Life | September 2024 - Browse Articles

21 pages, 1618 KiB

Open AccessCase Report

Superficial Vein Thrombosis in an Asymptomatic Case of Cholangiocarcinoma with Recent History of COVID-19

by Mihai-Lucian Ciobica, Bianca-Andreea Sandulescu, Mihai Alexandru Sotcan, Lucian-Marius-Florin Dumitrescu, Lucian-George Eftimie, Cezar-Ionut Calin, Mihaela Iordache, Dragos Cuzino, Mara Carsote, Claudiu Nistor and Ana-Maria Radu

Life 2024, 14(9), 1095; https://doi.org/10.3390/life14091095 (registering DOI) - 30 Aug 2024

Abstract

The COVID-19 pandemic brought into prominence several emergent medical and surgical entities, but, also, it served as trigger and contributor for numerous apparently unrelated ailments such as arterial and venous thromboembolic complications. Additional risk factors for these thrombotic traits may be concurrent (known [...] Read more.

The COVID-19 pandemic brought into prominence several emergent medical and surgical entities, but, also, it served as trigger and contributor for numerous apparently unrelated ailments such as arterial and venous thromboembolic complications. Additional risk factors for these thrombotic traits may be concurrent (known or unknown) malignancies, including at hepatic level. Among these, cholangiocarcinoma (CCA), a rare cancer of intra- and extra-hepatic biliary ducts, represents a very aggressive condition that typically associates local and distant advanced stages on first presentation requiring a prompt diagnosis and a stratified management. This neoplasia has been reported to present a large spectrum of paraneoplastic syndromes in terms of dermatologic, renal, systemic, neurologic, endocrine, and cardiovascular settings, that, overall, are exceptional in their epidemiologic impact when compared to other cancers. Our aim was to introduce a most unusual case of CCA-associated distant thrombosis in a male adult who initially was considered to experience COVID-19-related thrombotic features while having a history of obesity and bariatric surgery. This is a hybrid type of paper: this clinical vignette is accompanied by two distinct sample-focused analyses as a basis for discussion; they each had different methods depending on their current level of statistical evidence. We only included English-published articles in PubMed, as follows: Firstly, we conducted a search of reports similar to the present case, regarding distant vein thrombosis in CCA, from inception until the present time. We performed a literature search using the keywords “cholangiocarcinoma”, “thrombosis”, and “Trousseau’s syndrome” and identified 20 cases across 19 original papers; hence, the current level of evidence remains very low Secondly, we searched for the highest level of statistical evidence concerning the diagnosis of venous thrombosis/thromboembolism in patients who underwent COVID-19 infection (key search terms were “COVID-19”, alternatively, “coronavirus”, and “SARS-CoV-2”, and “thrombosis”, alternatively, “thromboembolism”) and included the most recent systematic reviews and meta-analyses that were published in 2024 (from 1 January 2024 until 8 July 2024). After excluding data on vaccination against coronavirus or long COVID-19 syndrome, we identified six such articles. To conclude, we presented a probably unique case of malignancy with an initial manifestation consisting of recurrent superficial vein thrombosis under anticoagulation therapy, with no gastrointestinal manifestations, in a patient with a notable history for multiple episodes of SARS-CoV-2 infection and a prior endocrine (gastric) surgery. To our knowledge, this is the first identification of a CCA under these specific circumstances. Full article

(This article belongs to the Special Issue Novel Diagnosis and Treatment of Gastrointestinal Disease)

14 pages, 1076 KiB

Open AccessReview

Prostate Cancer: Emerging Modifiable Risk Factors and Therapeutic Strategies in the Management of Advanced Cancer

by Sabrina Bossio, Lidia Urlandini, Anna Perri, Francesco Conforti, Antonio Aversa, Silvia Di Agostino and Vittoria Rago

Life 2024, 14(9), 1094; https://doi.org/10.3390/life14091094 (registering DOI) - 30 Aug 2024

Abstract

Prostate cancer (PCa) is the third highest cause of cancer death in men. PCa is a very heterogeneous tumor form in terms of grade, phenotypes, and genetics, often accompanied by complex networks. PCa is characterized by slow growth that does not compromise the [...] Read more.

Prostate cancer (PCa) is the third highest cause of cancer death in men. PCa is a very heterogeneous tumor form in terms of grade, phenotypes, and genetics, often accompanied by complex networks. PCa is characterized by slow growth that does not compromise the patient’s quality of life, unlike more aggressive forms showing rapid growth and progression. Early diagnosis, even for the most aggressive forms, increases the possibilities of cure with less aggressive treatments and fewer side effects. However, it is important to know how to decrease the exposure to modifiable risk factors, including diet, sedentary life, smoking and alcohol, can represent an effective tool to reduce the incidence of PCa. In addition, the chronic exposure to environmental factors, most of which act as endocrine disruptors, is the focus of recent studies for their potential role in promoting the onset and progression of PCa. Although molecular therapies and clinical trials for biomarker identification have been introduced into the management of PCa, these still lag behind research performed in other solid tumors. This review provides an overview of the modifiable factors of PCa, linked to lifestyle and environmental pollutants, which together with the development of new therapeutic targets, can reduce the incidence of PCa and improve the quality of life of patients. Full article

(This article belongs to the Special Issue Prostate Cancer: 3rd Edition)

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9 pages, 510 KiB

Open AccessArticle

Multiplex-PCR Detection of Clostridium tyrobutyricum, Clostridium butyricum, and Clostridium sporogenes in Raw Milk for Cheesemaking

by Irene Floris, Francesca Martucci, Angelo Romano, Giuseppina Marello, Carmela Ligotti and Daniela Manila Bianchi

Life 2024, 14(9), 1093; https://doi.org/10.3390/life14091093 - 30 Aug 2024

Abstract

Late blowing defects in semi-hard and hard cheeses caused by spore-forming clostridia (e.g., Clostridium tyrobutyricum, Clostridium butyricum, Clostridium sporogenes) pose a major issue for the dairy industry. With this study, we applied a multiplex PCR for the rapid and simultaneous [...] Read more.

Late blowing defects in semi-hard and hard cheeses caused by spore-forming clostridia (e.g., Clostridium tyrobutyricum, Clostridium butyricum, Clostridium sporogenes) pose a major issue for the dairy industry. With this study, we applied a multiplex PCR for the rapid and simultaneous detection of clostridia in raw milk for cheese production. Spore detection in milk usually relies on culture-dependent methods, among which the most probable number (MPN) technique is sensitive but time-consuming and nonspecific. We tested two PCR-based protocols: the one entailed direct milk analysis with results obtained within 24 h; the other included an enrichment step and gave results within 72 h. The second protocol was found to be more sensitive; it detected concentrations as low as 100 cells/L for C. sporogenes and C. butyricum and 800 cells/L for C. tyrobutyricum. Both protocols were applied to field samples (211 samples underwent protocol no. 1; 117 samples underwent protocol no. 2) collected from four dairy processing plants in Piedmont. The prevalence of C. butyricum (protocol no. 1: 9.5%; protocol no. 2: 23%) was higher than either C. sporogenes (0%; 9.4%) or C. tyrobutyricum (0%; 6.8%). Protocol no. 2 detected multiple targets in eight samples, indicating that more than one microorganism was present. Our findings underscore the importance of implementing preventive measures and early detection strategies to mitigate the risk of cheese spoilage due to clostridial contamination. Full article

(This article belongs to the Special Issue Food Microbiological Contamination)

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12 pages, 260 KiB

Open AccessArticle

Pre-Operative Mechanical Bowel Preparation Does Not Affect the Impact of Anastomosis Leakage in Left-Side Colorectal Surgery—A Single Center Observational Study

by Ludovít Danihel, Marian Cerny, Ivor Dropco, Petra Zrnikova, Milan Schnorrer, Marek Smolar, Miloslav Misanik and Stefan Durdik

Life 2024, 14(9), 1092; https://doi.org/10.3390/life14091092 - 30 Aug 2024

Abstract

Despite rapid advances in colorectal surgery, morbidity and mortality rates in elective gastrointestinal surgery play a significant role. For decades, there have been tempestuous discussions on preventative measures to minimize the risk of anastomotic dehiscence. When mechanical bowel preparation before an elective procedure, [...] Read more.

