Medical Sciences

9 pages, 3319 KiB

Open AccessCase Report

Waldenström’s Macroglobulinemia and Cryoglobulinemic Glomerulonephritis: An Unusual Case of Monoclonal Gammopathy of Renal Significance

by José C. De La Flor, Jesús de María Sulca, Pablo Rodríguez, Daniel Villa, Edna Sandoval, Rocío Zamora, Maribel Monroy-Condori, Roxana Lipa, Henry Perez and Michael Cieza

Med. Sci. 2023, 11(4), 77; https://doi.org/10.3390/medsci11040077 - 05 Dec 2023

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Abstract

Cryoglobulins are immunoglobulins that precipitate at temperatures below 37 °C and dissolve upon reheating. They can induce small-vessel vasculitis with renal involvement. Cryoglobulinemic glomerulonephritis is a rare manifestation that occurs in patients with monoclonal gammopathy, specifically Waldenström’s macroglobulinemia. We present the case of [...] Read more.

Cryoglobulins are immunoglobulins that precipitate at temperatures below 37 °C and dissolve upon reheating. They can induce small-vessel vasculitis with renal involvement. Cryoglobulinemic glomerulonephritis is a rare manifestation that occurs in patients with monoclonal gammopathy, specifically Waldenström’s macroglobulinemia. We present the case of a 52-year-old patient with a history of cutaneous vasculitis and hypothyroidism, who presented with generalized edema, moderate anemia, hypercholesterolemia, nephrotic range proteinuria of 12.69 g/day, microhematuria, arterial hypertension, and hypocomplementemia via the classical pathway, without acute kidney injury and with negative serological studies and positive cryoglobulins in the second determination. Serum and urine protein electrophoresis and immunofixation studies showed a monoclonal band of IgM and kappa light chain. Renal biopsy was consistent with cryoglobulinemic glomerulonephritis. In the context of dysproteinemia and cryoglobulinemic glomerulonephritis, bone-marrow aspiration and biopsy were performed, leading to the diagnosis of Waldenström’s macroglobulinemia. Monoclonal gammopathies have been described in association with type I cryoglobulinemias. This described association is uncommon, which is why we present this case, along with a review of the literature. Full article

(This article belongs to the Section Nephrology and Urology)

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20 pages, 3876 KiB

Open AccessArticle

Bioinformatics Analysis of Global Diversity in Meningococcal Vaccine Antigens over the Past 10 Years: Vaccine Efficacy Prognosis

by Viktoriia Yu. Savitskaya, Nina G. Dolinnaya, Vadim V. Strekalovskikh, Elizaveta S. Peskovatskova, Viktoriia G. Snyga, Vadim S. Trefilov, Mayya V. Monakhova and Elena A. Kubareva

Med. Sci. 2023, 11(4), 76; https://doi.org/10.3390/medsci11040076 - 01 Dec 2023

Viewed by 1434

Abstract

Neisseria meningitidis (N. meningitidis) serogroup B (MenB) is the leading cause of invasive meningococcal disease worldwide. The pathogen has a wide range of virulence factors, which are potential vaccine components. Studying the genetic variability of antigens within a population, especially their long-term [...] Read more.

Neisseria meningitidis (N. meningitidis) serogroup B (MenB) is the leading cause of invasive meningococcal disease worldwide. The pathogen has a wide range of virulence factors, which are potential vaccine components. Studying the genetic variability of antigens within a population, especially their long-term persistence, is necessary to develop new vaccines and predict the effectiveness of existing ones. The multicomponent 4CMenB vaccine (Bexsero), used since 2014, contains three major genome-derived recombinant proteins: factor H-binding protein (fHbp), Neisserial Heparin-Binding Antigen (NHBA) and Neisserial adhesin A (NadA). Here, we assessed the prevalence and sequence variations of these vaccine antigens in a panel of 5667 meningococcal isolates collected worldwide over the past 10 years and deposited in the PubMLST database. Using multiple amino acid sequence alignments and Random Forest Classifier machine learning methods, we estimated the potential strain coverage of fHbp and NHBA vaccine variants (51 and about 25%, respectively); the NadA antigen sequence was found in only 18% of MenB genomes analyzed, but cross-reactive variants were present in less than 1% of isolates. Based on our findings, we proposed various strategies to improve the 4CMenB vaccine and broaden the coverage of N. meningitidis strains. Full article

