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Diseases, Volume 11, Issue 1 (March 2023) – 52 articles

Cover Story (view full-size image): Hantaan virus and relatives were long thought to constitute a homogenous group of rodent-infecting trisegmented negative-sense RNA viruses. Recent metagenomic studies revealed the considerable diversity of these viruses not only in rodents, but also in bats, eulipotyphlans, fish, and reptiles (silhouettes), necessitating the creation of a family, Hantaviridae, including multiple genera (italicized terms). Only orthohantaviruses are known to cause human diseases, i.e., hemorrhagic fever with renal syndrome (HFRS) and hantavirus pulmonary syndrome (HPS). Background: electron-microscopic images of orthohantavirus particles produced during Hantaan virus and Sin Nombre virus infections. View this paper
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12 pages, 4875 KiB  
Article
The Association of Combined Per- and Polyfluoroalkyl Substances and Metals with Allostatic Load Using Bayesian Kernel Machine Regression
by Tahir Bashir and Emmanuel Obeng-Gyasi
Diseases 2023, 11(1), 52; https://doi.org/10.3390/diseases11010052 - 22 Mar 2023
Cited by 1 | Viewed by 2091
Abstract
Background/Objective: This study aimed to investigate the effect of exposure to per- and polyfluoroalkyl substances (PFAS), a class of organic compounds utilized in commercial and industrial applications, on allostatic load (AL), a measure of chronic stress. PFAS, such as perfluorodecanoic acid (PFDE), perfluorononanoic [...] Read more.
Background/Objective: This study aimed to investigate the effect of exposure to per- and polyfluoroalkyl substances (PFAS), a class of organic compounds utilized in commercial and industrial applications, on allostatic load (AL), a measure of chronic stress. PFAS, such as perfluorodecanoic acid (PFDE), perfluorononanoic acid (PFNA), perfluorooctane sulfonic acid (PFOS), perfluoroundecanoic acid (PFUA), perfluorooctanoic acid (PFOA), and perfluorohexane sulfonic acid (PFHS), and metals, such as mercury (Hg), barium (Ba), cadmium (Cd), cobalt (Co), cesium (Cs), molybdenum (Mo), lead (Pb), antimony (Sb), thallium (TI), tungsten (W), and uranium (U) were investigated. This research was performed to explore the effects of combined exposure to PFAS and metals on AL, which may be a disease mediator. Methods: Data from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2014 were used to conduct this study on persons aged 20 years and older. A cumulative index of 10 biomarkers from the cardiovascular, inflammatory, and metabolic systems was used to calculate AL out of 10. If the overall index was ≥ 3, an individual was considered to be chronically stressed (in a state of AL). In order to assess the dose-response connections between mixtures and outcomes and to limit the effects of multicollinearity and other potential interaction effects between exposures, Bayesian kernel machine regression (BKMR) was used. Results: The most significant positive trend between mixed PFAS and metal exposure and AL was revealed by combined exposure to cesium, molybdenum, PFHS, PFNA, and mercury (posterior inclusion probabilities, PIP = 1, 1, 0.854, 0.824, and 0.807, respectively). Conclusions: Combined exposure to metals and PFAS increases the likelihood of being in a state of AL. Full article
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16 pages, 1196 KiB  
Systematic Review
Neutrophil to Lymphocyte Ratio as a Predictor of Postoperative Outcomes in Traumatic Brain Injury: A Systematic Review and Meta-Analysis
by Andrew Nguyen, Alexander Nguyen, Timothy I. Hsu, Harrison D. Lew, Nithin Gupta, Brandon Nguyen, Akhil Mandavalli, Michael J. Diaz and Brandon Lucke-Wold
Diseases 2023, 11(1), 51; https://doi.org/10.3390/diseases11010051 - 15 Mar 2023
Cited by 1 | Viewed by 2029
Abstract
(1) Introduction: Traumatic brain injury (TBI) is a leading cause of injury and mortality worldwide, carrying an estimated cost of $38 billion in the United States alone. Neutrophil to lymphocyte ratio (NLR) has been investigated as a standardized biomarker that can be used [...] Read more.
(1) Introduction: Traumatic brain injury (TBI) is a leading cause of injury and mortality worldwide, carrying an estimated cost of $38 billion in the United States alone. Neutrophil to lymphocyte ratio (NLR) has been investigated as a standardized biomarker that can be used to predict outcomes of TBI. The aim of this review was to determine the prognostic utility of NLR among patients admitted for TBI. (2) Methods: A literature search was conducted in PubMed, Scopus, and Web of Science in November 2022 to retrieve articles regarding the use of neutrophil to lymphocyte ratio (NLR) as a prognostic measure in traumatic brain injury (TBI) patients. Inclusion criteria included studies reporting outcomes of TBI patients with associated NLR values. Exclusion criteria were studies reporting only non-primary data, those insufficiently disaggregated to extract NLR data, and non-English or cadaveric studies. The Newcastle-Ottawa Scale was utilized to assess for the presence of bias in included studies. (3) Results: Following the final study selection 19 articles were included for quantitative and qualitative analysis. The average age was 46.25 years. Of the 7750 patients, 73% were male. Average GCS at presentation was 10.51. There was no significant difference in the NLR between surgical vs. non-surgical cohorts (SMD 2.41 95% CI −1.82 to 6.63, p = 0.264). There was no significant difference in the NLR between bleeding vs. non-bleeding cohorts (SMD 4.84 95% CI −0.26 to 9.93, p = 0.0627). There was a significant increase in the NLR between favorable vs. non-favorable cohorts (SMD 1.31 95% CI 0.33 to 2.29, p = 0.0090). (4) Conclusions: Our study found that NLR was only significantly predictive for adverse outcomes in TBI patients and not surgical treatment or intracranial hemorrhage, making it nonetheless an affordable alternative for physicians to assess patient prognosis. Full article
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12 pages, 996 KiB  
Article
The Possible Effect of the Long-Term Use of Glucagon-like Peptide-1 Receptor Agonists (GLP-1RA) on Hba1c and Lipid Profile in Type 2 Diabetes Mellitus: A Retrospective Study in KAUH, Jeddah, Saudi Arabia
by Ghada M. A. Ajabnoor, Kamal Talat Hashim, Mohammed Meshari Alzahrani, Abdullah Zeid Alsuheili, Abdullah Fahad Alharbi, Amani Matook Alhozali, Sumia Enani, Basmah Eldakhakhny and Ayman Elsamanoudy
Diseases 2023, 11(1), 50; https://doi.org/10.3390/diseases11010050 - 14 Mar 2023
Cited by 1 | Viewed by 3707
Abstract
(1) Background: Type 2 diabetes (T2DM) is a chronic metabolic disease with serious health complications. T2DM is associated with many chronic illnesses, including kidney failure, cardiovascular diseases (CVD), vision loss, and other related diseases. Obesity is one of the major factors associated with [...] Read more.