Despite rapid advances in colorectal surgery, morbidity and mortality rates in elective gastrointestinal surgery play a significant role. For decades, there have been tempestuous discussions on preventative measures to minimize the risk of anastomotic dehiscence. When mechanical bowel preparation before an elective procedure, one of the key hypotheses, was introduced into practice, it was assumed that it would decrease the number of infectious complications and anastomotic dehiscence. The advancements in antibiotic treatment supported the concomitant administration of oral antibiotics and mechanical bowel preparation. In the prospective study conducted at our clinic, we performed left-side colorectal procedures without prior mechanical preparation. All patients enrolled in the study underwent the surgery and were observed in the 3rd Surgical Clinic, Faculty of Medicine, Comenius University in Bratislava, Slovakia, from January 2019 to January 2020. As a control group, we used a similar group of patients with MBP. Our observed group included 87 patients with tumors in the left part of their large intestine (lineal flexure, descendent colon, sigmoid colon, and rectum). Dixon laparoscopic resection was performed in 26 patients. Sigmoid laparoscopic resection was performed in 27 patients. In 12 patients, the procedure was started laparoscopically but had to be converted due to adverse anatomical conditions. The conservative approaches mostly included Dixon resections (19 patients), sigmoid colon resections (5 patients), left-side hemicolectomies (6 patients), and Miles’ tumor resections, with rectal amputation (4 patients). Our study highlighted the fact that MBP does not have an unequivocal benefit for patients with colorectal infection, which has an impact on the development of anastomotic dehiscence. Full article

(This article belongs to the Special Issue Advancements in Surgery: Trends in Prevention, Diagnostic and Treatment)

22 pages, 3832 KiB

Open AccessArticle

Comparison of the Skin Microbiota in the Periocular Region between Patients with Inflammatory Skin Diseases and Healthy Participants: A Preliminary Study

by Iva Ferček, Petar Ozretić, Arjana Tambić-Andrašević, Slave Trajanoski, Diana Ćesić, Marko Jelić, Goran Geber, Orjena Žaja, Josipa Paić, Liborija Lugović-Mihić and Rok Čivljak

Life 2024, 14(9), 1091; https://doi.org/10.3390/life14091091 - 30 Aug 2024

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Abstract

(1) Background: Periocular or periorbital dermatitis is a common term for all inflammatory skin diseases affecting the area of skin around the eyes. The clear etiopathogenesis of periocular dermatitis is still not fully understood. Advances in molecular techniques for studying microorganisms living in [...] Read more.

(1) Background: Periocular or periorbital dermatitis is a common term for all inflammatory skin diseases affecting the area of skin around the eyes. The clear etiopathogenesis of periocular dermatitis is still not fully understood. Advances in molecular techniques for studying microorganisms living in and on our bodies have highlighted the microbiome as a possible contributor to disease, as well as a promising diagnostic marker and target for innovative treatments. The aim of this study was to compare the composition and diversity of the skin microbiota in the periocular region between healthy individuals and individuals affected by the specific entity of periocular dermatitis. (2) Methods: A total of 35 patients with periocular dermatitis and 39 healthy controls were enrolled in the study. After a skin swab from the periocular region was taken from all participants, DNA extraction and 16S rRNA gene amplicon sequencing using Illumina NovaSeq technology were performed. (3) Results: Staphylococcus and Corynebacterium were the most abundant bacterial genera in the microbiota of healthy skin. Analysis of alpha diversity revealed a statistically significant change (p < 0.05) in biodiversity based on the Faith’s PD index between patients and healthy individuals. We did not observe changes in beta diversity. The linear discriminant analysis effect size (LEfSe) revealed that Rothia, Corynebacterium, Bartonella, and Paracoccus were enriched in patients, and Anaerococcus, Bacteroides, Porphyromonas, and Enhydrobacter were enriched in healthy controls. (4) Conclusions: According to the results obtained, we assume that the observed changes in the bacterial microbiota on the skin, particularly Gram-positive anaerobic cocci and skin commensals of the genus Corynebacterium, could be one of the factors in the pathogenesis of the investigated inflammatory diseases. The identified differences in the microbiota between healthy individuals and patients with periocular dermatitis should be further investigated. Full article

(This article belongs to the Special Issue Microbiota in Health and Disease)

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17 pages, 668 KiB

Open AccessReview

Clinical Examination, Diagnosis, and Conservative Treatment of Chronic Low Back Pain: A Narrative Review

by Paulien Custers, Erik Van de Kelft, Bart Eeckhaut, Wouter Sabbe, An Hofman, Annick Debuysscher, Gilles Van Acker and Gaethan Maes

Life 2024, 14(9), 1090; https://doi.org/10.3390/life14091090 - 29 Aug 2024

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Abstract

Chronic low back pain is one of the most frequent reasons for medical consultation. It is important to make the correct diagnosis to select the most appropriate treatment in a stepwise approach. In this narrative review, we focus on the clinical examination, the [...] Read more.

Chronic low back pain is one of the most frequent reasons for medical consultation. It is important to make the correct diagnosis to select the most appropriate treatment in a stepwise approach. In this narrative review, we focus on the clinical examination, the diagnosis, and the conservative treatment of chronic non-specific low back pain. Belgian guidelines for low back pain were used as a basis, followed by a snowball search starting from two articles. Besides that, the Cochrane database was consulted using the following research areas: “multidisciplinary biopsychosocial rehabilitation”, “physical examination of lumbar spine”, and “rehabilitation back pain”. Lastly, we took information from three handbooks. The diagnosis of low back pain starts with a thorough history, including red, yellow, orange, black, and blue flags. Physical, neurological, sensory, and motor testing is performed and complemented with specific tests for low back pain. With a focus on the conservative treatment, pharmacological and non-pharmacological treatments are possible. For CNSLBP, conservative management is advised, starting with reassurance and clear patient education about the condition. While additional treatments, such as manipulation, massage, and acupuncture, can be considered, their effectiveness is not well supported by evidence. Our center emphasizes exercise within a multidisciplinary biopsychosocial rehabilitation program, and although evidence for this approach is limited, we have seen positive outcomes, including improved mobility, strength, and higher return-to-work rates, particularly with the David Spine Concept (DSC). Full article

(This article belongs to the Section Medical Research)

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13 pages, 830 KiB

Open AccessArticle

Single Center Characterization of a Cohort of Salivary Gland Carcinomas

by Ria Winkelmann, Maja Weißgerber, Peter J. Wild, Julia Bein, Maximilian Fleischmann, Melanie Demes, Panagiotis Balermpas, Andreas Loth, Katrin Bankov and Jens von der Grün

Life 2024, 14(9), 1089; https://doi.org/10.3390/life14091089 - 29 Aug 2024

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Abstract

Salivary gland cancer (SGC) is a rare cancer that can present a diagnostic challenge to pathologists, with emerging, but still limited options for the treatment of recurrent/metastatic disease. We aimed to characterize the cohort of salivary gland cancers in our institute and generate [...] Read more.

Salivary gland cancer (SGC) is a rare cancer that can present a diagnostic challenge to pathologists, with emerging, but still limited options for the treatment of recurrent/metastatic disease. We aimed to characterize the cohort of salivary gland cancers in our institute and generate a tissue microarray (TMA) with clinical data available for immunohistochemical analysis. We extracted the cases of salivary gland cancers in our institute and generated a TMA with 72 patients between 2002 and 2017 with sufficient paraffin block material. Follow-up data were present for all cases. The TMA was stained with three p53 antibodies as well as MSH2, MSH6, PMS2 and MLH1 antibodies. Additionally, we applied fragment analysis based on the Bethesda panel, and the IdyllaTM MSI test to cases with expression loss of any of the mismatch repair proteins (MMR-P) according to our immunohistochemistry (IHC). The investigated cohort shows that pT and pN stage are the only factors independently associated with survival, according to our multivariate analysis (p = 0.037 and p = 0.014). In univariate analysis, risk factors identified in our cohort were also age (p = 0.015), (lympho-) vascular invasion (p = 0.002 and p = 0.003) and risk stratification (p = 0.037). The p53 protein investigated by three antibodies showed no statistically significant association with survival or other tumor characteristics in the investigated cohort. According to MMR-P IHC, six cases of SGC showed an aberrant IHC phenotype. Additional IdyllaTM MSI test and fragment length analysis failed to confirm microsatellite instability. The pT and pN stage are the most important factors for survival in our cohort. In our cohort, antibodies directed against the protein p53 did not contribute to clinical decision-making and were not correlated with any known clinical characteristics. MSI appears to be insignificant in SGCs. Larger cohorts are needed for verification. Full article

(This article belongs to the Special Issue Feature Paper in Physiology and Pathology: 2nd Edition)

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14 pages, 4396 KiB

Open AccessArticle

The Potential of Enamel Matrix Derivative in Countering Bisphosphonate-Induced Effects in Osteoblasts

by Minah Kim, Minji Choi, Yong-Dae Kwon, Joo-Young Ohe and Junho Jung

Life 2024, 14(9), 1088; https://doi.org/10.3390/life14091088 - 29 Aug 2024

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Abstract

The suppressive effect of bisphosphonates (BPs) on bone metabolism is considered to be a major cause of medication-related osteonecrosis of the jaw (MRONJ). Enamel matrix derivative (EMD) stimulates and activates growth factors, leading to the regeneration of periodontal tissues. In this study, we [...] Read more.

