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Search Results (363)

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12 pages, 269 KiB  
Article
Exploring the Interplay Between Glycated Albumin, AGEs, and Inflammation in Old Patients with CKD
by Simone Vettoretti, Lara Caldiroli, Paolo Molinari, Amanda Villa, Massimiliano M. Corsi Romanelli, Elena Vianello, Elena Dozio and Simonetta Genovesi
Metabolites 2025, 15(8), 515; https://doi.org/10.3390/metabo15080515 - 1 Aug 2025
Viewed by 183
Abstract
Introduction: Chronic kidney disease (CKD) increases cardiovascular risk through mechanisms such as oxidative stress and the accumulation of advanced glycation end products (AGEs). Glycated albumin (GA) is associated with cardiovascular risk in CKD patients, but its relationship with AGEs and systemic inflammation remains [...] Read more.
Introduction: Chronic kidney disease (CKD) increases cardiovascular risk through mechanisms such as oxidative stress and the accumulation of advanced glycation end products (AGEs). Glycated albumin (GA) is associated with cardiovascular risk in CKD patients, but its relationship with AGEs and systemic inflammation remains unclear. This study investigated these associations in old patients with severe CKD, with and without diabetes. Methods: We conducted a cross-sectional analysis in 122 patients aged ≥ 65 years with CKD stages G3a–G5, including 67 diabetics and 55 non-diabetics. Patients with confounding comorbidities were excluded. We measured GA, AGEs, various AGEs receptors (RAGE) isoforms, and inflammatory cytokines (CRP, IL-6, TNFα, and MCP-1) using standardized assays. Statistical analyses included group comparisons, correlation coefficients, and multivariate regression. Results: Of 122 patients (mean age 77.7 ± 11.3 years), diabetics had higher GA percentages than non-diabetics (22.0 ± 7.1% vs. 17.5 ± 5.4%, p = 0.0001), while AGEs (2931 ± 763 vs. 3156 ± 809 AU; p = 0.118) and inflammatory markers (CRP 0.240[0.380] vs. 0.200[0.280] mg/dL; p = 0.142; IL-6 3.4[4.0] vs. 3.0[3.8] pg/mL; p = 0.238) were similar between groups. Overall, GA was inversely correlated with estimated glomerular filtration rate (eGFR) (ρ = −0.189, p = 0.037) and positively with glycated hemoglobin (HbA1c) (ρ = 0.525, p < 0.0001), but showed no significant correlation with AGEs, RAGE isoforms, or inflammatory cytokines. In multivariate analysis, only HbA1c remained independently associated with GA (β = 0.222, p = 0.005). Conclusions: In old patients with severe CKD, GA appears to be a more useful marker of glycemic control than glycation stress, the latter of which is the result of multiple factors, including impaired kidney function and systemic inflammation. Full article
12 pages, 1648 KiB  
Article
Spatiotemporal Distribution of Hand, Foot, and Mouth Disease and the Influence of Air Pollutants and Socioeconomic Factors on Incidence in Fujian, China
by Meirong Zhan, Shaojian Cai, Zhonghang Xie, Senshuang Zheng, Zhengqiang Huang, Jianming Ou and Shenggen Wu
Trop. Med. Infect. Dis. 2025, 10(7), 188; https://doi.org/10.3390/tropicalmed10070188 - 3 Jul 2025
Viewed by 385
Abstract
Background: Hand, foot, and mouth disease (HFMD) typically exhibits spatiotemporal clustering. This study aimed to analyze the spatiotemporal heterogeneity of HFMD in Fujian Province, China, and to identify the associations of air pollutants and socioeconomic factors with the incidence. Methods: Daily reported HFMD [...] Read more.
Background: Hand, foot, and mouth disease (HFMD) typically exhibits spatiotemporal clustering. This study aimed to analyze the spatiotemporal heterogeneity of HFMD in Fujian Province, China, and to identify the associations of air pollutants and socioeconomic factors with the incidence. Methods: Daily reported HFMD case data, daily air pollutant data, and socioeconomic data in Fujian Province from 2014 to 2023 were collected for analysis. A descriptive analysis was used to describe the epidemiological trends of HFMD. Spatial autocorrelation analysis was applied to explore the spatiotemporal clustering characteristics. The associations between risk factors and HFMD incidence were evaluated using the generalized additive model (GAM). Results: HFMD incidence in Fujian has decreased since 2019, and the peak in each year occurred between May and June. Distinct high–high and low–low clustering areas were identified. The cumulative exposure–response curves for SO2, NO2, and CO showed a monotonically increasing trend, with relative risks (RRs) < 1 at concentrations lower than the median levels (SO2 ≈ 4 μg/m3, NO2 ≈ 16 μg/m3, CO ≈ 1 mg/m3). In contrast, the curves for O3 and PM2.5 showed a decreasing trend, with RR < 1 at concentrations above the median levels (O3 ≈ 55 μg/m3, PM2.5 ≈ 20 μg/m3). Among socioeconomic factors, only the proportion of the population under 15 years old was found to be associated with HFMD incidence. Conclusions: HFMD incidence in Fujian exhibited distinct spatiotemporal clustering. The incidence was associated with the concentrations of air pollutants. Targeted interventions should be implemented in high-risk areas to mitigate HFMD transmission, with particular attention given to the environmental and demographic factors. Full article
(This article belongs to the Special Issue Climate Change and Environmental Epidemiology of Infectious Diseases)
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10 pages, 1164 KiB  
Article
Myocardial Damage Patterns in Patients with Left Ventricular Systolic Dysfunction with and Without Coronary Artery Disease Referred for Cardiac Magnetic Resonance
by Justyna M. Sokolska, Katarzyna Logoń, Magdalena Pszczołowska and Wojciech Kosmala
Biomedicines 2025, 13(7), 1612; https://doi.org/10.3390/biomedicines13071612 - 1 Jul 2025
Viewed by 338
Abstract
Background: Cardiac magnetic resonance (CMR) is widely used to determine the underlying cause of left ventricular (LV) systolic dysfunction. Patients with ischemic disease are less frequently referred for CMR, as the underlying disease is often presumed to explain LV systolic dysfunction. However, [...] Read more.
