Topic Editors

Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong Provincial Hospital, Shandong University, Jinan 250021, China
Department of Ultrasound, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang 110002, China
Dr. Shanshan Shao
Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong Provincial Hospital, Shandong University, Jinan 250021, China
Dr. Tatsunori Miyata
Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan
Dr. Dongxing Xie
Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China

Diagnosis, Management, and Prognostic Assessment of Chronic Disease

Abstract submission deadline
5 May 2025
Manuscript submission deadline
5 July 2025
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44855

Topic Information

Dear Colleagues,

Chronic diseases—such as heart disease, cancer, diabetes, stroke, and arthritis—are the leading causes of disability and death throughout the world. In fact, 63% of all deaths worldwide are from chronic conditions. Chronic diseases constitute a major cause of mortality, and the World Health Organization (WHO) attributes 38 million deaths a year to non-communicable diseases. In the United States, approximately 40% of adults have at least two chronic conditions. Living with two or more chronic conditions is referred to as multimorbidity. Chronic diseases tend to occur in older adults and can usually be controlled, but not cured. The most common types of chronic disease are cancer, heart disease, stroke, diabetes, and arthritis. Subsequently, there is growing international interest in the potential diagnosis, management, and prognostic assessment of patients with chronic conditions. As treatment often centers around timely and comprehensive therapies, there is an urgent need to identify risk factors and effective diagnostic and treatment strategies to reduce morbidity, decrease disease recurrence, and improve survival rates. This Special Issue aims to cover novel state-of-the-art research on basic and clinical findings in relation to chronic diseases. Submissions should clarify the substantive improvements on work that has already been published, accepted for publication, or submitted in parallel to other conferences or journals.

Topics of interest include, but are not limited to, the following:

  • Biomarkers for chronic diseases and their complications;
  • Discovery of novel diagnostic and prognostic markers in chronic diseases;
  • Genomic research for chronic diseases and their complications;
  • Epigenomic research for chronic diseases;
  • Metabolic syndrome and chronic diseases;
  • Metabolic syndrome and cancers;
  • Metabolic abnormalities and chronic diseases;
  • Nutrition and metabolism for chronic diseases;
  • Drug use and chronic diseases;
  • Molecular mechanisms;
  • Predictive models;
  • Non-alcoholic fatty liver disease;
  • Obesity;
  • Cardiovascular disease.

Dr. Xiude Fan
Dr. Enfa Zhao
Dr. Yang Xia
Dr. Shanshan Shao
Dr. Tatsunori Miyata
Dr. Dongxing Xie
Topic Editors

Keywords

  • chronic conditions
  • cardiovascular disease
  • biomarkers
  • diagnosis
  • prognosis
  • predictive models
  • drug repurposing

Participating Journals

Journal Name Impact Factor CiteScore Launched Year First Decision (median) APC
Journal of Clinical Medicine
jcm
3.9 5.4 2012 17.9 Days CHF 2600 Submit
Journal of Personalized Medicine
jpm
3.4 2.6 2011 17.8 Days CHF 2600 Submit
Journal of Vascular Diseases
jvd
- - 2022 25 Days CHF 1000 Submit
Diagnostics
diagnostics
3.6 3.6 2011 20.7 Days CHF 2600 Submit
Cancers
cancers
5.2 7.4 2009 17.9 Days CHF 2900 Submit

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Published Papers (38 papers)