The suppressive effect of bisphosphonates (BPs) on bone metabolism is considered to be a major cause of medication-related osteonecrosis of the jaw (MRONJ). Enamel matrix derivative (EMD) stimulates and activates growth factors, leading to the regeneration of periodontal tissues. In this study, we aimed to explore the potential of EMD in reversing the detrimental effects of BPs on human fetal osteoblasts (hFOBs) and osteosarcoma-derived immature osteoblasts (MG63s) by assessing cell viability, apoptosis, migration, gene expression, and protein synthesis. While the suppressive effect of zoledronate (Zol) on cell viability and migration was observed, the addition of EMD significantly mitigated this effect and enhanced cell viability and migration. Furthermore, an increased apoptosis rate induced by Zol was decreased with the addition of EMD. The decreased gene expression of alkaline phosphatase (ALP), osteocalcin (OC), and the receptor activator of nuclear factors kappa-B ligand (RANKL) caused by BP treatment was reversed by the co-addition of EMD to hFOB cells. This trend was also observed for ALP and bone sialoprotein (BSP) levels in MG63 cells. Furthermore, suppressed protein levels of OC, macrophage colony-stimulating factor (M-CSF), BSP, and type 1 collagen (COL1) were recovered following the addition of EMD. This finding suggests that EMD could mitigate the effects of BPs, resulting in the recovery of cell survival, migration, and gene and protein expression. However, the behavior of the osteoblasts was not fully restored, and further studies are necessary to confirm their effects at the cellular level and to assess their clinical usefulness in vivo for the prevention and treatment of MRONJ. Full article

(This article belongs to the Section Physiology and Pathology)

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27 pages, 3962 KiB

Open AccessArticle

Epiphytic Yeasts from South Romania for Preventing Food Microbial Contamination

by Viorica Maria Corbu, Andreea Ștefania Dumbravă, Irina Gheorghe-Barbu and Ortansa Csutak

Life 2024, 14(9), 1087; https://doi.org/10.3390/life14091087 - 29 Aug 2024

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Abstract

Epiphytic yeasts represent an important source for the development of novel strategies aiming to combat food microbial contamination. The present study deals with the characterization of nine yeast strains belonging to Starmerella, Candida, Metschinikowia, Lachancea, Kodamaea and Pichia genera, [...] Read more.

Epiphytic yeasts represent an important source for the development of novel strategies aiming to combat food microbial contamination. The present study deals with the characterization of nine yeast strains belonging to Starmerella, Candida, Metschinikowia, Lachancea, Kodamaea and Pichia genera, isolated from the surface of plants from the Botanical Garden “Dimitrie Brandza” (Bucharest, Romania) for use as antimicrobial and probiotic agents. The tests involved the determination of the safe status, cell growth under stress conditions, and activity against pathogenic Candida and bacteria strains, respectively, as well as phytopathogenic filamentous fungi and lipolytic activity. None of the nine strains showed all the characteristics for virulence and pathogenicity, with the rare positive results being explained rather by their adaptability to the habitats of origin. The strains Lachancea thermotolerans CMGB-ST12 and Kodamaea ohmeri CMGB-ST19 grew at 37 °C; Metschnikowia reukaufii CMGB-ST21.2, M. reukaufii CMGB-ST.8.1 and M. reukaufii CMGB ST10 grew in the presence of 10% NaCl, while L. thermotolerans CMGB-ST12 and K. ohmeri CMGB-ST19 tolerated both acidic and alkaline pH values well (3.0 to 12.0). The studied yeast strains showed good antimicrobial activity against Candida krusei, Candida albicans and Gram-negative bacterial strains, with K. ohmeri CMGB-ST19 and Pichia membranaefaciens CMGB-ST53 inhibiting up to 100% the development of filamentous fungi. All the strains produced lipases for tributyrin hydrolysis, the best producer being Starmerella bombi CMGB-ST1, and only Candida magnoliae CMGB-ST8.2 tested positive against other probiotic yeasts. Overall, our nine yeast strains show high potential for industrial applications, for obtaining probiotic products and for preventing the development of a wide range of microbial food contaminants. Full article

(This article belongs to the Special Issue Food Microbiological Contamination)

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16 pages, 3171 KiB

Open AccessArticle

Comparative Analysis of the Kinematic Characteristics of Lunge-Style and Squat-Style Jerk Techniques in Elite Weightlifters

by Gongju Liu, Zhanyang He, Binyong Ye, Haiying Guo, Huiju Pan, Houwei Zhu and Guanliang Meng

Life 2024, 14(9), 1086; https://doi.org/10.3390/life14091086 (registering DOI) - 29 Aug 2024

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Abstract

This study aimed to discuss the differences in technical characteristics between the lunge-style and squat-style jerk techniques and to reveal the adaptability of these techniques for individual weightlifters. A total of 52 attempts by 32 male weightlifters were selected, and the video data [...] Read more.

This study aimed to discuss the differences in technical characteristics between the lunge-style and squat-style jerk techniques and to reveal the adaptability of these techniques for individual weightlifters. A total of 52 attempts by 32 male weightlifters were selected, and the video data were digitized manually using the SIMI Motion 7.50 three-dimensional analysis system. The technical characteristics of the lunge split and squat jerk were fundamentally consistent during the pre-squat, force exertion, and inertia ascent phases. The primary differences between the lunge split and squat jerk techniques were observed during the squatting and support phases, including the vertical descent velocity of the barbell at the end of the squat shoulder-locking phase and the stability angles in the sagittal and coronal axes. The vertical velocity of the barbell at the end of the squat shoulder-locking phase was significantly greater in the squat style (−0.41 ± 0.17 vs. −0.88 ± 0.14) compared to the lunge style (t = 6.393, p < 0.05). The stability angle on the sagittal axis at the end of the squat-supporting phase in the lunge style was significantly greater (46.99 ± 3.23 vs. 13.64 ± 0.51) than that of the squat style (t = 45.639, p < 0.05). Full article

(This article belongs to the Special Issue Effects of Physical Training on Youth Athletes' Physical Performance, Health and Well-Being)

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13 pages, 3004 KiB

Open AccessSystematic Review

Clinical Outcomes of Angiotensin II Therapy in Vasoplegic Shock: A Systematic Review and Meta-Analysis

by Ans Alamami, Alaa Rahhal, Bara Alqudah, Ahmed Shebani, Abdelkarim Alammora, Hashim Mohammad, Amr S. Omar and Ahmed Labib Shehatta

Life 2024, 14(9), 1085; https://doi.org/10.3390/life14091085 (registering DOI) - 29 Aug 2024

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Abstract

Background: Angiotensin II is a peptide hormone vasopressor that activates angiotensin type 1 (AT1) receptors leading to vasoconstriction, the augmentation of arterial blood pressure (ABP), and organ perfusion. Angiotensin II was found to increase the ABP in catecholamine-refractory vasodilatory shock. Whether this effect [...] Read more.

Background: Angiotensin II is a peptide hormone vasopressor that activates angiotensin type 1 (AT1) receptors leading to vasoconstriction, the augmentation of arterial blood pressure (ABP), and organ perfusion. Angiotensin II was found to increase the ABP in catecholamine-refractory vasodilatory shock. Whether this effect improves the chances of survival or not remains inconclusive. Therefore, we conducted a systematic review and meta-analysis to evaluate the efficacy and safety of angiotensin II in vasoplegic shock. Objectives: To evaluate the clinical significance of angiotensin II effects in vasoplegic shock concerning the hemodynamic impact, mortality outcomes, and side effects. Methods: Following PRISMA guidelines, we searched PubMed and EMBASE for experimental and observational studies published in English exploring the clinical outcomes of angiotensin II use in vasodilatory shock till 1 July 2024. Two independent authors assessed the quality and risk of bias of the included studies. A random effect model (Mantel–Haenszel) was used to combine data. The primary outcome was in-hospital mortality associated with angiotensin II use in comparison to standard therapy, while the secondary outcomes were mean arterial pressure (MAP) change, multi-organ failure (MOF), and the incidence of atrial fibrillation (AF). The Q test and I² were used to examine heterogeneity, with I² > 50% indicating marked heterogeneity. Results: A total of eight studies (n = 974) comparing angiotensin II to standard therapy in vasoplegic shock were included in the systematic review, with three studies comprising 461 patients included in the final analysis of the primary outcome. Only one study evaluated the use of angiotensin II as a primary vasopressor, while the rest reported angiotensin II use in catecholamine-refractory vasodilatory shock. Overall, angiotensin II use was associated with similar in-hospital mortality compared to standard therapy (risk ratio [RR] = 0.83; 95% CI, 0.68–1.02, I² = 0%). Likewise, there was no difference in MOF and AF (MOF: RR = 1.01; 95% CI, 0.61–1.65, I² = 0%; AF: RR = 1.27; 95% CI, 0.38–4.23, I² = 5%). However, angiotensin II use demonstrated a significant MAP increase (mean difference = −9.60; 95% CI, −9.71, −9.49, I² = 0%). Conclusions: In vasodilatory shock, angiotensin II use demonstrated comparable in-hospital mortality compared to standard therapy. Nevertheless, it resulted in significant MAP change, which may encourage clinicians to use it in cases of profound hypotension. Full article

