New Insights on Chronic Illness: Pathogenesis, Prevalence, Prevention, and Systemic Therapies

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Topic Information

Dear Colleagues,

Prior to the COVID-19 pandemic, chronic illnesses including heart disease, cancer, lung disease, stroke, Alzheimer’s disease, diabetes, and kidney disease were responsible for more than 70% of global deaths annually. Though traditionally more prevalent in older adults (70+ years), chronic illnesses are becoming more prevalent in younger adults (30–69 years), with more than 85% of these “premature” deaths occurring in low- and middle-income countries. Early data suggest SARS-CoV-2 infection is associated with the increased prevalence of many chronic illnesses, threatening an already overburdened global healthcare system.

In recent years, technological advances have allowed for substantial growth in elucidating the molecular mechanisms underpinning many chronic illnesses. However, with an increasing proportion of individuals experiencing more than one chronic illness, there remains a lack of knowledge on how individual disease pathogeneses may exacerbate underlying complications. In this Topic, entitled “New Insights on Chronic Illness: Pathogenesis, Prevalence, Prevention, and Systemic Therapies”, we welcome original research, clinical observations, reviews, and systematic reviews which provide novel insights into the area of chronic disease. Areas of interest include but are not limited to:

• Diabetes             
• Obesity
• Heart disease
• Cancer
• Lung disease
• Stroke
• Kidney disease
• Arthritis
• Asthma
• Oral diseases

Dr. Ram Prasad
Dr. Suresh K. Verma
Topic Editors

Keywords

Participating Journals

Journal Name	Impact Factor	CiteScore	Launched Year	First Decision (median)	APC
Biomedicines biomedicines	3.9	5.2	2013	14.6 Days	CHF 2600
Cancers cancers	4.5	8.0	2009	17.4 Days	CHF 2900
Healthcare healthcare	2.4	3.5	2013	20.3 Days	CHF 2700
Journal of Cardiovascular Development and Disease jcdd	2.4	2.6	2014	25.7 Days	CHF 2700
Journal of Clinical Medicine jcm	3.0	5.7	2012	16 Days	CHF 2600

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Published Papers (26 papers)

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22 pages, 4804 KiB  

Open AccessArticle

The Influence of Mobility Training on the Myofascial Structures of the Back and Extremities

by Gunda Slomka, Robert Schleip, Peter Frei, Nicolas Kurpiers, Michael Krämer, Katharina Bauermeister and Wolfgang Bauermeister

J. Clin. Med. 2024, 13(2), 329; https://doi.org/10.3390/jcm13020329 - 6 Jan 2024

Viewed by 5219

Abstract

Background: The subject of the study was the effect of a multicomponent program (Mobility Routine) on muscular and fascial stiffness, flexibility, subjective well-being, and body perception. Methods: The assumption was that high physical stress affects myofascial structures and joint range of motion. The [...] Read more.

Background: The subject of the study was the effect of a multicomponent program (Mobility Routine) on muscular and fascial stiffness, flexibility, subjective well-being, and body perception. Methods: The assumption was that high physical stress affects myofascial structures and joint range of motion. The assessment of myofascial stiffness employed a Shear Wave Elastography. The joint flexibility, pressure pain threshold, and subjective experiences with regard to tension, pain, and general discomfort were documented. Results: In the CT group, a greater increase in stiffness was measured in fewer measurement areas compared to the MR group. MR demonstrated superior gains in flexibility compared to CT. Both groups experienced significant reductions in pain, tension, and discomfort. In conclusion, repetitive motion patterns akin to CT lead to increased myofascial stiffness, whereas MR yields more balanced stiffness development, compensates for asymmetries, and improves body awareness. Conclusions: Hence, this study highlights the advantages of mobility training over Crosstrainer exercises and provides valuable insights for the recommendation of training regimens aiming at the enhancement of musculoskeletal functionality and overall well-being. Full article

(This article belongs to the Topic New Insights on Chronic Illness: Pathogenesis, Prevalence, Prevention, and Systemic Therapies)

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12 pages, 513 KiB  

Open AccessFeature PaperArticle

Combined Neurological Syndrome in Electrohypersensitivity and Multiple Chemical Sensitivity: A Clinical Study of 2018 Cases

by Dominique Belpomme and Philippe Irigaray

J. Clin. Med. 2023, 12(23), 7421; https://doi.org/10.3390/jcm12237421 - 30 Nov 2023

Cited by 2 | Viewed by 2803

Abstract

From a cohort of 2018 evaluable consecutive cases issued from the European Clinical Trial Database, we describe the complete clinical symptomatic presentation of electrohypersensitivity (EHS) and multiple chemical sensitivity (MCS) and their association in the framework of a unique, sensitivity-related environmental neurologic syndrome. [...] Read more.