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14 pages, 425 KiB

Open AccessSystematic Review

The Use of Synthetic Graft for MPFL Reconstruction Surgery: A Systematic Review of the Clinical Outcomes

by Panayiotis Tanos, Chryssa Neo, Edwin Tong and Andrea Volpin

Med. Sci. 2023, 11(4), 75; https://doi.org/10.3390/medsci11040075 - 28 Nov 2023

Viewed by 2007

Abstract

(1) Background: Acute patella dislocation (APD) is a prevalent knee injury, with rates between 5.8–77.8 per 100,000. APD often results in repeat lateral patella dislocations due to the instability of the medial patellofemoral ligament (MPFL). Non-operative treatments have a 50% recurrence rate. While [...] Read more.

(1) Background: Acute patella dislocation (APD) is a prevalent knee injury, with rates between 5.8–77.8 per 100,000. APD often results in repeat lateral patella dislocations due to the instability of the medial patellofemoral ligament (MPFL). Non-operative treatments have a 50% recurrence rate. While autologous grafting for MPFL has been favored, surgeons are now exploring synthetic grafts. We aimed to assess the effectiveness of synthetic grafts in MPFL reconstruction surgeries for repeated patellar dislocations; (2) Methods: Our research was based on a thorough search from the National Institute of Health and Clinical Excellence Healthcare Databases, using the Modified Coleman Methodology Score for quality assessment; (3) Results: Six studies met the inclusion criteria. A total of 284 patients and 230 knees were included. Seventy-five percent of patients were graded to have excellent-good clinical outcomes using the Crosby and Insall Grading System. International Knee Documentation Committee score and Knee injury and Osteoarthritis Outcome Score scores showed 59% and 60% post-operative improvement, respectively; (4) Conclusions: All studies showed improvement in post-operative functional outcomes and report no serious adverse events. The 6 mm, LARS (Orthomedic Ltd., Dollard-des-Ormeaux, QC, Canada) proved to have the most improvement in post-operative outcomes when used as a double bundle graft. Full article

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18 pages, 979 KiB

Open AccessArticle

Association of Mediterranean Diet Adherence with Disease Progression Characteristics, Lifestyle Factors and Overall Survival in Gastric Cancer Patients

by Eleni Pavlidou, Sousana K. Papadopoulou, Maria Tolia, Maria Mentzelou, Nikolaos Tsoukalas, Olga Alexatou, Theodora Tsiouda, Gerasimos Tsourouflis, Evmorfia Psara, Vasileios Bikos, Nikolaos Kavantzas, Ioly Kotta-Loizou, Antonios Dakanalis, Theofanis Vorvolakos and Constantinos Giaginis

Med. Sci. 2023, 11(4), 74; https://doi.org/10.3390/medsci11040074 - 15 Nov 2023

Cited by 1 | Viewed by 1774

Abstract

Background: The Mediterranean diet (MD) exerts a protective effect against cancer development and progression; however, the evaluation of its impact on gastric cancer still remains quite scarce. The present study aims to evaluate the association of MD adherence during the lifespan with disease [...] Read more.

Background: The Mediterranean diet (MD) exerts a protective effect against cancer development and progression; however, the evaluation of its impact on gastric cancer still remains quite scarce. The present study aims to evaluate the association of MD adherence during the lifespan with disease progression characteristics, lifestyle factors and overall survival in gastric carcinoma patients. Methods: This is an observational, cross-sectional study conducted on 186 gastric cancer patients followed up for a median time interval of 57 months or until death due to cancer disease. Tumor histopathological characteristics were retrieved from patients’ medical records, while validated questionnaires assessing, immediately after the time of diagnosis, health-related quality of life, physical activity levels, sleep quality, depression, anxiety and MD adherence during the lifespan were used. Results: Higher MD adherence during the lifespan was significantly associated with younger patients (p = 0.0106), regular smoking (p < 0.0001), abnormal BMI status (p < 0.0001), intestinal-type gastric carcinoma (p = 0.0111), high tumor histopathological grade (p < 0.0001) and earlier disease stage (p < 0.0001). Moreover, patients with elevated MD adherence during their lifespan showed significantly better health-related quality of life (p < 0.0001), higher physical activity levels (p < 0.0001), more adequate sleep quality (p < 0.0001) and lower prevalence of depression (p = 0.0003) and anxiety (p = 0.0006) compared to those with reduced MD adherence. In multiple regression analysis, elevated MD compliance during the lifespan was independently correlated with longer overall patient survival after adjustment for several confounders (Cox regression analysis, p = 0.0001). Conclusions: Higher MD adherence during the lifespan was associated with less advanced tumor histopathology characteristics and favorable mental and physical lifestyle factors. Moreover, higher MD adherence during the lifespan was also independently correlated with longer overall survival in gastric carcinoma patients. Thus, adopting a healthy dietary pattern like the MD during the lifespan may act as a preventive agent in combination with a healthy lifestyle against gastric cancer development and progression. Full article

