Search Results (53)

Background: Arterial hypertension (HT) is one of the most prevalent diseases, causing increased morbidity and mortality. Treatment of HT might be complicated by multiple drug intolerance syndrome (MDIS), defined as intolerance to three or more drug classes. This systematic review and meta-analysis aimed to assess the prevalence of MDIS in patients with hypertension and investigate its impact on disease control. Materials and Methods: MEDLINE, Scopus, Web of Science, and Embase were thoroughly searched in June 2024. The data concerning MDIS prevalence, MDIS risk factors, number of adverse drug reactions (ADRs), and types of reactions was extracted. Quality assessment was done with the use of the Newcastle-Ottawa Scale. Meta-analysis was conducted to determine the pooled prevalence of MDIS and ADRs. The study was conducted according to the PRISMA guidelines. Results: This review included four studies (2508 patients). The pooled prevalence of MDIS was 10% (95% CI: 4%–19%). Headache was the most frequent ADR reported in the studies (71.47%, 95% CI: 56.5%–84.44%), while pain in other body parts was present in 53.08% of patients. Female sex was found to increase the risk of MDIS in each included study. Other risk factors identified were older age, gastrointestinal disorders, anxiety disorders, panic attacks, and depression. Blood pressure was higher in the MDIS group, and in this group, more patients had uncontrolled hypertension. Conclusions: The prevalence of MDIS in the hypertensive population can be considered high. Furthermore, blood pressure control is worse in patients with MDIS. However, this phenomenon is still studied inadequately, and further research is necessary. Full article

Background: The Hall Technique (HT) in pediatric dentistry is a minimally invasive method for treating carious primary molars by sealing cavities with preformed stainless-steel crowns, eliminating the need for local anesthesia, caries removal or tooth preparation. Objectives: To assess the knowledge, attitude, and teaching of HT among pediatric dentistry faculty in Riyadh, Saudi Arabia. Methods: A cross-sectional descriptive study involved 36 pediatric dentistry faculty members from six dental colleges in Riyadh. Data were collected using a validated questionnaire covering demographics and professional information, HT knowledge, attitude, and teaching strategies. Results: Thirty-one pediatric dentistry faculty responded to the questionnaire, and 67.74% of participants use HT clinically, primarily for asymptomatic carious primary molars. Most participants learned about HT during postgraduate residency (61.29%), while only 6.45% were introduced to it in undergraduate training. Teaching practices varied, with 51.61% teaching HT to undergraduate and/or postgraduate students, and 16.13% omitting it from their curriculum. Key barriers to HT adoption included limited undergraduate exposure, misconceptions, and a lack of standardized guidelines. Fisher’s Exact Test showed that gender, academic position, and years of experience were significantly associated with HT use. Only years of experience were significantly associated with recommending HT use by undergraduate students. No factors were significantly associated with teaching HT. Conclusions: While awareness of HT is high among pediatric dentistry faculty, inconsistent teaching and limited clinical use hinder its full integration. Addressing these barriers through curriculum updates and professional development could enhance the acceptance and quality of HT use in pediatric dentistry in Saudi Arabia. Full article

Background/Objectives: Concerns about the occurrence of autoimmune diseases are one of the main reasons influencing the uptake of the human papillomavirus (HPV) vaccine. Limited evidence exists regarding the relationship between HPV vaccination and the risk of Hashimoto’s thyroiditis (HT). Therefore, the purpose of this study was to examine the association between HPV vaccination and the risk of HT development in American women. Methods: Using the National Health and Nutrition Examination Survey (NHANES) data from 2007 to 2012, we conducted a cross-sectional study of 2717 women aged 18–59 with comprehensive data on relevant HPV vaccination status, HPV DNA vaginal swab results, and thyroid function. The relationship between HPV vaccination and the risk of HT development was explored by weighted logistic regression, while the association between HPV vaccination and thyroid peroxidase antibodies (TPOAb)/thyroglobulin antibodies (TGAb) levels was analyzed by weighted linear regression. Results: In the fully adjusted model, HPV vaccination was associated with an 87% decrease in the risk of developing HT (OR 0.13; 95% CI 0.02, 0.76). Furthermore, weighted linear regression demonstrated significant negative associations between HPV vaccination and TPOAb levels (−22.27 (−34.86, −9.68), p = 0.001) and TGAb levels (−7.53 (−14.88, −0.18), p = 0.045). HPV vaccination was significantly negatively correlated with the risk of HT development and TPOAb/TGAb levels. Conclusions: We advocate for adherence to vaccination guidelines, which could confer dual protective benefits against HPV and potentially reduce the risk of HT development. Full article