(1) Background: Type 2 diabetes (T2DM) is a chronic metabolic disease with serious health complications. T2DM is associated with many chronic illnesses, including kidney failure, cardiovascular diseases (CVD), vision loss, and other related diseases. Obesity is one of the major factors associated with insulin resistance and dyslipidemia. Recently, the development of GLP-1 Receptor agonist (GLP-1RA) showed great therapeutic potential for T2DM. Aim: To retrospectively investigate the association of the long-term use of GLP-1RA therapy in T2DM patients with HbA1c levels and dyslipidemia. (2) Methods: Retrospective data collection and analysis of demographic, clinical records, and biochemical parameters were carried out for 72 T2DM taking GLP-1RA treatments for six months. (3) Results: A total of 72 T2DM patients with a mean age = 55 (28 male and 44 female) were divided into two groups. Group 1 received statins (n = 63), and group 2 did not receive statins (n = 9). The GLP-1RA effect on BMI was significantly decreased in group 1 (p < 0.01). A significant effect was observed for HbA1c in both groups for six months of treatment duration (p < 0.05). The AST levels significantly decreased in group 2 from 25.2 to 19.4 U\L (p = 0.011). (4) Conclusions: GLP-1RA treatments were associated with weight reduction and improved glycemic control for T2DM patients. Moreover, it is suggested that it has anti-inflammatory and hepatoprotective effects. However, no direct association was found with the lipid profile in all groups of T2DM. Full article
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10 pages, 1548 KiB  
Article
Ivermectin Augments the Anti-Cancer Activity of Pitavastatin in Ovarian Cancer Cells
by Mohammed Jasim Jawad and Alan Richardson
Diseases 2023, 11(1), 49; https://doi.org/10.3390/diseases11010049 - 14 Mar 2023
Cited by 2 | Viewed by 5365
Abstract
We have previously shown that pitavastatin has the potential to be used to treat ovarian cancer, although relatively high doses are likely to be necessary. One solution to this problem is to identify drugs that are synergistic with pitavastatin, thereby reducing the dose [...] Read more.
We have previously shown that pitavastatin has the potential to be used to treat ovarian cancer, although relatively high doses are likely to be necessary. One solution to this problem is to identify drugs that are synergistic with pitavastatin, thereby reducing the dose that is necessary to have a therapeutic effect. Here, we tested combinations of pitavastatin with the anti-parasitic drug ivermectin in six ovarian cancer cell lines. When tested on its own, ivermectin inhibited the growth of the cells but only with modest potency (IC50 = 10–20 µM). When the drugs were combined and assessed in cell growth assays, ivermectin showed synergy with pitavastatin in 3 cell lines and this was most evident in COV-318 cells (combination index ~ 0.6). Ivermectin potentiated the reduction in COV-318 cell viability caused by pitavastatin by 20–25% as well as potentiating apoptosis induced by pitavastatin, assessed by activation of caspase-3/7 (2–4 fold) and annexin-labelling (3–5 fold). These data suggest that ivermectin may be useful in the treatment of ovarian cancer when combined with pitavastatin, but methods to achieve an adequate ivermectin concentration in tumour tissue will be necessary. Full article
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13 pages, 1497 KiB  
Article
Promising Antimicrobial Action of Sustained Released Curcumin-Loaded Silica Nanoparticles against Clinically Isolated Porphyromonas gingivalis
by Adileh Shirmohammadi, Solmaz Maleki Dizaj, Simin Sharifi, Shirin Fattahi, Ramin Negahdari, Mohammad Ali Ghavimi and Mohammad Yousef Memar
Diseases 2023, 11(1), 48; https://doi.org/10.3390/diseases11010048 - 08 Mar 2023
Cited by 3 | Viewed by 1421
Abstract
Background. Porphyromonas gingivalis (P. gingivalis) has always been one of the leading causes of periodontal disease, and antibiotics are commonly used to control it. Numerous side effects of synthetic drugs, as well as the spread of drug resistance, have led to a [...] Read more.
Background. Porphyromonas gingivalis (P. gingivalis) has always been one of the leading causes of periodontal disease, and antibiotics are commonly used to control it. Numerous side effects of synthetic drugs, as well as the spread of drug resistance, have led to a tendency toward using natural antimicrobials, such as curcumin. The present study aimed to prepare and physicochemically characterize curcumin-loaded silica nanoparticles and to detect their antimicrobial effects on P. gingivalis. Methods. Curcumin-loaded silica nanoparticles were prepared using the chemical precipitation method and then were characterized using conventional methods (properties such as the particle size, drug loading percentage, and release pattern). P. gingivalis was isolated from one patient with chronic periodontal diseases. The patient’s gingival crevice fluid was sampled using sterile filter paper and was transferred to the microbiology laboratory in less than 30 min. The disk diffusion method was used to determine the sensitivity of clinically isolated P. gingivalis to curcumin-loaded silica nanoparticles. SPSS software, version 20, was used to compare the data between groups with a p value of <0.05 as the level of significance. Then, one-way ANOVA testing was utilized to compare the groups. Results. The curcumin-loaded silica nanoparticles showed a nanometric size and a drug loading percentage of 68% for curcumin. The nanoparticles had a mesoporous structure and rod-shaped morphology. They showed a relatively rapid release pattern in the first 5 days. The release of the drug from the nanoparticles continued slowly until the 45th day. The results of in vitro antimicrobial tests showed that P. gingivalis was sensitive to the curcumin-loaded silica nanoparticles at concentrations of 50, 25, 12.5, and 6.25 µg/mL. One-way ANOVA showed that there was a significant difference between the mean growth inhibition zone, and the concentration of 50 µg/mL showed the highest inhibition zone (p ≤ 0.05). Conclusion. Based on the obtained results, it can be concluded that the local nanocurcumin application for periodontal disease and implant-related infections can be considered a promising method for the near future in dentistry. Full article
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15 pages, 300 KiB  
Article
Three Perspectives on the Experience of Support for Family Caregivers in First Nations Communities
by Amber Ward, Laurie Buffalo, Colleen McDonald, Tanya L’Heureux, Lesley Charles, Cheryl Pollard, Peter G Tian, Sharon Anderson and Jasneet Parmar
Diseases 2023, 11(1), 47; https://doi.org/10.3390/diseases11010047 - 08 Mar 2023
Cited by 2 | Viewed by 1927
Abstract
There is a dearth of research on how family caregivers are supported in First Nations. We interviewed family caregivers, health and community providers, and leaders in two Alberta First Nations Communities about their experiences of care and support for the family caregivers in [...] Read more.
There is a dearth of research on how family caregivers are supported in First Nations. We interviewed family caregivers, health and community providers, and leaders in two Alberta First Nations Communities about their experiences of care and support for the family caregivers in their communities. We employed a qualitative, collaborative participatory action research methodology. We drew on Etuaptmumk, the Mi’kmaw understanding of being in the world is the gift of multiple perspectives. Participants in this research included family caregivers (n = 6), health and community providers (n = 14), and healthcare and community leaders (n = 6). The overarching caregiving theme is the “Hierarchy of challenge”. Six themes capture the challenges faced by family caregivers: (one) “Caregiving is a demanding job”: yet “No one in a sense is taking care of them”; (two) difficult navigation: “I am unable to access that”; (three) delayed assessments and treatment “And I don’t know how they’re being missed”; (four) disconnected health records: “It’s kind of on you to follow up”; (five) racism, “It’s treated differently”; and, (six) social determinants of health, “A lot of these factors have been developing for the longest time”. This study provides evidence that family caregivers’ need to care for and to maintain their own wellbeing is not top of mind in policy or programs in these First Nations communities. As we advocate for support for Canadian family caregivers, we need to ensure that Indigenous family caregivers are also recognized in policy and programs. Full article
12 pages, 642 KiB  
Article
Bayesian Spatial Modelling of HIV Prevalence in Jimma Zone, Ethiopia
by Legesse Kassa Debusho and Nemso Geda Bedaso
Diseases 2023, 11(1), 46; https://doi.org/10.3390/diseases11010046 - 08 Mar 2023
Cited by 1 | Viewed by 1281
Abstract
Background: Although the human immunodeficiency virus (HIV) is spatially heterogeneous in Ethiopia, current regional estimates of HIV prevalence hide the epidemic’s heterogeneity. A thorough examination of the prevalence of HIV infection using district-level data could assist to develop HIV prevention strategies. The [...] Read more.
