Search Results (128)

Background and Objectives: Pediatric pulmonary medicine relies heavily on accurate lung function assessment, yet conventional spirometry presents challenges in children due to cooperation requirements. In this context, the interrupter resistance technique (Rint), a method used in pediatric pulmonology, offers a potentially more feasible alternative for evaluating airway resistance in younger populations. This study aimed to assess the feasibility and clinical concordance between expiratory interrupter resistance (Rint(e)) and standard spirometry in healthy children under 8 years, thus contributing to the development of age-appropriate pulmonary function testing in pediatric medicine. Materials and Methods: A cross-sectional study was conducted on 200 healthy children (aged 2–8 years) in Tunisia. Pulmonary measurements were taken using a handheld device for both Rint(e) and spirometry. Feasibility rates were calculated, and correlations between the techniques were statistically analyzed. Results: Rint(e) showed significantly higher feasibility than spirometry (82.5% vs. 34.5%, p < 0.05). While older children had higher success rates with both techniques, feasibility was independent of sex, BMI, and passive smoking exposure. Moderate negative correlations were found between log Rint(e) and FEV1/FVC indices. Conclusions: In pediatric pulmonary assessment, Rint(e) demonstrated higher feasibility than spirometry among young children, making it a practical complementary method in clinical settings. However, due to only moderate correlation with spirometric indices, Rint(e) cannot yet replace spirometry in diagnostic use. Its integration into pediatric medicine may help address the gap in functional respiratory evaluation for children under the age of 8. Full article

Background/Objectives: Bisphosphonates may influence vascular calcification and atheroma formation via farnesyl pyrophosphate synthase inhibition in the mevalonate pathway regulating bone and lipid metabolism. However, the clinical impact of NCB use on cardiovascular outcomes remains uncertain, largely due to methodological heterogeneity in prior studies. We aimed to evaluate the association between nitrogen-containing bisphosphonate (NCB) therapy and coronary artery calcium (CAC) progression, as well as the incidence of cardiovascular disease (CVD) and coronary heart disease (CHD) events. Methods: From 6814 participants in MESA Exam 1, we excluded males (insufficient male NCB users in the MESA cohort), pre-menopausal women, baseline NCB users, and users of hormone replacement therapy, raloxifene, or calcitonin. Among 166 NCB initiators and 1571 non-users with available CAC measurements, propensity score matching was performed using the available components of FRAX, namely age, race, BMI, LDL cholesterol, alcohol, smoking, and steroid use, and baseline CAC yielded 165 NCB initiators matched to 473 non-users (1:3 ratio). Linear mixed-effects models evaluated CAC progression, and Cox models analyzed incident CVD and CHD events. Results: In the overall cohort, NCB use was not significantly associated with CAC progression (annual change: −0.01 log Agatston units; 95% CI: −0.05 to 0.01). However, among participants with a baseline estimated glomerular filtration rate (eGFR) < 65 mL/min/1.73 m², NCB use was associated with attenuated CAC progression compared with non-users (−0.06 log Agatston units/year; 95% CI: −0.12 to −0.007). No significant association was observed between NCB use and incident CVD events in the overall cohort (HR: 0.90; 95% CI: 0.60−1.36) or within kidney function subgroups. Conclusions: Incident NCB use among postmenopausal women with mild or no CAC at baseline was associated with reduced CAC progression only in women with impaired kidney function. However, this association did not correspond to a decreased risk of subsequent cardiovascular events, suggesting that the observed imaging benefit may not translate into meaningful clinical association. Full article