Background/Objectives: Yawning, a common physiological behavior, has emerged as a potential biomarker for drug responsiveness and side effects. This scoping review synthesizes current evidence on drug-induced yawning (DIY), focusing on its neurobiological mechanisms and clinical implications. Methods: A scoping review (INPLASY registration number: INPLASY202540048) was conducted using PubMed, Scopus, and Web of Science, including studies published in the past decade. The review adhered to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and Cochrane Handbook guidelines, ensuring systematic selection. Selected articles led to the analysis of 10 relevant studies encompassing 473 participants. Studies were evaluated for relevance to DIY, neurobiology, and clinical applications, with thematic analysis used to synthesize findings. Results: Four key themes emerged. (1) Yawning patterns: DIY involves frequent episodes (up to 80 yawns/day), varying by drug type and dosage. (2) Neurobiological mechanisms: Yawning is mediated by serotonin, dopamine, and oxytocin pathways, particularly via 5-HT2C and μ-opioid receptors. (3) Drug responsiveness: DIY is linked to SSRIs, opioids, and dopamine agonists. SSRIs induce yawning, while opioids suppress it, reflecting distinct neurochemical effects. (4) Clinical implications: Yawning may serve as a non-invasive biomarker for drug efficacy and side effects, particularly in opioid withdrawal and SSRI monitoring. Conclusions: DIY holds promise as a biomarker for drug safety and effectiveness, but research is limited by small sample sizes, methodological variability, and the absence of standardized yawning metrics. Future studies should establish consistent measures, account for interindividual variability, and evaluate DIY’s long-term clinical utility across diverse populations. Full article

The hospitality and tourism (H&T) sector, marked by intense employee–customer interactions, dynamic labor shifts, and high physical and emotional labor demands, faces chronic talent acquisition and retention. Therefore, tailored employer branding (EB) strategies that address the unique characteristics of the H&T sector are essential for improving the current situation. Despite the critical need for tailored solutions, a clear and unified approach for H&T companies to effectively manage their EB strategies, including the development of a compelling employee value proposition (EVP) that resonates with targeted professionals, has yet to be established. Following the PRISMA reporting guidelines, a systematic literature review of 30 peer-reviewed articles from the Scopus and Web of Science databases was conducted to synthesize existing research on EB practices in the H&T sector. The results reveal a fragmented literature that lacks a cohesive framework for categorizing and measuring EVP. The use of varied and inconsistent EVP models and scales across studies hampers comparative analysis and limits the development of generalizable insights. Furthermore, the review highlights a concentration of research within the hotel industry, leaving other important H&T industries, such as the restaurant and cruise industries, underexplored. This SLR emphasizes the urgent need for a unified approach to EB in H&T. Based on these results, promising research avenues are suggested to further advance EB research in H&T, along with managerial implications for enhancing talent attraction and retention in the sector. Full article