From a cohort of 2018 evaluable consecutive cases issued from the European Clinical Trial Database, we describe the complete clinical symptomatic presentation of electrohypersensitivity (EHS) and multiple chemical sensitivity (MCS) and their association in the framework of a unique, sensitivity-related environmental neurologic syndrome. Eligibility criteria are those of the Atlanta consensus meeting for MCS, and those of WHO for EHS. There were 1428 EHS, 85 MCS and 505 EHS/MCS evaluable cases, so EHS was associated with MCS in 25%. Women appeared to be much more susceptible to EHS and/or to MCS than men, with no statistical significance between the EHS and MCS groups (p = 0.07), but the combined group revealed a more significant female sex ratio of 80.4% (p < 0.0001). All symptoms except emotional behavior were significantly more frequent in EHS patients than in healthy controls (p < 0.0001). We found no pathognomonic symptoms to establish the diagnosis of both disorders or to distinguish EHS from MCS. The three groups of patients were found to share identical symptoms, while several symptoms were found to be more significantly frequent in EHS/MCS than in EHS (p < 0.0001). From these data, we suggest that EHS and MCS are new brain disorders, generated via a common etiopathogenic mechanism. Full article

(This article belongs to the Topic New Insights on Chronic Illness: Pathogenesis, Prevalence, Prevention, and Systemic Therapies)

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13 pages, 715 KiB  

Open AccessReview

MicroRNA-21 Silencing in Diabetic Nephropathy: Insights on Therapeutic Strategies

by Yogita Dhas, Numair Arshad, Nupur Biswas, Lawrence D. Jones and Shashaanka Ashili

Biomedicines 2023, 11(9), 2583; https://doi.org/10.3390/biomedicines11092583 - 20 Sep 2023

Cited by 13 | Viewed by 2713

Abstract

In diabetes, possibly the most significant site of microvascular damage is the kidney. Due to diabetes and/or other co-morbidities, such as hypertension and age-related nephron loss, a significant number of people with diabetes suffer from kidney diseases. Improved diabetic care can reduce the [...] Read more.

In diabetes, possibly the most significant site of microvascular damage is the kidney. Due to diabetes and/or other co-morbidities, such as hypertension and age-related nephron loss, a significant number of people with diabetes suffer from kidney diseases. Improved diabetic care can reduce the prevalence of diabetic nephropathy (DN); however, innovative treatment approaches are still required. MicroRNA-21 (miR-21) is one of the most studied multipotent microRNAs (miRNAs), and it has been linked to renal fibrosis and exhibits significantly altered expression in DN. Targeting miR-21 offers an advantage in DN. Currently, miR-21 is being pharmacologically silenced through various methods, all of which are in early development. In this review, we summarize the role of miR-21 in the molecular pathogenesis of DN and several therapeutic strategies to use miR-21 as a therapeutic target in DN. The existing experimental interventions offer a way to rectify the lower miRNA levels as well as to reduce the higher levels. Synthetic miRNAs also referred to as miR-mimics, can compensate for abnormally low miRNA levels. Furthermore, strategies like oligonucleotides can be used to alter the miRNA levels. It is reasonable to target miR-21 for improved results because it directly contributes to the pathological processes of kidney diseases, including DN. Full article

(This article belongs to the Topic New Insights on Chronic Illness: Pathogenesis, Prevalence, Prevention, and Systemic Therapies)

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8 pages, 984 KiB  

Open AccessFeature PaperArticle

Constipation as a Drug-Related Adverse Effect in Patients with Hyperkalemia: Sodium Zirconium Cyclosilicate versus Conventional Potassium Binders

by Yuki Hida, Teruhiko Imamura and Koichiro Kinugawa

J. Clin. Med. 2023, 12(18), 5971; https://doi.org/10.3390/jcm12185971 - 14 Sep 2023

Cited by 5 | Viewed by 2202

Abstract

(1) Background: Constipation is one of the most serious adverse effects of potassium-lowering agents and decreases patients’ quality of life. Sodium zirconium cyclosilicate (SZC) is a recently innovated potassium binder intended for patients with hyperkalemia. The impact of SZC on the worsening of [...] Read more.

(1) Background: Constipation is one of the most serious adverse effects of potassium-lowering agents and decreases patients’ quality of life. Sodium zirconium cyclosilicate (SZC) is a recently innovated potassium binder intended for patients with hyperkalemia. The impact of SZC on the worsening of constipation, as compared with conventional potassium binders, remains unknown. (2) Methods: Patients with hyperkalemia who continued SZC for over 3 months between July 2020 and May 2022 were included in this retrospective study. Patients who received other conventional potassium binders during the same period were included as a control group. Trends in the doses of anti-constipation agents during the 3-month therapeutic period were compared between the two groups as a surrogate for worsening constipation. (3) Results: A total of 50 patients (median age 74 years, 31 male) were included, consisting of 22 patients with SZC and 28 patients with other conventional potassium binders. All patients had hyperkalemia and chronic kidney disease at baseline. During the 3-month therapeutic period, serum potassium levels decreased significantly in both groups (p < 0.05 for both). The number of anti-constipation remained unchanged in the SZC group but tended to increase in the control group (p = 0.56 and p = 0.090, respectively). The total dose change in all anti-constipations was significantly lower in the SZC group than in the control group (p = 0.037). (4) Conclusions: Conventional potassium binders have a tendency to worsen constipation, whereas SZC may have the potential to improve hyperkalemia without worsening constipation. SZC may be recommended, particularly in elderly patients with ongoing or high-risk constipation. Full article