Background and Objectives: Pregnancies resulting from assisted reproductive technology (ART) have been associated with placenta-related adverse outcomes. Uterine artery Doppler pulsatility index (UtA-PI) reflects placental function. This study aimed to examine whether second-trimester UtA-PI differs according to the conception method after adjusting for potential confounding factors. Materials and Methods: In this retrospective cohort study, we included data from February 2015 to August 2024, at the third Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece, on singleton pregnancies presenting for their routine antenatal care, including a second-trimester anomaly scan. Pregnancies conceived via ART, including those conceived via ovulation induction/intrauterine insemination (OI/IUI) or in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI), were compared to those conceived spontaneously. Multiple linear regression was employed to investigate the association between the mode of conception and log₁₀ UtA-PI values, adjusting for various confounders, including gestational age at the time of the scan, maternal weight, height, age, parity, mode of delivery, smoking status, pre-existing diabetes mellitus (type I or II), and pre-existing thyroid disease. Results: The study included 15,552 singleton pregnancies, of which 82 (0.5%) were conceived via OI/IUI and 690 (4.4%) were conceived via IVF/ICSI. The median UtA-PI values were 0.99 (IQR: 0.85–1.17) for spontaneous conception (SC), 1.00 (IQR: 0.86–1.16) for OI/IUI, and 0.90 (IQR: 0.76–1.12) for IVF/ICSI. The Kruskal–Wallis test indicated a statistically significant difference among these groups (p < 0.001). Pairwise comparisons using the Wilcoxon rank-sum test with Bonferroni correction revealed that UtA-PI values in IVF/ICSI pregnancies were significantly lower compared to both SC and OI/IUI pregnancies (p < 0.001 for both). No significant difference was observed between the SC and OI/IUI groups. In the multivariable linear regression model, IVF/ICSI conception was independently associated with lower log₁₀ UtA-PI values (estimate = −0.076, 95% CI: −0.096, −0.056) while no association was found for OI/IUI conception. Conclusions: Although ART has been associated with placental-related complications, mid-trimester UtA flow was found to be lower in IVF/ICSI pregnancies, suggesting better utero-placental flow in ART pregnancies and other possible mechanisms in the maternal–placental interplay for the development of pregnancy complications. Full article

The growing demand for Ready-to-Eat (RTE) fish products increases the need for effective safety measures against Listeria monocytogenes, a pathogen associated with high fatality rates. This study evaluated the bioprotective potential of lactic acid bacteria (LAB) strains, including probiotic ones, against L. monocytogenes in cold-smoked rainbow trout. Two LAB cocktails were tested: a commercial mix (LC–LL) and a vegetable-derived mix (LAB2–LP15). LC–LL effectively inhibited L. monocytogenes at both static (5 °C) and dynamic (4–20 °C) conditions by the inhibitory effect of the bacteriocin leucocin (≈4 log unit growth inhibition). In contrast, LAB2–LP15 was effective only at 5 °C (≈2 log unit growth inhibition), maintaining the best sensory characteristics. These findings support the use of LAB as natural bioprotective agents in RTE fish, combining food safety and sensory preservation. Full article

An increasing number of patients are being diagnosed with tongue cancer despite lacking traditional risk factors such as tobacco, alcohol, or betel nut use. The potential role of human papillomavirus (HPV) in these cases has drawn attention, although its prognostic significance remains unclear. This retrospective cohort study, conducted in Southern Thailand, aimed to investigate the association between HPV status and overall survival in tongue cancer. Medical records of 186 patients treated between 2012 and 2021 were reviewed. HPV status was determined, and patients were categorized into HPV-negative, HPV-positive with other risk factors, and HPV-positive without known behavioral risk factors. Survival outcomes were compared using the log-rank test, and independent prognostic factors were analyzed using multivariable Cox regression. The overall prevalence of HPV infection was 9.6%, predominantly HPV16, HPV33, and HPV18. Although no significant differences were observed in 3-year overall survival, disease-specific survival, or recurrence-free survival among the groups, multivariable analysis revealed that HPV-positive patients without known behavioral risk factors (tobacco, alcohol, or betel nut use) had poorer overall survival (hazard ratio 3.54, p = 0.045). The observed associations warrant further research into the prognostic role of HPV in tongue cancer among non-smoking, non-drinking populations. Full article