Background: Although the human immunodeficiency virus (HIV) is spatially heterogeneous in Ethiopia, current regional estimates of HIV prevalence hide the epidemic’s heterogeneity. A thorough examination of the prevalence of HIV infection using district-level data could assist to develop HIV prevention strategies. The aims of this study were to examine the spatial clustering of HIV prevalence in Jimma Zone at district level and assess the effects of patient characteristics on the prevalence of HIV infection. Methods: The 8440 files of patients who underwent HIV testing in the 22 Districts of Jimma Zone between September 2018 and August 2019 were the source of data for this study. The global Moran’s index, Getis–Ord Gi* local statistic, and Bayesian hierarchical spatial modelling approach were applied to address the research objectives. Results: Positive spatial autocorrelation was observed in the districts and the local indicators of spatial analysis using the Getis–Ord statistic also identified three districts, namely Agaro, Gomma and Nono Benja, as hotspots, and two districts, namely Mancho and Omo Beyam, as coldspots with 95% and 90% confidence levels, respectively, for HIV prevalence. The results also showed eight patient-related characteristics that were considered in the study were associated with HIV prevalence in the study area. Furthermore, after accounting for these characteristics in the fitted model, there was no spatial clustering of HIV prevalence suggesting the patient characteristics had explained most of the heterogeneity in HIV prevalence in Jimma Zone for the study data. Conclusions: The identification of hotspot districts and the spatial dynamic of HIV infection in Jimma Zone at district level may allow health policymakers in the zone or Oromiya region or at national level to develop geographically specific strategies to prevent HIV transmission. Because clinic register data were used in the study, it is important to use caution when interpreting the results. The results are restricted to Jimma Zone districts and may not be generalizable to Ethiopia or the Oromiya region. Full article
(This article belongs to the Special Issue Infectious Disease Epidemiology II)
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11 pages, 310 KiB  
Review
Acute Traumatic Pain in the Emergency Department
by Christian Zanza, Tatsiana Romenskaya, Marta Zuliani, Fabio Piccolella, Maria Bottinelli, Giorgia Caputo, Eduardo Rocca, Antonio Maconi, Gabriele Savioli and Yaroslava Longhitano
Diseases 2023, 11(1), 45; https://doi.org/10.3390/diseases11010045 - 03 Mar 2023
Cited by 5 | Viewed by 3189
Abstract
Trauma is a major cause of mortality throughout the world. Traumatic pain—acute, sudden, or chronic—is defined as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage”. Patients’ perceptions of pain assessment and management have become an important criterion and [...] Read more.
Trauma is a major cause of mortality throughout the world. Traumatic pain—acute, sudden, or chronic—is defined as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage”. Patients’ perceptions of pain assessment and management have become an important criterion and relevant outcome measure for healthcare institutions. Several studies show that 60–70% of ER patients experience pain, and more than half of them express a feeling of sorrow, which can be moderate or severe, at triage. The few studies that have analyzed how pain is assessed and managed in these departments agree that approximately 70% of patients receive no analgesia or receive it with remarkable delay. Specifically, less than half of the patients receive treatment for pain during admission and 60% of discharged patients have higher intensity pain than at admission. Trauma patients are also the ones who most commonly report low satisfaction with pain management. Associated with this lack of satisfaction, we can describe the poor use of tools for measuring and recording pain, poor communication among caregivers, inadequate training in pain assessment and management, and widespread misconceptions among nurses about the reliability of patients’ estimation of pain. The aim of this article is to review the scientific literature to explore the methodologies of pain management in trauma patients attending the emergency room and analyzing their weaknesses as a starting point to improve the approach to this, unfortunately too often, underestimated issue. A literature search was performed using the major databases to identify relevant studies in indexed scientific journals. The literature showed that the multimodal approach in trauma patients is the best approach to pain management. It is becoming increasingly crucial to manage the patient on multiple fronts. Drugs acting on different pathways can be administered together at lower doses, minimizing risks. Every emergency department must have staff trained in the assessment and immediate management of pain symptoms as this allows the reduction of mortality and morbidity and shortens hospital stays, contributing to early mobilization, reduced hospital costs, and enhanced patient satisfaction and quality of life. Full article
6 pages, 509 KiB  
Brief Report
Laparoscopic Surgery with Concomitant Hernia Repair and Cholecystectomy: An Alternative Approach to Everyday Practice
by Paul Zarogoulidis, Aris Ioannidis, Marios Anemoulis, Dimitrios Giannakidis, Dimitris Matthaios, Konstantinos Romanidis, Konstantinos Sapalidis, Lavrentios Papalavrentios and Isaak Kesisoglou
Diseases 2023, 11(1), 44; https://doi.org/10.3390/diseases11010044 - 03 Mar 2023
Viewed by 3080
Abstract
Introduction: Concomitant surgeries have been performed previously in several centers with experience in laparoscopic surgeries. These surgeries are performed in one patient under one operation with anesthesia. Methods: We performed a retrospective unicenter study from October 2021 to December 2021 analyzing patients who [...] Read more.
Introduction: Concomitant surgeries have been performed previously in several centers with experience in laparoscopic surgeries. These surgeries are performed in one patient under one operation with anesthesia. Methods: We performed a retrospective unicenter study from October 2021 to December 2021 analyzing patients who underwent laparoscopic hiatal hernia repair with cholecystectomy. We extracted data from 20 patients who underwent hiatal hernia repair together with cholecystectomy. Grouping of data by hiatal hernia type showed 6 type IV hernias (complex hernia), 13 type III hernias (mixed type) and 1 type I hernia (sliding hernia). Out of the 20 cases analyzed, 19 were patients suffering from chronic cholecystitis and 1 patient presented with acute cholecystitis. The average operating time was 179 min. Minimum blood loss was achieved. Cruroraphy was performed in all cases, mesh reinforcement was added in five cases, and fundoplication was performed in all cases, with 3 Toupet, 2 Dor and 15 floppy Nissen fundoplication procedures performed. Fundopexy was routinely performed in cases of Toupet fundoplication. A total of 1 bipolar and 19 retrograde cholecystectomies were performed. Results: All patients had favorable postoperative hospitalization. Patient follow-up took place at 1 month, 3 months and 6 months, with no sign of recurrence of hiatal hernia (anatomical or symptomatic) and no symptoms of postcholecystectomy syndrome. In two patients, we had to perform colostomy. Conclusion: Concomitant laparoscopic hiatal hernia repair and cholecystectomy is safe and feasible. Full article
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10 pages, 638 KiB  
Article
Lipoprotein(a) and Its Autoantibodies in Association with Calcific Aortic Valve Stenosis
by Anna L. Burdeynaya, Olga I. Afanasieva, Marat V. Ezhov, Elena A. Klesareva, Marina A. Saidova and Sergey N. Pokrovsky
Diseases 2023, 11(1), 43; https://doi.org/10.3390/diseases11010043 - 03 Mar 2023
Viewed by 1193
Abstract
Aortic valve stenosis is the most common valvular heart disease in the Western world. Lipoprotein(a) (Lp(a)) is an independent risk factor of coronary heart disease (CHD) and calcific aortic valve stenosis (CAVS). The aim of this study was to assess the role of [...] Read more.
Aortic valve stenosis is the most common valvular heart disease in the Western world. Lipoprotein(a) (Lp(a)) is an independent risk factor of coronary heart disease (CHD) and calcific aortic valve stenosis (CAVS). The aim of this study was to assess the role of Lp(a) and its autoantibodies [autoAbs] in CAVS in patients with and without CHD. We included 250 patients (mean age 69 ± 3 years, males 42%) and divided them into three groups. There were two groups of patients with CAVS depending on the presence (group 1) or absence of CHD (group 2). The control group included the patients without CHD or CAVS. According to logistic regression analysis, levels of Lp(a), IgM autoAbs to oxidized Lp(a) (oxLp(a)), and age were independent predictors of CAVS. A concomitant increase in Lp(a) level (≥30 mg/dL) and a decrease in IgM autoAbs concentration (<9.9 lab. Units) are associated with CAVS with an odds ratio (OR) of 6.4, p < 0.01, and with CAVS and CHD with an OR of 17.3, p < 0.001. IgM autoantibodies to oxLp(a) are associated with calcific aortic valve stenosis regardless of Lp(a) concentration and other risk factors. Higher Lp(a) and lower IgM autoantibodies to oxLp(a) levels are associated with a much higher risk of calcific aortic valve stenosis. Full article
(This article belongs to the Section Cardiology)
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16 pages, 1716 KiB  
Review
Primary Bone Lymphoma: A Review of the Literature with Emphasis on Histopathology and Histogenesis
by Theofilos Kanavos, Effrosyni Birbas, Alexandra Papoudou-Bai, Eleftheria Hatzimichael, Aikaterini Kitsouli, Georgia Karpathiou and Panagiotis Kanavaros
Diseases 2023, 11(1), 42; https://doi.org/10.3390/diseases11010042 - 02 Mar 2023
Cited by 1 | Viewed by 4032
Abstract
Primary bone lymphoma (PBL) is a rare neoplasm of malignant lymphoid cells presenting with one or more bone lesions without nodal or other extranodal involvement. It accounts for approximately 1% of all lymphomas and 7% of malignant primary bone tumors. Diffuse large B-cell [...] Read more.