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14 pages, 1726 KiB  
Article
Using Machine Learning with Impulse Oscillometry Data to Develop a Predictive Model for Chronic Obstructive Pulmonary Disease and Asthma
by Chien-Hua Huang, Kun-Ta Chou, Diahn-Warng Perng, Yi-Han Hsiao and Chien-Wen Huang
J. Pers. Med. 2024, 14(4), 398; https://doi.org/10.3390/jpm14040398 - 09 Apr 2024
Viewed by 250
Abstract
We aimed to develop and validate a machine learning model using impulse oscillometry system (IOS) profiles for accurately classifying patients into three assessment-based categories: no airflow obstruction, asthma, and chronic obstructive pulmonary disease (COPD). Our research questions were as follows: (1) Can machine [...] Read more.
We aimed to develop and validate a machine learning model using impulse oscillometry system (IOS) profiles for accurately classifying patients into three assessment-based categories: no airflow obstruction, asthma, and chronic obstructive pulmonary disease (COPD). Our research questions were as follows: (1) Can machine learning methods accurately classify obstructive disease states based solely on multidimensional IOS data? (2) Which IOS parameters and modeling algorithms provide the best discrimination? We used data for 480 patients (240 with COPD and 240 with asthma) and 84 healthy individuals for training. Physiological and IOS parameters were combined into six feature combinations. The classification algorithms tested were logistic regression, random forest, neural network, k-nearest neighbor, and support vector machine. The optimal feature combination for identifying individuals without pulmonary obstruction, with asthma, or with COPD included 15 IOS and physiological features. The neural network classifier achieved the highest accuracy (0.786). For discriminating between healthy and unhealthy individuals, two combinations of twenty-three features performed best in the neural network algorithm (accuracy of 0.929). When distinguishing COPD from asthma, the best combination included 15 features and the neural network algorithm achieved an accuracy of 0.854. This study provides compelling technical evidence and clinical justifications for advancing IOS data-driven models to aid in COPD and asthma management. Full article
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11 pages, 652 KiB  
Article
CARDS, a Novel Prognostic Index for Risk Stratification and In-Hospital Monitoring
by Siyu Liang, Qing Chang, Yuelun Zhang, Hanze Du, Huijuan Zhu, Shi Chen and Hui Pan
J. Clin. Med. 2024, 13(7), 1961; https://doi.org/10.3390/jcm13071961 - 28 Mar 2024
Viewed by 294
Abstract
Background: Sodium fluctuation is independently associated with clinical deterioration. We developed and validated a prognostic index based on sodium fluctuation for risk stratification and in-hospital monitoring. Methods: This study included 33,323 adult patients hospitalized at a tertiary care hospital in 2014. [...] Read more.
Background: Sodium fluctuation is independently associated with clinical deterioration. We developed and validated a prognostic index based on sodium fluctuation for risk stratification and in-hospital monitoring. Methods: This study included 33,323 adult patients hospitalized at a tertiary care hospital in 2014. The first 28,279 hospitalizations were analyzed to develop the model and then the validity of the model was tested using data from 5044 subsequent hospitalizations. We predict in-hospital mortality using age, comorbidity, range of sodium fluctuation, and duration of sodium fluctuation, abbreviated as CARDS. Results: In-hospital mortality was similar in the derivation (0.6%) and validation (0.4%) cohorts. In the derivation cohort, four independent risk factors for mortality were identified using logistic regression: age (66–75, 2 points; >75, 3 points); Charlson comorbidity index (>2, 5 points); range of sodium fluctuation (7–10, 4 points; >10, 10 points); and duration of fluctuation (≤3, 3 points). The AUC was 0.907 (95% CI: 0.885–0.928) in the derivation cohort and 0.932 (95% CI: 0.895–0.970) in the validation cohort. In the derivation cohort, in-hospital mortality was 0.106% in the low-risk group (0–7 points), 1.076% in the intermediate-risk group (8–14 points), and 8.463% in the high-risk group (15–21 points). In the validation cohort, in-hospital mortality was 0.049% in the low-risk group, 1.064% in the intermediate-risk group, and 8.403% in the high-risk group. Conclusions: These results suggest that patients at low, intermediate, and high risk for in-hospital mortality may be identified by CARDS mainly based on sodium fluctuation. Full article
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23 pages, 6644 KiB  
Article
Concatenated Modified LeNet Approach for Classifying Pneumonia Images
by Dhayanithi Jaganathan, Sathiyabhama Balsubramaniam, Vidhushavarshini Sureshkumar and Seshathiri Dhanasekaran
J. Pers. Med. 2024, 14(3), 328; https://doi.org/10.3390/jpm14030328 - 21 Mar 2024
Viewed by 599
Abstract
Pneumonia remains a critical health concern worldwide, necessitating efficient diagnostic tools to enhance patient care. This research proposes a concatenated modified LeNet classifier to classify pneumonia images accurately. The model leverages deep learning techniques to improve the diagnosis of Pneumonia, leading to more [...] Read more.
Pneumonia remains a critical health concern worldwide, necessitating efficient diagnostic tools to enhance patient care. This research proposes a concatenated modified LeNet classifier to classify pneumonia images accurately. The model leverages deep learning techniques to improve the diagnosis of Pneumonia, leading to more effective and timely treatment. Our modified LeNet architecture incorporates a revised Rectified Linear Unit (ReLU) activation function. This enhancement aims to boost the discriminative capacity of the features learned by the model. Furthermore, we integrate batch normalization to stabilize the training process and enhance performance within smaller, less complex, CNN architectures like LeNet. Batch normalization addresses internal covariate shift, a phenomenon where the distribution of activations within a network alter during training. These modifications help to prevent overfitting and decrease computational time. A comprehensive dataset is used to evaluate the model’s performance, and the model is benchmarked against relevant deep-learning models. The results demonstrate a high recognition rate, with an accuracy of 96% in pneumonia image recognition. This research suggests that the Concatenated Modified LeNet classifier has the potential to be a highly useful tool for medical professionals in the diagnosis of pneumonia. By offering accurate and efficient image classification, our model could contribute to improved treatment decisions and patient outcomes. Full article
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13 pages, 1194 KiB  
Article
Association between Chronic Kidney Disease and Chronic Rhinosinusitis: A Longitudinal Follow-Up Study Using a National Health Screening Cohort
by Heejin Kim, Tae Jun Kim, Mi Jung Kwon, Jee Hye Wee, Sung Kwang Hong, Hyo Geun Choi and Joong Seob Lee
J. Pers. Med. 2024, 14(3), 268; https://doi.org/10.3390/jpm14030268 - 29 Feb 2024
Viewed by 708
Abstract
Chronic kidney disease (CKD) is a leading cause of global mortality. While recent reports suggest potential connections between CKD and chronic rhinosinusitis (CRS), further research is needed to elucidate the direct association between CKD and CRS. This study investigated the association between CKD [...] Read more.
Chronic kidney disease (CKD) is a leading cause of global mortality. While recent reports suggest potential connections between CKD and chronic rhinosinusitis (CRS), further research is needed to elucidate the direct association between CKD and CRS. This study investigated the association between CKD and CRS using data from the Korean National Health Insurance Service Health Screening Cohort. Participants were recruited according to medical claim codes, and individuals with CKD were matched in a 1:4 ratio with the control group. Covariates, such as demographics, health-related data, and medical history were used. The incidence rates and hazard ratio of CRS were analyzed. A further analysis was performed based on the presence of nasal polyps. Among the 514,866 participants, 16,644 patients with CKD and 66,576 matched controls were included in the analysis. The CKD group demonstrated a higher incidence of CRS than the controls: 18.30 versus 13.10 per 10,000 person-years. The CKD group demonstrated a higher risk of CRS than the control group (1.28 adjusted hazard ratio). In additional analyses, the CKD group did not exhibit a statistically significant correlation for the development of CRS with nasal polyps. This study suggests that CKD is associated with an increased risk for CRS. Full article
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9 pages, 263 KiB  
Brief Report
Perceived Parental Style Is Better in Adults with Congenital Heart Disease than Healthy Controls—But There Is Work Left to Do in Specific Subgroups
by Leon Brudy, Julia Hock, Laura Willinger, Renate Oberhoffer-Fritz, Alfred Hager, Peter Ewert and Jan Müller
J. Vasc. Dis. 2024, 3(1), 58-66; https://doi.org/10.3390/jvd3010005 - 01 Feb 2024
Viewed by 411
Abstract
Objective: To compare perceived parental style in a large cohort of adults with congenital heart disease (ACHD) to healthy reference (RCs). Furthermore, factors associated with perceived parental style were determined in ACHD. Patients and Methods: From September 2016 to April 2019, 912 ACHD [...] Read more.
Objective: To compare perceived parental style in a large cohort of adults with congenital heart disease (ACHD) to healthy reference (RCs). Furthermore, factors associated with perceived parental style were determined in ACHD. Patients and Methods: From September 2016 to April 2019, 912 ACHD (34.9 ± 10.4 years, 45% female) and 175 RCs (35.8 ± 12.2 years, 53% female) completed the Measure of Parental Style (MOPS) questionnaire. Results: After adjusting for age and sex, ACHD recalled the parental style of both their parents to be significantly less indifferent (mother: ACHD: 1.2 ± 0.01 vs. RC: 1.3 ± 0.03, p < 0.001; father: ACHD: 1.3 ± 0.02 vs. RC: 1.7 ± 0.05, p < 0.001), overcontrolling (mother: ACHD: 1.6 ± 0.63 vs. RC: 1.9 ± 0.62, p < 0.001; father: ACHD: 1.4 ± 0.52 vs. RC: 1.5 ± 0.50, p < 0.001), and abusive (mother: ACHD: 1.2 ± 0.47 vs. RC: 1.4 ± 0.46, p < 0.001; father: ACHD: 1.3 ± 0.59 vs. RC: 1.5 ± 0.57, p < 0.001) than healthy controls did. In ACHD, female sex (β = 0.068, p = 0.017), higher age (β = 0.005, p = 0.003), Ebstein anomaly (β = 0.170, p = 0.005), and cyanotic CHD (β = 0.336, p = 0.004) contribute to perceiving the parental style of at least one of the parents negatively. Conclusions: While ACHD appear to recall the parental style to be less negative, subgroup analysis revealed specific patients at risk. These findings point to the need for interventions in specific subgroups susceptible to psychological distress. Full article
14 pages, 2534 KiB  
Article
Ultrasound and Sialendoscopy Findings in Radioactive Iodine–Induced Sialadenitis: Comparative Analysis and Possible Impact on Management
by Michael Koch, Sarina Müller, Konstantinos Mantsopoulos, Heinrich Iro and Matti Sievert
J. Clin. Med. 2024, 13(3), 657; https://doi.org/10.3390/jcm13030657 - 23 Jan 2024
Viewed by 502
Abstract
Background: To assess the correlation/association between ultrasound and sialendoscopy findings in radioactive iodine therapy–induced sialadenitis (RAIS). Methods: Patients presenting with RAIS were investigated with ultrasound and sialendoscopy. Four pathologic ultrasound parameters and seven pathologic sialendoscopy parameters were retrospectively assessed. Correlations/associations between ultrasound and [...] Read more.
Background: To assess the correlation/association between ultrasound and sialendoscopy findings in radioactive iodine therapy–induced sialadenitis (RAIS). Methods: Patients presenting with RAIS were investigated with ultrasound and sialendoscopy. Four pathologic ultrasound parameters and seven pathologic sialendoscopy parameters were retrospectively assessed. Correlations/associations between ultrasound and sialendoscopy findings and associations between the changes between the first and last ultrasound and sialendoscopy findings were assessed separately for the parotid (PG) and submandibular glands (SMG). Results: Sixty-seven patients were included. In the first examination, 107 glands were investigated (PGs 88.8%, SMGs 11.21%), and in the last examination, 64 glands were investigated (90.6% PGs, 9.4% SMGs). Highly significant positive associations were observed between the severity or category of ultrasound and sialendoscopy findings for first and last examinations for PGs (both p = 0.0001) and SMGs (p = 0.002; p = 0.037). Duct dilation had a significant negative association with the sialendoscopy findings for PGs in the first and last examinations (both p = 0.0001), but not for SMGs. Comparison of changes in the ultrasound and sialendoscopy findings between the first and last examinations showed a significant positive association for PGs (p = 0.0001) but not for SMGs. Conclusions: Ultrasound and sialendoscopy findings for the parenchyma and duct system in RAIS showed significant associations/correlations and can be useful for effective management in RAIS. Full article