(This article belongs to the Topic New Insights on Chronic Illness: Pathogenesis, Prevalence, Prevention, and Systemic Therapies)

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7 pages, 1536 KiB  

Open AccessCase Report

Unexplained Left Ventricular Hypertrophy Diagnosed as a Cardiac Variant of Late-Onset Fabry Disease: A Case Report

by Maomao Zhao, Xiaowei Niu, Lu Bai, Yinchang Zhang, Ting Wang, Yongling Wa, Junchu Wei, Kang Dong, Xin Zhang and Ming Bai

J. Cardiovasc. Dev. Dis. 2023, 10(9), 389; https://doi.org/10.3390/jcdd10090389 - 10 Sep 2023

Viewed by 2224

Abstract

The cardiac variant of Fabry disease (FD) has high rates of missed diagnosis and misdiagnosis due to the lack of systemic symptoms. Here, we report a case of a 68-year-old female with delayed-onset FD presenting as concentric left ventricular hypertrophy (LVH) with right [...] Read more.

The cardiac variant of Fabry disease (FD) has high rates of missed diagnosis and misdiagnosis due to the lack of systemic symptoms. Here, we report a case of a 68-year-old female with delayed-onset FD presenting as concentric left ventricular hypertrophy (LVH) with right bundle branch block, atrial fibrillation, and diastolic dysfunction, which was first presented with coronary artery spasm. Early cardiac-specific signs are crucial for diagnosing this disease due to the lack of extracardiac indications and the late onset of symptoms. This case raises a new red flag that patients with unexplained LVH and its atypical electrocardiographic (ECG) manifestations accompanied by diastolic dysfunction should be considered for FD. We also recommend further refinement of examinations associated with Fabry disease, which will contribute to the early diagnosis and treatment of the disease. Full article

(This article belongs to the Topic New Insights on Chronic Illness: Pathogenesis, Prevalence, Prevention, and Systemic Therapies)

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15 pages, 2344 KiB  

Open AccessFeature PaperArticle

Changes in Peripheral Blood Eosinophil Counts and Risk of Eosinophilic Granulomatosis with Polyangiitis Onset after Initiation of Dupilumab Administration in Adult Patients with Asthma

by Yoshitomo Kushima, Yasuo Shimizu, Hiromi Hoshi, Ryo Arai, Naoya Ikeda, Yusuke Nakamura, Meitetsu Masawa, Hiroaki Okutomi, Nana Yazawa, Kazuyuki Chibana, Akihiro Takemasa and Seiji Niho

J. Clin. Med. 2023, 12(17), 5721; https://doi.org/10.3390/jcm12175721 - 1 Sep 2023

Cited by 5 | Viewed by 2741

Abstract

Background: The purpose of this study is to clarify the changes in peripheral blood eosinophil (PBE) counts and eosinophilic granulomatosis with polyangiitis (EGPA) onset in patients with asthma who were treated with dupilumab in clinical practice. Methods: The primary outcome of this study [...] Read more.

Background: The purpose of this study is to clarify the changes in peripheral blood eosinophil (PBE) counts and eosinophilic granulomatosis with polyangiitis (EGPA) onset in patients with asthma who were treated with dupilumab in clinical practice. Methods: The primary outcome of this study is to determine the onset of EGPA in patients whose PBE counts continued to rise within 6 months of dupilumab initiation (rising group) and in patients whose PBE counts peaked and subsequently declined within 6 months (peaked and declined group). As a secondary outcome, the incidence of developing EGPA in patients with PBE counts greater than 1500 cells/μL at 3 or 6 months after dupilumab administration is investigated. Results: A total of 37 individual were enrolled (male/female = 14/23, median age = 57.0 years old). The development of EGPA was significantly more frequent in the rising group compared with the peaked and declined group (p = 0.042, effect size = 0.455, moderate association). Patients with PBE counts greater than 1500 cells/μL showed a significantly higher risk of developing EGPA (p = 0.017, effect size = 0.678, strong association). Conclusions: Physicians should check for the onset of EGPA by monitoring the elevation of eosinophils within 6 months after dupilumab administration, especially in patients with PBE counts greater than 1500 cells/μL at 3 months. Full article

(This article belongs to the Topic New Insights on Chronic Illness: Pathogenesis, Prevalence, Prevention, and Systemic Therapies)

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10 pages, 272 KiB  

Open AccessOpinion

Effectiveness of Pulmonary Rehabilitation for Chronic Obstructive Pulmonary Disease Therapy: Focusing on Traditional Medical Practices

by Katrina O. Tonga and Brian G. Oliver

J. Clin. Med. 2023, 12(14), 4815; https://doi.org/10.3390/jcm12144815 - 21 Jul 2023

Cited by 11 | Viewed by 9918

Abstract

Chronic obstructive pulmonary disease (COPD) is a complex and serious disease that is characterized by dyspnea, fatigue, decreased exercise tolerance, peripheral muscle dysfunction, and mood disorders. These manifestations are successfully treated with pulmonary rehabilitation, a comprehensive intervention and holistic approach designed to improve [...] Read more.