Introduction: The American Academy of Pediatrics (AAP) published in 2017 new guidelines for the screening and management of hypertension in children containing different nomograms compared to the European guidelines, leading to a reclassification of blood pressure values, the consequences of which are still little investigated. The aim of our study was to evaluate the prevalence of high blood pressure values estimated with both the most recent American and European guidelines and to analyze the relationship of blood pressure increases with lifestyles and potentially risky behaviors in a school population in Western Sicily. Methods: On the occasion of the XV World Hypertension Day, blood pressure values of 1301 students aged between 13 and 18 were measured. Two questionnaires were administered, one relating to anamnestic data and anthropometric parameters and a second aimed at investigating lifestyle. For the diagnosis of increased blood pressure, both ESH and AAP criteria were considered. Results: The prevalence of elevated blood pressure was 7.5% according to ESH criteria and nearly twice as high using AAP criteria, with a more pronounced discrepancy in females. Individuals with elevated blood pressure were younger, exhibited higher body weight and BMI, and had an increased prevalence of overweight and obesity. Classification based on ESH criteria revealed higher alcohol and drug consumption among normotensive individuals. AAP criteria identified a higher proportion of males and greater height in the hypertensive group. Systolic blood pressure correlated significantly with height, weight, and BMI, with stronger associations in males, while diastolic pressure correlated with weight and BMI. Conclusions: To the best of our knowledge, our study is the only one to analyze the prevalence of increased blood pressure and its relationship with lifestyle factors and anthropometric data in adolescence in our region. Our study confirms that elevated blood pressure is common in adolescence, with higher prevalence using the 2017 AAP criteria than ESH guidelines. Full article

With the implementation of strict emission regulations, new energy technologies are widely used in the field of maritime transportation. Fuel cells can be used as the power sources of ships due to the advantages of high efficiency, low noise and zero emissions. In this study, a three-dimensional non-isothermal numerical model of a high temperature proton exchange membrane fuel cell (HT-PEMFC) is established and used to investigate the effect of a flow field with baffles on cell performance. The effects of the number, height and length of baffles in the flow field on the species concentration distribution, current density and power density are comprehensively studied. Compared with the traditional straight channel, the baffles in the channel can effectively improve cell performance. When the number of baffles is nine, the height of the baffles is 0.75 mm and the length of the baffles is 1 mm, the current density is increased from 1.390 A/cm² to 1.524 A/cm² at a voltage of 0.4 V, which is an increase of 9.64%. This study can provide guidelines for flow channel design. Full article

Background: Cardiac allograft vasculopathy (CAV) is a major prognosis-limiting factor in patients undergoing orthotopic heart transplantation (HT). Due to the diffuse involvement of the coronary tree, CAV lesions are often not amenable to percutaneous coronary intervention (PCI), leaving coronary artery bypass grafting (CABG) and retransplantation as primary revascularization options. Aim and Results: The latest guidelines from the International Society for Heart and Lung Transplantation (ISHLT) recognize CABG as a viable option but with a downgraded strength of recommendation. The 2023 ISHLT guidelines now categorize CABG as a Class IIb recommendation (Level of Evidence: C) for highly selected CAV patients with anatomically suitable lesions, a downgrade from the Class IIa recommendation in the 2010 guidelines. This adjustment underscores the persisting reliance on limited, retrospective studies and the lack of substantial new data supporting CABG in CAV management. Our article examines the evidence collected since 2010 on this topic, highlighting key findings and assessing the role of CABG in contemporary transplant practice. This article calls for targeted investigations to better define the role of CABG as a therapeutic option, addressing the gaps in evidence for surgical revascularization in HT patients. Full article

A new insight into oxidative stress is based on oxidative deoxyribonucleic acid (DNA) damage. DNA is the pivotal biopolymer for life and health. Arterial hypertension (HT) is a globally common disease and a major risk factor for numerous cardiovascular (CV) conditions and non-cardiac complications, making it a significant health and socio-economic problem. The aetiology of HT is multifactorial. Oxidative stress is the main driver. Oxidative DNA damage (oxidised guanosine (8OHdG), strand breaks (SSBs, DSBs)) seems to be the crucial and initiating causal molecular mechanism leading to HT, acting through oxidative stress and the resulting consequences (inflammation, fibrosis, vascular remodelling, stiffness, thickness, and endothelial dysfunction). In light of the current European Society of Cardiology (ESC) guidelines with defined gaps in the evidence, this manuscript, for the first time, (1) summarizes evidence for oxidative DNA damage in HT and other CV risk factors, (2) incorporates them into the context of known mechanisms in HT genesis, (3) proposes the existing concept of HT genesis innovatively supplemented with oxidative DNA damage, and (4) mentions consequences such as promising new targets for the treatment of HT (DNA damage response (DDR) pathways). Full article