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31 pages, 3727 KiB  
Review
Prediction of Subclinical and Clinical Multiple Organ Failure Dysfunction in Breast Cancer Patients—A Review Using AI Tools
by Andreea-Iuliana Ionescu (Miron), Dimitrie-Ionut Atasiei, Radu-Tudor Ionescu, Flavia Ultimescu, Andrei-Alexandru Barnonschi, Alexandra-Valentina Anghel, Cătălin-Alexandru Anghel, Ionuț-Lucian Antone-Iordache, Ruxandra Mitre, Alexandra Maria Bobolocu, Andreea Zamfir, Horia-Dan Lișcu, Simona Coniac and Florica Șandru
Cancers 2024, 16(2), 381; https://doi.org/10.3390/cancers16020381 - 16 Jan 2024
Cited by 2 | Viewed by 1912
Abstract
This review explores the interconnection between precursor lesions of breast cancer (typical ductal hyperplasia, atypical ductal/lobular hyperplasia) and the subclinical of multiple organ failure syndrome, both representing early stages marked by alterations preceding clinical symptoms, undetectable through conventional diagnostic methods. Addressing the question [...] Read more.
This review explores the interconnection between precursor lesions of breast cancer (typical ductal hyperplasia, atypical ductal/lobular hyperplasia) and the subclinical of multiple organ failure syndrome, both representing early stages marked by alterations preceding clinical symptoms, undetectable through conventional diagnostic methods. Addressing the question “Why patients with breast cancer exhibit a tendency to deteriorate”, this study investigates the biological progression from a subclinical multiple organ failure syndrome, characterized by insidious but indisputable lesions, to an acute (clinical) state resembling a cascade akin to a waterfall or domino effect, often culminating in the patient’s demise. A comprehensive literature search was conducted using PubMed, Google Scholar, and Scopus databases in October 2023, employing keywords such as “MODS”, “SIRS”, “sepsis”, “pathophysiology of MODS”, “MODS in cancer patients”, “multiple organ failure”, “risk factors”, “cancer”, “ICU”, “quality of life”, and “breast cancer”. Supplementary references were extracted from the retrieved articles. This study emphasizes the importance of early identification and prevention of the multiple organ failure cascade at the inception of the malignant state, aiming to enhance the quality of life and extend survival. This pursuit contributes to a deeper understanding of risk factors and viable therapeutic options. Despite the existence of the subclinical multiple organ failure syndrome, current diagnostic methodologies remain inadequate, prompting consideration of AI as an increasingly crucial tool for early identification in the diagnostic process. Full article
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14 pages, 1969 KiB  
Article
Comorbidity Patterns and Management in Inpatients with Endocrine Diseases by Age Groups in South Korea: Nationwide Data
by Sung-Soo Kim and Hun-Sung Kim
J. Pers. Med. 2024, 14(1), 42; https://doi.org/10.3390/jpm14010042 - 28 Dec 2023
Viewed by 647
Abstract
This study aimed to examine comorbidity associations across age groups of inpatients with endocrine diseases as the primary diagnosis throughout the life cycle to develop an effective management strategy. Data were obtained from the Korean National Hospital Discharge In-depth Injury Survey (KNHDS) from [...] Read more.
This study aimed to examine comorbidity associations across age groups of inpatients with endocrine diseases as the primary diagnosis throughout the life cycle to develop an effective management strategy. Data were obtained from the Korean National Hospital Discharge In-depth Injury Survey (KNHDS) from 2006 to 2021, involving 68,515 discharged patients aged ≥ 19 years with a principal diagnosis of endocrine disease. A database was constructed for analysis, extracting general characteristics and comorbidities. Employing R version 4.2.3, the Chi-squared test and the Apriori algorithm of ARM (association rule mining) were used for analyzing general characteristics and comorbidity associations. There were more women (53.1%) than men (46.9%) (p < 0.001, with women (61.2 ± 17.2) having a higher average age than men (58.6 ± 58.6) (p < 0.001). Common comorbidities include unspecified diabetes mellitus; essential (primary) hypertension; unspecified diabetes mellitus; and other disorders of fluid, electrolyte, and acid-base balance. Notably, type 2 diabetes mellitus, disorders of lipoprotein metabolism and other lipidemia, polyneuropathy in diseases classified elsewhere, retinal disorders in diseases classified elsewhere, and essential (primary) hypertension prevail across all age groups. Association rules further highlight specific comorbidities appearing selectively in certain age groups. In conclusion, establishing a management strategy for comorbidities in patients with a primary diagnosis of an endocrine disorder is necessary. Full article
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11 pages, 262 KiB  
Article
Circadian Rhythms and Depression in Adolescents: A Comparative Analysis of First Episode and Recurrent-Episode Groups
by Young-Soo Jang, Hye-Mi Cho, Young-Eun Mok, Su-Hyuk Chi, Chang-Su Han and Moon-Soo Lee
J. Pers. Med. 2023, 13(12), 1665; https://doi.org/10.3390/jpm13121665 - 28 Nov 2023
Viewed by 773
Abstract
Circadian rhythm disruptions are a hallmark feature of mood disorders. Patients experiencing acute depressive episodes report noticeable changes in their sleep–wake cycles. This research explains the association between depression and various circadian rhythm metrics, explicitly focusing on adolescents diagnosed with depressive disorders. Adolescence [...] Read more.
Circadian rhythm disruptions are a hallmark feature of mood disorders. Patients experiencing acute depressive episodes report noticeable changes in their sleep–wake cycles. This research explains the association between depression and various circadian rhythm metrics, explicitly focusing on adolescents diagnosed with depressive disorders. Adolescence is a critical period marked by significant physiological and psychological changes, making it imperative to understand how mood disorders manifest during this phase. However, there have been minimal specific studies in pediatric populations to determine whether circadian rhythm changes differ between adolescents with first and multiple-recurrent depressive episodes. Our study involved a group of 61 adolescents aged between 13 and 18. We performed a cross-sectional study of a clinical population of patients presenting to a child and adolescent psychiatry clinic diagnosed with depression. Participants were asked to complete self-report evaluations using several tools: the Korean version of the Biological Rhythms Interview of Assessment in Neuropsychiatry (K-BRIAN), the Korean Translation of Composite Scale to Measure Morningness-Eveningness (KtCS), and the Seasonal Pattern Assessment Questionnaire (SPAQ). Tools such as the Children’s Depression Inventory (CDI), State-Trait Anxiety Inventory (STAI), and K-Mood Disorder Questionnaire (K-MDQ) were employed for the assessment of clinical characteristics of depression. Based on the frequency of their depressive episodes, participants were bifurcated into two distinct groups: those experiencing their first episode (n = 22, mean age: 15.09 ± 1.44 years) and those with recurrent episodes (n = 39, mean age: 15.95 ± 1.26 years). At first, the two groups’ data revealed no significant differences regarding mood or circadian rhythm metrics (CDI: first episode 26.18 ± 10.54 and recurrent episode 25.90 ± 10.59, STAI-S: first episode 56.91 ± 12.12 and recurrent episode 57.49 ± 11.93, STAI-T: first episode 60.36 ± 11.63 and recurrent episode 59.09 ± 12.10, SPAQ-total: first episode 6.59 ± 4.86 and recurrent episode 6.77 ± 5.23, KtCS: first episode 30.32 ± 5.83 and recurrent episode 28.13 ± 7.36). However, we observed significant correlations between circadian rhythm disruptions and depression scales (CDI with SPAQ-weight (r = 0.26), KtCS (r = −0.48), K-BRIAN-sleep (r = 0.58), K-BRIAN-activity (r = 0.64), K-BRIAN-social (r = 0.71), and K-BRIAN-eating (r = 0.40)). These correlations were especially pronounced in the recurrent episode group, suggesting that with the progression and chronicity of depression, the relationship between circadian rhythms and depression becomes more intertwined and evident. In conclusion, especially in adolescents, as the severity and chronicity of depression increase, the interplay between circadian rhythms and mood disorders becomes more pronounced, warranting further research and clinical attention. Full article
11 pages, 289 KiB  
Article
Preventing Dementia—A Cross-Sectional Study of Outpatients in a Tertiary Internal Medicine Department
by Ioana-Alexandra Sandu, Ramona Ștefăniu, Teodora Alexa-Stratulat, Adina-Carmen Ilie, Sabinne-Marie Albișteanu, Ana-Maria Turcu, Călina-Anda Sandu, Anisia-Iuliana Alexa, Anca-Iuliana Pîslaru, Gabriela Grigoraș, Cristinel Ștefănescu and Ioana-Dana Alexa
J. Pers. Med. 2023, 13(12), 1630; https://doi.org/10.3390/jpm13121630 - 22 Nov 2023
Viewed by 726
Abstract
Dementia is a significant health problem worldwide, being the seventh leading cause of death (2,382,000 deaths worldwide in 2016). Recent data suggest there are several modifiable risk factors that, if addressed, can decrease dementia risk. Several national dementia screening programs exist; however, limited-income [...] Read more.
Dementia is a significant health problem worldwide, being the seventh leading cause of death (2,382,000 deaths worldwide in 2016). Recent data suggest there are several modifiable risk factors that, if addressed, can decrease dementia risk. Several national dementia screening programs exist; however, limited-income countries do not have the means to implement such measures. We performed a prospective cross-sectional study in an outpatient department to identify individuals at risk for dementia. Patients with no known cognitive dysfunction seeking a medical consult were screened for dementia risk by means of the cardiovascular risk factors, ageing, and dementia (CAIDE) and modified CAIDE tests. Additionally, we collected demographic and clinical data and assessed each participant for depression, mental state, and ability to perform daily activities. Of the 169 patients enrolled, 63.3% were identified as being in the intermediate-risk or high-risk group, scoring more than seven points on the mCAIDE test. Over 40% of the elderly individuals in the study were assessed as “somewhat depressed” or “depressed” on the geriatric depression scale. Almost 10% of the study population was diagnosed de novo with cognitive dysfunction. In conclusion, using a simple questionnaire such as the mCAIDE in a predefined high-risk population is easy and does not represent a major financial burden. At-risk individuals can subsequently benefit from personalized interventions that are more likely to be successful. Limited-resource countries can implement such screening tools in outpatient clinics. Full article
7 pages, 1272 KiB  
Interesting Images
Obstructed Hemi-Vagina with Ipsilateral Renal Agenesis Syndrome in Adulthood: A Diagnostic Challenge
by Alexandros Loukas Grammatis, Femi Ajibade, Dinuke Warakaulle and Tunde Dada
Diagnostics 2023, 13(21), 3377; https://doi.org/10.3390/diagnostics13213377 - 03 Nov 2023
Viewed by 684
Abstract
A patient in her early 20s presented with constant and progressive lower abdominal and back pain, mainly on the right side of the abdomen, purulent vaginal discharge and pyrexia. A radiological assessment revealed a possible tubo-ovarian abscess and the incidental diagnosis of ipsilateral [...] Read more.
A patient in her early 20s presented with constant and progressive lower abdominal and back pain, mainly on the right side of the abdomen, purulent vaginal discharge and pyrexia. A radiological assessment revealed a possible tubo-ovarian abscess and the incidental diagnosis of ipsilateral renal agenesis. The patient was treated for pelvic inflammatory disease (PID); however, after antibiotic administration and since the symptoms did not resolve, an abdominal MRI was requested, which revealed uterus didelphys with two cervices, an obstructed haemivagina and evidence of haematocolpos. The diagnosis of Obstructed Hemi-Vagina with Ipsilateral Renal Agenesis (OHVIRA) syndrome was confirmed, and the patient underwent the excision of the vaginal septum, the drainage of the haematopyocolpos and the laparoscopic drainage of the tubo-ovarian abscess. She achieved a good recovery. Full article
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6 pages, 642 KiB  
Opinion
New Paradigms for Thoracic Outlet Compression and Thoracic Outlet Syndrome, with or without Complications or Sequelae: A Trans-Continental and Trans-Disciplinary Opinion Paper
by Pierre Abraham, Paul W. Wennberg, Pascal Bauer, Yongquan Gu, Nafi Ouedraogo, Lianrui Guo, Garry Tew, Lucia Mazzolai, Romeo Martini and Samir Henni
J. Vasc. Dis. 2023, 2(4), 413-418; https://doi.org/10.3390/jvd2040032 - 02 Nov 2023
Cited by 1 | Viewed by 705
Abstract
The anatomy of the human shoulder predisposes the neurovascular bundle to compression at different levels of the thoracic outlet during abduction of the arm. There are four possible levels of compression at the thoracic outlet pathway: at the costo-clavicular angle, the inter-scalenic angle, [...] Read more.