Primary bone lymphoma (PBL) is a rare neoplasm of malignant lymphoid cells presenting with one or more bone lesions without nodal or other extranodal involvement. It accounts for approximately 1% of all lymphomas and 7% of malignant primary bone tumors. Diffuse large B-cell lymphoma (DLBCL), not otherwise specified (NOS) represents the predominant histological type and constitutes over 80% of all cases. PBL may occur at all ages with a typical diagnosis age of 45–60 years and a slight male predominance. Local bone pain, soft tissue edema, palpable mass and pathological fracture are the most common clinical features. Diagnosis of the disease, which is frequently delayed due to its non-specific clinical presentation, is based on the combination of clinical examination and imaging studies and confirmed by combined histopathological and immunohistochemical examination. PBL can develop in any part of the skeleton, although it occurs most commonly in the femur, humerus, tibia, spine and pelvis. The imaging appearance of PBL is highly variable and unspecific. In terms of the cell-of-origin, most cases of primary bone DLBCL (PB-DLBCL), NOS belong to the germinal center B-cell-like subtype and specifically originate from germinal center centrocytes. PB-DLBCL, NOS has been considered a distinct clinical entity based on its particular prognosis, histogenesis, gene expression and mutational profile and miRNA signature. PBL carries a favorable prognosis, especially when treated with combined chemoradiotherapy. Full article
(This article belongs to the Section Oncology)
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18 pages, 1283 KiB  
Review
Effectiveness of mHealth Interventions in Medication Adherence among Patients with Cardiovascular Diseases: A Systematic Review
by Muhammad Arshed, Aidalina Binti Mahmud, Halimatus Sakdiah Minhat, Lim Poh Ying and Muhammad Farooq Umer
Diseases 2023, 11(1), 41; https://doi.org/10.3390/diseases11010041 - 01 Mar 2023
Cited by 3 | Viewed by 2360
Abstract
mHealth interventions have been reported to improve adherence to long-term therapies in chronic conditions. Therefore, this study aimed at determining the effectiveness of mHealth interventions in medication adherence among patients with cardiovascular diseases (CVDs), a leading cause of mortality globally. Relying on our [...] Read more.
mHealth interventions have been reported to improve adherence to long-term therapies in chronic conditions. Therefore, this study aimed at determining the effectiveness of mHealth interventions in medication adherence among patients with cardiovascular diseases (CVDs), a leading cause of mortality globally. Relying on our inclusion criteria and the PRISMA recommendations, a literature search was carried out in the PubMed, Medline, and ProQuest databases for primary studies that investigated the impact of mHealth on medication adherence for cardiovascular disease (CVD) between 2000–2021. A total of 23 randomized controlled trials with 34,915 participants matched the selection criteria. The mHealth interventions used included text messages, mobile phone applications, and voice calls, which were used either as a single intervention or combined. Additionally, studies on enhancing drug adherence had contradictory findings: most of the studies elaborated positive results; however, six studies were unable to reveal any significant effect. Finally, a risk bias analysis revealed varying outcomes across all studies. This review, as a whole, supported the notion that mHealth interventions can be effective in improving adherence to CVD medication even though they could not improve adherence to all CVD medications when compared with controls. Further trials with more refined designs integrated with comprehensive interventions are needed to produce better health outcomes. Full article
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2 pages, 195 KiB  
Editorial
COVID-19: Where We Are and Where We Are Going
by Ludovico Abenavoli and Ivan Gentile
Diseases 2023, 11(1), 40; https://doi.org/10.3390/diseases11010040 - 01 Mar 2023
Viewed by 994
Abstract
The impact of COVID-19 on global health has been colossal [...] Full article
(This article belongs to the Special Issue COVID-19 and Global Chronic Disease II)
18 pages, 554 KiB  
Review
Zoonotic Tuberculosis: A Neglected Disease in the Middle East and North Africa (MENA) Region
by Dalal Kasir, Nour Osman, Aicha Awik, Imane El Ratel, Rayane Rafei, Imad Al Kassaa, Dima El Safadi, Rayane Salma, Khaled El Omari, Kevin J. Cummings, Issmat I. Kassem and Marwan Osman
Diseases 2023, 11(1), 39; https://doi.org/10.3390/diseases11010039 - 01 Mar 2023
Cited by 2 | Viewed by 3224
Abstract
Mycobacterium bovis is the etiologic agent of bovine tuberculosis (BTB), a serious infectious disease in both humans and animals. BTB is a zoonotic disease primarily affecting cattle and occasionally humans infected through close contact with infected hosts or the consumption of unpasteurized dairy [...] Read more.
Mycobacterium bovis is the etiologic agent of bovine tuberculosis (BTB), a serious infectious disease in both humans and animals. BTB is a zoonotic disease primarily affecting cattle and occasionally humans infected through close contact with infected hosts or the consumption of unpasteurized dairy products. Zoonotic tuberculosis is strongly associated with poverty and poor hygiene, and low- and middle-income countries bear the brunt of the disease. BTB has been increasingly recognized as a growing public health threat in developing countries. However, the lack of effective surveillance programs in many of these countries poses a barrier to accurately determining the true burden of this disease. Additionally, the control of BTB is threatened by the emergence of drug-resistant strains that affect the effectiveness of current treatment regimens. Here, we analyzed current trends in the epidemiology of the disease as well as the antimicrobial susceptibility patterns of M. bovis in the Middle East and North Africa (MENA) region, a region that includes several developing countries. Following PRISMA guidelines, a total of 90 studies conducted in the MENA region were selected. Our findings revealed that the prevalence of BTB among humans and cattle varied significantly according to the population size and country in the MENA region. Most of the available studies were based on culture and/or PCR strategies and were published without including data on antimicrobial resistance and molecular typing. Our findings highlighted the paramount need for the use of appropriate diagnostic tools and the implementation of sustainable control measures, especially at the human/animal interface, in the MENA region. Full article
(This article belongs to the Section Infectious Disease)
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12 pages, 3572 KiB  
Review
A Brief History of Bunyaviral Family Hantaviridae
by Jens H. Kuhn and Connie S. Schmaljohn
Diseases 2023, 11(1), 38; https://doi.org/10.3390/diseases11010038 - 28 Feb 2023
Cited by 9 | Viewed by 2121
Abstract
The discovery of Hantaan virus as an etiologic agent of hemorrhagic fever with renal syndrome in South Korea in 1978 led to identification of related pathogenic and nonpathogenic rodent-borne viruses in Asia and Europe. Their global distribution was recognized in 1993 after connecting [...] Read more.