Chronic obstructive pulmonary disease (COPD) is a complex and serious disease that is characterized by dyspnea, fatigue, decreased exercise tolerance, peripheral muscle dysfunction, and mood disorders. These manifestations are successfully treated with pulmonary rehabilitation, a comprehensive intervention and holistic approach designed to improve the physical and psychological condition of people with COPD. Exercise is a big component of pulmonary rehabilitation programs, but the efficacy of non-traditional forms of exercise as used in alternative medicine is poorly understood. Here, we aim to address this gap in knowledge and summarize the clinical evidence for the use of traditional exercise regimens in the pulmonary rehabilitation of COPD patients. Full article

(This article belongs to the Topic New Insights on Chronic Illness: Pathogenesis, Prevalence, Prevention, and Systemic Therapies)

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19 pages, 1040 KiB  

Open AccessArticle

Knowledge and Attitudes toward Human Papillomavirus and Vaccination: A Survey among Nursing Students in Saudi Arabia

by Sally Mohammed Farghaly Abdelaliem, Abeer Mohammed Kuaia, Afnan Ahmed Hadadi, Alhanouf Khalid Alhujayri, Amal Awad Al Anazi, Areen Abdulelah Hajar, Ruba Shayaa AlShareda and Saleha Mohammed Amri

Healthcare 2023, 11(12), 1766; https://doi.org/10.3390/healthcare11121766 - 15 Jun 2023

Cited by 9 | Viewed by 5480

Abstract

Introduction: One of the most prevalent conditions affecting the vaginal organs is the human papilloma virus (HPV). Human papillomavirus (HPV) knowledge and attitudes have been the subject of numerous studies in Saudi Arabia. However, there are only a few studies that have examined [...] Read more.

Introduction: One of the most prevalent conditions affecting the vaginal organs is the human papilloma virus (HPV). Human papillomavirus (HPV) knowledge and attitudes have been the subject of numerous studies in Saudi Arabia. However, there are only a few studies that have examined university students’ attitudes and knowledge of the human papillomavirus and the vaccine that is associated with it. Aim: To predict the level of knowledge and attitudes regarding HPV and its related vaccine among undergraduate nursing students. Methodology: This was descriptive cross-sectional research. After being selected from Princess Nourah bint Abdulrahman University’s College of Nursing, 307 nursing students agreed to take part and completed an online survey that was self-administered. Results: The majority of the participants (73.5%) had a low level of knowledge of HPV with a mean score of 2.77 ± 1.78. In addition, more than half of the participating nursing students (57%) had a moderate attitude toward HPV vaccination with a mean score of 51.18 ± 11.16. The study results also verified that there was a highly significant correlation between the nursing students’ demographics and their knowledge and attitudes toward HPV (p < 0.001). According to the SEM, nursing students’ knowledge regarding HPV accounted for 48% of the variance in students’ attitudes. Conclusion: Nursing students’ knowledge regarding HPV vaccination is an important predictor of students’ attitudes regarding HPV. Full article

(This article belongs to the Topic New Insights on Chronic Illness: Pathogenesis, Prevalence, Prevention, and Systemic Therapies)

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12 pages, 760 KiB  

Open AccessArticle

Guideline Implementation for Improved Asthma Management and Treatment Adherence in Children in Jordan

by Roqia Maabreh, Mahmoud H. Alrabab’a, Madiha Amin Morsy, Hekmat Yousef Al-Akash, Ahmad Rajeh Saifan and Nabeel Al-Yateem

Healthcare 2023, 11(12), 1693; https://doi.org/10.3390/healthcare11121693 - 9 Jun 2023

Viewed by 1646

Abstract

Asthma imposes a significant social burden on children, their families, and society at large. As a chronic health condition, effective management could greatly benefit from consistent adherence to guidelines. Despite this, minimal effort has been exerted to examine the impact of asthma management [...] Read more.