The anatomy of the human shoulder predisposes the neurovascular bundle to compression at different levels of the thoracic outlet during abduction of the arm. There are four possible levels of compression at the thoracic outlet pathway: at the costo-clavicular angle, the inter-scalenic angle, under the pectoralis minor muscle or at the level of the humeral head. The positional thoracic outlet compression (TOC) often remains completely asymptomatic. When symptomatic, compressions are collectively referred to as thoracic outlet syndrome (TOS) and may require surgery if physical therapy fails to improve symptoms. The “thoracic outlet compression with complications or sequelae” (the acronym of which is “TOC-CS”, which can be simplified as “TOX”) will almost invariably lead to surgery to release the compression, and other possible treatment targeting the complications as required. There is a continuum between TOC, TOS and TOX, which are simply different clinical stages of the same mechanical issue, just like the Rutherford grades represent different stages of lower extremity arterial disease. We believe that discriminating between TOC, TOS and TOX clarifies clinical definitions and their respective treatment options. TOC is to be considered as a physiological positional phenomenon, TOS requires medical or surgical treatment and surgery should be considered as a primary option in TOX. Full article
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13 pages, 1753 KiB  
Article
Urinary Liver-Type Fatty Acid Binding Protein, a Biomarker for Disease Progression, Dialysis and Overall Mortality in Chronic Kidney Disease
by Nicos Mitsides, Vikram Mitra, Ananya Saha, Shelly Harris, Philip A. Kalra and Sandip Mitra
J. Pers. Med. 2023, 13(10), 1481; https://doi.org/10.3390/jpm13101481 - 11 Oct 2023
Viewed by 846
Abstract
Chronic kidney disease (CKD) is a major public health concern with an increasing proportion of sufferers progressing to renal replacement therapy (RRT). Early identification of those at risk of disease progression could be key in improving outcomes. We hypothesise that urinary liver-type fatty [...] Read more.
Chronic kidney disease (CKD) is a major public health concern with an increasing proportion of sufferers progressing to renal replacement therapy (RRT). Early identification of those at risk of disease progression could be key in improving outcomes. We hypothesise that urinary liver-type fatty acid binding protein (uL-FABP) may be a suitable biomarker for CKD progression and can add value to currently established biomarkers such as the urinary protein-to-creatinine ratio (uPCR). A total of 583 participants with CKD 1–5 (not receiving renal replacement therapy) entered a 2 yr prospective longitudinal study. UPCR and uL-FABP were measured at baseline and CKD progression was defined as either (i) a decline in eGFR of >5 mL/min/1.73 m2 or an increase in serum creatinine by 10% at 1 yr; (ii) a decline in eGFR of >6 mL/min/1.73 m2 or an increase in serum creatinine by 20% at 2 yrs; or (iii) the initiation of RRT. A combined outcome of initiating RRT or death was also included. Approximately 40% of participants showed CKD progression. uL-FABP predicted CKD progression at both years 1 and 2 (OR 1.01, p < 0.01). Sensitivity and specificity were comparable to those of uPCR (AUC 0.623 v 0.706) and heat map analysis suggested that uL-FABP in the absence of significant proteinuria can predict an increase in serum creatinine of 10% at 1 yr and 20% at 2 yrs. The risk of the combined outcome of initiating RRT or death was 23% higher in those with high uL-FABP (p < 0.01) independent of uPCR. uL-FABP appears to be a highly sensitive and specific biomarker of CKD progression. The use of this biomarker could enhance the risk stratification of CKD and its progression and should be assessed further. Full article
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14 pages, 910 KiB  
Article
The Worsening of Heart Failure with Reduced Ejection Fraction: The Impact of the Number of Hospital Admissions in a Cohort of Patients
by Jorge Perea-Armijo, José López-Aguilera, Rafael González-Manzanares, Cristina Pericet-Rodriguez, Juan Carlos Castillo-Domínguez, Gloria Heredia-Campos, Álvaro Roldán-Guerra, Cristina Urbano-Sánchez, Lucas Barreiro-Mesa, Nerea Aguayo-Caño, Mónica Delgado-Ortega, Manuel Crespín-Crespín, Martín Ruiz-Ortiz, Dolores Mesa-Rubio, Manuel Pan-Álvarez Osorio and Manuel Anguita-Sánchez
J. Clin. Med. 2023, 12(18), 6082; https://doi.org/10.3390/jcm12186082 - 20 Sep 2023
Viewed by 869
Abstract
Background: Worsening heart failure (WFH) includes heart failure (HF) hospitalisation, representing a strong predictor of mortality in patients with heart failure with reduced ejection fraction (HFrEF). However, there is little evidence analysing the impact of the number of previous HF admissions. Our main [...] Read more.
Background: Worsening heart failure (WFH) includes heart failure (HF) hospitalisation, representing a strong predictor of mortality in patients with heart failure with reduced ejection fraction (HFrEF). However, there is little evidence analysing the impact of the number of previous HF admissions. Our main objective was to analyse the clinical profile according to the number of previous admissions for HF and its prognostic impact in the medium and long term. Methods: A retrospective study of a cohort of patients with HFrEF, classified according to previous admissions: cohort-1 (0–1 previous admission) and cohort-2 (≥2 previous admissions). Clinical, echocardiographic and therapeutic variables were analysed, and the medium- and long-term impacts in terms of hospital readmissions and cardiovascular mortality were assessed. A total of 406 patients were analysed. Results: The mean age was 67.3 ± 12.6 years, with male predominance (73.9%). Some 88.9% (361 patients) were included in cohort-1, and 45 patients (11.1%) were included in cohort-2. Cohort-2 had a higher proportion of atrial fibrillation (49.9% vs. 73.3%; p = 0.003), chronic kidney disease (36.3% vs. 82.2%; p < 0.001), and anaemia (28.8% vs. 53.3%; p = 0.001). Despite having similar baseline ventricular structural parameters, cohort-1 showed better reverse remodelling. With a median follow-up of 60 months, cohort-1 had longer survival free of hospital readmissions for HF (37.5% vs. 92%; p < 0.001) and cardiovascular mortality (26.2% vs. 71.9%; p < 0.001), with differences from the first month. Conclusions: Patients with HFrEF and ≥2 previous admissions for HF have a higher proportion of comorbidities. These patients are associated with worse reverse remodelling and worse medium- and long-term prognoses from the early stages, wherein early identification is essential for close follow-up and optimal intensive treatment. Full article
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19 pages, 1379 KiB  
Systematic Review
The Influence of Electroconvulsive Therapy (ECT) on Brain-Derived Neurotrophic Factor (BDNF) Plasma Level in Patients with Schizophrenia—A Systematic Review and Meta-Analysis
by Anna Maria Szota, Beata Kowalewska, Małgorzata Ćwiklińska-Jurkowska and Wiktor Dróżdż
J. Clin. Med. 2023, 12(17), 5728; https://doi.org/10.3390/jcm12175728 - 02 Sep 2023
Viewed by 1063
Abstract
The main aim of this systematic review and meta-analysis is to establish whether there is a correlation between the brain-derived neurotrophic factor (BDNF) level and electroconvulsive therapy (ECT) treatment and the reduction in psychotic symptoms in patients diagnosed with schizophrenia. A systematic search [...] Read more.
The main aim of this systematic review and meta-analysis is to establish whether there is a correlation between the brain-derived neurotrophic factor (BDNF) level and electroconvulsive therapy (ECT) treatment and the reduction in psychotic symptoms in patients diagnosed with schizophrenia. A systematic search of PubMed/Medline, Cochrane Library, Web of Science, Scopus and Embase was conducted up to March 2023. Inclusion criteria: studies in which adult patients with schizophrenia treated with antipsychotic medication received ECT therapy and had the BDNF level measured before and after ECT treatment. Exclusion criteria: animal and in vitro studies or studies not involving complete information about the treatment and concentration of BDNF in plasma. The risk of bias was assessed using Egger’s regression-based test for meta-analysis with continuous outcomes. Six studies comprising 248 individuals with schizophrenia were included. A statistically significant increase in BDNF levels after ECT treatment was observed only in two studies (p < 0.001 and p < 0.027, respectively), whereas in four other studies, an upward trend without statistical significance was noticed. The estimated overall size effect revealed that ECT therapy caused a slight change in the BDNF level but without statistical significance (ES = −0.328). Different numbers of ECT procedures (4-10), final measurement of the BDNF level made at a different time point, using bilateral or unilateral electrode positioning during ECT and treatment with different combinations of typical or atypical antipsychotic medications may be potential reasons for the lack of statistical significance in the changes in BDNF levels after treatment. Data regarding the measurement of BDNF levels pre and post ECT therapy in patients with schizophrenia are very limited without an extended follow-up period and evaluation of mental health change. Our meta-analysis showed that treatment with ECT therapy and antipsychotic medication increases serum BDNF levels in patients with drug-resistant schizophrenia compared to patients treated with medication only; however, this effect is not statistically significant. Full article
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13 pages, 2434 KiB  
Article
High Frequency of Osteophytes Detected by High-Resolution Ultrasound at the Finger Joints of Asymptomatic Factory Workers
by Mario Giulini, Ralph Brinks, Stefan Vordenbäumen, Hasan Acar, Jutta G. Richter, Xenofon Baraliakos, Benedikt Ostendorf, Matthias Schneider, Oliver Sander and Philipp Sewerin
J. Pers. Med. 2023, 13(9), 1343; https://doi.org/10.3390/jpm13091343 - 30 Aug 2023
Viewed by 762
Abstract
Hand Osteoarthritis (HOA) is a frequently occurring musculoskeletal disease that impacts health. Diagnostic criteria often incorporate osteophytes documented through imaging procedures. Radiographic imaging is considered the gold standard; however, more sensitive and safer methods like ultrasound imaging are becoming increasingly important. We conducted [...] Read more.
Hand Osteoarthritis (HOA) is a frequently occurring musculoskeletal disease that impacts health. Diagnostic criteria often incorporate osteophytes documented through imaging procedures. Radiographic imaging is considered the gold standard; however, more sensitive and safer methods like ultrasound imaging are becoming increasingly important. We conducted a population-based cross-sectional study to examine the prevalence, grade, and pattern of osteophytes using high-resolution ultrasound investigation. Factory workers were recruited on-site for the study. Each participant had 26 finger joints examined using ultrasonography to grade the occurrence of osteophytes on a semi-quantitative scale ranging from 0–3, where higher scores indicate larger osteophytes. A total of 427 participants (mean age 53.5 years, range 20–79 years) were included, resulting in 11,000 joints scored. At least one osteophyte was found in 4546 out of 11,000 (41.3%) joints or in 426 out of 427 (99.8%) participants, but only 5.0% (553) of the joints showed grade 2 or 3 osteophytes. The total osteophyte sum score increased by 0.18 per year as age increased (p < 0.001). The distal interphalangeal joints were the most commonly affected, with 61%, followed by the proximal interphalangeal joints with 48%, carpometacarpal joint 1 with 39%, and metacarpophalangeal joints with 16%. There was no observed impact of gender or workload. In conclusion, ultrasound imaging proves to be a practical screening tool for osteophytes and HOA. Grade 1 osteophytes are often detected in the working population through ultrasound assessments and their incidence increases with age. The occurrence of grade 2 or 3 osteophytes is less frequent and indicates the clinical presence of HOA. Subsequent evaluations are imperative to ascertain the predictive significance of early osteophytes. Full article
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13 pages, 1138 KiB  
Article
Cancer and Pregnancy: Estimates in Italy from Record-Linkage Procedures between Cancer Registries and the Hospital Discharge Database
by Daniela Pierannunzio, Alice Maraschini, Tania Lopez, Serena Donati, Rosalba Amodio, Fortunato Bianconi, Rossella Bruni, Marine Castaing, Claudia Cirilli, Giovanna Fantaci, Linda Guarda, Silvia Iacovacci, Lucia Mangone, Guido Mazzoleni, Walter Mazzucco, Anna Melcarne, Elisabetta Merlo, Fabio Parazzini, Fedro Alessandro Peccatori, Massimo Rugge, Giuseppe Sampietro, Giovanni Scambia, Giovanna Scarfone, Ausilia Sferrazza, Fabrizio Stracci, Antonina Torrisi, Maria Francesca Vitale and Silvia Francisciadd Show full author list remove Hide full author list
Cancers 2023, 15(17), 4305; https://doi.org/10.3390/cancers15174305 - 28 Aug 2023