(This article belongs to the Special Issue Alternative Pharmacological Approaches for Septic Shock Management: Beyond Traditional Amine-Based Therapies)

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26 pages, 997 KiB

Open AccessReview

Prenatal Nutritional Factors and Neurodevelopmental Disorders: A Narrative Review

by Federica Cernigliaro, Andrea Santangelo, Rosaria Nardello, Salvatore Lo Cascio, Sofia D’Agostino, Edvige Correnti, Francesca Marchese, Renata Pitino, Silvia Valdese, Carmelo Rizzo, Vincenzo Raieli and Giuseppe Santangelo

Life 2024, 14(9), 1084; https://doi.org/10.3390/life14091084 (registering DOI) - 29 Aug 2024

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Abstract

According to the DSM-5, neurodevelopmental disorders represent a group of heterogeneous conditions, with onset during the developmental period, characterized by an alteration of communication and social skills, learning, adaptive behavior, executive functions, and psychomotor skills. These deficits determine an impairment of personal, social, [...] Read more.

According to the DSM-5, neurodevelopmental disorders represent a group of heterogeneous conditions, with onset during the developmental period, characterized by an alteration of communication and social skills, learning, adaptive behavior, executive functions, and psychomotor skills. These deficits determine an impairment of personal, social, scholastic, or occupational functioning. Neurodevelopmental disorders are characterized by an increased incidence and a multifactorial etiology, including genetic and environmental components. Data largely explain the role of genetic and environmental factors, also through epigenetic modifications such as DNA methylation and miRNA. Despite genetic factors, nutritional factors also play a significant role in the pathophysiology of these disorders, both in the prenatal and postnatal period, underscoring that the control of modifiable factors could decrease the incidence of neurodevelopmental disorders. The preventive role of nutrition is widely studied as regards many chronic diseases, such as diabetes, hypertension, and cancer, but actually we also know the effects of nutrition on embryonic brain development and the influence of prenatal and preconceptional nutrition in predisposition to various pathologies. These factors are not limited only to a correct caloric intake and a good BMI, but rather to an adequate and balanced intake of macro and micronutrients, the type of diet, and other elements such as exposure to heavy metals. This review represents an analysis of the literature as regards the physiopathological mechanisms by which food influences our state of health, especially in the age of development (from birth to adolescence), through prenatal and preconceptional changes, underlying how controlling these nutritional factors should improve mothers’ nutritional state to significantly reduce the risk of neurodevelopmental disorders in offspring. We searched key words such as “maternal nutrition and neurodevelopmental disorders” on Pubmed and Google Scholar, selecting the main reviews and excluding individual cases. Therefore, nutrigenetics and nutrigenomics teach us the importance of personalized nutrition for good health. So future perspectives may include well-established reference values in order to determine the correct nutritional intake of mothers through food and integration. Full article

(This article belongs to the Special Issue From Stem Cells to Embryos, Congenital Anomalies and Epidemiology)

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10 pages, 2086 KiB

Open AccessArticle

COVID-19 in Brazilian Pediatric Patients: A Retrospective Cross-Sectional Study with a Predictive Model for Hospitalization

by Ana Paula Pacheco, Henrique Laureano, Laire Schidlowski, Natalia Ciorcero, Thalita Zanatto, Ariela Borgmann, Gabrielle Fragoso, Ana Luisa Giamberardino, Renata Dourado, Karine dos Anjos, Paulo João, Marina Assahide, Maria Cristina Silveira, Victor Costa-Junior, Heloisa Giamberardino and Carolina Prando

Life 2024, 14(9), 1083; https://doi.org/10.3390/life14091083 - 29 Aug 2024

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Abstract

Background: This study was conducted to ascertain the most frequent symptoms of COVID-19 infection at first consultation in a pediatric cohort and to devise a predictive model for hospitalization. Methods: This is a retrospective cross-sectional study of 1028 Brazilian patients aged <18 years [...] Read more.

Background: This study was conducted to ascertain the most frequent symptoms of COVID-19 infection at first consultation in a pediatric cohort and to devise a predictive model for hospitalization. Methods: This is a retrospective cross-sectional study of 1028 Brazilian patients aged <18 years with SARS-CoV-2 infection in a single reference hospital in the first year of the pandemic. Clinical, demographic, laboratory, and disease spectrum data were analyzed via multivariate logistic regression modeling to develop a predictive model of factors linked to hospitalization. Results: The majority of our cohort were schoolchildren and adolescents, with a homogeneous distribution concerning sex. At first consultation, most patients presented with fever (64.1%) and respiratory symptoms (63.3%). We had 204 admitted patients, including 11 with Pediatric Multisystem Inflammatory Syndrome. Increased D-dimer levels were associated with comorbidities (p = 0.018). A high viral load was observed in patients within the first two days of symptoms (p < 0.0001). Our predictive model included respiratory distress, number and type of specific comorbidities, tachycardia, seizures, and vomiting as factors for hospitalization. Conclusions: Most patients presented with mild conditions with outpatient treatment. However, understanding predictors for hospitalization can contribute to medical decisions at the first patient visit. Full article

(This article belongs to the Special Issue COVID-19 and SARS-CoV-2 Investigations: Characteristics, Clinical Course, Prevention, Treatment and Prognosis)

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13 pages, 1264 KiB

Open AccessArticle

The Effects of Body Cold Exposure (Cryolipolysis) on Fat Mass and Plasma Cholesterol

by Rodrigo Alvaro Brandão Lopes-Martins, Ludymilla Vicente Barbosa, Mirian Martins Barbosa Sousa, Anna Beatriz Lobo, Elize Leonice da Rocha Santos, Alberto Souza de Sá Filho, Matheus Bernardes Souza, Jivago Carneiro Jaime, Constanza Thaise Xavier da Silva, Carlos Ruiz-Silva and Patrícia Sardinha Leonardo

Life 2024, 14(9), 1082; https://doi.org/10.3390/life14091082 - 29 Aug 2024

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Abstract

Introduction: This study investigates the impact of cryolipolysis on reducing localized fat and altering plasma lipid profiles in 30 overweight and obese women. Conducted at the Health Technology Laboratory of the Evangelical University of Goiás, this clinical research adhered to stringent ethical guidelines. [...] Read more.

Introduction: This study investigates the impact of cryolipolysis on reducing localized fat and altering plasma lipid profiles in 30 overweight and obese women. Conducted at the Health Technology Laboratory of the Evangelical University of Goiás, this clinical research adhered to stringent ethical guidelines. Methods: Participants underwent three cryolipolysis sessions, with comprehensive assessments of body composition and plasma lipids performed pre- and post-intervention. Results: Significant findings include a reduction in abdominal fat mass by an average of 4.1 kg and a decrease in BMI by 0.7 points (p < 0.05). Notably, total cholesterol levels decreased by an average of 15.7 mg/dL, and LDL cholesterol saw a reduction of 10.2 mg/dL (p < 0.01), with no significant changes in HDL cholesterol or triglyceride levels. These results suggest that cryolipolysis, in conjunction with standardized dietary control, offers a non-invasive alternative to surgical fat reduction, potentially mitigating cardiovascular risks associated with obesity. Conclusions: The study confirms the efficacy of cryolipolysis in targeted fat reduction and underscores its role in improving key cardiovascular risk factors. These findings warrant further exploration into the long-term benefits of cryolipolysis in metabolic health management and not only for aesthetic treatments. Full article

(This article belongs to the Special Issue New Updates in Adipocytes and Adipose Tissue: 2nd Edition)

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16 pages, 2594 KiB

Open AccessArticle

Effects of Inertial Flywheel Training vs. Accentuated Eccentric Loading Training on Strength, Power, and Speed in Well-Trained Male College Sprinters

by Zhongzhong Hu, Yuhang Liu, Keke Huang, Hao Huang, Yu Zhang and Xiaoyi Yuan

Life 2024, 14(9), 1081; https://doi.org/10.3390/life14091081 - 29 Aug 2024

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Abstract

This study aimed to evaluate and compare the effects of inertial flywheel training and accentuated eccentric loading training on the neuromuscular performance of well-trained male college sprinters. Fourteen sprinters were recruited and randomly assigned to either the flywheel training (FWT, n = 7) [...] Read more.