Asthma imposes a significant social burden on children, their families, and society at large. As a chronic health condition, effective management could greatly benefit from consistent adherence to guidelines. Despite this, minimal effort has been exerted to examine the impact of asthma management guidelines and adherence to treatment on children with asthma and the mothers caring for them. This study was designed to evaluate the influence of asthma management guidelines on the knowledge and treatment adherence among children with asthma and their mothers. A quasi-experimental design was utilized, and the study was conducted at two large hospitals in Jordan: Princess Rahma Hospital and King Hussein Medical Center. A purposive sample of children aged 6–12 years (n = 100) who were accompanied by their mothers (n = 100) were recruited for this study. Data were collected using a structured questionnaire and an observation checklist before and after the implementation of guidelines. Statistical analyses were performed using SPSS. The results revealed a statistically significant improvement in knowledge related to asthma among children and their mothers (p < 0.001). Additionally, a statistically significant difference was observed in the children’s adherence to their treatment regimen before and after the implementation of asthma management guidelines (p < 0.001). Moreover, the improvements in knowledge and practice related to asthma were sustained in the follow-up assessments. In conclusion, the guidelines had a beneficial effect on the children’s adherence to their treatment regimen both before and after their implementation. Thus, asthma patients should adhere to conventional guidelines at various health services to manage their condition effectively. Full article

(This article belongs to the Topic New Insights on Chronic Illness: Pathogenesis, Prevalence, Prevention, and Systemic Therapies)

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12 pages, 1641 KiB  

Open AccessArticle

Outcomes of Percutaneous Coronary Intervention in Elderly Patients with Rheumatoid Arthritis: A Nationwide Population-Based Cohort Study

by Bo Young Kim, HyeSung Moon, Sung-Soo Kim and Hyun-Sook Kim

Healthcare 2023, 11(10), 1381; https://doi.org/10.3390/healthcare11101381 - 10 May 2023

Cited by 2 | Viewed by 1713

Abstract

Rheumatoid arthritis (RA) increases the risk of cardiovascular disease. This study aimed to evaluate the clinical outcomes of elderly patients with and without RA who underwent percutaneous coronary intervention (PCI). The Korean National Health Insurance Service claims database was used to extract data [...] Read more.

Rheumatoid arthritis (RA) increases the risk of cardiovascular disease. This study aimed to evaluate the clinical outcomes of elderly patients with and without RA who underwent percutaneous coronary intervention (PCI). The Korean National Health Insurance Service claims database was used to extract data on 74,623 patients (14,074 with RA and 60,549 without RA) aged ≥ 65 years who were diagnosed with acute coronary syndrome and underwent PCI between 2008 and 2019. The primary outcome was survival of elderly patients with and without RA. The secondary outcome was survival in the RA subgroup. During a 10-year follow-up, the all-cause mortality survival rate was lower in patients with RA than that in patients without (53.7% vs. 58.3%, respectively, log-rank: p < 0.001). In the all-cause mortality RA subgroup, patients with elderly-onset RA had poor survival outcomes, whereas patients with young-onset RA had good survival outcomes compared with that in patients without RA (48.1% vs. 73.7% vs. 58.3%, respectively, log-rank: p < 0.001). Elderly patients with RA who underwent PCI had an increased mortality risk, particularly those with elderly rather than young-onset RA. Full article

(This article belongs to the Topic New Insights on Chronic Illness: Pathogenesis, Prevalence, Prevention, and Systemic Therapies)

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13 pages, 958 KiB  

Open AccessArticle

Handgrip Strength and Muscle Quality: Results from the National Health and Nutrition Examination Survey Database

by Zhangxin Wen, Jiaxuan Gu, Rong Chen, Qinyi Wang, Na Ding, Lingqiong Meng, Xiangbing Wang, Hong Liu, Zhifeng Sheng and Houfeng Zheng

J. Clin. Med. 2023, 12(9), 3184; https://doi.org/10.3390/jcm12093184 - 28 Apr 2023

Cited by 14 | Viewed by 3187

Abstract

Background: Handgrip strength (HGS) and the appendicular lean mass index (ALMI) are important determinants of sarcopenia. Muscle quality (MQ) is a measure of muscle strength relative to muscle mass. We examined trends in handgrip strength, the appendicular lean mass index, and analyzed their [...] Read more.

Background: Handgrip strength (HGS) and the appendicular lean mass index (ALMI) are important determinants of sarcopenia. Muscle quality (MQ) is a measure of muscle strength relative to muscle mass. We examined trends in handgrip strength, the appendicular lean mass index, and analyzed their relationship with age, anthropometry, and body composition in a sample of participants in the United States (US). Methods: This cross-sectional study analyzed data from 14,741 US males (49.7%) and females (50.3%) 6–80 years old who responded to the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2014. Dual X-ray absorptiometry was used to measure appendicular skeletal muscle mass. HGS was evaluated using the Takei Digital Grip Strength Dynamometer. Smoothed normative curves for HGS and the ALMI were constructed using a generalized additive model. Multiple regression analyses were used to examine associations of HGS and the ALMI with age, nutrition-related factors, physical activity, and body composition. Results: Mean HGS and the ALMI declined with advancing age. While mean HGS increased with the ALMI, it decreased with the fat mass index. HGS increased in males with an increase in body mass index, energy intake, the ALMI, and vitamins; however, HGS in females increased with albumin, but it had a negative association with the fat mass index and age, but not with increasing adiposity. Conclusions: HGS and the ALMI change with age: HGS increases with age, then stabilizes and declines; the ALMI increases with age, then stabilizes. In addition, we provide evidence for the effect of anthropometry, nutrition, physical activity, and body composition on HGS and the ALMI in US population. Full article