Background: Cardiac magnetic resonance (CMR) is widely used to determine the underlying cause of left ventricular (LV) systolic dysfunction. Patients with ischemic disease are less frequently referred for CMR, as the underlying disease is often presumed to explain LV systolic dysfunction. However, various etiologies of myocardial impairment may coexist. Late gadolinium enhancement (LGE) is a technique used for tissue characterization, particularly visualization of myocardial fibrosis. Objectives: The aim of this study was to assess the prevalence of LGE patterns suggesting ischemic or non-ischemic etiology of myocardial damage in patients with LV systolic dysfunction with and without known coronary artery disease (CAD). Methods: 131 patients (76% male, 55 ± 15 years old) with LV ejection fraction (LVEF) ≤ 50% in echocardiography underwent CMR between December 2021 and November 2022. Patients were divided according to the known history of CAD. Regional subendocardial and transmural LGE was interpreted as ischemic etiology, whereas midmyocardial and subepicardial LGE was non-ischemic. Results: The mean LVEF assessed in CMR was 35 ± 10%. A total of 122 patients underwent CMR with LGE sequence. LGE was detected in 62% of patients: 34% had a non-ischemic pattern, 16% ischemic, and 11% mixed. LGE patterns did not differ between patients with and without CAD. In every third patient with CAD and almost every second patient without CAD, no myocardial fibrosis was detected. A completely normal CMR study was found in 6% of patients without CAD and 1% of patients with CAD (all p NS). Conclusions: The LGE patterns suggesting ischemic or non-ischemic myocardial damage are similarly prevalent in patients with and without known CAD. The diagnosis based solely on clinical information may be unreliable, as LV dysfunction might have multifactorial origins. The absence of local myocardial fibrosis is relatively common in patients with LV dysfunction, irrespective of its etiology. Full article
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29 pages, 2914 KiB  
Article
Protein and Amino Acid Supplementation Among Recreational Gym Goers and Associated Factors—An Exploratory Study
by Sandor-Richard Nagy, Magdalena Mititelu, Violeta Popovici, Mihaela Gabriela Bontea, Annamaria Pallag and Tünde Jurca
J. Funct. Morphol. Kinesiol. 2025, 10(3), 248; https://doi.org/10.3390/jfmk10030248 - 28 Jun 2025
Viewed by 1598
Abstract
Objective: The present study investigated the relationship between protein and amino acid supplementation and various associated aspects among recreational gym goers at 2 gymnasiums in Oradea (Romania). Methods: A total of 165 gym goers (110 men and 55 women, most of them 18–30 [...] Read more.