This study aimed to evaluate and compare the effects of inertial flywheel training and accentuated eccentric loading training on the neuromuscular performance of well-trained male college sprinters. Fourteen sprinters were recruited and randomly assigned to either the flywheel training (FWT, n = 7) group or the accentuated eccentric loading training (AELT, n = 7) group. The FWT group completed four sets of 2 + 7 repetitions of flywheel squats, whereas the AELT group performed four sets of seven repetitions of barbell squats (concentric/eccentric: 80%/120% 1RM). Both groups underwent an eight-week squat training program, with two sessions per week. A two-way repeated ANOVA analysis was used to find differences between the two groups and between the two testing times (pre-test vs. post-test). The results indicated significant improvements in all measured variables for the FWT group: 1RM (5.0%, ES = 1.28), CMJ (13.3%, ES = 5.42), SJ (6.0%, ES = 2.94), EUR (6.5%, ES = 4.42), SLJ (2.9%, ES = 1.77), and 30 m sprint (−3.4%, ES = −2.80); and for the AELT group: 1RM (6.3%, ES = 2.53), CMJ (7.4%, ES = 3.44), SJ (6.4%, ES = 2.21), SLJ (2.2%, ES = 1.20), and 30 m sprint (−3.0%, ES = −1.84), with the exception of EUR (0.9%, ES = 0.63, p = 0.134), showing no significant difference. In addition, no significant interaction effects between group and time were observed for 1RM back squat, SJ, SLJ, and 30 m sprint (p > 0.05). Conversely, a significant interaction effect between group and time was observed for both CMJ and EUR (p < 0.001); post hoc analysis revealed that the improvements in CMJ and EUR were significantly greater in the FWT group compared to the AELT group (p < 0.001). These findings indicate that both FWT and AELT are effective at enhancing lower-body strength, power, and speed in well-trained male college sprinters, with FWT being particularly more effective in promoting elastic energy storage and the full utilization of the stretch–shortening cycle. Full article

(This article belongs to the Special Issue Focus on Exercise Physiology and Sports Performance)

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14 pages, 1877 KiB

Open AccessArticle

Exploring the Th2 Response in Obesity and Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD): A Potential Modulator of the Renin-Angiotensin System (RAS) Pathway in Hypertension Development

by Lucía Angélica Méndez-García, Galileo Escobedo, Itzel Baltazar-Pérez, Nydia Angélica Ocampo-Aguilera, José Alfonso Arreola-Miranda, Miguel Angel Cid-Soto, Ana Alfaro-Cruz, Antonio González-Chávez, Aquiles Ranferi Ocaña-Guzmán and Helena Solleiro-Villavicencio

Life 2024, 14(9), 1080; https://doi.org/10.3390/life14091080 - 29 Aug 2024

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Abstract

Non-alcoholic fatty liver disease (NAFLD), now referred to as metabolic dysfunction-associated steatotic liver disease (MASLD), is alarmingly increasing alongside the cases of obesity worldwide. MASLD is an underestimated metabolic abnormality closely linked with a higher risk of developing systemic arterial hypertension (SAH). However, [...] Read more.

Non-alcoholic fatty liver disease (NAFLD), now referred to as metabolic dysfunction-associated steatotic liver disease (MASLD), is alarmingly increasing alongside the cases of obesity worldwide. MASLD is an underestimated metabolic abnormality closely linked with a higher risk of developing systemic arterial hypertension (SAH). However, the underlying mechanism of association between MASLD and SAH remains unknown. Inflammation may link these two entities by regulating the renin-angiotensin system (RAS). For this reason, in this study, we evaluated the hepatic expression of a cytokine profile and critical molecules in the RAS pathway in patients with morbid obesity and MASLD, both with SAH. We found a statistically significant correlation between ACE levels and the cytokines IL-4, IL-10, and IL-13 of Th2 response. Furthermore, according to a multiple linear regression analysis, the cytokines IL-4 and IL-13 were the best predictors of ACE levels. Moreover, we observed increased hepatic IL-13 expression in patients with morbid obesity, MASLD, and SAH compared to those without SAH. These results allow us to propose, for the first time, that the Th2 response, through regulating the RAS, could play a critical role in developing SAH in individuals with MASLD and obesity. Full article

(This article belongs to the Special Issue Metabolic Health: The Interplay between NAFLD, MAFLD, MASLD and Cardiovascular Disease)

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13 pages, 1419 KiB

Open AccessArticle

Evaluation of Antimicrobial Resistance Patterns of Pseudomonas aeruginosa Strains Isolated among COVID-19 Patients in Brazil Typed by Fourier-Transform Infrared Spectroscopy

by Paula Araujo de Souza, Milena Cristina Silva dos Santos, Rebeca Vitória da Silva Lage de Miranda, Luciana Veloso da Costa, Raphael Paiva Paschoal da Silva, Catia Aparecida Chaia de Miranda, Ana Paula Roque da Silva, Stephen James Forsythe, Maria Helena Simões Villas Bôas and Marcelo Luiz Lima Brandão

Life 2024, 14(9), 1079; https://doi.org/10.3390/life14091079 - 29 Aug 2024

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Abstract

This study aimed to characterize Pseudomonas aeruginosa strains isolated from hospitalized patients during the COVID-19 pandemic. This was achieved using phenotypic and molecular techniques, including their antimicrobial resistance profile and biofilm formation. Eighteen strains were isolated from a hospital in Rio de Janeiro, [...] Read more.

This study aimed to characterize Pseudomonas aeruginosa strains isolated from hospitalized patients during the COVID-19 pandemic. This was achieved using phenotypic and molecular techniques, including their antimicrobial resistance profile and biofilm formation. Eighteen strains were isolated from a hospital in Rio de Janeiro, Brazil, and identified by VITEK^®2, MALDI-TOF/MS (VITEK MS^® and MALDI Biotyper^®), and 16S rRNA sequencing. Fourier-transform infrared (FTIR) spectroscopy, antimicrobial susceptibility testing, and biofilm formation and disinfectant tolerance tests were applied to evaluate the virulence characteristics of the strains. VITEK^®2 (≥99%), VITEK MS^® (≥82.7%), and MALDI Biotyper^® (score ≥ 2.01) accurately identified the P. aeruginosa strains, but 16S rRNA sequencing did not differentiate the species P. aeruginosa from P. paraeruginosa. FTIR typing identified three different clusters, but no correlation between the phenotypical or antimicrobial susceptibility testing patterns was found. Most strains exhibited resistance to various antimicrobials. The exceptions were sensitivity to amikacin and norfloxacin, and consequently, these could be considered potential treatment options. Most strains (n = 15, 83.3%) produced biofilms on polystyrene. Sodium hypochlorite treatment (0.5%/15 min) was shown to be the most effective disinfectant for biofilm elimination. P. aeruginosa biofilm formation and tolerance to disinfectants demonstrate the need for effective cleaning protocols to eliminate contamination by this organism in the hospital environment and medical equipment. Full article

(This article belongs to the Special Issue Trends in Microbiology 2024)

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13 pages, 2175 KiB

Open AccessArticle

The Etiological and Antimicrobial Susceptibility Profiles of the Bacteria Obtained from Ovine Caseous Lymphadenitis Cases in the Çankırı Region, Türkiye

by Serdal Tarhane and Fatih Büyük

Life 2024, 14(9), 1078; https://doi.org/10.3390/life14091078 - 28 Aug 2024

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Abstract

Sheep caseous lymphadenitis (CLA) causes significant economic losses in the livestock sector by causing a loss in the quantity and quality of animal products and a loss in the breeding value of animals. Although the primary agent in CLA’s etiology is Corynebacterium pseudotuberculosis [...] Read more.