Objectives: This study aimed to investigate the prognostic value of the Naples Prognostic Score (NPS), a composite index of inflammation and nutrition markers, in patients with non-small cell lung cancer (NSCLC) and to assess its role in predicting survival across clinical subgroups. Methods: A retrospective analysis was conducted on 250 patients diagnosed with NSCLC between 2018 and 2023. Patients were categorized into low (≤2) and high (>2) NPS groups based on the scoring system derived from neutrophil–lymphocyte ratio (NLR), lymphocyte–monocyte ratio (LMR), serum albumin, and total cholesterol levels. Survival outcomes were analyzed using Kaplan–Meier curves, log-rank tests, and univariate and multivariate Cox regression analyses. Receiver operating characteristic (ROC) analysis was performed to determine the discriminatory ability of NPS. Results: Patients with high NPS (>2) had significantly lower overall survival (median OS: 10.4 vs. 18.2 months, p < 0.001) and progression-free survival (median PFS: 7.3 vs. 12.5 months, p < 0.001) than those with low NPS. High NPS was found to be an independent prognostic factor in multivariate Cox regression analysis (HR: 1.98, 95% CI: 1.42–2.76, p < 0.001). ROC analysis showed an AUC of 0.78 for NPS in predicting survival. Subgroup analyses demonstrated the consistent prognostic impact of high NPS across histological subtypes, TNM stages, smoking status, albumin levels, and age groups. Conclusions: NPS is an independent and practical prognostic tool in NSCLC. Its use may enhance risk stratification and support personalized treatment planning, particularly in advanced-stage patients. Full article

Background: Pediatric-onset familial inflammatory bowel disease (IBD) may differ from sporadic pediatric-onset IBD in its genetic and environmental background and may have distinct clinical and therapeutic implications. Objective: To evaluate the influence of a positive family history of IBD on the use of medical therapies and surgical interventions in adult patients with pediatric-onset IBD. Methods: Retrospective case–control study using the Spanish ENEIDA registry, including adults diagnosed with pediatric-onset IBD since 2006. Familial forms (FFs) (defined by a first-degree relative with IBD) and sporadic forms (SF) (with no relatives of any grade with IBD) were matched 1:4 by type of IBD, sex, age at IBD diagnosis, disease location, disease pattern, development of perianal disease and smoking status at diagnosis. The study outcomes were the use of immunomodulators, biological therapies, intestinal surgery, and perianal surgery during follow-up. Results: Six-hundred and fifty-five Crohn’s disease (CD) (131 FF) and 440 ulcerative colitis (UC) (88 FF) patients were included. Immunomodulators, biological therapy, and intestinal surgery were used evenly among FF and SF patients for both UC and CD. However, a higher requirement for perianal surgery among FF-CD patients (18.3% vs. 10.5%, p = 0.014), together with a shorter time to perianal surgery (11 vs. 20 months, log-rank p = 0.004), was observed. Conclusions: Patients with FF of pediatric-onset IBD do not exhibit an increased use of immunomodulators, biological agents, or intestinal surgery, but do exhibit a higher need for perianal surgery, as compared to patients with SF pediatric-onset IBD. Full article

Background: Vitamin K is a cofactor necessary for the biological activity of proteins like Matrix Gla Protein (MGP), which reduce calcification and help preserve lung function. This study aims to determine, first, whether low vitamin K status is associated with chronic obstructive pulmonary disease (COPD), and secondary, whether the level of vitamin K is associated with COPD severity, smoking exposure, or mortality. Methods: The plasma concentration of dephosphorylated uncarboxylated (dp-uc) MGP was used as an inverse biomarker for vitamin K in 98 COPD patients from the CODEX-P COPD study and 986 controls from the DanFunD study. Low vitamin K status was defined as the upper quartile of dp-ucMGP (>589 pmol/L). Using a logistic regression model, we examined whether low vs. high/moderate vitamin K status increased the odds ratio (OR) of having COPD. Secondary analyses, in the COPD cohort only, examined the association between low vitamin K status and COPD severity, smoking exposure in packyears and all-cause mortality, using a Welch’s t-test and log-rank test, respectively. Results: Low vitamin K status was associated with increased odds of having COPD, OR 9.7 (95% CI [5.5 to 17.5], p < 0.001). We found no associations between low vitamin K and COPD severity (est. −0.03, p = 0.7; 95% CI [−0.2 to 0.1]), smoking exposure (p = 0.7), or all-cause mortality (p = 0.5). Conclusions: Low vitamin K status was associated with substantially higher odds of having COPD compared to high/moderate vitamin K status. No association was found between low vitamin K status and COPD severity, smoking exposure, or all-cause mortality. Further studies are needed to determine if vitamin K plays a role in the pathophysiology of COPD and whether supplement therapy is indicated. Full article