Objective: The present study investigated the relationship between protein and amino acid supplementation and various associated aspects among recreational gym goers at 2 gymnasiums in Oradea (Romania). Methods: A total of 165 gym goers (110 men and 55 women, most of them 18–30 years old) with high educational levels were included in the present study, which was conducted as face-to-face interviews. Results: Participants were divided into 4 groups: protein supplement users (PSUs, 42/165), creatine supplement users (CSUs, 38/165), L-carnitine supplement users (LcSUs, 37/165), and protein + creatine + L-carnitine supplement users (PCLcSUs, 48/165). Most consumers were young (18–30 years) and preferred the triple combination. Females consumed PS and CS (38.2% and 34.5%, respectively), while the most-used NSs by males were PCLcS (36.4%) and LcS (27.3%). Obese gym goers opted for LcS consumption (r = 0.999, p < 0.05). Creatine and L-carnitine were consumed for force training (65.79 and 62.16%), while PCLcS and PS were used in cardio + force and force training in equal measures (42.86 and 47.92%, respectively). Most PSUs were gym goers for 7–12 months and more than 1 year (r = 0.999 and r = 0.952, respectively, p < 0.05), while PCLcSUs had a training frequency of at least 5 times a week (r = 0.968, p < 0.05). Muscle mass growth was the primary training focus for all NS users (57.89%), followed by muscular tonus (40.54%, p < 0.05). Almost 30% of one-only NS users reported various side effects, whereas all PCLcSUs claimed side effects (p < 0.05). Conclusions: Age and gender were key factors in diet type, training type, frequency, duration, scope, NS type, and dose intake. The frequency of side effects substantially depended on the kind of NS and the dose consumed. The present study’s results highlight the need for health professionals’ advice and monitoring in personalized diets and protein and amino acid supplementation in recreational gym goers. Full article
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16 pages, 3629 KiB  
Article
Ten Previously Unassigned Human Cosavirus Genotypes Detected in Feces of Children with Non-Polio Acute Flaccid Paralysis in Nigeria in 2020
by Toluwani Goodnews Ajileye, Toluwanimi Emmanuel Akinleye, Temitope O. C. Faleye, Lander De Coninck, Uwem Etop George, Anyebe Bernard Onoja, Sheriff Tunde Agbaje, Ijeoma Maryjoy Ifeorah, Oluseyi Adebowale Olayinka, Elijah Igbekele Oni, Arthur Obinna Oragwa, Bolutife Olubukola Popoola, Olaitan Titilola Olayinka, Oluwadamilola Gideon Osasona, Oluwadamilola Adefunke George, Philip G. Ajayi, Adedolapo A. Suleiman, Ahmed Iluoreh Muhammad, Isaac Komolafe, Adekunle Johnson Adeniji, Jelle Matthijnssens and Moses Olubusuyi Adewumiadd Show full author list remove Hide full author list
Viruses 2025, 17(6), 844; https://doi.org/10.3390/v17060844 - 12 Jun 2025
Viewed by 674
Abstract
Since its discovery via metagenomics in 2008, human cosavirus (HCoSV) has been detected in the cerebrospinal fluid (CSF) and feces of humans with meningitis, acute flaccid paralysis (AFP), and acute gastroenteritis. To date, 34 HCoSV genotypes have been documented by the Picornaviridae study [...] Read more.
Since its discovery via metagenomics in 2008, human cosavirus (HCoSV) has been detected in the cerebrospinal fluid (CSF) and feces of humans with meningitis, acute flaccid paralysis (AFP), and acute gastroenteritis. To date, 34 HCoSV genotypes have been documented by the Picornaviridae study group. However, the documented genetic diversity of HCoSV in Nigeria is limited. Here we describe the genetic diversity of HCoSV in Nigeria using a metagenomics approach. Archived and anonymized fecal specimens from children (under 15 years old) diagnosed with non-polio AFP from five states in Nigeria were analyzed. Virus-like particles were purified from 55 pools (made from 254 samples) using the NetoVIR protocol. Pools were subjected to nucleic acid extraction and metagenomic sequencing. Reads were trimmed and assembled, and contigs classified as HCoSV were subjected to phylogenetic, pairwise identity, recombination analysis, and, when necessary, immuno-informatics and capsid structure prediction. Fifteen pools yielded 23 genomes of HCoSV. Phylogenetic and pairwise identity analysis showed that all belonged to four species (eleven, three, three, and six members of Cosavirus asiani, Cosavirus bepakis, Cosavirus depakis, and Cosavirus eaustrali, respectively) and seventeen genotypes. Ten genomes belong to seven (HCoSV-A3/A10, A15, A17, A19, A24, D3, and E1) previously assigned genotypes, while the remaining thirteen genomes belonged to ten newly proposed genotypes across the four HCoSV species, based on the near-complete VP1 region (VP1*) of the cosavirus genome. Our analysis suggests the existence of at least seven and eight Cosavirus bepakis and Cosavirus eaustrali genotypes, respectively (including those described here). We report the first near-complete genomes of Cosavirus bepakis and Cosavirus depakis from Nigeria, which contributes to the increasing knowledge of the diversity of HCoSV, raising the number of tentative genotypes from 34 to over 40. Our findings suggest that the genetic diversity of HCoSV might be broader than is currently documented, highlighting the need for enhanced surveillance. Full article
(This article belongs to the Section Human Virology and Viral Diseases)
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11 pages, 1657 KiB  
Case Report
Unusual Evolution of Carotid Atherosclerosis in a Patient with Transient Ischemic Attack
by Corina Cinezan, Camelia Bianca Rus, Ioana Tiberia Ilias, Alexandra Comanescu and Alexandra Cinezan
Life 2025, 15(6), 831; https://doi.org/10.3390/life15060831 - 22 May 2025
Viewed by 1349
Abstract
Here, we report an unusual case of a nonsmoker and hypertensive 72-year-old male who was admitted with a transient ischemic attack to the Neurology Department of Clinical County Emergency Hospital Bihor. He presented a first transient ischemic attack and paroxysmal atrial fibrilation 2 [...] Read more.