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19 pages, 1363 KiB

Open AccessArticle

An Open-Label Case Series of Glutathione Use for Symptomatic Management in Children with Autism Spectrum Disorder

by Karam Radwan, Gary Wu, Kamilah Banks-Word and Ryan Rosenberger

Med. Sci. 2023, 11(4), 73; https://doi.org/10.3390/medsci11040073 - 15 Nov 2023

Viewed by 2408

Abstract

Autism spectrum disorder (ASD) is a type of neurodevelopmental disorder that has been diagnosed in an increasing number of children around the world. The existing data suggest that early diagnosis and intervention can improve ASD outcomes. The causes of ASD remain complex and [...] Read more.

Autism spectrum disorder (ASD) is a type of neurodevelopmental disorder that has been diagnosed in an increasing number of children around the world. The existing data suggest that early diagnosis and intervention can improve ASD outcomes. The causes of ASD remain complex and unclear, and there are currently no clinical biomarkers for autism spectrum disorder. There is an increasing recognition that ASD might be associated with oxidative stress through several mechanisms including abnormal metabolism (lipid peroxidation) and the toxic buildup of reactive oxygen species (ROS). Glutathione acts as an antioxidant, a free radical scavenger and a detoxifying agent. This open-label pilot study investigates the tolerability and effectiveness of oral supplementation with Opitac^TM gluthathione as a treatment for patients with ASD. The various aspects of glutathione Opitac^TM glutathione bioavailability were examined when administered by oral routes. The absorption of glutathione from the gastrointestinal tract has been recently investigated. The results of this case series suggest that oral glutathione supplementation may improve oxidative markers, but this does not necessarily translate to the observed clinical improvement of subjects with ASD. The study reports a good safety profile of glutathione use, with stomach upset reported in four out of six subjects. This article discusses the role of the gut microbiome and redox balance in ASD and notes that a high baseline oxidative burden may make some patients poor responders to glutathione supplementation. In conclusion, an imbalance in redox reactions is only one of the many factors contributing to ASD, and further studies are necessary to investigate other factors, such as impaired neurotransmission, immune dysregulation in the brain, and mitochondrial dysfunction. Full article

(This article belongs to the Section Neurosciences)

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7 pages, 1471 KiB

Open AccessCase Report

Primary Orbital Myxoid Liposarcoma

by Miguel Armando Benavides-Huerto, Lourdes Páramo-Figueroa, Daniel Moreno-Páramo and Francisco Alejandro Lagunas-Rangel

Med. Sci. 2023, 11(4), 72; https://doi.org/10.3390/medsci11040072 - 08 Nov 2023

Viewed by 1758

Abstract

Although liposarcoma is the most prevalent soft tissue sarcoma in adults, head and neck liposarcomas are rare and account for less than 5% of all liposarcomas. The primary orbital location is even more exceptional, with fewer than 100 cases documented in the medical [...] Read more.