Viewed by 850
Abstract
The aim of this study is to describe the frequency and trend of pregnancy-associated cancer (PAC) in Italy, an increasingly relevant phenomenon due to postponing age at childbirth. To this purpose, a population-based retrospective longitudinal study design based on cohorts of women aged [...] Read more.
The aim of this study is to describe the frequency and trend of pregnancy-associated cancer (PAC) in Italy, an increasingly relevant phenomenon due to postponing age at childbirth. To this purpose, a population-based retrospective longitudinal study design based on cohorts of women aged 15–49 diagnosed with cancer and concomitant pregnancy is proposed. The study uses 19 population-based Cancer Registries, covering about 22% of Italy, and linked at an individual level with Hospital Discharge Records. A total of 2,861,437 pregnancies and 3559 PAC are identified from 74,165 women of the cohort with a rate of 1.24 PAC per 1000 pregnancies. The most frequent cancer site is breast (24.3%), followed by thyroid (23.9%) and melanoma (14.3%). The most frequent outcome is delivery (53.1%), followed by voluntary termination of pregnancy and spontaneous abortion (both 12.0%). The trend of PAC increased from 2003 to 2015, especially when the outcome is delivery, thus confirming a new attitude of clinicians to manage cancer throughout pregnancy. This represents the first attempt in Italy to describe PAC from Cancer Registries data; the methodology is applicable to other areas with the same data availability. Evidence from this study is addressed to clinicians for improving clinical management of women with PAC. Full article
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12 pages, 470 KiB  
Review
Fibrotic Diseases of the Human Urinary and Genital Tract: Current Understanding and Potential Strategies for Treatment
by Harrina E. Rahardjo, Viktoria Märker, Dimitrios Tsikas, Markus A. Kuczyk, Stefan Ückert and Andreas Bannowsky
J. Clin. Med. 2023, 12(14), 4770; https://doi.org/10.3390/jcm12144770 - 19 Jul 2023
Viewed by 1502
Abstract
Fibrosis is a disease condition characterized by abnormalities of the extracellular matrix, such as accumulation of the transforming growth factor β, infiltration by myofibroblasts, deposition of collagen, and a generalized dysregulation of collagen maturation. It can severely impair the function of organs by [...] Read more.
Fibrosis is a disease condition characterized by abnormalities of the extracellular matrix, such as accumulation of the transforming growth factor β, infiltration by myofibroblasts, deposition of collagen, and a generalized dysregulation of collagen maturation. It can severely impair the function of organs by replacing normal tissue with a highly collagenized matrix, thereby reducing the elasticity and compliance of tissues. Fibrotic diseases of the genitourinary tract present relevant problems in healthcare, and their principles of pathophysiology remain unclarified; hence, the armamentarium for prevention and treatment is limited. These diseases include renal fibrosis, Peyronie’s disease and ureteral and urethral strictures due to perturbations in the process of wound healing in response to injuries. Such deteriorations may contribute to obstructive uropathies or sexual dysfunction. This review provides a brief overview of the most frequent fibrotic diseases of the genitourinary system and of how the pathophysiology is related to symptoms, and also highlights potential therapeutic strategies to address the abnormal deposition of collagen. Although the understanding of factors associated with fibrotic conditions of the urinary and genital tract is still limited, some beneficial advances have been made. Further research will serve to provide a more comprehensive insight into factors responsible for the development of fibrotic tissue deposition. Full article
(This article belongs to the Topic Diagnosis, Management, and Prognostic Assessment of Chronic Disease)
(This article belongs to the Section Nephrology & Urology)
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12 pages, 1609 KiB  
Article
Previous Lumbar Spine Surgery Decreases the Therapeutic Efficacy of Dorsal Root Ganglion Pulsed Radiofrequency in Patients with Chronic Lumbosacral Radicular Pain
by Jiri Jandura, Milan Vajda, Roman Kostysyn, Jiri Vanasek, Eva Cermakova, Jan Zizka and Pavel Ryska
J. Pers. Med. 2023, 13(7), 1054; https://doi.org/10.3390/jpm13071054 - 27 Jun 2023
Cited by 1 | Viewed by 907
Abstract
Chronic lumbosacral radicular pain (CLRP) as a possible adverse consequence of lumbar spine surgery represents a serious medical challenge. Pulsed radiofrequency of dorsal root ganglion (PRF–DRG) treatment is known to be effective in alleviating CLRP. This retrospective study compares the efficacy of a [...] Read more.
Chronic lumbosacral radicular pain (CLRP) as a possible adverse consequence of lumbar spine surgery represents a serious medical challenge. Pulsed radiofrequency of dorsal root ganglion (PRF–DRG) treatment is known to be effective in alleviating CLRP. This retrospective study compares the efficacy of a single CT-guided PRF–DRG procedure in the treatment of unilateral CLRP between patients without (non-PSS) and with (PSS) previous lumbar spine surgery. Non-PSS and PSS groups included 30 and 20 patients, respectively. Outcomes (pain intensity and disability) were evaluated by means of the visual analog scale (VAS) and Oswestry disability index (ODI) immediately after the procedure (VAS), as well as three and six months after the procedure, respectively. Non-PSS group showed a significant (p ˂ 0.001) decrease of VAS (median) at all follow-up intervals (from 6 to 4; 4; 4.5 points, respectively). The PSS group showed a significant yet transient VAS (median) decrease (from 6 to 5 points) immediately after the procedure only (p < 0.001). The decrease of VAS was more pronounced in the non-PSS group after three and six months (p = 0.0054 and 0.011, respectively) in intergroup comparison. A relative decrease of VAS ≥ 50% during follow-up was achieved in 40%; 43.3%; 26.7% (non-PSS), and 25%; 5%; 0% (PSS) of patients. ODI (median) significantly decreased in the non-PSS group (from 21.5 to 18 points) at three and six months (p = 0.014 and 0.021, respectively). In conclusion, previous lumbar spine surgery decreases the therapeutic efficacy of PRF–DRG procedure in CLRP patients. Full article
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15 pages, 481 KiB  
Article
Association between Psychological, Biochemical and Personal Factors with the Inflammatory Marker High-Sensitive C Reactive Protein (Hs-CRP) in Mexican Healthy Population
by Aniel Jessica Leticia Brambila-Tapia, Ana Lilia Jacquez-Castañeda, Laura Arely Carrillo-Delgadillo, Jessica Natalia Dávila-Flores, Fabiola Macías-Espinoza, Saúl Ramírez-De Los Santos and Itzae Adonai Gutiérrez-Hurtado
J. Pers. Med. 2023, 13(5), 876; https://doi.org/10.3390/jpm13050876 - 22 May 2023
Viewed by 1293
Abstract
In the last decades, it has been shown that inflammatory processes play a role in the development of mental and physical problems; although some studies have researched the relationship between inflammation and psychological variables, the inclusion of biochemical variables as possible confounders has [...] Read more.
In the last decades, it has been shown that inflammatory processes play a role in the development of mental and physical problems; although some studies have researched the relationship between inflammation and psychological variables, the inclusion of biochemical variables as possible confounders has been limited. Therefore, the aim of this study was to determine whether psychological variables are associated with the inflammatory marker, highly sensitive CRP (hs-CRP), after controlling for personal and biochemical variables in the Mexican population. The study was performed at the University of Guadalajara facilities, during the second half of 2022. Healthy subjects were invited to participate in the study, which consisted of the measurement of personal, psychological, and biochemical variables. We included 172 participants, 92 (52.9%) of which were women; the median (range) of age of the whole sample was 22 (18–69) years old. In the bivariate analysis, significant positive correlations were observed between hs-CRP and body mass index (BMI) and waist/hip ratio (WHR) in both sexes, together with leukocytes, uric acid, low-density lipoprotein (LDL), triglycerides, and the liver enzymes gamma glutamyl transferase (GGT) and alkaline phosphatase (ALP). In the multivariate regression analysis of the global and men’s samples, anxiety was positively associated with hs-CRP, while depression and positive relations with others were negatively associated with hs-CRP. In conclusion, psychological variables influence inflammation mainly in men, and anxiety was the main contributor; in addition, positive relation with others is a variable that should be further explored as a psychological protector of inflammation in both sexes. Full article
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9 pages, 1371 KiB  
Brief Report
Increased Red Blood Cell Distribution Predicts Severity of Chronic Obstructive Pulmonary Disease Exacerbation
by Elias Saad, Basheer Maamoun and Assy Nimer
J. Pers. Med. 2023, 13(5), 843; https://doi.org/10.3390/jpm13050843 - 17 May 2023
Cited by 1 | Viewed by 1628
Abstract
Introduction: Increased red blood cell distribution width (RDW) has been reported to be related to underlying chronic inflammation. Our aim is to investigate the relationship of different complete blood count (CBC) parameters such as hemoglobin level, mean corpuscular volume (MCV), mean platelet volume [...] Read more.
Introduction: Increased red blood cell distribution width (RDW) has been reported to be related to underlying chronic inflammation. Our aim is to investigate the relationship of different complete blood count (CBC) parameters such as hemoglobin level, mean corpuscular volume (MCV), mean platelet volume (MPV) or RDW with COPD exacerbation severity. Methods: In the present retrospective analysis, consecutive patients admitted with the diagnosis of “COPD Exacerbation” between 1 January 2012 and 31 December 2015 were evaluated. Results: The study population included 804 patients with COPD exacerbation. The maximal partial pressure of carbon dioxide in the arterial blood (PaCO2) during hospital stay was significantly higher in patients with high MCV (p < 0.001), and in patients with a high RDW (p < 0.001). The hospitalization duration was significantly longer in patients with high RDW (p < 0.001) and in patients with elevated C-reactive protein (CRP) levels (p < 0.001). CRP levels strongly correlated to RDW (p = 0.001). Conclusions: Our study demonstrated that different CBC parameters, such as MCV and RDW, are in correlation with the severity of acute exacerbation of COPD reflected by the PaCO2 level and the duration of hospitalization. Furthermore, we also found a positive correlation between RDW and CRP levels. This finding supports the hypothesis that RDW is a good biomarker of acute inflammation. Full article
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11 pages, 315 KiB  
Article
Hemophilic Arthropathy of the Knee and Its Association with Reduced Muscle Strength and Activation and the Pressure Pain Threshold: A Case-Control Study
by Mar Villalón-González, Íñigo Fernández de Luco-Santamaría, Rubén Cuesta-Barriuso, José Antonio López-Pina and Raúl Pérez-Llanes
J. Clin. Med. 2023, 12(9), 3275; https://doi.org/10.3390/jcm12093275 - 04 May 2023
Cited by 1 | Viewed by 989
Abstract
(1) Background: Hemophilia is characterized by recurrent hemarthrosis leading to degenerative arthropathy. The aim was to evaluate the differences in muscle strength and activity and the pressure pain threshold between patients with knee arthropathy and their healthy peers; (2) Methods: A case-control study [...] Read more.
(1) Background: Hemophilia is characterized by recurrent hemarthrosis leading to degenerative arthropathy. The aim was to evaluate the differences in muscle strength and activity and the pressure pain threshold between patients with knee arthropathy and their healthy peers; (2) Methods: A case-control study in which 23 adult patients with knee arthropathy and 24 healthy peers matched in terms of characteristics were recruited. The study variables were quadriceps muscle strength, muscle activation and the pressure pain threshold; (3) Results: There were significant differences between the two groups in quadriceps strength on the dominant (CI95%: 64.69, 129.2) and non-dominant (CI95%: 29.95, 93.55) sides and in the pressure pain threshold on the dominant (CI95%: 3.30, 43.54) and non-dominant (CI95%: 3.09, 45.25) sides. There were differences in neuromuscular fatigue on the non-dominant side in the vastus medialis (CI95%: 8.72, 21.51), vastus lateralis (CI95%: 4.84, 21.66) and rectus femoris (CI95%: 6.48, 24.95) muscles; (4) Conclusions: Muscle strength and the pressure pain threshold are lower in patients with hemophilia. Quadriceps muscle activation in patients with hemophilic knee arthropathy does not in any way differ from activation in healthy subjects. However, muscle fatigue is greater in patients with knee arthropathy. Strength training in patients with hemophilia should focus on the activation of the vastus medialis and lateralis muscles. Full article