Here, we report an unusual case of a nonsmoker and hypertensive 72-year-old male who was admitted with a transient ischemic attack to the Neurology Department of Clinical County Emergency Hospital Bihor. He presented a first transient ischemic attack and paroxysmal atrial fibrilation 2 years before, when anticoagulation was started on top of his antihypertensive medication. At that time, carotid Doppler ultrasound revealed nonobstructive atherosclerosis and statin therapy was started, according to current guidelines, in order to lower the initial 70 mg/dL LDL-cholesterol level to under 55 mg/dL. Cardio-embolism was considered the mechanism of stroke at that time. Despite all the medication and the maintenance of LDL below 50 mg/dL, carotid atherosclerosis evolved to an important left internal carotid artery stenosis and transient ischemic attacks reappeared two years later. Carotid stenosis was then considered the most probable cause, although elucidating the exact mechanism was difficult. After medical treatment and subsequent endarterectomy, the patient had a good outcome. The progressive course of atheromatosis, despite maximal medication, urged us to look for further proper measures of prevention. No chronic disease was detected during the postoperative phase, except for early-stage periodontal disease, for which adequate preventive measures were applied. Considering that subclinical inflammation induced by periodontal disease can induce the progression of atherosclerosis, chronic treatment with colchicine was added, with a favorable outcome. Full article
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12 pages, 2438 KiB  
Article
High-Dose Ceftriaxone in Elderly Patients with Enterococcal Infective Endocarditis: Population Pharmacokinetics of Free Ceftriaxone and Dose Optimization
by Beatriz Fernández Rubio, Fernando Docobo Pérez, Laura Herrera Hidalgo, Luis Eduardo López-Cortés, Rafael Luque Márquez, José Manuel Lomas Cabezas, Luis Fernando López-Cortés, Marta Mejías Trueba, Ana Belén Guisado Gil, Alicia Gutiérrez Valencia, Arístides de Alarcón González and María Victoria Gil Navarro
Antibiotics 2025, 14(5), 508; https://doi.org/10.3390/antibiotics14050508 - 15 May 2025
Viewed by 720
Abstract
Background: Ampicillin plus ceftriaxone (AC) is a first-line treatment for Enterococcus faecalis infective endocarditis (IE). Its administration in outpatient parenteral antibiotic treatment (OPAT) programs is challenging. The design of a ceftriaxone regimen suitable for OPAT requires deep knowledge of ceftriaxone pharmacokinetics (PK). Objective: [...] Read more.
Background: Ampicillin plus ceftriaxone (AC) is a first-line treatment for Enterococcus faecalis infective endocarditis (IE). Its administration in outpatient parenteral antibiotic treatment (OPAT) programs is challenging. The design of a ceftriaxone regimen suitable for OPAT requires deep knowledge of ceftriaxone pharmacokinetics (PK). Objective: We aim to explore ceftriaxone PK in elderly patients and propose dose regimens adapted to OPAT to maintain synergistic concentrations (Cs) with ampicillin against E. faecalis. Methods: We conducted a prospective observational pharmacokinetic study on patients (>55 years old) affected by E. faecalis IE. Ceftriaxone free concentration was measured at three time-points: before the administration (Cmin) and two and four hours after ceftriaxone administration (C2 and C4). Both structural and covariate population pharmacokinetic models were built. Monte Carlo simulations of six ceftriaxone dosages were performed and the probability of target attainment (PTA) of an optimal Cs range was analyzed. The pharmacokinetic/pharmacodynamic index (PK/PD) to predict efficacy was defined as maintaining free ceftriaxone concentrations superior to the Cs at 50–100% of the dosing interval (fT ≥ Cs ≥ 50–100% of the dosing interval). Ceftriaxone dosing regimens were considered optimal if at least 90% of the simulated population was able to achieve the defined PK/PD targets. Results: Twenty-four episodes from 16 patients were included. Mean free ceftriaxone concentration pre-dose, +2 h, and +4 h were Cmin = 7.8 ± 6.5 mg/L, C2 = 34 ± 26.5 mg/L, and C4 = 22.7 ± 19.7 mg/L, respectively. A two-compartment model with first-order absorption and elimination best described the data. Ceftriaxone one-hour infusions only achieved the minimum PK/PD target when the 2 g/12 h regimen was tested. On the other hand, ceftriaxone continuous infusion maintained a Cs above the PK/PD target for 100% of the dosing interval using ceftriaxone 4–6 g regimens. Conclusions: Our findings suggest that the optimal ceftriaxone exposure may be achieved using high-dose continuous infusions to ensure an ampicillin-killing effect when treating E. faecalis IE. Full article
(This article belongs to the Section Pharmacokinetics and Pharmacodynamics of Drugs)
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13 pages, 566 KiB  
Article
Plasmodium spp. Infections Among Mbalmayo Inhabitants of Central Region in Cameroon: Discrepancies Between Rapid Diagnostic Tests and Molecular Methods
by Lidia Stopyra, Wanesa Wilczyńska, Daria Kołodziej, Assamba Noel and Krzysztof Korzeniewski
Pathogens 2025, 14(5), 462; https://doi.org/10.3390/pathogens14050462 - 9 May 2025
Viewed by 676
Abstract
Malaria remains a major public health threat in Cameroon, with an estimated 3 million new cases of Plasmodium spp. infections reported each year. The aim of this study was to assess the occurrence of Plasmodium infections in Cameroon in a group of symptomatic [...] Read more.