Although liposarcoma is the most prevalent soft tissue sarcoma in adults, head and neck liposarcomas are rare and account for less than 5% of all liposarcomas. The primary orbital location is even more exceptional, with fewer than 100 cases documented in the medical literature. Given the scarcity of cases of orbital liposarcoma and the limited familiarity of physicians and pathologists with this pathology, there is an increased risk of non-diagnosis or misdiagnosis, which may lead to inappropriate patient management. To address these challenges, we present a case of primary orbital myxoid liposarcoma and subsequently discuss the primary findings of this case based on the evidence documented in the medical literature. This comprehensive text is designed to serve as a valuable resource for healthcare professionals and pathologists, with the goal of promoting both clinical suspicion and accurate diagnosis and treatment of this rare condition in future cases. Full article

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17 pages, 720 KiB

Open AccessSystematic Review

Occupational Therapy Interventions in Patients with Frontotemporal Dementia: A Systematic Review

by Pinelopi Vlotinou, Anna Tsiakiri, Georgia Detsaridou, Alexandrina Nikova, Dimitrios Tsiptsios, Konstantinos Vadikolias and Nikolaos Aggelousis

Med. Sci. 2023, 11(4), 71; https://doi.org/10.3390/medsci11040071 - 06 Nov 2023

Viewed by 2494

Abstract

Frontotemporal dementia (FTD) is a neurodegenerative disorder characterized by progressive impairments in behavior, executive function, and language, primarily affecting individuals under the age of 65. This disorder is associated with expressive and receptive anomia, word comprehension deficits, and behavioral symptoms such as apathy, [...] Read more.

Frontotemporal dementia (FTD) is a neurodegenerative disorder characterized by progressive impairments in behavior, executive function, and language, primarily affecting individuals under the age of 65. This disorder is associated with expressive and receptive anomia, word comprehension deficits, and behavioral symptoms such as apathy, loss of empathy, and disinhibition, all of which closely correlate with functional impairment in daily activities. Despite substantial efforts, research on occupational therapy (OT) interventions has yet to demonstrate clear benefits in managing the disease. The aim of this study is to investigate OT interventions and assess their efficacy, with a specific focus on individuals suffering from FTD. We systematically conducted searches on two databases, namely Medline and Science Direct, spanning a ten-year period from 2003 to 2023, in accordance with the PRISMA guidelines. Eleven studies met the inclusion criteria. OT interventions targeted both patients and caregivers and yielded significant positive improvements in their lives. A key focus of these interventions was to teach acceptable alternatives to the behaviors exhibited by FTD patients, as these behaviors are strongly influenced by the disease itself. OT contributes positively to enhancing the quality of life of FTD patients and alleviating the caregiving burden experienced by those providing long-term care to these patients. Full article

(This article belongs to the Section Neurosciences)

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20 pages, 1387 KiB

Open AccessReview

Alveolar Hyperoxia and Exacerbation of Lung Injury in Critically Ill SARS-CoV-2 Pneumonia

by Ahilanandan Dushianthan, Luke Bracegirdle, Rebecca Cusack, Andrew F. Cumpstey, Anthony D. Postle and Michael P. W. Grocott

Med. Sci. 2023, 11(4), 70; https://doi.org/10.3390/medsci11040070 - 01 Nov 2023

Cited by 2 | Viewed by 2812

Abstract

Acute hypoxic respiratory failure (AHRF) is a prominent feature of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) critical illness. The severity of gas exchange impairment correlates with worse prognosis, and AHRF requiring mechanical ventilation is associated with substantial mortality. Persistent impaired gas exchange [...] Read more.

Acute hypoxic respiratory failure (AHRF) is a prominent feature of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) critical illness. The severity of gas exchange impairment correlates with worse prognosis, and AHRF requiring mechanical ventilation is associated with substantial mortality. Persistent impaired gas exchange leading to hypoxemia often warrants the prolonged administration of a high fraction of inspired oxygen (FiO₂). In SARS-CoV-2 AHRF, systemic vasculopathy with lung microthrombosis and microangiopathy further exacerbates poor gas exchange due to alveolar inflammation and oedema. Capillary congestion with microthrombosis is a common autopsy finding in the lungs of patients who die with coronavirus disease 2019 (COVID-19)-associated acute respiratory distress syndrome. The need for a high FiO₂ to normalise arterial hypoxemia and tissue hypoxia can result in alveolar hyperoxia. This in turn can lead to local alveolar oxidative stress with associated inflammation, alveolar epithelial cell apoptosis, surfactant dysfunction, pulmonary vascular abnormalities, resorption atelectasis, and impairment of innate immunity predisposing to secondary bacterial infections. While oxygen is a life-saving treatment, alveolar hyperoxia may exacerbate pre-existing lung injury. In this review, we provide a summary of oxygen toxicity mechanisms, evaluating the consequences of alveolar hyperoxia in COVID-19 and propose established and potential exploratory treatment pathways to minimise alveolar hyperoxia. Full article