The discovery of Hantaan virus as an etiologic agent of hemorrhagic fever with renal syndrome in South Korea in 1978 led to identification of related pathogenic and nonpathogenic rodent-borne viruses in Asia and Europe. Their global distribution was recognized in 1993 after connecting newly discovered relatives of these viruses to hantavirus pulmonary syndrome in the Americas. The 1971 description of the shrew-infecting Hantaan-virus-like Thottapalayam virus was long considered an anomaly. Today, this virus and many others that infect eulipotyphlans, bats, fish, rodents, and reptiles are classified among several genera in the continuously expanding family Hantaviridae. Full article
11 pages, 622 KiB  
Article
Reproductive Health Practices in Spanish Women Who Underwent Voluntary Termination of Pregnancy
by M. V. Lapresa-Alcalde, A. M. Cubo, M. Alonso-Sardón and M. J. Doyague-Sánchez
Diseases 2023, 11(1), 37; https://doi.org/10.3390/diseases11010037 - 27 Feb 2023
Viewed by 1211
Abstract
Background: The incidence of Voluntary Termination of Pregnancy (VTP) is an important indicator of unplanned pregnancies and the differences in the functioning of contraceptive services and the effectiveness of their use. Its analysis is essential for monitoring the well-being of women and their [...] Read more.
Background: The incidence of Voluntary Termination of Pregnancy (VTP) is an important indicator of unplanned pregnancies and the differences in the functioning of contraceptive services and the effectiveness of their use. Its analysis is essential for monitoring the well-being of women and their partners. Our aim was to analyse the socio-demographic profile of women who request voluntary termination of pregnancy in the province of Salamanca, as well as their satisfaction with the intervention and its influence on their contraceptive methods. Methods: An intervention study (before-after) designed without a control group, including all women requesting a voluntary termination of pregnancy through the Salamanca Public Health System. Socio-demographic and reproductive health variables were used. After the termination of pregnancy, a satisfaction survey and analysis of consequences were carried out. Results: A total of 176 surveys were obtained. Women who underwent VTP in Salamanca were between 20 and 25 years old, had secondary education but were still studying or working, lived alone and had no children. The most commonly used contraceptive method was the condom (55%), followed by the pill (25%). The most frequent reason for termination of pregnancy was economic (47.7%). The abortion entailed a significant change in contraception. Whereas before the abortion only 34% used a hormonal method, 66% were willing to use one afterwards (p = 0.006). Conclusion: Reproductive health education needs to be improved so that couples use reliable contraceptive methods appropriately. Although women are generally satisfied with the care received during abortion, they would prefer better accessibility to the procedure and more comprehensive information about the process from a neutral stance. Full article
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10 pages, 1290 KiB  
Article
Comparative Analysis on the Effect of Sarcopenia in Patients with Knee Osteoarthritis before and after Total Knee Arthroplasty
by Chrysanthi Liliana Tzartza, Nikolaos Karapalis, Gavriela Voulgaridou, Christiana Zidrou, Anastasios Beletsiotis, Ioanna P. Chatziprodromidou, Constantinos Giaginis and Sousana K. Papadopoulou
Diseases 2023, 11(1), 36; https://doi.org/10.3390/diseases11010036 - 22 Feb 2023
Cited by 1 | Viewed by 1376
Abstract
Introduction: Primary sarcopenia is an age-related disease that occurs mainly in older adults, while its possibility of appearance increases with age. Secondary sarcopenia is related to the presence of a disease. At times, studies have implied a connection between various diseases and the [...] Read more.
Introduction: Primary sarcopenia is an age-related disease that occurs mainly in older adults, while its possibility of appearance increases with age. Secondary sarcopenia is related to the presence of a disease. At times, studies have implied a connection between various diseases and the appearance of sarcopenia. Due to pain, patients with knee osteoarthritis limit their everyday activities, leading to a decrease in muscle mass and physical function. Purpose: This study aimed to investigate the impact of the coexistence of sarcopenia and osteoarthritis on patients’ rehabilitation and symptoms, such as pain, after total knee arthroplasty, compared with patients with osteoarthritis without sarcopenia. Methodology: This cross-sectional study material consisted of 20 patients with osteoarthritis, who were hospitalized at Papageorgiou Hospital of Thessaloniki for total knee arthroplasty from November 2021 to April 2022. The patients were evaluated for sarcopenia according to the FNIH criteria. The two groups were asked to complete the KOOS score questionnaire in order to evaluate the condition of their knee in two phases, before surgery and 3 months after surgery. Results: The two groups, 5 sarcopenic patients and 15 non-sarcopenic, did not show a statistically significant difference in muscle strength measurements. However, the lean mass indices, ALM (15.18 ± 3.98 versus 19.96 ± 3.65, respectively; p = 0.023) and ALM/height2 (5.53 ± 1.40 versus 6.98 ± 0.75, respectively; p = 0.007) had significant differences, since the sarcopenic group showed a reduced lean mass, especially in patients with a comorbidity of cancer. Sarcopenic patients showed a smaller increase in KOOS score compared to non-sarcopenic patients before (0.38 ± 0.09 vs. 0.35 ± 0.09, respectively; p = 0.312) and after surgery (0.54 ± 0.08 vs. 0.59 ± 0.10, respectively; p = 0.909), but without a statistically significant difference. The score increased for both groups, with the time factor playing a greater role than the group. Conclusions: Both the sarcopenic group and the control group did not show significant differences in their scores for the assessment of the affected limb in any of the two phases while completing the questionnaire. However, there was an improvement in their osteoarthritis symptoms before and after arthroplasty in both groups. Further research with a larger sample and longer recovery time is needed to draw more accurate conclusions and confirm the present results. Full article
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17 pages, 7195 KiB  
Review
Effective Coverage in Health Systems: Evolution of a Concept
by Aliya Karim and Don de Savigny
Diseases 2023, 11(1), 35; https://doi.org/10.3390/diseases11010035 - 22 Feb 2023
Viewed by 1795
Abstract
The manner in which high-impact, life-saving health interventions reach populations in need is a critical dimension of health system performance. Intervention coverage has been a standard metric for such performance. To better understand and address the decay of intervention effectiveness in real-world health [...] Read more.
The manner in which high-impact, life-saving health interventions reach populations in need is a critical dimension of health system performance. Intervention coverage has been a standard metric for such performance. To better understand and address the decay of intervention effectiveness in real-world health systems, the more complex measure of “effective coverage” is required, which includes the health gain the health system could potentially deliver. We have carried out a narrative review to trace the origins, timeline, and evolution of the concept of effective coverage metrics to illuminate potential improvements in coherence, terminology, application, and visualizations, based on which a combination of approaches appears to have the most influence on policy and practice. We found that the World Health Organization first proposed the concept over 45 years ago. It became increasingly popular with the further development of theoretical underpinnings, and after the introduction of quantification and visualization tools. The approach has been applied in low- and middle-income countries, mainly for HIV/AIDS, TB, malaria, child health interventions, and more recently for non-communicable diseases, particularly diabetes and hypertension. Nevertheless, despite decades of application of effective coverage concepts, there is considerable variability in the terminology used and the choices of effectiveness decay steps included in the measures. Results frequently illustrate a profound loss of service effectiveness due to health system factors. However, policy and practice rarely address these factors, and instead favour narrowly targeted technical interventions. Full article
(This article belongs to the Special Issue In Honour of Marcel Tanner, Parasitologist Extraordinaire)
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8 pages, 3414 KiB  
Case Report
Priapism in a Patient with Rectal Adenocarcinoma
by Navdeep Dehar, Justin Tong, Zain Siddiqui, Michael Leveridge and Anna Tomiak
Diseases 2023, 11(1), 34; https://doi.org/10.3390/diseases11010034 - 17 Feb 2023
Cited by 1 | Viewed by 1729
Abstract
Background: Priapism is a very rare complication of malignancy and is usually accompanied by locally advanced or widely metastatic disease. We describe a case of priapism arising in a 46-year-old male with localised rectal cancer that was responding to therapy. Case presentation: This [...] Read more.