Malaria remains a major public health threat in Cameroon, with an estimated 3 million new cases of Plasmodium spp. infections reported each year. The aim of this study was to assess the occurrence of Plasmodium infections in Cameroon in a group of symptomatic and asymptomatic individuals, residents of the town of Mbalmayo, located in the Central Region of Cameroon. Screening was conducted in December 2024 at the Mbalayo District Hospital. This study involved a total of 93 people aged between 1 and 70 years old, who voluntarily agreed to have their blood samples taken and tested for malaria. As part of this study, the demographic variables of the participants were taken, malaria rapid diagnostic tests (mRDTs) were performed, and blood samples were applied to the Whatman FTA cards for further real-time PCR diagnostics. The occurrence of Plasmodium infections in the residents of Mbalmayo differed depending on the diagnostic method used (30.1% with mRDT vs. 60.2% when RT-PCR assays were performed). A total of 55 malaria cases were found to be caused by P. falciparum, while one case was found to be caused by P. vivax. Nearly half of the study participants exhibited no signs or symptoms of malaria, whereas 35.7% reported fever, 17.9% respiratory symptoms, and 10.7% gastrointestinal symptoms. The prevalence of malaria remains high in populations inhabiting the Central Region in Cameroon. P. falciparum is the dominant species in the region. A considerable proportion of infected individuals are asymptomatic, which supports the finding that asymptomatic carriers play a critical role in disease transmission. The differences between the results depending on the diagnostic method used (mRDT vs. RT-PCR) suggest that there is a need to use a combination of different methods for the identification of malaria, especially in cases of low parasitemia. Full article
(This article belongs to the Section Epidemiology of Infectious Diseases)
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20 pages, 781 KiB  
Article
Cardio-Oncology Challenges in Elderly Patients
by Ester Topa, Eliana De Rosa, Alessandra Cuomo, Francesco Curcio, Marika Rizza, Francesco Elia, Veronica Flocco, Umberto Attanasio, Martina Iengo, Francesco Fiore, Maria Cristina Luise, Grazia Arpino, Roberto Bianco, Chiara Carlomagno, Mario Giuliano, Luigi Formisano, Marco Picardi, Carminia Maria Della Corte, Floriana Morgillo, Giulia Martini, Erika Martinelli, Stefania Napolitano, Teresa Troiani, Giovanni Esposito, Antonio Cittadini, Guido Iaccarino, Giuseppe Rengo, Pasquale Abete, Valentina Mercurio and Carlo Gabriele Tocchettiadd Show full author list remove Hide full author list
J. Clin. Med. 2025, 14(9), 3257; https://doi.org/10.3390/jcm14093257 - 7 May 2025
Viewed by 628
Abstract
Background and Objectives: Along with the ageing of the population, cancer and cardiovascular (CV) diseases more frequently coexist, complicating patients’ management. Here, we focus on elderly oncologic patients, describing clinical features and comorbidities, discussing therapeutic management CV risk factors and CV complications risen [...] Read more.
Background and Objectives: Along with the ageing of the population, cancer and cardiovascular (CV) diseases more frequently coexist, complicating patients’ management. Here, we focus on elderly oncologic patients, describing clinical features and comorbidities, discussing therapeutic management CV risk factors and CV complications risen during our CV follow-up, and exploring the different items of the comprehensive geriatric assessment (CGA) and the correlation between cardiac function by means of standard 2D echocardiography and each of the CGA items. Methods: A total of 108 consecutive patients (mean age 73.55 ± 5.43 years old; 40.7% females) referred to our cardio-oncology unit were enrolled, and three different groups were identified: Group 1, patients naïve for oncologic treatments (mean age 73.32 ± 5.40; 33% females); Group 2, patients already on antineoplastic protocols (mean age 73.46 ± 5.09; 44.1% females); and Group 3, patients who had already completed cancer treatments (mean age 74.34 ± 6.23; 55% female). The correlation between CGA, performed in a subgroup of 62 patients (57.4%), and echocardiographic parameters was assessed. Results: Group 2 patients had the highest incidence of CV events (CVEs) (61.8% vs. 14.8% in Group 1, 15% in Group 3; p ≤ 0.001) and withdrawals from oncologic treatments (8.8% vs. none in Group 1; p = 0.035). Group 2 had worse 48-month survival (47.1% vs. 22.2% in Group 1, 20% in Group 3; p = 0.05), which was even more evident when focusing on patients who died during follow-up. When assessing echocardiographic parameters, physical activity showed an inverse correlation with the left ventricular mass index (p = 0.034), while the Frailty index showed a direct correlation with the E/e’ ratio (p = 0.005). Conclusions: A thorough baseline CV assessment is important in elderly oncologic patients eligible for anticancer treatment. In this population, CGA can be a simple, feasible screening tool that might help identify patients at a greater risk of developing CVEs correlating to several pivotal cardiovascular parameters. Full article
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46 pages, 15851 KiB  
Article
Emerging Human Fascioliasis in India: Review of Case Reports, Climate Change Impact, and Geo-Historical Correlation Defining Areas and Seasons of High Infection Risk
by Santiago Mas-Coma, Pablo F. Cuervo, Purna Bahadur Chetri, Timir Tripathi, Albis Francesco Gabrielli and M. Dolores Bargues
Trop. Med. Infect. Dis. 2025, 10(5), 123; https://doi.org/10.3390/tropicalmed10050123 - 2 May 2025
Cited by 1 | Viewed by 2088
Abstract
The trematodes Fasciola hepatica and F. gigantica are transmitted by lymnaeid snails and cause fascioliasis in livestock and humans. Human infection is emerging in southern and southeastern Asia. In India, the number of case reports has increased since 1993. This multidisciplinary study analyzes [...] Read more.