(This article belongs to the Section Critical Care Medicine)

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12 pages, 268 KiB

Open AccessArticle

Major Adverse Cardiac and Cerebrovascular Events in Geriatric Patients with Obstructive Sleep Apnea: An Inpatient Sample Analysis

by Rupak Desai, Sai Priyanka Mellacheruvu, Sai Anusha Akella, Adil Sarvar Mohammed, Pakhal Saketha, Abdul Aziz Mohammed, Mushfequa Hussain, Aamani Bavanasi, Jyotsna Gummadi and Praveena Sunkara

Med. Sci. 2023, 11(4), 69; https://doi.org/10.3390/medsci11040069 - 30 Oct 2023

Viewed by 2063

Abstract

Background: Obstructive sleep apnea (OSA) is associated with an increased risk of major cardiac and cerebrovascular events (MACCE). However, data on the burden and predictors of MACCE in geriatric patients with OSA (G-OSA) remain limited. Methods: Using the National Inpatient Sample from 2018, [...] Read more.

Background: Obstructive sleep apnea (OSA) is associated with an increased risk of major cardiac and cerebrovascular events (MACCE). However, data on the burden and predictors of MACCE in geriatric patients with OSA (G-OSA) remain limited. Methods: Using the National Inpatient Sample from 2018, we identified G-OSA admissions (age ≥ 65 years) and divided them into non-MACCE vs. MACCE (all-cause mortality, stroke, acute myocardial infarction, and cardiac arrest). We compared the demographics and comorbidities in both cohorts and extracted the odds ratio (multivariate analysis) of MACCE and associated in-hospital mortality. Results: Out of 1,141,120 geriatric obstructive sleep apnea G-OSA admissions, 9.9% (113,295) had MACCE. Males, Asians, or the Pacific Islander/Native American race, and patients from the lowest income quartile revealed a higher MACCE rate. Significant clinical predictors of MACCE in elderly OSA patients on multivariable regression analysis in decreasing odds were pulmonary circulation disease (OR 1.47, 95% CI 1.31–1.66), coagulopathy (OR 1.43, 95% CI 1.35–1.50), peripheral vascular disease (OR 1.34, 95% CI 1.28–1.40), prior sudden cardiac arrest (OR 1.34, 95% CI 1.11–1.62), prior myocardial infarction (OR 1.27, 95% CI 1.22–1.33), fluid and electrolyte imbalances (OR 1.25, 95% CI 1.20–1.29), male sex (OR 1.22, 95% CI-1.18–1.26), hyperlipidemia (OR 1.20, 95% CI 1.16–1.24), low household income (OR 1.19, CI 1.13–1.26), renal failure (OR 1.15, 95% CI 1.12–1.19), diabetes (OR 1.14, 95% CI 1.10–1.17), metastatic cancer (OR 1.14, 95% CI 1.03–1.25), and prior stroke or TIA (OR 1.12, 95% CI 1.07–1.17) (All p value < 0.05). Conclusions: This study emphasizes the significant association between obstructive sleep apnea (OSA) and major cardiac and cerebrovascular events (MACCE) in the geriatric population. Among the elderly OSA patients, a substantial 9.9% were found to have MACCE, with specific demographics like males, Asian or Pacific Islander/Native American individuals, and those from the lowest income quartile being particularly vulnerable. The study sheds light on several significant clinical predictors, with pulmonary circulation disease, coagulopathy, and peripheral vascular disease topping the list. The highlighted predictors provide valuable insights for clinicians, allowing for better risk stratification and targeted interventions in this vulnerable patient cohort. Further research is essential to validate these findings and inform how tailored therapeutic approaches for geriatric OSA patients can mitigate MACCE risk. Clinical Implications: Elderly individuals with a high risk for MACCE should undergo routine OSA screening using tools like the sensitive STOP-BANG Questionnaire. Implementing CPAP treatment can enhance cardiovascular outcomes in these patients. Full article