Sheep caseous lymphadenitis (CLA) causes significant economic losses in the livestock sector by causing a loss in the quantity and quality of animal products and a loss in the breeding value of animals. Although the primary agent in CLA’s etiology is Corynebacterium pseudotuberculosis, some other opportunistic microorganisms also play a role. Therefore, the control and treatment of CLA necessitates the identification of the relevant etiological agents. This study aimed to conduct an in vitro culture and molecular characterization (PCR analysis and 16S rRNA sequencing) of the bacteria involved in sheep CLA cases reported in the Çankırı province of Türkiye and determine the antibiotic susceptibility of the case isolates. In total, 82 (16.4%) of 500 sheep in five farms were diagnosed with CLA. Following the culture of the superficial abscesses samples, C. pseudotuberculosis was identified in 30 (36.59%) as a result of PCR, Pseudomonas spp. in 8 (9.76%), and Enterobacter cancerogenus in 1 (1.22%), as a result of 16S rRNA sequencing. These data revealed extensive heterogeneity among the Pseudomonas isolates, with hints of derivation from a common ancestry for some and phylogenetic similarity to isolates from Germany, Malaysia, and India. In contrast to the high susceptibility to cefoperazone and lincomycin, the high resistances of C. pseudotuberculosis and Pseudomonas spp. isolates to cephalothin, ceftiofur, cloxacillin, amoxicillin, and bacitracin were remarkable. Based on these findings, it was concluded that for an effective treatment and control of ovine CLA cases, there is a need to consider the possible involvement of opportunistic bacteria other than the primary causative agent, C. pseudotuberculosis. It also contributed to increasing the country-specific sequence data and establishing new taxa from a universal perspective. Full article

(This article belongs to the Section Microbiology)

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12 pages, 3582 KiB

Open AccessArticle

The Hepatoprotective Effects of Camellia sinensis on Cisplatin-Induced Acute Liver Injury

by Adnan Yilmaz, Fatih Dizman, Kerimali Akyildiz, Sibel Mataraci Karakas, Tolga Mercantepe, Huseyin Avni Uydu, Levent Tumkaya and Koksal Ozturk

Life 2024, 14(9), 1077; https://doi.org/10.3390/life14091077 - 28 Aug 2024

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Abstract

Acute liver injury is an increasing global health problem. It is a widespread side effect of cisplatin treatment in the clinic and can lead to liver failure if not treated promptly. Previous studies have revealed that green tea can protect some organs from [...] Read more.

Acute liver injury is an increasing global health problem. It is a widespread side effect of cisplatin treatment in the clinic and can lead to liver failure if not treated promptly. Previous studies have revealed that green tea can protect some organs from treatments. However, the potential of white tea to prevent the negative effects of acute liver injury has not been addressed so far. The purpose of this study was to investigate the reduction in cisplatin-induced liver injury in rats receiving white tea. Female Sprague Dawley rats with similar weight were selected in this study. Twenty-four rats were divided into three groups of eight animals each and ad libitum nutrition was provided. The control and cisplatin groups were given tap water only, while the white tea + cisplatin group received white tea at a 0.5% weight/volume concentration for four weeks. At the end of the fourth week, the white tea + cisplatin group and the cisplatin group received a single dose of cisplatin (7 mg/kg) via the intraperitoneal route. Five days after that procedure, the rats were anesthetized. Liver tissues and blood samples were collected, which were used for biochemical and histopathological analyses. According to biochemical results, liver tissue MDA and GSH, serum ALT, and AST levels significantly increased in the cisplatin group compared to the control group. Compared with the cisplatin group, although MDA, AST, ALT, and GSH levels were lower in the white tea + cisplatin group, only GSH levels were statistically different. The examination of histopathological and immunohistochemical findings revealed apoptotic cells, vascular congestion, and sinusoidal dilatation in the cisplatin group compared to the control group. This adverse event decreased in the white tea + cisplatin group compared to the cisplatin group. In conclusion, white tea exhibits an ameliorating effect on cisplatin-induced liver injury. Full article

(This article belongs to the Special Issue Gastrointestinal Health: Clinical Research and Therapeutic Innovations)

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16 pages, 924 KiB

Open AccessArticle

A Blood Supply Pathophysiological Microcirculatory Mechanism for Long COVID

by Aristotle G. Koutsiaris

Life 2024, 14(9), 1076; https://doi.org/10.3390/life14091076 - 28 Aug 2024

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Abstract

Background: The term “Long COVID” is commonly used to describe persisting symptoms after acute COVID-19. Until now, proposed mechanisms for the explanation of Long COVID have not related quantitative measurements to basic laws. In this work, a common framework for the Long COVID [...] Read more.

Background: The term “Long COVID” is commonly used to describe persisting symptoms after acute COVID-19. Until now, proposed mechanisms for the explanation of Long COVID have not related quantitative measurements to basic laws. In this work, a common framework for the Long COVID pathophysiological mechanism is presented, based on the blood supply deprivation and the flow diffusion equation. Methods: Case–control studies with statistically significant differences between cases (post-COVID patients) and controls, from multiple tissues and geographical areas, were gathered and tabulated. Microvascular loss (ML) was quantified by vessel density reduction (VDR), foveal avascular zone enlargement (FAZE), capillary density reduction (CDR), and percentage of perfused vessel reduction (PPVR). Both ML and hemodynamic decrease (HD) were incorporated in the tissue blood supply reduction (SR) estimation. Results: ML data were found from 763 post-COVID patients with an average VDR, FAZE, CDR, and PPVR of 16%, 31%, 14%, and 21%, respectively. The average HD from 72 post-COVID patients was 37%. The estimated SR for multiple tissues with data from 634 post-COVID patients reached a sizeable 47%. This large SR creates conditions of lower mass diffusion rates, hypoxia, and undernutrition, which at a multi-tissue level, for a long time, can explain the wide variety of the Long COVID symptoms. Conclusions: Disruption of peripheral tissue blood supply by the contribution of both ML and HD is proposed here to be the principal cause of the mechanism leading to Long COVID symptoms. Full article

(This article belongs to the Special Issue Microvascular Dynamics: Insights and Applications)

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Graphical abstract

1 pages, 173 KiB

Open AccessCorrection

Correction: Păcurar et al. Hepatitis B in Pediatric Population: Observational Retrospective Study in Romania. Life 2024, 14, 348

by Daniela Păcurar, Alexandru Dinulescu, Gheorghiță Jugulete, Alexandru-Sorin Păsărică and Irina Dijmărescu

Life 2024, 14(9), 1075; https://doi.org/10.3390/life14091075 - 28 Aug 2024

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Abstract

Text Correction [...] Full article

25 pages, 4014 KiB

Open AccessArticle

Antioxidant Defenses, Oxidative Stress Responses, and Apoptosis Modulation in Spontaneous Abortion: An Immunohistochemistry Analysis of First-Trimester Chorionic Villi

by Ioana Vornic, Alexandru Nesiu, Ana Maria Ardelean, Oana Cristina Todut, Victoria Cristina Pasare, Cristina Onel, Ionuț Daniel Raducan and Cristian George Furau

Life 2024, 14(9), 1074; https://doi.org/10.3390/life14091074 - 28 Aug 2024

Viewed by 265

Abstract

Oxidative stress (OS) and apoptosis are critical factors in placental development and function. Their interplay influences trophoblast proliferation, differentiation, and invasion, as well as vascular development. An imbalance between these processes can lead to pregnancy-related disorders such as preeclampsia, intrauterine growth restriction, and [...] Read more.

Oxidative stress (OS) and apoptosis are critical factors in placental development and function. Their interplay influences trophoblast proliferation, differentiation, and invasion, as well as vascular development. An imbalance between these processes can lead to pregnancy-related disorders such as preeclampsia, intrauterine growth restriction, and even spontaneous abortion. Our study seeks to elucidate the associations between preventive antioxidant/protective OS response factors—glutathione (GSH), MutT Homolog 1 (MTH1), and apoptotic regulation modulators—tumor protein p53 and B-cell lymphoma (Bcl-2) transcripts, in the context of spontaneous abortion (30 samples) versus elective termination of pregnancy (20 samples), using immunohistochemistry (IHC) to determine their proteomic expression in chorionic villi within abortive fetal placenta tissue samples. Herein, comparative statistical analyses revealed that both OS response factors, GSH and MTH1, were significantly under-expressed in spontaneous abortion cases as compared to elective. Conversely, for apoptotic regulators, p53 expression was significantly higher in spontaneous abortion cases, whereas Bcl-2 expression was significantly lower in spontaneous abortion cases. These findings suggest that a strong pro-apoptotic signal is prevalent within spontaneous abortion samples, alongside reduced anti-apoptotic protection, depleted antioxidant defenses and compromised oxidative DNA damage prevention/repair, as compared to elective abortion controls. Herein, our hypothesis that OS and apoptosis are closely linked processes contributing to placental dysfunction and spontaneous abortion was thus seemingly corroborated. Our results further highlight the importance of maintaining redox homeostasis and apoptotic regulation for a successful pregnancy. Understanding the mechanisms underlying this interplay is essential for developing potential therapies to manage OS, promote placentation, and avoid unwanted apoptosis, ultimately improving pregnancy outcomes. Antioxidant supplementation, modulation of p53 activity, and the enhancement of DNA repair mechanisms may represent potential approaches to mitigate OS and apoptosis in the placenta. Further research is needed to explore these strategies and their efficacy in preventing spontaneous abortion. Full article

(This article belongs to the Special Issue Study on Placenta and Pregnancy Screening)

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12 pages, 1018 KiB

Open AccessReview

The Patient’s Journey in Obesity within the United States: An Exercise of Resilience against Disease

by Kayla Northam, Malikiya Hinds, Sreevidya Bodepudi and Fatima Cody Stanford

Life 2024, 14(9), 1073; https://doi.org/10.3390/life14091073 - 27 Aug 2024

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Abstract

Obesity is often viewed as a result of patient failure to adhere to healthy dietary intake and physical activity; however, this belief undermines the complexity of obesity as a disease. Rates of obesity have doubled for adults and quadrupled for adolescents since the [...] Read more.