 Background/Objectives: Extrapulmonary neuroendocrine carcinomas (EP-NECs) are rare, aggressive malignancies with no standardized treatment approach. Although platinum-based chemotherapy is considered the first-line therapy, overall survival (OS) and progression-free survival (PFS) remain limited. This study aims to evaluate the clinical and pathological characteristics of EP-NEC patients, their treatment responses, and survival outcomes. Methods: This retrospective observational study included 29 EP-NEC patients diagnosed and followed between 2015 and 2024. Clinical and demographic data, tumor localization, disease stage, administered treatments, and survival outcomes were analyzed. Kaplan–Meier survival analysis was used to assess OS and PFS, with subgroup comparisons performed via the log-rank test. Results: The most common primary tumor sites were the pancreas (21%), prostate (17%), and cervix (14%). At diagnosis, 55.2% of patients had metastatic disease. First-line platinum-based chemotherapy achieved an objective response rate of 82.1%, with a median PFS of 8.16 months and a median OS of 14.16 months. Surgical intervention significantly improved survival (p = 0.020), while a high Ki-67 proliferation index (>80%) was associated with worse PFS (p = 0.032). Other factors, including smoking status and liver-directed therapies, had no significant impact on survival. Conclusions: EP-NECs present with a poor prognosis despite platinum-based chemotherapy achieving high response rates. Surgical resection improves survival outcomes, whereas high Ki-67 expression is associated with a worse prognosis. These findings highlight the need for further research into novel therapeutic strategies for EP-NECs. Full article

With the rapid implementation of high-pressure processing in many sectors of the food industry, considerations associated with pressure-stressed microorganisms are emerging. Nisin was utilized in this study for controlling the proliferation of Listeria monocytogenes and L. innocua inoculated on cold-smoked trout during a 4-week refrigerated shelf-life trial. Wild-type and pressure-stressed phenotypes of Listeria were compared in this study. The pressure-stressed phenotypes were prepared by treating the surrogate strain and pathogen mixture at 103.4 MPa (15K PSI) for 20 min. L. monocytogenes multiplied extensively during the 4-week refrigerated trial and counts were increased (p < 0.05) from 3.68 ± 0.1 log CFU/g on the first week to 6.03 ± 0.1 log CFU/g. Both phenotypes and the surrogate microorganisms illustrated similar (p ≥ 0.05) multiplication trends. Unlike samples subjected to water treatment, nisin was effective (p < 0.05) in keeping the microbial counts lower compared with the controls, particularly earlier during the shelf-life trial. Our study illustrates that the selected surrogate microorganism has comparable sensitivity to nisin relative to L. monocytogenes and thus could be used interchangeably in future public health microbiology challenge studies with similar scope. Additionally, we observed that pressure-stressed L. monocytogenes has proliferation and sensitivity to nisin comparable to wild-type pathogen. Full article

Background: The aim of this study was to evaluate the serological response after the complete hepatitis B vaccination of patients according to the immunosuppressive treatment they underwent, and to identify potential factors associated with non-responders. Methods: A prospective cohort study was conducted, and patients under immunosuppressive therapies were considered exposed. The main outcome was non-response to hepatitis B vaccination. Bivariate analysis was conducted to detect differences between exposed and non-exposed patients. A multivariable log-binomial regression model was designed to analyze potential factors independently associated with non-responders. Results: A total of 289 patients were included. Immunosuppressive treatment was associated with non-response to hepatitis B vaccination (RR = 2.49, 95% CI: 1.26–4.96). Concretely, the use of cytotoxic therapies showed increased risk, although anti-CD20 and anti-JAK also showed a tendency to be associated with non-responders. Other variables associated with non-responders were older age (6–7% higher risk per year), smoking (RR = 3.08, 95% CI: 1.41–6.74) and certain vaccine regimens. These findings were similar for persistent non-responders despite an additional booster dose. Conclusions: Patients receiving immunosuppressive treatments, who are older in age or who are smokers have a higher risk of non-response to conventional hepatitis B vaccination. These data might serve to optimize hepatitis B vaccination in high-risk patients. Full article