Objective: This review aims to elucidate the link between Hashimoto’s thyroiditis (HT) and periodontal disease (PD) and to substantiate whether the autoimmune mechanisms involved in the pathogenesis of HT influence the integrity of oral tissues, eventually inducing the development of PD. Methods: The present article is a narrative review that has been composed conforming to the Scale for the Assessment of Narrative Review Articles (SANRA) guidelines on the topic ‘Association between HT and PD’. Results: Eight studies, including four case–control studies, one cross-sectional study, two case reports, and one bidirectional Mendelian randomization study, were cited. These studies were filtered by language (all in English) and relevance to the topic and were sourced from the Google Scholar and PubMed databases. The results suggest a potential link between HT and PD, indicating that HT may have a direct impact on oral tissues. Conclusion: Existing research shows limited but probable evidence associating HT with PD; nevertheless, further large-scale studies with refined methodologies are required to assess this hypothesis and elucidate the precise mechanisms by which HT may contribute to PD pathogenesis. Full article

Introduction: The abscopal effect is a systemic immune response characterized by metastases regression at sites distant from the irradiated lesion. This systematic review aims to explore the immunological mechanisms of action underlying the abscopal effect and to investigate how hyperthermia (HT) can increase the chances of radiotherapy (RT) triggering systemic anti-tumor immune responses. Methods: This review is created in accordance with the PRISMA guidelines. Results and Conclusion: HT and RT have both complementary and synergistic immunological effects. Both methods trigger danger signal release, promoting cytokine and chemokine secretion, which increases T-cell infiltration and facilitates cell death. Both treatments upregulate extracellular tumor HSP70, which could amplify DAMP recognition by macrophages and DCs, leading to stronger tumor antigen presentation and CTL-mediated immune responses. Additionally, the combined increase in cell adhesion molecules (VCAM-1, ICAM-1, E-selectin, L-selectin) could enhance leukocyte adhesion to tumors, improving lymphocyte trafficking and boosting systemic anti-tumor effects. Lastly, HT causes vasodilation and improves blood flow, which might exacerbate those distant effects. We suggest the combination of local radiotherapy with fever-range whole-body hyperthermia to optimally enhance the chances of triggering the abscopal effect mediated by the immune system. Full article

Background/Objectives: Cannabis sativa L. is a plant that has been used for thousands of years for its industrial and medicinal properties. In recent years, there has been a rise in the study of this plant due to its bioactive compounds for pharmaceutical applications. Particularly, cannabidiol has demonstrated analgesic and non-psychoactive properties. The objective of this systematic review is to update and to gather the clinical and preclinical evidence on CBD in pain treatment. Methods: This study was performed following the PRISMA guidelines and using the following search terms “((cannabidiol) NOT (THC)) NOT (tetrahydrocannabinol)) AND (pain treatment)” in PubMed and Web of Science, with the following inclusion criteria: CBD pain treatment without THC in monotherapy, including both clinical and preclinical trials. From the initial sample of more than 500 articles, a total of 40 studies were selected, eliminating duplicate studies from the databases and considering the inclusion and exclusion criteria. On one hand, clinical trials were analyzed using CBD products without THC used in monotherapy, assigning a Jadad score to evaluate the quality/bias of the trials; on the other hand, the main preclinical trials were analyzed, grouping the results into in vivo and in vitro trials. Results: Based on the review conducted, there is sufficient clinical and preclinical evidence of CBD in pain treatment, so CBD could be an effective and safe treatment in reducing pain due to its analgesic and anti-inflammatory properties. These effects appear to be primarily mediated by the activation of TRPV-1, 5HT-1A, and CB1, with emerging therapeutic relevance in the management of osteoarthritis and chronic pain. Conclusions: Although clinical and preclinical research show promising results, clinical evidence is limited, and more studies should be performed in the future with isolated CBD. Full article