Obesity is often viewed as a result of patient failure to adhere to healthy dietary intake and physical activity; however, this belief undermines the complexity of obesity as a disease. Rates of obesity have doubled for adults and quadrupled for adolescents since the 1990s. Without effective interventions to help combat this disease, patients with obesity are at increased risk for developing type 2 diabetes, heart attack, stroke, liver disease, obstructive sleep apnea, and more. Patients often go through several barriers before they are offered pharmacotherapy or bariatric surgery, even though evidence supports the use of these interventions earlier. This partially stems from the cultural barriers associated with using these therapies, but it is also related to healthcare provider bias and limited knowledge of these therapies. Finally, even when patients are offered treatment for obesity, they often run into insurance barriers that keep them from treatment. There needs to be a cultural shift to accept obesity as a disease and improve access to effective treatments sooner to help decrease the risk of health complications associated with obesity. Full article

(This article belongs to the Section Physiology and Pathology)

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8 pages, 1165 KiB

Open AccessArticle

Effects of Spinal Decompression and Segmental Spinal Instrumentation on Lower Limb Functionality in Patients with Spinal Osteoarthritis

by Milan Mirković, Filip Kukić, Dragan Mirkov, Dejan Marinković, Lazar Mičeta, Sanja Mirković, Biljana Božić Nedeljković and Zoran Baščarević

Life 2024, 14(9), 1072; https://doi.org/10.3390/life14091072 - 27 Aug 2024

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Abstract

Spinal osteoarthritis, a degenerative condition of the spine, significantly impairs quality of life, causing pain, stiffness, and limited mobility. Treatment primarily aims to improve functionality and quality of life. This study investigated the effects of lower back surgery (e.g., spinal decompression with vertebra [...] Read more.

Spinal osteoarthritis, a degenerative condition of the spine, significantly impairs quality of life, causing pain, stiffness, and limited mobility. Treatment primarily aims to improve functionality and quality of life. This study investigated the effects of lower back surgery (e.g., spinal decompression with vertebra stabilization) on upper-limb maximum strength, lower limb functionality, and quality of life in osteoarthritis patients. A total of 16 patients (♀ = 10 and ♂ = 6) patients from the orthopedic clinic who were diagnosed with osteoarthritis based on MRI and clinical symptoms underwent the surgery. Their handgrip strength, lower limb functionality (6 min walk test), and quality of life (Flanagan quality of life scale) were assessed before and after the surgery. A repeated measures ANOVA was conducted to assess differences in these metrics pre- and post-surgery across the entire patient cohort, as well as within gender-specific subgroups. A large positive effect was seen in the 6 min walk (p = 0.02, d = −0.83) test but not in the handgrip test or quality of life. However, female patients showed a trend towards better quality of life. The results of this study provide evidence for the effectiveness of surgery in the treatment of spinal osteoarthritis and underscore the need for personalized treatment approaches in the treatment of spinal osteoarthritis. Full article

(This article belongs to the Section Physiology and Pathology)

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9 pages, 1730 KiB

Open AccessCase Report

Multidisciplinary Approach in the Diagnosis and Treatment of Twin Anemia Polycythemia Sequence in Monochorionic Twin Pregnancies: Case Report

by Marina Fortún Agud, María Marfil González, Susana Monis Rodríguez, Maria Suarez Arana, Marta Blasco Alonso, Jesus Jimenez Lopez and Isidoro Narbona Arias

Life 2024, 14(9), 1071; https://doi.org/10.3390/life14091071 - 27 Aug 2024

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Abstract

Twin anemia–polycythemia sequence (TAPS) in monochorionic twin pregnancies is a potentially serious complication caused by unidirectional vascular anastomoses in the placenta, resulting in one anemic donor twin and one polycythemic recipient twin. Diagnosis of this condition is achieved through Doppler ultrasound assessment of [...] Read more.

Twin anemia–polycythemia sequence (TAPS) in monochorionic twin pregnancies is a potentially serious complication caused by unidirectional vascular anastomoses in the placenta, resulting in one anemic donor twin and one polycythemic recipient twin. Diagnosis of this condition is achieved through Doppler ultrasound assessment of the difference between the MoM of the peak systolic velocity of the middle cerebral artery between the twins, establishing the diagnosis with a delta value >0.5 MoM. Management of this situation is individualized and may include intrauterine transfusions, intrauterine laser treatment, and expectant management through ultrasound monitoring of both fetuses to prevent complications. In severe cases, pregnancy termination may be necessary. It is essential that these pregnancies are managed by a multidisciplinary team of professionals, including obstetricians specialized in fetal medicine and neonatologists, to ensure the best possible outcome for both the mother and the fetuses. Early detection and treatment are crucial in the management of pregnancies complicated by twin anemia–polycythemia sequence. The main objective of this article is to conduct a review of the existing literature on the anemia–polycythemia sequence in monochorionic pregnancies, emphasizing the exceptional nature of the presented case due to its spontaneous occurrence, which has a very low prevalence compared to post-laser TAPS cases. It also discusses the different treatment options, highlighting the importance of expectant management and individualization in each case. Full article

(This article belongs to the Special Issue Clinical Management and Prevention of Adverse Pregnancy Outcomes)

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33 pages, 5323 KiB

Open AccessArticle

Investigating the Effects of Chelidonic Acid on Oxidative Stress-Induced Premature Cellular Senescence in Human Skin Fibroblast Cells

by Burcu Turkoglu and Banu Mansuroglu

Life 2024, 14(9), 1070; https://doi.org/10.3390/life14091070 - 27 Aug 2024

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Abstract

This study investigated the effects of chelidonic acid (CA) on hydrogen peroxide (H₂O₂) induced cellular senescence in human skin fibroblast cells (BJ). Cellular senescence is a critical mechanism that is linked to age-related diseases and chronic conditions. CA, a [...] Read more.

This study investigated the effects of chelidonic acid (CA) on hydrogen peroxide (H₂O₂) induced cellular senescence in human skin fibroblast cells (BJ). Cellular senescence is a critical mechanism that is linked to age-related diseases and chronic conditions. CA, a γ-pyrone compound known for its broad pharmacological activity, was assessed for its potential to mitigate oxidative stress and alter senescence markers. A stress-induced premature senescence (SIPS) model was designed in BJ fibroblast cells using the oxidative stress agent H₂O₂. After this treatment, cells were treated with CA, and the potential effect of CA on senescence was evaluated using senescence-related β-galactosidase, 4′,6-diamino-2-phenylindole (DAPI), acridine-orange staining (AO), comet assay, molecular docking assays, gene expression, and protein analysis. These results demonstrate that CA effectively reduces senescence markers, including senescence-associated β-galactosidase activity, DNA damage, lysosomal activity, and oxidative stress indicators such as malondialdehyde. Molecular docking revealed CA’s potential interactions with critical proteins involved in senescence signalling pathways, suggesting mechanisms by which CA may exert its effects. Gene expression and protein analyses corroborated the observed anti-senescent effects, with CA modulating p16, p21, and pRB1 expressions and reducing oxidative stress markers. In conclusion, CA appeared to have senolytic and senomorphic potential in vitro, which could mitigate and reverse SIPS markers in BJ fibroblasts. Full article

(This article belongs to the Section Cell Biology and Tissue Engineering)

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20 pages, 1882 KiB

Open AccessReview

Alternative Pathways in Astrobiology: Reviewing and Synthesizing Contingency and Non-Biomolecular Origins of Terrestrial and Extraterrestrial Life

by Kuhan Chandru, Christian Potiszil and Tony Z. Jia

Life 2024, 14(9), 1069; https://doi.org/10.3390/life14091069 - 27 Aug 2024

Viewed by 375

Abstract

The pursuit of understanding the origins of life (OoL) on and off Earth and the search for extraterrestrial life (ET) are central aspects of astrobiology. Despite the considerable efforts in both areas, more novel and multifaceted approaches are needed to address these profound [...] Read more.