Objective: To evaluate the differences in overall survival (OS) and progression-free survival (PFS) between men and women with non-small-cell lung cancer (NSCLC) treated with immune checkpoint inhibitors (ICIs) in second-line and later treatments. Methods: A retrospective, single-center observational study was conducted on patients with advanced NSCLC treated with ICIs (nivolumab, pembrolizumab, and atezolizumab) from January 2015 to December 2019 (with follow-up until December 2021). Demographic, clinical, and treatment-related variables were collected. OSand PFSwere analyzed using the Kaplan–Meier method and compared between genders using the log-rank test.A multivariate Cox regression analysis was performed to adjust for confounders. Results: A total of 189 patients were included, and 47 (25%) were women. The most common histology was adenocarcinoma (61%). Women began treatment at a younger age (59.8 vs. 66 years, p < 0.001) and had higher rates of active smoking (46.8% vs. 38%, p = 0.001). The median OS was similar between men (9.5 months, 95% CI: 7.1–11.8) and women (9.2 months, 95% CI: 3.3–15.2; p = 0.382) while PFS was significantly higher in males (3.2 months, 95% CI: 2.5–4.0) than in females (2.1 months; 95% CI = 1.6–2.5) (p = 0.002).Women had higher rates of tumor cachexia (BMI < 20).Worse PFS was observed for women both in the <20 kg/m² (median PFS: 1.8 vs. 2.7 months, p = 0.016) and 20–24.9 kg/m² groups (median PFS: 2.2 vs. 3.3 months, p = 0.077), while in patients with a BMI >= 25 kg/m², median OS was higher in women than in men (14.7 months vs. 10.1 months). Women had also a significantly worse PFS than men among those with a cumulative tobacco consumption of <30 packs-year (median PFS: 2.2 vs. 3.2, p = 0.038. In the multivariate analysis, the male sex was significantly associated with a better PFS(HR = 0.59; p = 0.009), without significant differences between sexes in OS (HR = 0.90; p = 0.618). Among the other variables analyzed, only an ECOG >= 2 was significantly associated with both worse OS (HR = 3.53; 95% CI = 1.93–6.47) and PFS (HR = 2.19; 95% CI = 1.23–3.89). Women who discontinued due to toxicity (n = 7) had a median OS of 41.4 months (95% CI: 14.7–68.1) after discontinuation, whereas men (n = 15) had a median OS of 8.8 months (95% CI: 6.9–10.8), (p = 0.045). Conclusions: Sex-based differences were observed in the ICI outcomes. Women had worse PFS, particularly with lower BMI and lower tobacco exposure, despite similar OS between sexes. Women discontinued ICIs due to toxicity earlier but showed longer OS after discontinuation. Poor ECOG status was linked to worse outcomes across all the patients. Full article