(This article belongs to the Topic New Insights on Chronic Illness: Pathogenesis, Prevalence, Prevention, and Systemic Therapies)

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12 pages, 1092 KiB  

Open AccessArticle

Decreased Interoceptive Awareness as a Risk Factor for Moderate to Severe Pain in Japanese Full-Time Workers: A Longitudinal Cohort Study

by Saki Takaoka, Kenta Wakaizumi, Chisato Tanaka, Shintaro Tanaka, Morihiko Kawate, Reiko Hoshino, Ko Matsudaira, Daisuke Fujisawa, Hiroshi Morisaki and Shizuko Kosugi

J. Clin. Med. 2023, 12(8), 2896; https://doi.org/10.3390/jcm12082896 - 16 Apr 2023

Cited by 1 | Viewed by 2274

Abstract

Interoceptive awareness, the conscious perception of internal bodily states, is a key construct of mind-body interaction. Decreases in interoceptive awareness, as measured by the Multidimensional Assessment of Interoceptive Awareness (MAIA), are found in chronic pain patients. In this study, we explored whether a [...] Read more.

Interoceptive awareness, the conscious perception of internal bodily states, is a key construct of mind-body interaction. Decreases in interoceptive awareness, as measured by the Multidimensional Assessment of Interoceptive Awareness (MAIA), are found in chronic pain patients. In this study, we explored whether a specific aspect of interoceptive awareness is a risk for the onset and chronicity of pain. A longitudinal cohort study was conducted in 2018 and 2020 among a sample of full-time workers in an industrial manufacturing company in Japan. Participants completed a questionnaire on pain intensity, MAIA, exercise habits, kinesiophobia, psychological distress and work stress. Principal component analyses using the MAIA identified two principal components: self-control and emotional stability. Low emotional stability was associated with the prevalence of moderate to severe pain in 2020 among people with mild or no pain in 2018 (p < 0.01). Lack of exercise habits were associated with the prevalence of moderate to severe pain in 2020 among people with pain in 2018 (p < 0.01). Furthermore, exercise habits were associated with reduction in kinesiophobia among people with moderate to severe pain in 2018 (p = 0.047). Overall, these findings indicate that low emotional stability may be a risk for the onset of moderate to severe pain; lack of exercise habits may sustain kinesiophobia and be a risk for the chronicity of pain. Full article

(This article belongs to the Topic New Insights on Chronic Illness: Pathogenesis, Prevalence, Prevention, and Systemic Therapies)

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14 pages, 2036 KiB  

Open AccessReview

The Effects of SGLT2 Inhibitors on Liver Cirrhosis Patients with Refractory Ascites: A Literature Review

by Yasunori Miyamoto, Akira Honda, Seiji Yokose, Mariko Nagata and Jiro Miyamoto

J. Clin. Med. 2023, 12(6), 2253; https://doi.org/10.3390/jcm12062253 - 14 Mar 2023

Cited by 14 | Viewed by 8784

Abstract

Decompensated liver cirrhosis is often complicated by refractory ascites, and intractable ascites are a predictor of poor prognosis in patients with liver cirrhosis. The treatment of ascites in patients with cirrhosis is based on the use of aldosterone blockers and loop diuretics, and [...] Read more.

Decompensated liver cirrhosis is often complicated by refractory ascites, and intractable ascites are a predictor of poor prognosis in patients with liver cirrhosis. The treatment of ascites in patients with cirrhosis is based on the use of aldosterone blockers and loop diuretics, and occasionally vasopressin receptor antagonists are also used. Recent reports suggest that sodium–glucose cotransporter 2 (SGLT2) inhibitors may be a new treatment for refractory ascites with a different mechanism with respect to conventional agents. The main mechanisms of ascites reduction with SGLT2 inhibitors appear to be natriuresis and osmotic diuresis. However, other mechanisms, including improvements in glucose metabolism and nutritional status, hepatoprotection by ketone bodies and adiponectin, amelioration of the sympathetic nervous system, and inhibition of the renin–angiotensin–aldosterone system, may also contribute to the reduction of ascites. This literature review describes previously reported cases in which SGLT2 inhibitors were used to effectively treat ascites caused by liver cirrhosis. The discussion of the mechanisms involved is expected to contribute to establishing SGLT2 therapy for ascites in the future. Full article

(This article belongs to the Topic New Insights on Chronic Illness: Pathogenesis, Prevalence, Prevention, and Systemic Therapies)

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10 pages, 1491 KiB  

Open AccessArticle

Comparison of the Clinical Results of Platelet-Rich Plasma, Steroid and Autologous Blood Injections in the Treatment of Chronic Lateral Epicondylitis

by Aybars Kıvrak and Ibrahim Ulusoy

Healthcare 2023, 11(5), 767; https://doi.org/10.3390/healthcare11050767 - 6 Mar 2023

Cited by 9 | Viewed by 2888

Abstract

Background: The aim of our study is to compare the efficacy of PRP, steroids, and autologous blood injection in patients with chronic lateral epicondylitis. Method: A total of 120 patients comprised our study. Three groups of 40 patients each received only one of [...] Read more.

