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Volume 12
Issue 9
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Diseases, Volume 12, Issue 9 (September 2024) – 5 articles

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11 pages, 564 KiB  
Article
Characteristics of Patients with Persistent COVID-19 Symptoms and Unscheduled Return Visits to a Centre for COVID-19 Evaluation
by Silvia Nica, Remus Iulian Nica, Horia Alexandru Nica, Daniela Miricescu, Mohamed Abuzied Ali Khattab Abdelfatah, Oana Maria Schiopu, Ioan Cristian Nedelcu, Danut Gheorghe Cimponeriu, Constantin Stefani, Iulia-Ioana Stanescu-Spinu and Mariana Cătălina Ciornei
Diseases 2024, 12(9), 199; https://doi.org/10.3390/diseases12090199 - 30 Aug 2024
Viewed by 318
Abstract
Background: This retrospective study aimed to evaluate the characteristics of patients with long COVID syndrome. Methods: This study included 457 adults who had at least one persistent symptom after COVID-19 infection. Results: The median time interval between the last SARS-CoV-2 infection and emergency [...] Read more.
Background: This retrospective study aimed to evaluate the characteristics of patients with long COVID syndrome. Methods: This study included 457 adults who had at least one persistent symptom after COVID-19 infection. Results: The median time interval between the last SARS-CoV-2 infection and emergency room presentation was 3 months. Older patients had comorbidities (61.7 vs. 44.9 years, p < 0.0001), moderate or severe forms of COVID-19 (61.2 vs. 50.9 years, p < 0.0001), and respiratory symptoms (56.1 vs. 52.0 years, p = 0.0027). Non-vaccinated patients were older than vaccinated patients (56.0 vs. 51.5 years, p = 0.0008) and had residual lung abnormalities following COVID-19 infection (51.5% vs. 36.8%, p < 0.003). The time interval between the last SARS-CoV-2 infection and the hospital evaluation was shorter for vaccinated patients (3.2 vs. 3.9 months, p < 0.0001) and those with mild forms (3.3 vs. 4.12 months, p = 0.0001) versus non-vaccinated individuals. After the last SARS-CoV-2 infection, 107 patients developed impaired fasting glucose, impaired glucose tolerance, or diabetes mellitus, being patients with already known chronic diseases (p = 0.0002), or hypertension (p = 0.001). Conclusions: Our study pointed out the heterogeneity of symptoms following COVID-19, and they are associated with age, vaccination status, or severity of SARS-CoV-2 infection. Full article
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15 pages, 4190 KiB  
Article
Utility of Extraction-Free SARS-CoV-2 Detection by RT–qPCR for COVID-19 Testing in a Resource-Limited Setting
by Akua K. Yalley, Selasie Ahiatrogah, Iddrisu I. Moro, Peter Gmagna, Isaac K. Yankson, Anna A. Kafintu-Kwashie and Nicholas I. Nii-Trebi
Diseases 2024, 12(9), 198; https://doi.org/10.3390/diseases12090198 - 26 Aug 2024
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Abstract
The COVID-19 epidemic had a profound impact on global health and the economy and Ghana was no exception to its far-reaching consequences. Regarding detection of the causative agent—the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), reverse-transcription–qPCR (RT–qPCR) is widely recognized as a very [...] Read more.
The COVID-19 epidemic had a profound impact on global health and the economy and Ghana was no exception to its far-reaching consequences. Regarding detection of the causative agent—the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), reverse-transcription–qPCR (RT–qPCR) is widely recognized as a very sensitive and reliable diagnostic technique used globally. There are, however, high operational costs in acquiring test kits, equipment, and accessories for RT–qPCR testing, which pose significant challenges in resource-limited settings. Hence, this proof-of-concept study set out to develop a more affordable COVID-19 protocol for use in low or lower-middle-income settings, such as Ghana, that would bypass the traditional extraction process using inexpensive reagents and evaluate the possibility of processing samples collected using wooden shaft swabs. Several less expensive media were used for the extraction-free process. Results demonstrated that direct RT–qPCR assay after 5 min heat inactivation of virus at 95 °C in 0.1× PBS or molecular grade water resulted in viral detection with quantification cycle (Cq) values that are comparable to results obtained following the extraction process. Also, wooden shaft swabs could be used for sampling if incubation times are kept to less than 6 h. The study demonstrates that extraction-free protocols are one way to minimize the cost of COVID-19 testing by RT–qPCR. Full article
(This article belongs to the Section Infectious Disease)
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19 pages, 1528 KiB  
Review
Current Gallstone Treatment Methods, State of the Art
by Xiangtian Li, Jun Ouyang and Jingxing Dai
Diseases 2024, 12(9), 197; https://doi.org/10.3390/diseases12090197 - 26 Aug 2024
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Abstract
This study aims to provide valuable references for clinicians in selecting appropriate surgical methods for biliary tract stones based on patient conditions. In this paper, the advantages and disadvantages of various minimally invasive cholelithiasis surgical techniques are systematically summarized and innovative surgical approaches [...] Read more.