Background and Objectives: Cancer survival poses significant challenges in oncology, with lifestyle modifications increasingly recognized as crucial in modifying patient outcomes post-diagnosis. This meta-analysis aims to systematically evaluate the impact of various lifestyle interventions on cancer survival across different types of cancer. Methods: A comprehensive literature search of electronic databases including PubMed, Scopus and Cochrane was performed to identify relevant studies up to 30 November 2024. Relevant studies were chosen and data were extracted and analyzed using SPSS Version 29.0 software. Results: Our systematic review included data from 98 studies involving a total of 1,461,834 cancer patients to evaluate the impact of lifestyle factors on cancer survival. Out of these, 64 studies were included in the meta-analysis. Our meta-analysis demonstrates that adherence to specific dietary patterns significantly improves cancer-specific outcomes. The Healthy Eating Index (HEI) diet was associated with a reduction in cancer-specific mortality (pooled log HR: −0.22; 95% CI: [−0.32, −0.12]; p < 0.001). Similar benefits were observed with the Mediterranean diet (aMED), which also reduced cancer mortality and recurrence (pooled log HR: −0.24; 95% CI: [−0.40, −0.07]; p < 0.001), and the Dietary Approaches to Stop Hypertension (DASH) diet (pooled log HR: −0.22; 95% CI: [−0.33, −0.12]; p < 0.001). Additionally, general dietary improvements were beneficial for breast cancer-specific mortality across 17 cohort studies (pooled log HR: −0.15; 95% CI: [−0.25, −0.06]; p < 0.001). Engaging in any form of physical activity post-diagnosis was associated with significant improvements in cancer-specific mortality or recurrence (pooled log HR: −0.31; 95% CI: [−0.38, −0.25]; p < 0.001). Participants who ceased smoking after diagnosis exhibited more favorable cancer outcomes (pooled log HR: −0.33; 95% CI: [−0.42, −0.24]; p < 0.001), with smoking cessation notably reducing cancer-specific mortality among lung cancer survivors (pooled log HR: −0.34; 95% CI: [−0.48, −0.20]; p < 0.001). Additionally, reducing alcohol intake post-diagnosis significantly improved cancer outcomes (pooled log HR: −0.26; 95% CI: [−0.33, −0.19]; p < 0.001). Alcohol moderation in gastrointestinal tract cancer survivors specifically decreased both cancer-specific mortality and recurrence (pooled log HR: −0.22; 95% CI: [−0.29, −0.15]; p < 0.001). Conclusions: Lifestyle modifications after cancer diagnosis significantly improve cancer-specific outcomes. Specific dietary patterns, increased physical activity, smoking cessation, and reduced alcohol intake are all associated with lower cancer-specific mortality. Integrating these lifestyle changes into oncology care may enhance patient survival and quality of life. Full article

Background/Objectives: We investigated maternal and parent-of-origin (PoO) gene-environment interaction effects on the risk of nonsyndromic orofacial clefts for two maternal environmental factors: periconceptional smoking and folic acid supplementation. Methods: Genome-wide single nucleotide polymorphisms (SNPs) genotypes and TopMed-imputed genotypes were obtained for case-parent triads from the EUROCRAN and ITALCLEFT studies. Candidate regions were selected around target SNPs from a previous genome-wide association study, resulting in 12 (726 SNPs) and 11 regions (730 SNPs) for maternal and PoO effects, respectively. Log-linear models were used to analyze 404 case-parent triads and 40 case-parent dyads. p-values were combined across regions. Results: None of the interactions reached statistical significance after correction for the number of regions tested. Nominally significant (pooled p-values < 0.05) interactions pointed to regions in or close to genes LRRC7 (maternal gene-folate interaction), NCKAP5 (PoO-smoking interaction), and IFT43 and GPATCH2L (PoO-folate interaction). Conclusions: Our results suggested that the genetic effects in or around these genes were heightened under periconceptional exposure to tobacco or no folic acid supplementation. The involvement of these genes in orofacial cleft development, in conjunction with environmental exposures, should be further studied. Full article

Skeletal muscle is associated with cardiometabolic health. The appendicular skeletal muscle index (aSMI) represents the skeletal muscle mass “corrected” for height and constitutes a clinically applicable feature of sarcopenia. The relation of the aSMI with dietary habits is not clear, especially in young adults. The present pilot study aimed to investigate the relationship between the aSMI and Mediterranean diet adherence in young adults. A cross-sectional study of 151 university students was conducted. Anthropometry and bioimpedance analysis (TANITA-MC780) were performed. The aSMI was calculated as the sum of the upper and lower extremity muscle masses divided by height squared. The HPAQ questionnaire was used for physical activity evaluation. A validated food frequency questionnaire was used for dietary assessment, and the Mediterranean Diet Score (MedDietScore) was calculated. Multivariate linear regression models with log-aSMI as a dependent variable were applied. The MedDietScore was positively related to log-aSMI in the total sample (B = 0.009, SE = 0.004, p = 0.05, R² for total model = 71%) irrespective of gender, age, ΒΜΙ, smoking, physical activity, and academic year and in males (B = 0.027, SE = 0.011, p = 0.023 R² for total model = 37%) irrespective οf age and ΒΜΙ. The positive association of the MedDietScore with aSMI supports the importance of the adoption of a Mediterranean dietary pattern—rich in plant proteins and antioxidant/anti-inflammatory compounds—in maintaining/attaining muscle mass in young subjects. Full article