Background: Priapism is a very rare complication of malignancy and is usually accompanied by locally advanced or widely metastatic disease. We describe a case of priapism arising in a 46-year-old male with localised rectal cancer that was responding to therapy. Case presentation: This patient had just completed two weeks of neoadjuvant, long-course chemoradiation when he presented with persistent painful penile erection. Assessment and diagnosis were delayed for more than 60 h, and although a cause could not be determined from imaging, a near complete radiological response of the primary rectal cancer was seen. His symptoms were refractory to urologic intervention and were associated with extreme psychological distress. He re-presented shortly thereafter with extensively metastatic disease in the lungs, liver, pelvis, scrotum, and penis; additionally, multiple venous thromboses were identified, including in the dorsal penile veins. His priapism was not reversible and was associated with a considerable symptom burden for the remainder of his life. His malignancy did not respond to first-line palliative chemotherapy or radiation, and his clinical course was further complicated by obstructive nephropathy, ileus, and genital skin breakdown with a suspected infection. We initiated comfort measures, and he ultimately died in hospital less than five months after his initial presentation. Conclusion: Priapism in cancer is usually related to tumour infiltration of the penis and corporal bodies resulting in poor venous and lymphatic drainage. The management is palliative and can include chemotherapy, radiation, surgical shunting, and potentially penectomy; however, conservative penis-sparing therapy may be reasonable in patients with limited life expectancy. Full article
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11 pages, 1088 KiB  
Opinion
Secreted Protein Acidic and Rich in Cysteine (SPARC)—Mediated Exercise Effects: Illustrative Molecular Pathways against Various Diseases
by Abdelaziz Ghanemi, Mayumi Yoshioka and Jonny St-Amand
Diseases 2023, 11(1), 33; https://doi.org/10.3390/diseases11010033 - 13 Feb 2023
Cited by 2 | Viewed by 2084
Abstract
The strong benefits of exercise, in addition to the development of both the therapeutic applications of physical activity and molecular biology tools, means that it has become very important to explore the underlying molecular patterns linking exercise and its induced phenotypic changes. Within [...] Read more.
The strong benefits of exercise, in addition to the development of both the therapeutic applications of physical activity and molecular biology tools, means that it has become very important to explore the underlying molecular patterns linking exercise and its induced phenotypic changes. Within this context, secreted protein acidic and rich in cysteine (SPARC) has been characterized as an exercise-induced protein that would mediate and induce some important effects of exercise. Herein, we suggest some underlying pathways to explain such SPARC-induced exercise-like effects. Such mechanistic mapping would not only allow us to understand the molecular processes of exercise and SPARC effects but would also highlight the potential to develop novel molecular therapies. These therapies would be based on mimicking the exercise benefits via either introducing SPARC or pharmacologically targeting the SPARC-related pathways to produce exercise-like effects. This is of a particular importance for those who do not have the ability to perform the required physical activity due to disabilities or diseases. The main objective of this work is to highlight selected potential therapeutic applications deriving from SPARC properties that have been reported in various publications. Full article
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9 pages, 430 KiB  
Systematic Review
Vaccine Hesitancy in Sub-Saharan Africa in the Context of COVID-19 Vaccination Exercise: A Systematic Review
by Elizabeth A. Ochola
Diseases 2023, 11(1), 32; https://doi.org/10.3390/diseases11010032 - 09 Feb 2023
Cited by 6 | Viewed by 2014
Abstract
Presently, the COVID-19 vaccine is seen as a means to an end in light of other challenges, such as vaccine inequity. Through COVID-19 Vaccines Global Access (COVAX), an initiative founded to guarantee fair and equitable distribution, vaccine hesitancy remains a critical component that [...] Read more.
Presently, the COVID-19 vaccine is seen as a means to an end in light of other challenges, such as vaccine inequity. Through COVID-19 Vaccines Global Access (COVAX), an initiative founded to guarantee fair and equitable distribution, vaccine hesitancy remains a critical component that needs to be addressed in sub-Saharan Africa. Utilizing a documentary search strategy and using the keywords and subject headings Utilitarianism and COVID-19 or Vaccine hesitancy and sub-Saharan Africa, this paper identified 67 publications from different databases (PubMed, Scopus and Web of Science), which were further screened by title and full text to achieve (n = 6) publications that were analyzed. The reviewed papers demonstrate that vaccine hesitancy occurs against a colonial backdrop of inequities in global health research, social–cultural complexities, poor community involvement and public distrust. All of these factors undermine the confidence that is crucial for sustaining collective immunity in vaccine programs. Even though mass vaccination programs are known to limit personal freedom, the exchange of information between healthcare professionals and citizens must be improved to encourage complete disclosure of vaccine information at the point of delivery. Moreover, addressing components of vaccine hesitancy should involve relying not on coercive public policies but on consistent ethical strategies that go beyond current healthcare ethics toward broader bioethics. Full article
(This article belongs to the Special Issue Serological Studies on SARS-CoV-2 and COVID-19 Infection)
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12 pages, 1210 KiB  
Article
The Prevalence of Hearing Impairments in Women with Silicone Breast Implants
by Assaf Greenbaum, Gilad Halpert, Arad Dotan, Shaked Shivatzki, Harald Heidecke, Ricky Kaplan Neeman, Michael Ehrenfeld, Amit Wolfovitz, Howard Amital, Yael Henkin and Yehuda Shoenfeld
Diseases 2023, 11(1), 31; https://doi.org/10.3390/diseases11010031 - 09 Feb 2023
Cited by 1 | Viewed by 1644
Abstract
Many women with silicone breast implants (SBIs) report non-specific complaints, including hearing impairments. Hearing impairment appears to be associated with a number of autoimmune conditions. The current study aimed to evaluate the prevalence and severity of hearing impairments among women with SBIs and [...] Read more.
Many women with silicone breast implants (SBIs) report non-specific complaints, including hearing impairments. Hearing impairment appears to be associated with a number of autoimmune conditions. The current study aimed to evaluate the prevalence and severity of hearing impairments among women with SBIs and to explore potential improvements in their hearing capability following implant removal. Symptomatic women with SBIs (n = 160) underwent an initial anamnestic interview, and women who reported hearing impairments were selected for the study. These women completed self-report telephone questionnaires regarding their hearing difficulties. Some of these women underwent subjective and objective hearing tests. Out of 159 (50.3%) symptomatic women with SBIs, 80 reported hearing impairments, including hearing loss (44/80; 55%) and tinnitus (45/80; 56.2%). Five out of seven (71.4%) women who underwent an audiologic evaluation exhibited hearing loss. Of women who underwent silicone implant removal, 27 out of 47 (57.4%) reported the improvement or resolution of their hearing complaints. In conclusion, hearing impairment is a frequent complaint among symptomatic women with SBIs, and tinnitus was found to be the most common complaint. A significant reduction in hearing difficulties was observed following silicone implant removal. Further studies using larger populations are needed to verify the occurrence of hearing impairments in these women. Full article
(This article belongs to the Section Immunology)
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18 pages, 2200 KiB  
Review
Protein Misfolding and Aggregation in Proteinopathies: Causes, Mechanism and Cellular Response
by Mohammad Rehan Ajmal
Diseases 2023, 11(1), 30; https://doi.org/10.3390/diseases11010030 - 09 Feb 2023
Cited by 9 | Viewed by 4434
Abstract
Proteins are central to life functions. Alterations in the structure of proteins are reflected in their function. Misfolded proteins and their aggregates present a significant risk to the cell. Cells have a diverse but integrated network of protection mechanisms. Streams of misfolded proteins [...] Read more.