(This article belongs to the Section Cardiovascular Disease)

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13 pages, 1475 KiB

Open AccessArticle

Epidemiological Profile of Ophir Loyola Cancer Hospital: A Snapshot of the Incidence of Solid Neoplasms in the Eastern Amazon

by Juliana Ramos Chaves, Mateus Itiro Tamazawskas Otake, Diego Di Felipe Ávila Alcantara, Rosilene Silva Lima, Ana Paula Borges de Souza, Janaina Silva da Costa Rodrigues, Margareth Maria Braun Guimarães Imbiriba and Rommel Mario Rodriguez Burbano

Med. Sci. 2023, 11(4), 68; https://doi.org/10.3390/medsci11040068 - 27 Oct 2023

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Abstract

Background: Solid neoplasms have a heterogeneous incidence worldwide and in Brazil. Thus, the region delimited by the Legal Amazon has a distinct epidemiological profile. In Pará, Ophir Loyola Cancer Hospital(OLCH) accounts for 71.11% of hospital visits in the state. Methods: This was an [...] Read more.

Background: Solid neoplasms have a heterogeneous incidence worldwide and in Brazil. Thus, the region delimited by the Legal Amazon has a distinct epidemiological profile. In Pará, Ophir Loyola Cancer Hospital(OLCH) accounts for 71.11% of hospital visits in the state. Methods: This was an ecological, exploratory, and mixed descriptive studythat investigated the epidemiological profile of patients with cancer treated at OLCH from January to December 2020. Sociodemographic data at admission were the primary variables, which were analyzed according to spatial distribution. Results: In this study, the data of 2952 patients were analyzed, with the majority being between the ages of 50 and 79 years (62.47%), female (59.49%), and diagnosed but without previous treatment (87.30%). The most common cancers were breast (16.50%), cervical (13.40%), stomach (8.98%), and prostate (7.72%). Of the 12 integration regions, Guajará had the highest number of referrals (49.86%), followed by Guamá (12.94%) and Caeté River (8.98%). Conclusion: The profile of care at OLCH showed a high incidence of solid malignancies compared to that in other regions of Brazil, indicating environmental and sociocultural influences on the carcinogenic profile present in the eastern Amazon. Full article

(This article belongs to the Section Cancer and Cancer-Related Research)

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9 pages, 1089 KiB

Open AccessCase Report

Bone Marrow Aplasia after CAR-T-Cell Therapy for Relapsed/Refractory Burkitt’s Lymphoma

by Troy J. Kenkel, Nithya Sridhar, Lindsay R. Hammons, Maria Hintzke and Nirav N. Shah

Med. Sci. 2023, 11(4), 67; https://doi.org/10.3390/medsci11040067 - 12 Oct 2023

Cited by 1 | Viewed by 2076

Abstract

Chimeric antigen receptor T-cells (CAR-T) are now a standard approach for treating relapsed/refractory B-cell lymphomas. Immune effector cell-associated hemophagocytic lymphohistiocytosis-like syndrome (IEC-HS) is a newly described entity that can manifest following CAR-T. Bone marrow (BM) aplasia is an uncommon manifestation of IEC-HS reported [...] Read more.

Chimeric antigen receptor T-cells (CAR-T) are now a standard approach for treating relapsed/refractory B-cell lymphomas. Immune effector cell-associated hemophagocytic lymphohistiocytosis-like syndrome (IEC-HS) is a newly described entity that can manifest following CAR-T. Bone marrow (BM) aplasia is an uncommon manifestation of IEC-HS reported after CAR-T-cell therapy and is defined as the reduction or absence of hematopoietic progenitor cells resulting in severe pancytopenia. We describe the case of a 44-year-old female with relapsed/refractory Burkitt lymphoma (BL) who received treatment with lisocabtagene maraleucel with her post-CAR-T course complicated by cytokine release syndrome (CRS) and IEC-HS ultimately leading to persistent BM aplasia. She underwent a rescue allogeneic stem cell transplant but ultimately succumbed to progressive disease. IEC-HS is an increasingly recognized complication that occurs after CAR-T treatments that can result in aplasia, a dangerous complication with serious sequelae including infection, transfusion dependence, and high risk for hemorrhage. The underlying mechanism is poorly understood, and further studies are needed to understand how to treat it better. Full article