The trematodes Fasciola hepatica and F. gigantica are transmitted by lymnaeid snails and cause fascioliasis in livestock and humans. Human infection is emerging in southern and southeastern Asia. In India, the number of case reports has increased since 1993. This multidisciplinary study analyzes the epidemiological scenario of human infection. The study reviews the total of 55 fascioliasis patients, their characteristics, and geographical distribution. Causes underlying this emergence are assessed by analyzing (i) the climate change suffered by India based on 40-year-data from meteorological stations, and (ii) the geographical fascioliasis hotspots according to archeological–historical records about thousands of years of pack animal movements. The review suggests frequent misdiagnosis of the wide lowland-distributed F. gigantica with F. hepatica and emphasizes the need to obtain anamnesic information about the locality of residence and the infection source. Prevalence appears to be higher in females and in the 30–40-year age group. The time elapsed between symptom onset and diagnosis varied from 10 days to 5 years (mean 9.2 months). Infection was diagnosed by egg finding (in 12 cases), adult finding (28), serology (3), and clinics and image techniques (12). Climate diagrams and the Wb-bs forecast index show higher temperatures favoring the warm condition-preferring main snail vector Radix luteola and a precipitation increase due to fewer rainy days but more days of extreme rainfall, leading to increasing surface water availability and favoring fascioliasis transmission. Climate trends indicate a risk of future increasing fascioliasis emergence, including a seasonal infection risk from June–July to October–November. Geographical zones of high human infection risk defined by archeological–historical analyses concern: (i) the Indo-Gangetic Plains and corridors used by the old Grand Trunk Road and Daksinapatha Road, (ii) northern mountainous areas by connections with the Silk Road and Tea-Horse Road, and (iii) the hinterlands of western and eastern seaport cities involved in the past Maritime Silk Road. Routes and nodes are illustrated, all transhumant–nomadic–pastoralist groups are detailed, and livestock prevalences per state are given. A baseline defining areas and seasons of high infection risk is established for the first time in India. This is henceforth expected to be helpful for physicians, prevention measures, control initiatives, and recommendations for health administration officers. Full article
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19 pages, 7124 KiB  
Article
Associations Between 10-Year Physical Performance and Activities of Daily Living Trajectories and Physical Behaviors in Older Adults
by Mikael Anne Greenwood-Hickman, Weiwei Zhu, Abisola Idu, Laura B. Harrington, Susan M. McCurry, Andrea Z. LaCroix, Pamela A. Shaw and Dori E. Rosenberg
Int. J. Environ. Res. Public Health 2025, 22(5), 704; https://doi.org/10.3390/ijerph22050704 - 29 Apr 2025
Viewed by 644
Abstract
Physical function is likely bidirectionally associated with physical activity (PA), sedentary behavior (SB), and sleep. We examined trajectories of physical function as predictors of these behaviors in community-dwelling adults aged ≥65 y without dementia from the Adult Changes in Thought cohort. Exposures were [...] Read more.