Proteins are central to life functions. Alterations in the structure of proteins are reflected in their function. Misfolded proteins and their aggregates present a significant risk to the cell. Cells have a diverse but integrated network of protection mechanisms. Streams of misfolded proteins that cells are continuously exposed to must be continually monitored by an elaborated network of molecular chaperones and protein degradation factors to control and contain protein misfolding problems. Aggregation inhibition properties of small molecules such as polyphenols are important as they possess other beneficial properties such as antioxidative, anti-inflammatory, and pro-autophagic properties and help neuroprotection. A candidate with such desired features is important for any possible treatment development for protein aggregation diseases. There is a need to study the protein misfolding phenomenon so that we can treat some of the worst kinds of human ailments related to protein misfolding and aggregation. Full article
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26 pages, 633 KiB  
Article
Vitamin D and Calcium in Osteoporosis, and the Role of Bone Turnover Markers: A Narrative Review of Recent Data from RCTs
by Gavriela Voulgaridou, Sousana K. Papadopoulou, Paraskevi Detopoulou, Despoina Tsoumana, Constantinos Giaginis, Foivi S. Kondyli, Evgenia Lymperaki and Agathi Pritsa
Diseases 2023, 11(1), 29; https://doi.org/10.3390/diseases11010029 - 08 Feb 2023
Cited by 11 | Viewed by 4256
Abstract
Osteoporosis is a common disease, defined primarily by a low measured bone density, which is associated with an increased risk of fragility fractures. Low calcium intake and vitamin D deficiency seem to be positively correlated with the prevalence of osteoporosis. Although they are [...] Read more.
Osteoporosis is a common disease, defined primarily by a low measured bone density, which is associated with an increased risk of fragility fractures. Low calcium intake and vitamin D deficiency seem to be positively correlated with the prevalence of osteoporosis. Although they are not suitable for the diagnosis of osteoporosis, the biochemical markers of bone turnover can be measured in serum and/or urine, enabling the assessment of the dynamic bone activity and the short-term effectiveness of the osteoporosis treatment. Calcium and vitamin D are essential for maintaining bone health. The aim of this narrative review is to summarize the effects of vitamin D and calcium supplementation separately and in combination, on bone density and circulating serum and blood plasma vitamin D, calcium, parathyroid hormone levels, markers of bone metabolism concentrations, and clinical outcomes, such as falls and osteoporotic fractures. We searched the PubMed online database to find clinical trials from the last five years (2016–April 2022). A total of 26 randomized clinical trials (RCTs) were included in this review. The present reviewed evidence suggests that vitamin D alone or in combination with calcium increases circulating 25(OH)D. Calcium with concomitant vitamin D supplementation, but not vitamin D alone, leads to an increase in BMD. In addition, most studies did not detect significant changes in circulating levels of plasma bone metabolism markers, nor in the incidence of falls. Instead, there was a decrease in blood serum PTH levels in the groups receiving vitamin D and/or Ca supplementation. The plasma vitamin D levels at the beginning of the intervention, and the dosing regimen followed, may play a role in the observed parameters. However, further study is needed to determine an appropriate dosing regimen for the treatment of osteoporosis and the role of bone metabolism markers. Full article
(This article belongs to the Special Issue The Relationship between Nutrition and Diseases 2.0)
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10 pages, 1155 KiB  
Article
Comparative Study on MNVT of OPV Type I and III Reference Products in Different Periods
by Xiyan Wang, Ruirui Ren, Bo Ma, Jing Xie, Yan Ma, Hong Luo, Yu Guo, Ling Ding, Liang Zhang, Mengyuan Zhang, Tianlang Wang, Zhichao Shuang and Xiujuan Zhu
Diseases 2023, 11(1), 28; https://doi.org/10.3390/diseases11010028 - 08 Feb 2023
Viewed by 1453
Abstract
Widespread vaccination using the oral live attenuated polio vaccine (OPV) and Sabin strain inactivated vaccine (sIPV) have greatly reduced the incidence of polio worldwide. In the period post-polio, the virulence of reversion of the Sabin strain makes the use of OPV gradually becoming [...] Read more.
Widespread vaccination using the oral live attenuated polio vaccine (OPV) and Sabin strain inactivated vaccine (sIPV) have greatly reduced the incidence of polio worldwide. In the period post-polio, the virulence of reversion of the Sabin strain makes the use of OPV gradually becoming one of the major safety hazards. The verification and release of OPV has become the top priority. The monkey neurovirulence test (MNVT) is the gold standard for detecting whether OPV meets the criteria, which are recommended by the WHO and Chinese Pharmacopoeia. Therefore, we statistically analyzed the MNVT results of type I and III OPV at different stages: 1996–2002 and 2016–2022. The results show that the upper and lower limits and C value of the qualification standard of type I reference products in 2016–2022 have decreased compared with the corresponding scores in the 1996–2002 period. The upper and lower limit and C value of the qualified standard of type III reference products were basically the same as the corresponding scores in the 1996–2002. We also found significant differences in the pathogenicity of the type I and III in the cervical spine and brain, with the decreasing trend in the diffusion index of the type I and type III in the cervical spine and brain. Finally, two evaluation criteria were used to judge the OPV test vaccines from 2016 to 2022. The vaccines all met the test requirements under the evaluation criteria of the above two stages. Based on the characteristics of OPV, data monitoring was one of the most intuitive methods to judge changes in virulence. Full article
(This article belongs to the Topic Inflammation: The Cause of All Diseases)
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10 pages, 269 KiB  
Article
“To Be or Not to Be Benign” at Partial Nephrectomy for Presumed RCC Renal Masses: Single-Center Experience with 195 Consecutive Patients
by Raffaele Baio, Giovanni Molisso, Christian Caruana, Umberto Di Mauro, Olivier Intilla, Umberto Pane, Costantino D’Angelo, Antonio Campitelli, Francesca Pentimalli and Roberto Sanseverino
Diseases 2023, 11(1), 27; https://doi.org/10.3390/diseases11010027 - 07 Feb 2023
Cited by 2 | Viewed by 1372
Abstract
In daily medical practice, an increasing number of kidney masses are being incidentally detected using common imaging techniques, owing to the improved diagnostic accuracy and increasingly frequent use of these techniques. As a consequence, the rate of detection of smaller lesions is increasing [...] Read more.
In daily medical practice, an increasing number of kidney masses are being incidentally detected using common imaging techniques, owing to the improved diagnostic accuracy and increasingly frequent use of these techniques. As a consequence, the rate of detection of smaller lesions is increasing considerably. According to certain studies, following surgical treatment, up to 27% of small enhancing renal masses are identified as benign tumors at the final pathological examination. This high rate of benign tumors challenges the appropriateness of surgery for all suspicious lesions, given the morbidity associated with such an intervention. The objective of the present study was, therefore, to determine the incidence of benign tumors at partial nephrectomy (PN) for a solitary renal mass. To meet this end, a total of 195 patients who each underwent one PN for a solitary renal lesion with the intent to cure RCC were included in the final retrospective analysis. A benign neoplasm was identified in 30 of these patients. The age of the patients ranged from 29.9–79 years (average: 60.9 years). The tumor size range was 1.5–7 cm (average: 3 cm). All the operations were successful using the laparoscopic approach. The pathological results were renal oncocytoma in 26 cases, angiomyolipomas in two cases, and cysts in the remaining two cases. In conclusion, we have shown in our present series the incidence rate of benign tumors in patients who have been subjected to laparoscopic PN due to a suspected solitary renal mass. Based on these results, we advise that the patient should be counseled not only about the intra- and post-operative risks of nephron-sparing surgery but also about its dual therapeutic and diagnostic role. Therefore, the patients should be informed of the considerably high probability of a benign histological result. Full article
(This article belongs to the Section Oncology)
8 pages, 445 KiB  
Communication
Non-Small-Cell Lung Cancer Immunotherapy and Sleep Characteristics: The Crossroad for Optimal Survival
by Paul Zarogoulidis, Dimitrios Petridis, Christoforos Kosmidis, Konstantinos Sapalidis, Lila Nena, Dimitris Matthaios, Vasilis Papadopoulos, Eleni Isidora Perdikouri, Konstantinos Porpodis, Paschalis Kakavelas and Paschalis Steiropoulos
Diseases 2023, 11(1), 26; https://doi.org/10.3390/diseases11010026 - 01 Feb 2023
Cited by 1 | Viewed by 4150
Abstract
Introduction: Non-small-cell lung cancer is still diagnosed at an inoperable stage and systematic treatment is the only option. Immunotherapy is currently considered to be the tip of the arrow as the first-line treatment for patients with a programmed death-ligand 1 ≥ 50. Sleep [...] Read more.