Background: The aim of our study is to compare the efficacy of PRP, steroids, and autologous blood injection in patients with chronic lateral epicondylitis. Method: A total of 120 patients comprised our study. Three groups of 40 patients each received only one of the following: PRP, steroids, or autologous blood injections. Thereafter, VAS (visual analog scale), DASH (Disabilities of the Arm, Shoulder, and Hand), and Nirschl scores of those treated were evaluated in the second week, the fourth week, the third month, and the sixth month. Results: The baseline evaluation revealed no significant change in VAS, DASH, and Nirschl scores among the three groups (p > 0.050). At the second week evaluation, patients treated with steroids showed significant improvement compared to patients treated with PRP and autologous blood (p < 0.001). The fourth-week evaluation revealed the VAS, DASH, and Nirschl scores of the patients treated with steroids to have improved more significantly than those of patients treated with PRP and autologous blood (p < 0.001). The third month, when the results of all three groups were compared, revealed similar results (p > 0.050). The sixth-month evaluation, when the results of all three groups were compared, revealed the autologous blood and PRP applications provided significantly better results than the group treated with steroids (p < 0.001). Conclusion: We concluded that steroid administration is effective in the short term, while PRP and autologous blood applications are more effective than steroid administration in the long term. Full article

(This article belongs to the Topic New Insights on Chronic Illness: Pathogenesis, Prevalence, Prevention, and Systemic Therapies)

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Open AccessArticle

Epigallocatechin Gallate (EGCG), an Active Phenolic Compound of Green Tea, Inhibits Tumor Growth of Head and Neck Cancer Cells by Targeting DNA Hypermethylation

by Anshu Agarwal, Vikash Kansal, Humaira Farooqi, Ram Prasad and Vijay Kumar Singh

Biomedicines 2023, 11(3), 789; https://doi.org/10.3390/biomedicines11030789 - 5 Mar 2023

Cited by 18 | Viewed by 2952

Abstract

Head and neck cancers are among the deadliest cancers, ranked sixth globally in rates of high mortality and poor patient prognoses. The prevalence of head and neck squamous cell carcinoma (HNSCC) is associated with smoking and excessive alcohol consumption. Despite several advances in [...] Read more.

Head and neck cancers are among the deadliest cancers, ranked sixth globally in rates of high mortality and poor patient prognoses. The prevalence of head and neck squamous cell carcinoma (HNSCC) is associated with smoking and excessive alcohol consumption. Despite several advances in diagnostic and interventional methods, the morbidity of subjects with HNSCC has remained unchanged over the last 30 years. Epigenetic alterations, such as DNA hypermethylation, are commonly associated with several cancers, including HNSCC. Thus, epigenetic changes are considered promising therapeutic targets for chemoprevention. Here, we investigated the effect of EGCG on DNA hypermethylation and the growth of HNSCC. First, we assessed the expression levels of global DNA methylation in HNSCC cells (FaDu and SCC-1) and observed enhanced methylation levels compared with normal human bronchial epithelial cells (NHBE). Treatment of EGCG to HNSCC cells significantly inhibited global DNA hypermethylation by up to 70–80% after 6 days. Inhibition of DNA hypermethylation in HNSCC cells was confirmed by the conversion of 5-methylcytosine (5-mc) into 5-hydroxy methylcytosine (5hmC). DNA methyltransferases regulate DNA methylation. Next, we checked the effect of EGCG on the expression levels of DNA methyltransferases (DNMTs) and DNMT activity. Treatment of EGCG to HNSCC cells significantly reduced DNMT activity to 60% in SCC-1 and 80% in FaDu cells. The protein levels of DNMT3a and DNMT3b were downregulated in both cell lines after EGCG treatment. EGCG treatment to HNSCC cells reactivated tumor suppressors and caused decreased cell proliferation. Our in vivo study demonstrated that administration of EGCG (0.5%, w/w) as a supplement within an AIN76A diet resulted in inhibition of tumor growth in FaDu xenografts in nude mice (80%; p < 0.01) compared with non-EGCG-treated controls. The growth inhibitory effect of dietary EGCG on the HNSCC xenograft tumors was associated with the inhibition of DNMTs and reactivation of silenced tumor suppressors. Together, our study provides evidence that EGCG acts as a DNA demethylating agent and can reactivate epigenetically silenced tumor suppressors to inhibit the growth of HNSCC cells. Full article

(This article belongs to the Topic New Insights on Chronic Illness: Pathogenesis, Prevalence, Prevention, and Systemic Therapies)