14 pages, 469 KiB  
Article
Development of a Predictive Model of Cardiovascular Risk in a Male Population from the Peruvian Amazon
by Jose M. Alcaide-Leyva, Manuel Romero-Saldaña, María García-Rodríguez, Rafael Molina-Luque, Rocío Jiménez-Mérida and Guillermo Molina-Recio
J. Clin. Med. 2023, 12(9), 3199; https://doi.org/10.3390/jcm12093199 - 29 Apr 2023
Viewed by 939
Abstract
Background: The coexistence of malnutrition due to over- and under-nutrition in the Peruvian Amazon increases chronic diseases and cardiovascular risk. Methods: A cross-sectional study of a male population where anthropometric, clinical, and demographic variables were obtained to create a binary logistic regression predictive [...] Read more.
Background: The coexistence of malnutrition due to over- and under-nutrition in the Peruvian Amazon increases chronic diseases and cardiovascular risk. Methods: A cross-sectional study of a male population where anthropometric, clinical, and demographic variables were obtained to create a binary logistic regression predictive model of cardiovascular risk. Results: We compared two methods with good predictive results, finally choosing Model 4 (r2 = 0.57, sensitivity 73.68%, specificity 95.35%, Youden index 0.69, and validity index 94.21), with non-invasive variables such as blood pressure (p < 0.001), hip circumference (p < 0.001), and FINDRISC test result (p < 0.05); Conclusions: We developed a cheap, fast, and non-invasive tool to determine cardiovascular risk in the population of this endemic area. Full article
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8 pages, 246 KiB  
Brief Report
Eosinopenia as a Prognostic Biomarker for Noninvasive Ventilation Use in COPD Exacerbations
by Konstantinos Bartziokas, Evgenia Papathanasiou, Andriana I. Papaioannou, Ilias Papanikolaou, Emmanouil Antonakis, Ioanna Makou, Georgios Hillas, Theodoros Karampitsakos, Ourania Papaioannou, Katerina Dimakou, Vasiliki Apollonatou, Galateia Verykokou, Spyros Papiris, Petros Bakakos, Stelios Loukides and Konstantinos Kostikas
J. Pers. Med. 2023, 13(4), 686; https://doi.org/10.3390/jpm13040686 - 19 Apr 2023
Cited by 2 | Viewed by 1049
Abstract
Background: In recent years, blood eosinophils have been evaluated as a surrogate biomarker for eosinophilic airway inflammation and as a prognostic indicator of the outcomes of hospitalized COPD subjects. During an exacerbation of COPD, eosinopenia has been proposed as a prognostic marker of [...] Read more.
Background: In recent years, blood eosinophils have been evaluated as a surrogate biomarker for eosinophilic airway inflammation and as a prognostic indicator of the outcomes of hospitalized COPD subjects. During an exacerbation of COPD, eosinopenia has been proposed as a prognostic marker of adverse outcomes. Objectives: The aim of the present post hoc analysis was to elucidate the effectiveness of blood eosinophils for predicting the need of NIV in subjects with COPD exacerbation. Methods: Consecutive subjects admitted to a hospital for COPD exacerbation were included in the analysis. The eosinophil count from the first complete blood count was used to designate the eosinophil groups. The relationship between the clinical characteristics and blood eosinophil counts, as dichotomized using 150 cells/μL, was evaluated. Results Subjects with blood eosinophil number < 150 k/μL had a more severe disease on admission compared to subjects with ≥150 k/μL, regarding pH 7.400 (7.36, 7.44) vs. 7.42 (7.38, 7.45), p = 0.008, PO2/FiO2 levels 238.1 (189.8, 278.6) vs. 276.2 (238.2, 305.6), p < 0.001, CRP (mg/L) levels 7.3 (3.1, 19.9) vs. 3.5 (0.7, 7.8), p < 0.001 and required a longer hospital stay (days) 10.0 (8.0, 14.0) vs. 5.0 (3.0, 7.0) p < 0.001 respectively. The number of blood eosinophils correlated with the levels of CRP upon admission (p < 0.001, r = −0.334), with arterial pH upon admission (p < 0.030, r = 0.121), with PO2/FiO2 (p < 0.001, r = −0.248), and with duration of hospital stay (p < 0.001, r = −0.589). In the multinomial logistic regression analysis, blood eosinophil count < 150 k/μL was an independent predictor of the use of NIV during hospital stay. Conclusion: During COPD exacerbation, low blood eosinophil levels upon admission are related to more severe disease and can be used as a predictor of the need of NIV. Further prospective studies are needed to identify the use of blood eosinophil levels as a predictor of unfavorable outcomes. Full article
13 pages, 2231 KiB  
Article
Myocardial Strain during Surveillance Screening Is Associated with Future Cardiac Dysfunction among Survivors of Childhood, Adolescent and Young Adult-Onset Cancer
by Wendy J. Bottinor, Xiaoyan Deng, Dipankar Bandyopadhyay, Gary Coburn, Corey Havens, Melissa Carr, Daniel Saurers, Chantelle Judkins, Wu Gong, Chang Yu, Debra L. Friedman, Scott C. Borinstein and Jonathan H. Soslow
Cancers 2023, 15(8), 2349; https://doi.org/10.3390/cancers15082349 - 18 Apr 2023
Cited by 1 | Viewed by 1283
Abstract
Cardiovascular disease is a leading contributor to mortality among childhood, adolescent and young adult (C-AYA) cancer survivors. While serial cardiovascular screening is recommended in this population, optimal screening strategies, including the use of echocardiography-based myocardial strain, are not fully defined. Our objective was [...] Read more.
Cardiovascular disease is a leading contributor to mortality among childhood, adolescent and young adult (C-AYA) cancer survivors. While serial cardiovascular screening is recommended in this population, optimal screening strategies, including the use of echocardiography-based myocardial strain, are not fully defined. Our objective was to determine the relationship between longitudinal and circumferential strain (LS, CS) and fractional shortening (FS) among survivors. This single-center cohort study retrospectively measured LS and CS among C-AYAs treated with anthracycline/anthracenedione chemotherapy. The trajectory of LS and CS values over time were examined among two groups of survivors: those who experienced a reduction of >5 fractional shortening (FS) units from pre-treatment to the most recent echocardiogram, and those who did not. Using mixed modeling, LS and CS were used to estimate FS longitudinally. A receiver operator characteristic curve was generated to determine the ability of our model to correctly predict an FS ≤ 27%. A total of 189 survivors with a median age of 14 years at diagnosis were included. Among the two survivor groups, the trajectory of LS and CS differed approximately five years from cancer diagnosis. A statistically significant inverse relationship was demonstrated between FS and LS −0.129, p = 0.039, as well as FS and CS −0.413, p < 0.001. The area under the curve for an FS ≤ 27% was 91%. Among C-AYAs, myocardial strain measurements may improve the identification of individuals with cardiotoxicity, thereby allowing earlier intervention. Full article
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20 pages, 2849 KiB  
Article
The Survival Outcomes, Prognostic Factors and Adverse Events following Systemic Chemotherapy Treatment in Bone Sarcomas: A Retrospective Observational Study from the Experience of the Cancer Referral Center in Northern Thailand
by Wachiranun Sirikul, Nida Buawangpong, Dumnoensun Pruksakorn, Chaiyut Charoentum, Pimpisa Teeyakasem and Nut Koonrungsesomboon
Cancers 2023, 15(7), 1979; https://doi.org/10.3390/cancers15071979 - 26 Mar 2023
Viewed by 1524
Abstract
This study aimed to assess survival outcomes, prognostic factors, and adverse events following chemotherapy treatment for osteosarcoma and Ewing’s sarcoma. This retrospective observational study was conducted to collect the data of the patients with osteosarcoma or Ewing’s sarcoma who received chemotherapy treatment between [...] Read more.
This study aimed to assess survival outcomes, prognostic factors, and adverse events following chemotherapy treatment for osteosarcoma and Ewing’s sarcoma. This retrospective observational study was conducted to collect the data of the patients with osteosarcoma or Ewing’s sarcoma who received chemotherapy treatment between 2008 and 2019. The flexible parametric survival model was performed to explore the adjusted survival probability and the prognostic factors. A total of 102 patients (79 with osteosarcoma and 23 with Ewing’s sarcoma) were included. The estimated 5-year disease-free survival (DFS) and 5-year overall survival (OS) probabilities in patients with resectable disease were 60.9% and 63.3% for osteosarcoma, and 54.4% and 88.3% for Ewing’s sarcoma, respectively, whereas the 5-year DFS and 5-year OS for those with unresectable/metastatic disease remained below 25%. Two prognostic factors for osteosarcoma included a response to neoadjuvant chemotherapy and female gender. Ewing’s sarcoma patients aged 25 years and older were significantly associated with poorer survival outcomes. Of 181 chemotherapy treatment cycles, common self-reported adverse symptoms included tumor pain (n = 32, 17.7%), fever (n = 21, 11.6%), and fatigue (n = 16, 8.8%), while common grade III adverse events included febrile neutropenia (n = 13, 7.3%) and neutropenia (n = 9, 5.1%). There was no chemotherapy-related mortality (grade V) or anaphylaxis events. Full article
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19 pages, 1546 KiB  
Article
Association of Alternative Markers of Carbohydrate Metabolism (Fructosamine and 1,5-Anhydroglucitol) with Perioperative Characteristics and In-Hospital Complications of Coronary Artery Bypass Grafting in Patients with Type 2 Diabetes Mellitus, Prediabetes, and Normoglycemia
by Alexey N. Sumin, Natalia A. Bezdenezhnykh, Andrey V. Bezdenezhnykh, Anastasiya A. Kuzmina, Yuliya A. Dyleva and Olga L. Barbarash
Diagnostics 2023, 13(5), 969; https://doi.org/10.3390/diagnostics13050969 - 03 Mar 2023
Viewed by 1229
Abstract
Patients with type 2 diabetes make up 25 to 40% of those referred for coronary bypass surgery, and the impact of diabetes on the results of the operation is studied in various aspects. To assess the state of carbohydrate metabolism before any surgical [...] Read more.
Patients with type 2 diabetes make up 25 to 40% of those referred for coronary bypass surgery, and the impact of diabetes on the results of the operation is studied in various aspects. To assess the state of carbohydrate metabolism before any surgical interventions, including CABG, daily glycemic control, and the determination of glycated hemoglobin (HbA1c) is recommended. Glycated hemoglobin reflects the glucose concentration for the 3 months prior to the measurement, but alternative markers that reflect glycemic fluctuations over a shorter period of time may be useful in preoperative preparation. The aim of this study was to study the relationship between the concentration of alternative markers of carbohydrate metabolism (fructosamine and 1,5-anhydroglucitol) with patients’ clinical characteristics and the rate of hospital complications after coronary artery bypass grafting (CABG). Method. In the cohort of 383 patients, besides the routine examination, additional markers of carbohydrate metabolism were determined before and on days 7–8 after CABG: glycated hemoglobin (HbA1c), fructosamine, and 1,5-anhydroglucitol. We evaluated the dynamics of these parameters in groups of patients with diabetes mellitus, prediabetes, and normoglycemia, as well as the association of these parameters with clinical parameters. Additionally, we assessed the incidence of postoperative complications and factors associated with their development. Results. In all groups of patients (diabetes mellitus, prediabetes, normoglycemia), there was a significant decrease in the level of fructosamine on the 7th day after CABG compared with baseline (p1st–2nd point 0.030, 0.001, and 0.038 in groups 1, 2, and 3, respectively), whereas the level of 1,5-anhydroglucitol did not change significantly. The preoperative level of fructosamine was associated with the risk of surgery according to the EuroSCORE II scale (p = 0.002), as were the number of bypasses (p = 0.012), body mass index and overweightness (p < 0.001 in both cases), triglyceride (p < 0.001) and fibrinogen levels (p = 0.002), preoperative and postoperative glucose and HbA1c levels (p < 0.001 in all cases), left atrium size (p = 0.028), multiplicity of cardioplegia, cardiopulmonary bypass duration and aortic clamp time (p < 0.001 in all cases). The preoperative level of 1,5-anhydroglucitol showed an inverse correlation with fasting glucose and fructosamine levels before surgery (p < 0.001 in all cases), intima media thickness (p = 0.016), and a direct correlation with LV end-diastolic volume (p = 0.020). The combined endpoint (presence of significant perioperative complications + extended hospital stay after surgery >10 days) was identified in 291 patients. In binary logistic regression analysis patient age (p = 0.005) and fructosamine level (p = 0.022) were independently associated with the development of this composite endpoint (presence of significant perioperative complications + extended hospital stay after surgery >10 days). Conclusions: This study demonstrated that in patients after CABG there was the significant decrease in the level of fructosamine compared with baseline, whereas the level of 1,5-anhydroglucitol did not change. Preoperative fructosamine levels were one of the independent predictors of the combined endpoint. The prognostic value of preoperative assessment of alternative markers of carbohydrate metabolism in cardiac surgery deserves further study. Full article
