
(This article belongs to the Special Issue Advancements in Lung Cancer Diagnosis and Treatment)
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