Introduction: Non-small-cell lung cancer is still diagnosed at an inoperable stage and systematic treatment is the only option. Immunotherapy is currently considered to be the tip of the arrow as the first-line treatment for patients with a programmed death-ligand 1 ≥ 50. Sleep is known to be an essential part of our everyday life. Patients and Methods: We investigated, upon diagnosis and after nine months, 49 non-small-cell lung cancer patients undergoing immunotherapy treatment with nivolumab and pemprolisumab. A polysomnographic examination was conducted. Moreover, the patients completed the Epworth Sleepiness Scale (ESS), the Pittsburgh Sleep Quality Index (PSQI), the Fatigue Severity Scale (FSS) and the Medical Research Council (MRC) dyspnea scale. Results: Tukey mean-difference plots, summary statistics, and the results of paired t-test of five questionnaire responses in accordance with the PD-L1 test across groups were examined. The results indicated that, upon diagnosis, patients had sleep disturbances which were not associated with brain metastases or their PD-L1 expression status. However, the PD-L1 status and disease control were strongly associated, since a PD-L1 ≥80 improved the disease status within the first 4 months. All data from the sleep questionnaires and polysomnography reports indicated that the majority of patients with a partial response and complete response had their initial sleep disturbances improved. There was no connection between nivolumab or pembrolisumab and sleep disturbances. Conclusion: Upon diagnosis, lung cancer patients have sleep disorders such as anxiety, early morning wakening, late sleep onset, prolonged nocturnal waking periods, daytime sleepiness, and unrefreshing sleep. However, these symptoms tend to improve very quickly for patients with a PD-L1 expression ≥80, because disease status improves also very quickly within the first 4 months of treatment. Full article
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12 pages, 262 KiB  
Article
Association of Sociodemographic Factors with Tuberculosis Outcomes in Mississippi
by Omer Osman, Azad R. Bhuiyan, Amal K. Mitra, Vincent L. Mendy, Sophia Leggett and Clifton Addison
Diseases 2023, 11(1), 25; https://doi.org/10.3390/diseases11010025 - 01 Feb 2023
Cited by 1 | Viewed by 1464
Abstract
Tuberculosis (TB) is one of the leading causes of death worldwide. In the US, the national incidence of reported TB cases was 2.16 per 100,000 persons in 2020 and 2.37 per 100,000 persons in 2021. Furthermore, TB disproportionately affects minorities. Specifically, in 2018, [...] Read more.
Tuberculosis (TB) is one of the leading causes of death worldwide. In the US, the national incidence of reported TB cases was 2.16 per 100,000 persons in 2020 and 2.37 per 100,000 persons in 2021. Furthermore, TB disproportionately affects minorities. Specifically, in 2018, 87% of reported TB cases occurred in racial and ethnic minorities in Mississippi. Data from TB patients from the Mississippi Department of Health (2011–2020) were used to examine the association between sociodemographic subgroups (race, age, place of birth, gender, homelessness, and alcohol use) with TB outcome variables. Of the 679 patients with active TB cases in Mississippi, 59.53% were Black, and 40.47% were White. The mean age was 46 ± ten years; 65.1% were male, and 34.9% were female. Among patients with previous TB infections, 70.8% were Black, and 29.2% were White. The rate of previous TB cases was significantly higher among US-born (87.5%) persons compared with non-US-born persons (12.5%). The study suggested that sociodemographic factors play a significant role in TB outcome variables. This research will help public health professionals to develop an effective TB intervention program that addresses sociodemographic factors in Mississippi. Full article
(This article belongs to the Special Issue Infectious Disease Epidemiology II)
8 pages, 1162 KiB  
Case Report
A Case of Light Chain Deposition Disease Leading to Acute Liver Failure and Review of Literature
by Mustafa Gandhi, Syed Bilal Pasha, Emily Reznicek, Syed Raheel Pasha, Hamza Ertugrul, Adel Araslanova, Feng Yin and Veysel Tahan
Diseases 2023, 11(1), 24; https://doi.org/10.3390/diseases11010024 - 01 Feb 2023
Viewed by 1971
Abstract
Light chain deposition disease (LCDD) is a monoclonal immunoglobulin deposition disease characterized by light chain deposition in soft tissues and viscera, causing systemic organ dysfunction with an underlying lymphoproliferative disorder. While the kidney is the most affected organ, cardiac and hepatic involvement is [...] Read more.
Light chain deposition disease (LCDD) is a monoclonal immunoglobulin deposition disease characterized by light chain deposition in soft tissues and viscera, causing systemic organ dysfunction with an underlying lymphoproliferative disorder. While the kidney is the most affected organ, cardiac and hepatic involvement is also seen with LCDD. Hepatic manifestation can range from mild hepatic injury to fulminant liver failure. Herein, we are presenting a case of an 83-year-old woman with a monoclonal gammopathy of undetermined significance (MGUS), who presented to our institution with acute liver failure progressing to circulatory shock and multiorgan failure. After an extensive workup, a diagnosis of hepatic LCDD was determined. In conjunction with the hematology and oncology department, chemotherapy options were discussed, but given her poor prognosis, the family decided to pursue a palliative route. Though establishing a prompt diagnosis is important for any acute condition, the rarity of this condition, along with paucity of data, makes timely diagnosis and treatment challenging. The available literature shows variable rates of success with chemotherapy for systemic LCDD. Despite chemotherapeutic advances, liver failure in LCDD indicates a dismal prognosis, where further clinical trials are difficult owing to the low prevalence of the condition. In our article, we will also be reviewing previous case reports on this disease. Full article
(This article belongs to the Section Rare Syndrome)
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12 pages, 1913 KiB  
Review
Racial Disparities and Common Respiratory Infectious Diseases in Children of the United States: A Systematic Review and Meta-Analysis
by Elizabeth A. K. Jones, Amal K. Mitra and Shelia Malone
Diseases 2023, 11(1), 23; https://doi.org/10.3390/diseases11010023 - 31 Jan 2023
Cited by 1 | Viewed by 2257
Abstract
Due to the lack of sufficient data on the relationship between racial disparities and the occurrence of infectious respiratory diseases in children, the aim of this systematic review and meta-analysis is to evaluate the presence of racial gaps in the occurrence of respiratory [...] Read more.
Due to the lack of sufficient data on the relationship between racial disparities and the occurrence of infectious respiratory diseases in children, the aim of this systematic review and meta-analysis is to evaluate the presence of racial gaps in the occurrence of respiratory infectious diseases in children. This study follows the PRISMA flow guidelines for systematic reviews and the standards of meta-analysis for 20 quantitative studies conducted from 2016 to 2022 including 2,184,407 participants. As evidenced from the review, in the U.S., racial disparities are present among children, with Hispanic and Black children carrying the burden of infectious respiratory disease occurrence. Several factors are contributory to these outcomes among Hispanic and Black children, including higher rates of poverty; higher rates of chronic conditions, such as asthma and obesity; and seeking care outside of the home. However, vaccinations can be used to reduce the risk of infection among Black and Hispanic children. Whether a child is very young or a teen, racial disparities are present in occurrence rates of infectious respiratory diseases, with the burden resting among minorities. Therefore, it is important for parents to be aware of the risk of infectious diseases and to be aware of resources, such as vaccines. Full article
(This article belongs to the Special Issue Infectious Disease Epidemiology II)
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