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24 pages, 3348 KiB  
Article
Data Analysis of Impaired Renal and Cardiac Function Using a Combination of Standard Classifiers
by Danijela Tasic, Drasko Furundzic, Katarina Djordjevic, Slobodanka Galovic, Zorica Dimitrijevic and Sonja Radenkovic
J. Pers. Med. 2023, 13(3), 437; https://doi.org/10.3390/jpm13030437 - 28 Feb 2023
Viewed by 1440
Abstract
We examine the significance of the predictive potential of EPI cystatin C (EPI CysC) in combination with NTproBNP, sodium, and potassium in the evaluation of renal function in patients with cardiorenal syndrome using standard mathematical classification models from the domain of artificial intelligence. [...] Read more.
We examine the significance of the predictive potential of EPI cystatin C (EPI CysC) in combination with NTproBNP, sodium, and potassium in the evaluation of renal function in patients with cardiorenal syndrome using standard mathematical classification models from the domain of artificial intelligence. The criterion for the inclusion of subjects with combined impairment of heart and kidney function in the study was the presence of newly discovered or previously diagnosed clinically manifest cardiovascular disease and acute or chronic kidney disease in different stages of evolution. In this paper, five standard classifiers from the field of machine learning were used for the analysis of the obtained data: ensemble of neural networks (MLP), ensemble of k-nearest neighbors (k-NN) and naive Bayes classifier, decision tree, and a classifier based on logistic regression. The results showed that in MLP, k-NN, and naive Bayes, EPI CysC had the highest predictive potential. Thus, our approach with utility classifiers recognizes the essence of the disorder in patients with cardiorenal syndrome and facilitates the planning of further treatment. Full article
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13 pages, 2756 KiB  
Article
Association between Metabolic Obesity Phenotypes and the Burden of Hospitalized Postmenopausal Patients Concomitant with Osteoporosis: A Retrospective Cohort Study Based on the National Readmission Database
by Jie Jiang, Chao Xu, Zinuo Yuan, Junming Han, Zhixiang Wang, Yang Tian, Yingchun Dong, Weibo Xia, Xiude Fan and Jiajun Zhao
J. Clin. Med. 2023, 12(4), 1623; https://doi.org/10.3390/jcm12041623 - 17 Feb 2023
Viewed by 1396
Abstract
Background: The present definition of obesity based on body mass index (BMI) is not accurate and effective enough to identify hospitalized patients with a heavier burden, especially for postmenopausal hospitalized patients concomitant with osteoporosis. The link between common concomitant disorders of major chronic [...] Read more.
Background: The present definition of obesity based on body mass index (BMI) is not accurate and effective enough to identify hospitalized patients with a heavier burden, especially for postmenopausal hospitalized patients concomitant with osteoporosis. The link between common concomitant disorders of major chronic diseases such as osteoporosis, obesity, and metabolic syndrome (MS) remains unclear. Here, we aim to evaluate the impact of different metabolic obesity phenotypes on the burden of postmenopausal hospitalized patients concomitant with osteoporosis in view of unplanned readmissions. Methods: Data was acquired from the National Readmission Database 2018. The study population was classified into metabolically healthy non-obese (MHNO), metabolically unhealthy non-obese (MUNO), metabolically healthy obese (MHO), and metabolically unhealthy obese (MUO) patients. We estimated the associations between metabolic obesity phenotypes and 30- and 90-day unplanned readmissions. A multivariate Cox Proportional Hazards (PH) model was used to assess the effect of factors on endpoints, with results expressed as HR and 95% CI. Results: The 30-day and 90-day readmission rates for the MUNO and MUO phenotypes were higher than that of the MHNO group (all p < 0.05), whereas no significant difference was found between the MHNO and MHO groups. For 30-day readmissions, MUNO raised the risk mildly (hazard ratio [HR] = 1.110, p < 0.001), MHO had a higher risk (HR = 1.145, p = 0.002), and MUO further elevated this risk (HR = 1.238, p < 0.001). As for 90-day readmissions, both MUNO and MHO raised the risk slightly (HR = 1.134, p < 0.001; HR = 1.093, p = 0.014, respectively), and MUO had the highest risk (HR = 1.263, p < 0.001). Conclusions: Metabolic abnormalities were associated with elevated rates and risks of 30- or 90-day readmission among postmenopausal hospitalized women complicated with osteoporosis, whereas obesity did not seem to be innocent, and the combination of these factors led to an additional burden on healthcare systems and individuals. These findings indicate that clinicians and researchers should focus not only on weight management but also metabolism intervention among patients with postmenopausal osteoporosis. Full article
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12 pages, 1469 KiB  
Article
Arterial Stiffness in Patients with Sarcoidosis and Obstructive Sleep Apnea
by Maurice Roeder, Noriane A. Sievi, Stefan Malesevic, Thomas Gaisl, Daniel Franzen and Malcolm Kohler
J. Vasc. Dis. 2023, 2(1), 165-176; https://doi.org/10.3390/jvd2010011 - 16 Feb 2023
Viewed by 1333
Abstract
Background: Obstructive sleep apnea (OSA) and sarcoidosis have both been implied to be risk factors for increased arterial stiffness. However, it is unclear whether an elevated apnea–hypopnea index (AHI) in sarcoidosis patients increases arterial stiffness and thus the cardiovascular risk. Methods: We performed [...] Read more.
Background: Obstructive sleep apnea (OSA) and sarcoidosis have both been implied to be risk factors for increased arterial stiffness. However, it is unclear whether an elevated apnea–hypopnea index (AHI) in sarcoidosis patients increases arterial stiffness and thus the cardiovascular risk. Methods: We performed non-invasive applanation tonometry in 57 adults with sarcoidosis. The participants underwent SphygmoCor to assess arterial stiffness using an aortic augmentation index with a heart rate of 75/min (AIx) and level-3 respiratory polygraphy. An AHI of ≥5/h, ≥15/h, and ≥30/h defined mild, moderate, and severe OSA, respectively. Multivariate regression analysis was used to investigate the association between AIx and AHI, adjusted for prespecified risk factors for AIx. Results: 23 (40%) sarcoidosis patients had at least mild OSA (AHI ≥ 5), while 7 (12%) patients showed AHI ≥ 15/h. AHI was significantly associated with AIx (coef. (95%CI) of 0.31 (0.09/0.52), p = 0.006) even after adjustment for known risk factors of arterial stiffness. While severe OSA was positively associated with increased AIx, mild and moderate OSA were not associated with increased AIx after adjusting for known risk factors. Conclusions: Increased AHI is independently associated with increased arterial stiffness in sarcoidosis patients. Further investigations are needed to underline the association between OSA severity and the magnitude of arterial stiffness. Full article
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15 pages, 2133 KiB  
Article
Establishing a Prediction Model for the Efficacy of Platinum—Based Chemotherapy in NSCLC Based on a Two Cohorts GWAS Study
by Qi Xiao, Chenxue Mao, Ying Gao, Hanxue Huang, Bing Yu, Lulu Yu, Xi Li, Xiaoyuan Mao, Wei Zhang, Jiye Yin and Zhaoqian Liu
J. Clin. Med. 2023, 12(4), 1318; https://doi.org/10.3390/jcm12041318 - 07 Feb 2023
Viewed by 1506
Abstract
Platinum drugs combined with other agents have been the first-line treatment for non-small cell lung cancer (NSCLC) in the past decades. To better evaluate the efficacy of platinum–based chemotherapy in NSCLC, we establish a platinum chemotherapy response prediction model. Here, a total of [...] Read more.
Platinum drugs combined with other agents have been the first-line treatment for non-small cell lung cancer (NSCLC) in the past decades. To better evaluate the efficacy of platinum–based chemotherapy in NSCLC, we establish a platinum chemotherapy response prediction model. Here, a total of 217 samples from Xiangya Hospital of Central South University were selected as the discovery cohort for a genome-wide association analysis (GWAS) to select SNPs. Another 216 samples were genotyped as a validation cohort. In the discovery cohort, using linkage disequilibrium (LD) pruning, we extract a subset that does not contain correlated SNPs. The SNPs with p < 10−3 and p < 10−4 are selected for modeling. Subsequently, we validate our model in the validation cohort. Finally, clinical factors are incorporated into the model. The final model includes four SNPs (rs7463048, rs17176196, rs527646, and rs11134542) as well as two clinical factors that contributed to the efficacy of platinum chemotherapy in NSCLC, with an area under the receiver operating characteristic (ROC) curve (AUC) of 0.726. Full article
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21 pages, 7294 KiB  
Article
A Multi-Omics Analysis of NASH-Related Prognostic Biomarkers Associated with Drug Sensitivity and Immune Infiltration in Hepatocellular Carcinoma
by Yongting Liu, Zhaohui Jiang, Xin Zhou, Yin Li, Ping Liu, Yihong Chen, Jun Tan, Changjing Cai, Ying Han, Shan Zeng, Hong Shen and Ziyang Feng
J. Clin. Med. 2023, 12(4), 1286; https://doi.org/10.3390/jcm12041286 - 06 Feb 2023
Viewed by 1893
Abstract
Background: Nonalcoholic steatohepatitis (NASH)-driven hepatocellular carcinoma (HCC) is becoming a major health-related problem. The exploration of NASH-related prognostic biomarkers and therapeutic targets is necessary. Methods: Data were downloaded from the GEO database. The “glmnet” package was used to identify differentially expressed [...] Read more.
Background: Nonalcoholic steatohepatitis (NASH)-driven hepatocellular carcinoma (HCC) is becoming a major health-related problem. The exploration of NASH-related prognostic biomarkers and therapeutic targets is necessary. Methods: Data were downloaded from the GEO database. The “glmnet” package was used to identify differentially expressed genes (DEGs). The prognostic model was constructed by the univariate Cox and LASSO regression analyses. Validation of the expression and prognosis by immunohistochemistry (IHC) in vitro. Drug sensitivity and immune cell infiltration were analyzed by CTR-DB and ImmuCellAI. Results: We constructed a prognostic model that identified the NASH-related gene set (DLAT, IDH3B, and MAP3K4), which was validated in a real-world cohort. Next, seven prognostic transcription factors (TFs) were identified. The prognostic ceRNA network included three mRNAs, four miRNAs, and seven lncRNAs. Finally, we found that the gene set was associated with drug response which was validated in six clinical trial cohorts. Moreover, the expression level of the gene set was inversely correlated with CD8 T cell infiltration in HCC. Conclusions: We established a NASH-related prognostic model. Upstream transcriptome analysis and the ceRNA network provided clues for mechanism exploration. The mutant profile, drug sensitivity, and immune infiltration analysis further guided precise diagnosis and treatment strategies. Full article
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12 pages, 1200 KiB  
Article
Changes in Clinical Manifestations Due to AFLD Retyping Based on the New MAFLD Criteria: An Observational Study Based on the National Inpatient Sample Database
by Xiaoshan Feng, Ruirui Xuan, Yingchun Dong, Xiaoqin Wu, Yiping Cheng, Zinuo Yuan, Hang Dong, Junming Han, Fang Zhong, Jiajun Zhao and Xiude Fan
Diagnostics 2023, 13(3), 488; https://doi.org/10.3390/diagnostics13030488 - 29 Jan 2023
Cited by 1 | Viewed by 1723
Abstract
(1) Background: As the introduction of “positive” diagnostic criteria for metabolic dysfunction-associated fatty liver disease (MAFLD) does not exclude alcohol consumption, some patients originally diagnosed with alcoholic fatty liver disease (AFLD) may be diagnosed with dual- etiology fatty liver disease (AFLD&MAFLD), which requires [...] Read more.
(1) Background: As the introduction of “positive” diagnostic criteria for metabolic dysfunction-associated fatty liver disease (MAFLD) does not exclude alcohol consumption, some patients originally diagnosed with alcoholic fatty liver disease (AFLD) may be diagnosed with dual- etiology fatty liver disease (AFLD&MAFLD), which requires us to urgently explore the impact of the changes in this classification of AFLD on clinical manifestations. (2) Methods: Utilizing data from the Nationwide Inpatient Sample database 2016–2018, a total of 9269 participants with AFLD were selected. With the definition of MAFLD, these patients were further categorized into two groups: single AFLD and AFLD&MAFLD. The primary outcome was the risk of comorbidities and organ failures. The secondary outcomes were the length of stay, total charges, and in-hospital all-cause mortality. (3) Results: The patients with AFLD&MAFLD were older, were predominantly male, and had more comorbidities and organ failures compared to the patients with AFLD. These comorbidities included coronary atherosclerosis, myocardial infarction, cerebrovascular disease, arrhythmia, asthma, chronic obstructive pulmonary disease, and chronic kidney disease (all p values < 0.05). The patients with AFLD&MAFLD were more likely to develop acute and chronic heart and/or kidney failures than those with single AFLD (all p < 0.05). The length of stay and total charges of the patients in the AFLD&MAFLD group were greater than the single AFLD group (p = 0.029 and p < 0.001, respectively). No significant difference in all-cause mortality was observed. (4) Conclusions: The patients with AFLD&MAFLD have more comorbidities and organ failures, longer hospital stays, and higher hospitalization costs than the patients with single AFLD. Hence, patients with dual-etiology fatty liver disease deserve more attention from clinical staff during treatment. Full article