Physical function is likely bidirectionally associated with physical activity (PA), sedentary behavior (SB), and sleep. We examined trajectories of physical function as predictors of these behaviors in community-dwelling adults aged ≥65 y without dementia from the Adult Changes in Thought cohort. Exposures were trajectories of physical performance (short Performance-Based Physical Function [sPPF]) and self-reported activities of daily living (ADL) impairment. Outcomes were device-measured PA and SB and self-reported sleep. We fit linear mixed-effects models to define trajectory slopes and intercepts for each functional measure over the prior 10 years. We used multivariable linear regression to investigate the relationship between trajectory features and outcomes, using bootstrap confidence intervals. Participants (N = 905) were 77.6 (SD = 6.9) years old, 55% female, 91% white, and had a median sPPF score of 9 (IQR = [8, 11]) and median impairment of 1 ADL (IQR = [0, 2]) at the time of activity measurement (baseline). Steeper decreases in sPPF (0.3-unit, 25% of the range) were associated with fewer steps (−1180, 95% CI = [−2853, −185]) and less moderate-to-vigorous PA (−15.7 min/day [−35.6, −2.3]). Steeper increases in ADL impairment were associated with 35.0 min/day (4.3, 65.0) additional sitting time, longer mean sitting bout duration (3.5 min/bout [0.8, 6.2]), fewer steps (−1372 [−2223, −638]), less moderate-to-vigorous PA (−13 min/day [−22.6, −5.0]), and more time-in-bed (25.5 min/day [6.5, 43.5]). No associations were observed with light PA or sleep quality. Worsening physical function is associated with lower PA and higher SB, but not with light-intensity movement or sleep quality, supporting the bidirectional nature of the relationship between physical function and physical behaviors. Full article
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16 pages, 1580 KiB  
Article
A Train-the-Trainer Approach to Build Community Resilience to the Health Impacts of Climate Change in the Dominican Republic
by Hannah N. W. Weinstein, Kristie Hadley, Jessica Patel, Sarah Silliman, R. Yamir Gomez Carrasco, Andres J. Arredondo Santana, Heidi Sosa, Stephanie M. Rosa, Carol Martinez, Nicola P. Hamacher, Haley Campbell, James K. Sullivan, Danielly de Paiva Magalhães, Cecilia Sorensen and Ana Celia Valenzuela González
Int. J. Environ. Res. Public Health 2025, 22(4), 650; https://doi.org/10.3390/ijerph22040650 - 20 Apr 2025
Viewed by 799
Abstract
Communities in the Dominican Republic (DR) face increased natural disasters, poor air quality, food insecurity, and health impacts related to climate change. We evaluated the success of a train-the-trainer program to empower community leaders, women, and at-risk youth with the knowledge and skills [...] Read more.
Communities in the Dominican Republic (DR) face increased natural disasters, poor air quality, food insecurity, and health impacts related to climate change. We evaluated the success of a train-the-trainer program to empower community leaders, women, and at-risk youth with the knowledge and skills to increase individual and community resilience in Cristo Rey, Dominican Republic. Three in-person two-day courses were conducted between July and August 2024 at the Universidad Iberoamericana. Each session included eight lectures and collaborative learning activities on climate change science, adaptation, resilience, and health impacts. Intra-group analyses comparing pre- and post-course surveys assessed participants’ climate change awareness, literacy, and communication and response skills. One hundred and four attendees participated in the survey study. Of the 100 participants with demographic data, 55% (n = 55) were 35 years old or younger, 70% (n = 70) identified as female, and 45% (n = 45) lived in Cristo Rey. The participants reported high baseline climate change awareness. Compared to before the course, the participants reported increased literacy regarding the environmental impacts of climate change relevant to the DR and the specific health impacts (p-value < 0.05) and increased climate change-related communication and response skills (p-value < 0.001). This study suggests competency-based, regional-specific courses deployed in a train-the-trainer model, have the potential to equip community members with knowledge to protect their health. Full article
(This article belongs to the Section Global Health)
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12 pages, 456 KiB  
Case Report
EMG-Triggered Functional Electrical Stimulation for Central Facial Palsy Following Stroke: A Clinical Case Report
by Frauke Johannes, Anna Maria Pekacka-Egli, Simone Köhler, Andreas Disko, Jan von Meyenburg and Bartosz Bujan
Brain Sci. 2025, 15(4), 410; https://doi.org/10.3390/brainsci15040410 - 17 Apr 2025
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Abstract
Background: Central facial palsy (CFP) is a common condition following stroke, typically affecting the lower face and causing symptoms such as drooling, dysarthria, and facial asymmetry. Despite available rehabilitation methods, the evidence supporting their effectiveness is limited. Electromyography (EMG)-triggered Functional Electrical Stimulation (FES) [...] Read more.
Background: Central facial palsy (CFP) is a common condition following stroke, typically affecting the lower face and causing symptoms such as drooling, dysarthria, and facial asymmetry. Despite available rehabilitation methods, the evidence supporting their effectiveness is limited. Electromyography (EMG)-triggered Functional Electrical Stimulation (FES) has shown promise in neurorehabilitation for motor impairments, but its application to CFP remains unclear. Methods: This case report explores the use of EMG-triggered FES in a 77-year-old patient with CFP following a severe ischemic stroke of the middle cerebral artery (MCA). Therapy, focused on stimulating the orbicularis oris muscle to address persistent drooling and improve facial symmetry, was alongside usual care. The stimulation duration was 5–15 min, frequency 35 Hz, and pulse duration 300 µs, applied 5 times a week. Stimulation duration was adjusted based on the patient’s progress. Results: The patient underwent 16 sessions of EMG-triggered FES over four weeks. Post-therapy reassessment with the Sunnybrook Facial Grading System (SFGS) showed an improvement in facial motor function, with the score increasing from 58/100 to 78/100. Reassessment of the Facial Disability Index (FDI) revealed significant improvement in physical function (55 to 85 points), though the social function score slightly decreased (76 to 64 points). Improvements in dysarthria and the complete resolution of drooling were reflected in the physical function domain of the FDI and the Allensbach Dysarthria Severity Scale. Conclusions: The results highlight that EMG-triggered FES was well tolerated and effectively supported therapy, contributing to the resolution of drooling, improved facial symmetry, and enhanced speech function. Future research should focus on randomized controlled trials to confirm its effectiveness and determine optimal therapy parameters. Full article
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7 pages, 25226 KiB  
Case Report
Arthroscopic Flexor Hallux Brevis and Plantar Capsule Release (Cochrane Procedure) for Hallux Rigidus: Case Presentation with Long-Term Follow-Up
by Kenichiro Nakajima
J. Clin. Med. 2025, 14(8), 2785; https://doi.org/10.3390/jcm14082785 - 17 Apr 2025
Viewed by 507
Abstract
Background: In 1927, Cochrane observed persistent elastic resistance to hallux dorsiflexion after cheilectomy for hallux rigidus, attributing it to soft tissue tightness beneath the first metatarsophalangeal (MTP) joint. An innovative surgery was introduced using a plantar approach, dividing the plantar tissues. This [...] Read more.