This study aims to provide valuable references for clinicians in selecting appropriate surgical methods for biliary tract stones based on patient conditions. In this paper, the advantages and disadvantages of various minimally invasive cholelithiasis surgical techniques are systematically summarized and innovative surgical approaches and intelligent stone removal technologies are introduced. The goal is to evaluate and predict future research priorities and development trends in the field of gallstone surgery. In recent years, the incidence of gallstone-related diseases, including cholecystolithiasis and choledocholithiasis, has significantly increased. This surge in cases has prompted the development of several innovative methods for gallstone extraction, with minimally invasive procedures gaining the most popularity. Among these techniques, PTCS, ERCP, and LCBDE have garnered considerable attention, leading to new surgical techniques; however, it must be acknowledged that each surgical method has its unique indications and potential complications. The primary challenge for clinicians is selecting a surgical approach that minimizes patient trauma while reducing the incidence of complications such as pancreatitis and gallbladder cancer and preventing the recurrence of gallstones. The integration of artificial intelligence with stone extraction surgeries offers new opportunities to address this issue. Regarding the need for preoperative preparation for PTCS surgery, we recommend a combined approach of PTBD and PTOBF. For ERCP-based stone extraction, we recommend a small incision of the Oddi sphincter followed by 30 s of balloon dilation as the optimal procedure. If conditions permit, a biliary stent can be placed post-extraction. For the surgical approach of LCBDE, we recommend the transduodenal (TD) approach. Artificial intelligence is involved throughout the entire process of gallstone detection, treatment, and prognosis, and more AI-integrated medical technologies are expected to be applied in the future. Full article
(This article belongs to the Section Gastroenterology)
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9 pages, 1790 KiB  
Case Report
Malignant Epithelioid Neoplasm versus Dedifferentiated Malignant Melanoma: A Case Report
by Angela Rosenberg, Chapman Wei, Yisroel Grabie, Stephanie Chain, Sakura Thapa and Gita Vatandoust
Diseases 2024, 12(9), 196; https://doi.org/10.3390/diseases12090196 - 24 Aug 2024
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Abstract
The metastasis of poorly differentiated epithelioid carcinoma to the axillary node is uncommon. This tumor has heterogeneous expression and is challenging to diagnose with certainty. Often, it necessitates immunoperoxidase staining to ascertain the tumor lineage, and diagnosis is prolonged due to low suspicion. [...] Read more.
The metastasis of poorly differentiated epithelioid carcinoma to the axillary node is uncommon. This tumor has heterogeneous expression and is challenging to diagnose with certainty. Often, it necessitates immunoperoxidase staining to ascertain the tumor lineage, and diagnosis is prolonged due to low suspicion. Herein, we present a case involving a 75-year-old male war veteran with a prior history of a gunshot wound complicated by colostomy that presented with an axillary mass, fecal and urinary incontinence, leg weakness, fevers, night sweats, and substantial weight loss. On admission, he had heightened leukocytosis (43K), anemia (hemoglobin 6.6), and thrombophilia (1000). This patient constantly picked at his back to remove recurrent “gun shrapnel” eruptions. An excisional biopsy of the axillary mass was performed for diagnosis and lymph node removal. Notably, after excision, there was marked improvement in the presenting symptoms. Diagnostic challenges arose due to the tumor cells’ inconsistent immunohistochemical marker expression. The staining patterns alluded to metastatic melanoma. Yet, the tumor displayed epithelial characteristics, supported by an immunophenotypic marker pattern indicative of poorly differentiated carcinoma. This case underscores the morphological and immunoperoxidase staining similarities between poorly differentiated carcinoma and dedifferentiated tumors of varying origins. It illustrates the intricate nature of these malignant metastatic tumors and their overlapping manifestations, which requires provider awareness. The timely diagnosis of poorly differentiated epithelial carcinoma remains paramount to early treatment and improved prognosis. Therefore, in patients manifesting with an axillary mass, fecal and urinary incontinence, and B-symptoms, poorly differentiated epithelial carcinoma should be included in the differential diagnosis. Full article
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12 pages, 863 KiB  
Review
Ceramides—Emerging Biomarkers of Lipotoxicity in Obesity, Diabetes, Cardiovascular Diseases, and Inflammation
by Ginka Delcheva, Katya Stefanova and Teodora Stankova
Diseases 2024, 12(9), 195; https://doi.org/10.3390/diseases12090195 - 23 Aug 2024
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Abstract
Abnormalities in lipid homeostasis have been associated with many human diseases, and the interrelation between lipotoxicity and cellular dysfunction has received significant attention in the past two decades. Ceramides (Cers) are bioactive lipid molecules that serve as precursors of all complex sphingolipids. Besides [...] Read more.
Abnormalities in lipid homeostasis have been associated with many human diseases, and the interrelation between lipotoxicity and cellular dysfunction has received significant attention in the past two decades. Ceramides (Cers) are bioactive lipid molecules that serve as precursors of all complex sphingolipids. Besides their function as structural components in cell and mitochondrial membranes, Cers play a significant role as key mediators in cell metabolism and are involved in numerous cellular processes, such as proliferation, differentiation, inflammation, and induction of apoptosis. The accumulation of various ceramides in tissues causes metabolic and cellular disturbances. Recent studies suggest that Cer lipotoxicity has an important role in obesity, metabolic syndrome, type 2 diabetes, atherosclerosis, and cardiovascular diseases (CVDs). In humans, elevated plasma ceramide levels are associated with insulin resistance and impaired cardiovascular and metabolic health. In this review, we summarize the role of ceramides as key mediators of lipotoxicity in obesity, diabetes, cardiovascular diseases, and inflammation and their potential as a promising diagnostic tool. Full article
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