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15 pages, 1043 KiB

Open AccessArticle

Association of Maternal Risk Factors with the Prevalence of Caesarean Section Deliveries: A Cross-Sectional Study

by Eleni Pavlidou, Georgios Antasouras, Sousana K. Papadopoulou, Olga Alexatou, Dimitrios Papandreou, Maria Mentzelou, Gerasimos Tsourouflis, Aikaterini Louka, Nikolaos E. Rodopaios, Maria Chrysafi, Anastasia Sampani and Constantinos Giaginis

Med. Sci. 2023, 11(4), 66; https://doi.org/10.3390/medsci11040066 - 09 Oct 2023

Cited by 1 | Viewed by 1995

Abstract

In the last few years, there has been a gradually increasing rate of caesarean section deliveries worldwide that negatively affects both mothers’ and children’s health. The present survey intended to explore the relations of common maternal risk factors with the prevalence of caesarean [...] Read more.

In the last few years, there has been a gradually increasing rate of caesarean section deliveries worldwide that negatively affects both mothers’ and children’s health. The present survey intended to explore the relations of common maternal risk factors with the prevalence of caesarean sections. This is a cross-sectional study including 5182 healthy mothers from geographically diverse regions of Greece, which has applied relevant inclusion and exclusion criteria. An elevated 56.4% incidence of caesarean sections was noted. The prevalence of caesarean section deliveries was estimated to be 51.5% in private hospitals and 48.5% in public hospitals. Maternal age, pre-pregnancy overweight/obesity, excess gestational weight gain, preterm birth, financial status, smoking habits, and private type of birth hospital were considerably associated with a high probability of caesarean section, regardless of several confounders. In conclusion, caesarean section rates are constantly increasing, and various maternal risk factors additively elevate its incidence, which additionally enhances the likelihood of postpartum complications for both the mothers and their infants. Public health procedures and approaches are strongly recommended to notify future mothers of the potential risk factors that may result in adverse pregnancy outcomes of caesarean section delivery, highlighting its use only for emergency medical reasons and also promoting healthier nutritional and lifestyle habits that may reduce the increasing prevalence of caesarean section deliveries. Full article

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11 pages, 448 KiB

Open AccessArticle

The Association of Toxoplasma gondii with the Combination of Cardiovascular Disease, Chronic Kidney Disease, or Chronic Liver Disease: A Preliminary Study

by Amani Babekir, Sayed Mostafa and Emmanuel Obeng-Gyasi

Med. Sci. 2023, 11(4), 65; https://doi.org/10.3390/medsci11040065 - 03 Oct 2023

Viewed by 1674

Abstract

Toxoplasma gondii is a protozoan parasite widespread worldwide, with over 40 million individuals in the United States. It may infect vital organs such as the heart, kidneys, and liver, resulting in chronic infections. The main objective of this study is to investigate the [...] Read more.

Toxoplasma gondii is a protozoan parasite widespread worldwide, with over 40 million individuals in the United States. It may infect vital organs such as the heart, kidneys, and liver, resulting in chronic infections. The main objective of this study is to investigate the association of Toxoplasma infection with the combination of cardiovascular disease, chronic kidney disease (CKD), or chronic liver disease (CLD). The National Health and Nutrition Examination Survey (NHANES 2009–2010) data were used, and the association of infection with chronic disease was assessed with biomarkers and indexes using statistical modeling. The percentage of participants with a combination of CLD and CKD was higher among Toxoplasma positive participants compared to the negative participants (2.76 vs. 1.26). Furthermore, exposure to T. gondii may increase the odds of cardiovascular disease, CKD, or CLD, or vice versa. Full article

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19 pages, 859 KiB

Open AccessReview

May Nutritional Status Positively Affect Disease Progression and Prognosis in Patients with Esophageal and Pharyngeal Cancers? A Scoping Review of the Current Clinical Studies

by Georgios Antasouras, Sousana K. Papadopoulou, Maria Tolia, Aimilia-Lynn Pandi, Maria Spanoudaki, Nikolaos Tsoukalas, Gerasimos Tsourouflis, Evmorfia Psara, Maria Mentzelou and Constantinos Giaginis

Med. Sci. 2023, 11(4), 64; https://doi.org/10.3390/medsci11040064 - 02 Oct 2023

Viewed by 1648

Abstract

Background: Malnutrition in esophageal and pharyngeal cancer patients constitutes a common and serious concern, which significantly reduces patients’ prognoses. Cancers of the esophagus and the pharynx can considerably impair feeding in patients, resulting in severe undernutrition. This is a scoping review that intends [...] Read more.