Background: In 1927, Cochrane observed persistent elastic resistance to hallux dorsiflexion after cheilectomy for hallux rigidus, attributing it to soft tissue tightness beneath the first metatarsophalangeal (MTP) joint. An innovative surgery was introduced using a plantar approach, dividing the plantar tissues. This procedure achieved complete pain resolution and high satisfaction in 12 patients. Despite addressing the etiology of hallux rigidus, this approach has not been adopted in current surgeries. This report presents a case treated with the arthroscopic Cochrane procedure with a long-term follow-up. Methods: A 73-year-old male with hallux rigidus presented with limited dorsiflexion, a painful bony prominence, and pain during walking at the first MTP joint, treated with the arthroscopic Cochrane procedure. Results: During surgery, hallux dorsiflexion did not improve after resecting all spurs in the MTP joint, but the dorsiflexion angle immediately improved from 55° to 85°after releasing the flexor hallucis brevis tendon, plantar capsule, and plantar portion of the lateral ligament. Improvements in both visual analog scale scores (70–0) and Japanese Society for Surgery of the Foot scores (57–88) were noted from preoperatively to 9 years and 6 months postoperatively. No postoperative cockup deformity was observed. Conclusions: The arthroscopic Cochrane procedure can yield favorable long-term outcomes without postoperative cockup deformity. Full article
(This article belongs to the Special Issue Foot and Ankle Surgery: State of the Art and Future Perspectives)
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9 pages, 700 KiB  
Article
Intravenous Fosfomycin for Difficult-to-Treat Infections: A Real-Life Multicentric Study in Italy
by Verena Zerbato, Gianfranco Sanson, Lisa Fusaro, Valentina Gerussi, Sara Sincovich, Fabiana Dellai, Giovanni Del Fabro, Nicholas Geremia, Cristina Maurel, Donatella Giacomazzi, Chiara Biasinutto, Filippo Giorgio Di Girolamo, Gianfranco Scrivo, Venera Costantino, Manuela Di Santolo, Marina Busetti, Lory Saveria Crocè, Simone Giuliano, Massimo Crapis, George Zhanel, Carlo Tascini, Roberto Luzzati and Stefano Di Bellaadd Show full author list remove Hide full author list
Antibiotics 2025, 14(4), 401; https://doi.org/10.3390/antibiotics14040401 - 14 Apr 2025
Viewed by 1939
Abstract
Background: Fosfomycin, an old antibiotic attracting renewed interest, offers a broad spectrum of activity and unique synergy with other agents. While widely used in severe infections, real-world data on intravenous fosfomycin remain limited. Objectives: This study aimed to describe the clinical and microbiological [...] Read more.
Background: Fosfomycin, an old antibiotic attracting renewed interest, offers a broad spectrum of activity and unique synergy with other agents. While widely used in severe infections, real-world data on intravenous fosfomycin remain limited. Objectives: This study aimed to describe the clinical and microbiological characteristics of patients treated with intravenous fosfomycin and to analyze its administration modalities in a real-world setting. Methods: A multicenter retrospective cohort study was conducted across five Italian hospitals. Adult patients receiving intravenous fosfomycin between January 2020 and December 2023 were included. Results: We enrolled 393 patients. The median age was 69 years, with most patients (45%) admitted to Critical Care Units. Pneumonia (34%), bloodstream infections (22%), and urinary tract infections (21%) were the most common indications. Gram-negative bacteria, particularly E. coli and P. aeruginosa, were the predominant pathogens. Fosfomycin was used as empirical therapy in 55% of cases and was combined with other agents in almost all cases (99%). The most frequent partners were piperacillin/tazobactam (21%) and new beta-lactam/beta-lactamase inhibitor combinations (18%). The median treatment duration was seven days, with most subjects (65%) receiving a fosfomycin dosage regimen of 16 g/day. Minimum inhibitory concentrations (MICs) values for fosfomycin were available for 61 isolates (15%), with 78.7% (48/61) showing MIC ≤ 32 mg/L. C. difficile infection occurred in only 2% of patients. Mortality rates at 30, 60, and 90 days were 21.6%, 26.7%, and 29.3%, respectively. Conclusions: This study provides valuable insights into the real-world use of intravenous fosfomycin. Full article
(This article belongs to the Section Antibiotic Therapy in Infectious Diseases)
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