The pursuit of understanding the origins of life (OoL) on and off Earth and the search for extraterrestrial life (ET) are central aspects of astrobiology. Despite the considerable efforts in both areas, more novel and multifaceted approaches are needed to address these profound questions with greater detail and with certainty. The complexity of the chemical milieu within ancient geological environments presents a diverse landscape where biomolecules and non-biomolecules interact. This interaction could lead to life as we know it, dominated by biomolecules, or to alternative forms of life where non-biomolecules could play a pivotal role. Such alternative forms of life could be found beyond Earth, i.e., on exoplanets and the moons of Jupiter and Saturn. Challenging the notion that all life, including ET life, must use the same building blocks as life on Earth, the concept of contingency—when expanded beyond its macroevolution interpretation—suggests that non-biomolecules may have played essential roles at the OoL. Here, we review the possible role of contingency and non-biomolecules at the OoL and synthesize a conceptual model formally linking contingency with non-biomolecular OoL theories. This model emphasizes the significance of considering the role of non-biomolecules both at the OoL on Earth or beyond, as well as their potential as agnostic biosignatures indicative of ET Life. Full article

(This article belongs to the Special Issue Feature Papers in Origins of Life)

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7 pages, 3195 KiB

Open AccessCase Report

A Case of Interstitial Lung Disease-Related Pulmonary Hypertension Successfully Treated with Inhaled Iloprost

by Ji Hoon Jang, Hang-Jea Jang and Jae Ha Lee

Life 2024, 14(9), 1068; https://doi.org/10.3390/life14091068 - 27 Aug 2024

Viewed by 299

Abstract

Pulmonary hypertension (PH) associated with interstitial lung disease (ILD) (PH-ILD) significantly worsens clinical symptoms and survival, with no effective treatment available. This case report presents the successful treatment of PH-ILD with inhaled iloprost in a patient with idiopathic pulmonary fibrosis (IPF). The patient, [...] Read more.

Pulmonary hypertension (PH) associated with interstitial lung disease (ILD) (PH-ILD) significantly worsens clinical symptoms and survival, with no effective treatment available. This case report presents the successful treatment of PH-ILD with inhaled iloprost in a patient with idiopathic pulmonary fibrosis (IPF). The patient, a 68-year-old female, was diagnosed with IPF in 2018 and was maintained on pirfenidone. She experienced stable disease until March 2023, when she developed progressive exertional dyspnea, despite stability indicated by a computed tomography (CT) scan, without progression. Transthoracic echocardiography (TTE) and right heart catheterization (RHC) confirmed PH-ILD with a mean pulmonary artery pressure (mPAP) of 43 mmHg. Due to the ineffectiveness of sildenafil and a CT scan indicating stable IPF, a repeat RHC was performed, which showed a worsening of PH (mPAP 62 mmHg). Consequently, inhaled iloprost, at a dosage of 10 mcg every eight hours, was added to the existing antifibrotic agent. After two months, the patient experienced reduced exertional dyspnea and home oxygen requirements. By the seventh month, pulmonary function tests, the six-minute walk test, and RHC parameters (mPAP 37 mmHg) showed marked improvements. This case suggests that inhaled iloprost may be beneficial for managing PH-ILD. Further research is needed to confirm the efficacy of iloprost in PH-ILD treatment. Full article

(This article belongs to the Special Issue Pulmonary Hypertension: From Bench to Bedside: 2nd Edition)

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16 pages, 5022 KiB

Open AccessArticle

Multi-Modal Assessment of Cerebral Hemodynamics in Resuscitated Out-of-Hospital Cardiac Arrest Patients: A Case-Series

by Shir Lynn Lim, May Zin Myint, Kai Lee Woo, Elaine Young Heng Chee, Chiew Sie Hong, Erta Beqiri, Peter Smielewski, Marcus Eng Hock Ong and Vijay Kumar Sharma

Life 2024, 14(9), 1067; https://doi.org/10.3390/life14091067 - 26 Aug 2024

Viewed by 321

Abstract

We assessed the feasibility of concurrent monitoring of cerebral hemodynamics in adult, comatose out-of-hospital cardiac arrest (OHCA) patients admitted to the National University Heart Centre Singapore from October 2021 to August 2023. Patients underwent continuous near-infrared spectroscopy (NIRS) monitoring in the first 72 [...] Read more.

We assessed the feasibility of concurrent monitoring of cerebral hemodynamics in adult, comatose out-of-hospital cardiac arrest (OHCA) patients admitted to the National University Heart Centre Singapore from October 2021 to August 2023. Patients underwent continuous near-infrared spectroscopy (NIRS) monitoring in the first 72 h after return of spontaneous circulation (ROSC) and 30-min transcranial Doppler ultrasound (TCD) monitoring at least once. With constant mechanical ventilatory settings and continuous electrocardiographic, pulse oximeter and end-tidal carbon dioxide monitoring, blood pressure was manipulated via vasopressors and cerebral autoregulation assessed by measuring changes in regional cerebral oxygenation (NIRS) and cerebral blood flow velocities (TCD) in response to changes in mean arterial pressure. The primary outcome was neurological recovery at hospital discharge. Amongst the first 16 patients (median age 61, 94% males), we observed four unique patterns: preserved cerebral autoregulation, loss of cerebral autoregulation, cardio-cerebral asynchrony and cerebral circulatory arrest. Patients with preserved cerebral autoregulation had lower levels of neuro-injury biomarkers (neurofilaments light and heavy) and the majority (86%) were discharged with good neurological recovery. Multi-modal assessment of cerebral hemodynamics after OHCA is feasible and derived patterns correlated with neurological outcomes. The between- and within-patient heterogeneity in cerebral hemodynamics calls for more research on individualized treatment strategies. Full article

(This article belongs to the Special Issue Clinical Update for Resuscitation Science)

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Open AccessCase Report

To Be, or Not to Be … Pectoral Angina? The Pain Is the Same, but the Etiology Is Different—A Case Report

by Ciprian Ilie Rosca, Daniel Florin Lighezan, Gabriel Veniamin Cozma, Horia Silviu Branea, Daniel Dumitru Nisulescu, Adrian Sebastian Zus, Stelian I. Morariu and Nilima Rajpal Kundnani

Life 2024, 14(9), 1066; https://doi.org/10.3390/life14091066 - 26 Aug 2024

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Abstract

Background: Chest pain is one of the most common causes of emergency room visits and also accounts for numerous visits to the family physician’s office or Outpatient Clinics of cardiology or internal medicine. Case Report: Here we present a case of a 48-year-old [...] Read more.

Background: Chest pain is one of the most common causes of emergency room visits and also accounts for numerous visits to the family physician’s office or Outpatient Clinics of cardiology or internal medicine. Case Report: Here we present a case of a 48-year-old female patient who presented to our hospital emergency unit but refused hospital admission. She presented in our Outpatient Clinic with a complaint of typical chest pain indicating it to be of coronary origin. A computed tomography (CT) coronary angiography for the evaluation of this chest pain was indicated. While ruling out the coronary origin of this chest pain, we were surprised to have incidentally identified the presence of an esophageal tumor mass that had intimate contact with carina of the trachea. After the diagnosis of esophageal leiomyoma was made and its surgical treatment was performed, the patient was asymptomatic. Approximately one year after the surgical intervention was performed, following the cessation of antiplatelet therapy and statin, the patient returned to our Outpatient Clinic complaining of chest pain again with the same characteristics as previously presented, being terrified by the possibility of the recurrence of the esophageal leiomyoma. Upon resuming investigations, it was proven through coronary angio-CT evaluation that the etiology of the chest pain was indeed coronary this time. However, the patient still refused hospital admission and the performance of percutaneous coronary angiography with the potential implantation of a coronary stent. Conclusions: Chest pain can be due to various underlying pathologies and should not be neglected. A thorough investigation and timely management are key to treating this possible fatal symptom. In our case, the patient presented twice with the complaint of typical chest pain indicating a possible coronary event, but at the first presentation, it was due to esophageal leiomyoma, while a year later, the patient had similar pain, which was indeed this time due to coronary blockage. Hence, it is of utmost importance to think of all possible scenarios and to investigate accordingly, leaving no stone unturned. Full article

(This article belongs to the Special Issue Novel Diagnosis and Treatment of Gastrointestinal Disease)

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Life, Volume 14, Issue 9 (September 2024) – 44 articles

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