Background: Malnutrition in esophageal and pharyngeal cancer patients constitutes a common and serious concern, which significantly reduces patients’ prognoses. Cancers of the esophagus and the pharynx can considerably impair feeding in patients, resulting in severe undernutrition. This is a scoping review that intends to critically analyze the most well-designed clinical studies investigating the potential beneficial impact of diverse nutritional assessment tools on the prognosis of patients with esophageal and pharyngeal cancers. Methods: The most accurate and remarkable scientific databases were comprehensively explored utilizing relative keywords to detect clinical studies that investigate whether nutritional status may affect disease prognosis. Results: Several assessment tools have evaluated and highlighted the potential beneficial impact of nutritional status on disease progression and patients’ prognosis in both esophageal and pharyngeal cancers. Regarding esophageal cancer, CONUT, PNI, PG-SGA, and NRS-2002 are more commonly used, while albumin is also frequently evaluated. Regarding pharyngeal cancers, fewer studies are currently available. PNI has been evaluated, and its significance as a factor for shorter survival’ times has been highlighted. The Comprehensive Nutritional Index has also been evaluated with positive results, as well as NRS 2002, GPS, and body-weight status. However, there is currently a lack of studies with an adequate number of women with cancer. An international literature gap was identified concerning follow-up studies with adequate methodology. Conclusions: Nutritional status may significantly affect disease progression and patients’ survival, highlighting the significance of a great nutritional status in individuals with esophageal and pharyngeal cancers. Further large-scale and well-designed prospective surveys should be performed to verify the potential beneficial effects of adequate nourishment in people suffering from cancer of the esophagus and pharynx. Full article

(This article belongs to the Section Cancer and Cancer-Related Research)

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19 pages, 634 KiB

Open AccessArticle

Exploring the Impact of Silicosis Incidence on Tuberculosis Mortality and Morbidity: A Multi-Country Study

by Muayad Albadrani

Med. Sci. 2023, 11(4), 63; https://doi.org/10.3390/medsci11040063 - 01 Oct 2023

Viewed by 1479

Abstract

Introduction: There are several risk factors attributed to tuberculosis (TB) mortality and morbidity. There are few studies and systematic reviews showing the association of silicosis and tuberculosis at a country level. Very limited studies have been conducted using multi-country data in studying the [...] Read more.

Introduction: There are several risk factors attributed to tuberculosis (TB) mortality and morbidity. There are few studies and systematic reviews showing the association of silicosis and tuberculosis at a country level. Very limited studies have been conducted using multi-country data in studying the association of incidence of silicosis with TB mortality and morbidity. Hence, the aim of this research was to explore the association of incidence of silicosis and other important risk factors with TB mortality and morbidity using multi-country data. Methods: Data from 217 WHO region countries were utilized, sourcing TB-related statistics from the Institute of Health Metrics and Evaluation and additional risk factors from the Demographic and Health Survey, Global Burden of Disease, and World Bank for 2019. Regression analysis was conducted to examine the association between silicosis incidence and TB outcomes. Results: The study found an average silicosis incidence of 121.92 per 100,000 population. Additionally, 62.69% of the sample population are exposed to air pollution from solid fuel cooking. Sanitation access stands at an average of 59.67%. Regression outcomes indicate that while alcohol consumption’s influence on TB is not statistically significant, a unit increase in silicosis incidence significantly elevates TB deaths (235.9, p = 0.005), YLL (9399.3, p = 0.011), and YLD (910.8, p = 0.002). Conclusion: The burden of silicosis is found to be one of the important determinants of deaths, YLL, and YLD due to tuberculosis. Country-specific strategies to prevent and control silicosis is a need of the hour. Full article

(This article belongs to the Section Pneumology and Respiratory Diseases)

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Med. Sci., Volume 11, Issue 4 (December 2023) – 15 articles

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