Background: Proton therapy requires caution when treating patients with targets near neural structures. Intuitive and quantitative guidelines are needed to support decision-making concerning the treatment modality. This study compared dosimetric profiles of intensity-modulated proton therapy (IMPT) and intensity-modulated radiation therapy (IMRT) using helical tomotherapy (HT) for adaptive re-planning in cT3-4 nasopharyngeal cancer (NPCa) patients, aiming to establish criteria for selecting appropriate treatment modalities. Methods: HT and IMPT plans were generated for 28 cT3-4 NPCa patients undergoing definitive radiotherapy. Dosimetric comparisons were performed for target coverage and high-priority organs at risk (OARs). The correlation between dosimetric parameters and RT modality selection was analyzed with the target OAR distances. Results: Target coverages were similar, while IMPT achieved better dose spillage. HT was more favorable for brainstem D₁, optic chiasm D_max, optic nerves D_max, and p-cord D₁. IMPT showed advantages for oral cavity D_mean. Actually, 14 IMPT and 14 HT plans were selected as adaptive plans, with IMPT allocated to most cT3 patients (92.9% vs. 42.9%, p = 0.013). The shortest distances from the target to neural structures were negatively correlated with OAR doses. Receiver operating characteristic curve analyses were carried out to discover the optimal cut-off values of the shortest distances between the target and the OARs (temporal lobes and brainstem), which were 0.75 cm (AUC = 0.908, specificity = 1.00) and 0.85 cm (AUC = 0.857, specificity = 0.929), respectively. Conclusions: NPCa patients with cT4 tumor or with the shortest distance between the target and critical neural structures < 0.8 cm were suboptimal candidates for IMPT adaptive re-planning. These criteria may improve resource utilization and clinical outcomes. Full article

Hypertension (HT) is a disease that poses a serious threat to human health, mediating organ damage such as the cardiovascular (CV) system, kidneys, central nervous system (CNS), and retinae, ultimately increasing the risk of death due to damage to the entire vascular system. Thus, the widespread prevalence of hypertension brings enormous health problems and socioeconomic burdens worldwide. The goal of hypertension management is to prevent the risk of hypertension-mediated organ damage and excess mortality of cardiovascular diseases. To achieve this goal, hypertension guidelines recommend accurate monitoring of blood pressure and assessment of associated target organ damage. Early identification of organ damage mediated by hypertension is therefore crucial. Plasma biomarkers as a non-invasive test can help identify patients with organ damage mediated by hypertension who will benefit from antihypertensive treatment optimization and improved prognosis. In this review, we provide an overview of some currently available, under-researched, potential plasma biomarkers of organ damage mediated by hypertension, looking for biomarkers that can be detected by simple testing to identify hypertensive patients with organ damage, which is of great significance in clinical work. Natriuretic peptides (NPs) can be utilized as a traditional biomarker to detect hypertension-mediated organ damage, especially for heart failure. Nevertheless, we additionally may need to combine two or more plasma biomarkers to monitor organ damage in the early stages of hypertension. Full article

Horse transport is considered a cause of stress in animals and is known to affect the 5-HT concentrations in both the brain and other tissues. The aim of this research was to investigate the effect of horse transportation and slaughter stress on plasma serotonin’s concentration and the expression levels of the related 5-HT1B and 5-HT2A receptors in PBMCs. Furthermore, the IL-12 levels and a variety of blood parameters, including triglycerides, total cholesterol, glucose, aspartate aminotransferase, creatine phosphokinase, lactate dehydrogenase, were also considered. This research was carried out on 32 horses submitted to short road transport of 40 km to slaughter. Blood samples were collected in baseline conditions (T0) and 24 h later, after they were slaughtered (T1). The results showed a significantly increased expression of 5-HT1B and 5-HT2A receptors and a significantly decreased expression of IL-12 in PBMCs at T1 vs. T0. Furthermore, a significant increase in cortisol and glucose concentrations, and LDH activity was observed at T1. In contrast, a significantly lower circulating 5-HT concentration was observed at T1 vs. T0. These results indicate that the stress induced by transport and slaughter stimuli led to the serotoninergic system’s activation, suggesting that the expression of serotonin receptors could be used as a pivotal marker of stress, with potential applications for the improvement of elective protocols to observe the guidelines relating to transported horses. Full article