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11 pages, 1314 KiB  
Article
Development and Validation of a Nomogram for Predicting Blood Pressure Change Failure in Patients with Pheochromocytoma and Concomitant Hypertension after Adrenalectomy
by Yuntian Ge, Yunhong Zhan, Chunyu Pan, Jia Li, Zhenhua Li, Song Bai and Lina Liu
J. Clin. Med. 2023, 12(3), 874; https://doi.org/10.3390/jcm12030874 - 22 Jan 2023
Viewed by 1164
Abstract
(1) Background: Pheochromocytoma is a common cause of secondary hypertension, which is considered curable; nevertheless, some patients still suffer from hypertension after adrenalectomy. Therefore, we developed and validated a nomogram for predicting blood pressure change failure in patients with pheochromocytoma and concomitant hypertension [...] Read more.
(1) Background: Pheochromocytoma is a common cause of secondary hypertension, which is considered curable; nevertheless, some patients still suffer from hypertension after adrenalectomy. Therefore, we developed and validated a nomogram for predicting blood pressure change failure in patients with pheochromocytoma and concomitant hypertension after adrenalectomy. (2) Methods: The development cohort of this study consisted of 259 patients with pheochromocytoma who underwent adrenalectomy at our center between 1 January 2007 and 31 December 2018. Each patient’s clinicopathologic data were recorded. LASSO (the least absolute shrinkage and selection operator) regression was used to reduce and select the features of the data. Furthermore, we used multivariate logistic regression analysis to develop the prediction model. An independent cohort of 110 consecutive patients from 1 January 2019 to 31 December 2021 was used for validation. The performance of this nomogram was assessed with regard to discrimination, calibration, and clinical usefulness. (3) Results: 40.9% and 46.4% of patients experienced blood pressure change failure in the development and validation cohorts of this study, respectively. We found that older patients with a longer duration of hypertension and concomitant cardiovascular events were more likely to suffer from blood pressure change failure. In the validation cohort, the model manifested great discrimination with an AUROC (area under the receiver operating characteristic) of 0.996 (p < 0.001) and good calibration (unreliability test, p = 0.359). Decision curve analysis demonstrated that the model was clinically useful. (4) Conclusions: This study presented a reliable nomogram that facilitated individualized preoperative prediction of blood pressure change failure after adrenalectomy in patients with pheochromocytoma, which may help decision-making in perioperative treatment and follow-up strategies. Full article
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10 pages, 2332 KiB  
Article
Clinical Relevance of a Vancomycin 24 h Area under the Concentration—Time Curve Values Using Different Renal Function Equations in Bayesian Dosing Software
by Hyun-Ki Kim and Tae-Dong Jeong
J. Pers. Med. 2023, 13(1), 120; https://doi.org/10.3390/jpm13010120 - 05 Jan 2023
Viewed by 1283
Abstract
With the updated 2020 vancomycin therapeutic drug monitoring (TDM) guidelines suggesting a ratio of area under the curve over 24 h to a minimum inhibitory concentration (AUC24/MIC) as a target from the Infectious Diseases Society of America, an accurate estimation of [...] Read more.
With the updated 2020 vancomycin therapeutic drug monitoring (TDM) guidelines suggesting a ratio of area under the curve over 24 h to a minimum inhibitory concentration (AUC24/MIC) as a target from the Infectious Diseases Society of America, an accurate estimation of AUC24 has become more critical. We aim to compare the AUC24 using Bayesian dosing software according to various estimated glomerular filtration rate (eGFR) equations in order to analyze the clinical impact of eGFR in vancomycin TDM. We reviewed the TDM dataset of 214 adult patients and analyzed the AUC24 values from various renal function equations, including the Cockcroft-Gault (C-G), the modification of diet in renal disease (MDRD), the chronic kidney disease epidemiology collaboration (CKD-EPI), and the revised Lund–Malmö. The AUC24/MIC results (assuming a MIC of 1 mg/L) were divided into three groups as follows: <400, 400–600, and >600. Additionally, we compared the group agreement between the C-G and the three eGFR formulas. Although there was a statistically significant difference in the AUC24 of the MDRD and the CKD-EPI formulas compared to the C-G, the group concordance rate of the eGFR formula was 95.2–100%, which indicates no clinical significance. The clinical impact of the eGFR formula type on drug dosing recommendations in vancomycin TDM using Bayesian software was insignificant in clinical practice. Full article
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14 pages, 2283 KiB  
Article
Immunodeficiencies Push Readmissions in Malignant Tumor Patients: A Retrospective Cohort Study Based on the Nationwide Readmission Database
by Wenchen Wang, Qingyu Meng, Yiping Cheng, Yalin Han, Yonggan Xue, Yanshen Kuang, Xuning Wang, Bobin Ning, Mu Ke, Zhipeng Teng, Sen Li, Peng Li, Hongyi Liu, Xiude Fan and Baoqing Jia
Cancers 2023, 15(1), 88; https://doi.org/10.3390/cancers15010088 - 23 Dec 2022
Cited by 2 | Viewed by 1103
Abstract
Background: Immunodeficiency diseases (IDDs) are associated with an increased proportion of cancer-related morbidity. However, the relationship between IDDs and malignancy readmissions has not been well described. Understanding this relationship could help us to develop a more reasonable discharge plan in the special tumor [...] Read more.
Background: Immunodeficiency diseases (IDDs) are associated with an increased proportion of cancer-related morbidity. However, the relationship between IDDs and malignancy readmissions has not been well described. Understanding this relationship could help us to develop a more reasonable discharge plan in the special tumor population. Methods: Using the Nationwide Readmissions Database, we established a retrospective cohort study that included patients with the 16 most common malignancies, and we defined two groups: non-immunodeficiency diseases (NOIDDs) and IDDs. Results: To identify whether the presence or absence of IDDs was associated with readmission, we identified 603,831 patients with malignancies at their time of readmission in which 0.8% had IDDs and in which readmission occurred in 47.3%. Compared with NOIDDs, patients with IDDs had a higher risk of 30-day (hazard ratio (HR) of 1.32; 95% CI of 1.25–1.40), 90-day (HR of 1.27; 95% CI of 1.21–1.34) and 180-day readmission (HR of 1.28; 95% CI of 1.22–1.35). More than one third (37.9%) of patients with IDDs had readmissions that occurred within 30 days and most (82.4%) of them were UPRs. An IDD was an independent risk factor for readmission in patients with colorectal cancer (HR of 1.32; 95% CI of 1.01–1.72), lung cancer (HR of 1.23; 95% CI of 1.02–1.48), non-Hodgkin’s lymphoma (NHL) (HR of 1.16; 95% CI of 1.04–1.28), prostate cancer (HR of 1.45; 95% CI of 1.07–1.96) or stomach cancer (HR of 2.34; 95% CI of 1.33–4.14). Anemia (44.2%), bacterial infections (28.6%) and pneumonia (13.9%) were the 30-day UPR causes in these populations. (4) Conclusions: IDDs were independently associated with higher readmission risks for some malignant tumors. Strategies should be considered to prevent the causes of readmission as a post discharge plan. Full article
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10 pages, 1044 KiB  
Article
Pulse Pressure Independent of Mean Arterial Pressure Is Associated with Cardiovascular and All-Cause Mortality in Normotensive Elders: Findings from National Health and Nutrition Examination Survey III 1999–2014
by Yuqi Jiang, Huanrui Zhang, Yu Yang, Yujiao Sun and Wen Tian
J. Vasc. Dis. 2022, 1(2), 113-122; https://doi.org/10.3390/jvd1020013 - 08 Dec 2022
Viewed by 1286
Abstract
Background: Pulse pressure (PP), a marker of arterial stiffening, is closely related to adverse outcomes in hypertensive patients. Correspondingly, less attention has been paid to the value of PP in the population with normal blood pressure. Methods: The study included normotensive elders aged [...] Read more.
Background: Pulse pressure (PP), a marker of arterial stiffening, is closely related to adverse outcomes in hypertensive patients. Correspondingly, less attention has been paid to the value of PP in the population with normal blood pressure. Methods: The study included normotensive elders aged over 60 years from the 1999–2014 National Health and Nutrition Examination Survey (NHANES). All included participants were followed up until the date of death or 31 December 2015. Restricted cubic spline analyses were used to explore the associations of PP with cardiovascular mortality and all-cause mortality. The population was categorized into two groups according to the optimal cut-off of PP for all-cause mortality by X-tile software. Propensity matching score analysis was further performed to reduce confounding bias. The Kaplan–Meier curves and Cox proportional hazard models were applied to estimate the associations of widening PP cardiovascular mortality and all-cause mortality. Subgroup analyses were also conducted. Results: A total of 6309 participants were included (52.9% men and median age 69 (63, 75) years). The median follow-up duration was 74 (42, 114) months. The restricted cubic spline analyses revealed that continuous PP was linearly related to cardiovascular mortality (p for linearity < 0.001; p for nonlinearity = 0.284) and nonlinearly related to all-cause mortality (p for nonlinearity = 0.001). After propensity score matching, 1855 subjects with widening PP and 1855 matched counterparts were included (50.2% men and average age 72 (66, 78) years, 50.9% men and average age 72 (66, 78) years, respectively), of which 966 (26.0%) died during a median follow-up duration of 71 (39, 105) months. In the Cox proportional hazards model, widening PP was associated with increased cardiovascular mortality Hazard Ratio (HR) 1.47; 95% Confidence Interval (CI) 1.07–2.00, p < 0.05] and all-cause mortality (HR 1.15; 95% CI 1.01–1.31, p < 0.05). After adjusting for other traditional risk factors, the association of widening PP with cardiovascular mortality (HR 1.44; 95%CI 1.05–1.98, p < 0.05) remained, and the association of widening PP with all-cause mortality was not statistically significant (p > 0.05). Conclusion: In the normotensive elder population, a low-risk population without traditional coronary risk factors, PP is an independent risk factor for cardiovascular mortality. Full article
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7 pages, 592 KiB  
Article
Measuring the Quality of Life in Patients with Chronic Venous Disease before and Short Term after Surgical Treatment—A Comparison between Different Open Surgical Procedures
by Sergiu-Ciprian Matei, Cristina Ștefania Dumitru and Daniela Radu
J. Clin. Med. 2022, 11(23), 7171; https://doi.org/10.3390/jcm11237171 - 02 Dec 2022
Cited by 3 | Viewed by 1294
Abstract
Chronic venous disease (CVD) is a common pathology that significantly affects the quality of life (QoL) of patients. Methods: QoL was assessed in 317 patients diagnosed with CVD who underwent surgeries, including cryostripping (n = 113), high ligation and stripping (HL&S, n [...] Read more.
Chronic venous disease (CVD) is a common pathology that significantly affects the quality of life (QoL) of patients. Methods: QoL was assessed in 317 patients diagnosed with CVD who underwent surgeries, including cryostripping (n = 113), high ligation and stripping (HL&S, n = 96), and phlebectomies (n = 108). CVD symptoms and QoL were assessed before surgery and 2 weeks after surgery using the following questionnaires: CIVIQ-20, VAS, Eq-5D, PHQ-9 and GAD-9. Results. The results reveal a significant correlation (p < 0.05) between CEAP score and QoL questionnaires performed preoperatively and postoperatively in all three surgical technique groups, with a statistical improvement postoperatively. Phlebectomy had the best postoperative QoL score (r = 0.495) compared to the other two types of procedures. Conclusions: Analyzing patients’ subjective perception following conventional surgery for CVD treatment, an improved QoL is observed both in functional and psychosocial aspects, even early postoperatively. Classical surgical procedures remain an effective and feasible option in CVD treatment. Full article
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