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15 pages, 2339 KiB  

Open AccessArticle

Localization Strategy Prior to Radiofrequency Ablation for Primary and Secondary Hyperparathyroidism

by Chih-Ying Lee, Yen-Hsiang Chang, Pi-Ling Chiang, Cheng-Kang Wang, An-Ni Lin, Chi-Cheng Chen, Yi-Fan Chen, Shun-Yu Chi, Fong-Fu Chou and Wei-Che Lin

Biomedicines 2023, 11(3), 672; https://doi.org/10.3390/biomedicines11030672 - 23 Feb 2023

Cited by 1 | Viewed by 3060

Abstract

Objective: Preoperative localization in patients with primary or secondary hyperparathyroidism before radiofrequency ablation (RFA) is crucial. There is currently a lack of consensus regarding imaging protocol. Evaluating the diagnostic performance of ultrasound, four-dimensional computed tomography (4D-CT), and technetium 99m-sestamibi single-photon-emission-computed tomography/computed tomography (SPECT/CT) [...] Read more.

Objective: Preoperative localization in patients with primary or secondary hyperparathyroidism before radiofrequency ablation (RFA) is crucial. There is currently a lack of consensus regarding imaging protocol. Evaluating the diagnostic performance of ultrasound, four-dimensional computed tomography (4D-CT), and technetium 99m-sestamibi single-photon-emission-computed tomography/computed tomography (SPECT/CT) is necessary for RFA of hyperparathyroidism. Methods: This retrospective study recruited patients with primary or secondary hyperparathyroidism who underwent ultrasound, 4D-CT, and SPECT/CT before RFA at a single institution. The sensitivity, accuracy, and receiver operating characteristic curve analysis were used to evaluate the diagnostic performance of the imaging modalities. Results: A total of 33 patients underwent RFA for hyperparathyroidism (8 patients with primary hyperparathyroidism, 25 patients with secondary hyperparathyroidism). Ultrasound had the highest sensitivity (0.953) and accuracy (0.943), while 4D-CT had higher sensitivity and accuracy than SPECT/CT (sensitivity/accuracy, 4D-CT vs. SPECT/CT: 0.929/0.920 vs. 0.741/0.716). Combined ultrasound with 4D-CT and the three combined modalities achieved equivalent, and the highest, diagnostic performance (sensitivity 1.000, accuracy 0.989). The lesion length and volume were important predictors of the diagnostic performance of 4D-CT and SPECT/CT (area under curve of length in 4D-CT/volume in 4D-CT/length in SPECT/volume in SPECT: 0.895/0.834/0.767/0.761). Conclusion: Combined ultrasound with 4D-CT provides optimal preoperative localization prior to RFA in patients with primary or secondary hyperparathyroidism. The length and volume of parathyroid lesions are determinative of the diagnostic performance of 4D-CT and SPECT/CT. Full article

(This article belongs to the Topic New Insights on Chronic Illness: Pathogenesis, Prevalence, Prevention, and Systemic Therapies)

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10 pages, 1046 KiB  

Open AccessBrief Report

Blood Markers of Biological Age Evaluates Clinic Complex Medical Spa Programs

by Fedor I. Isaev, Arsenii R. Sadykov and Alexey Moskalev

Biomedicines 2023, 11(2), 625; https://doi.org/10.3390/biomedicines11020625 - 19 Feb 2023

Cited by 1 | Viewed by 4581

Abstract

Background: Kivach Clinic has developed a special medical spa program to prevent aging-related conditions in metabolic, cardio-vascular, and neurological states. Spa programs modify diet, physical activity, and lymphatic drainage, as it deteriorates with aging. We investigated its influence on the blood markers of [...] Read more.

Background: Kivach Clinic has developed a special medical spa program to prevent aging-related conditions in metabolic, cardio-vascular, and neurological states. Spa programs modify diet, physical activity, and lymphatic drainage, as it deteriorates with aging. We investigated its influence on the blood markers of biological age of patients during their stay to objectify the potential of spa treatment for influencing the risk of age-related events. Methods: The artificial deep learning model Aging.ai 3.0 was based on blood parameters. The change in the biological age of 43 patients was assessed after their 14-day spa treatment at Kivach Clinic. Results: Biological age decreased in 29 patients (median decrease: 8 years, mean: 8.83 years), increased in 10 patients (median increase: 3 years, mean: 5.33 years) and remained unchanged in 4 patients. Overall mean values for the entire patient group were as follows: median value was −3 years, and mean was −4.79 ± 1.2 years (p-value = 0.00025, t-test). Conclusions: The capability of specially selected medical spa treatment to reduce human biological age (assessed by Aging.AI 3.0) has been established. Full article

(This article belongs to the Topic New Insights on Chronic Illness: Pathogenesis, Prevalence, Prevention, and Systemic Therapies)

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10 pages, 6467 KiB  

Open AccessPerspective

Increased Early Cancer Diagnosis: Unveiling Immune-Cancer Biology to Explain Clinical “Overdiagnosis”

by Bruce A. Wauchope, Brendon J. Coventry and David M. Roder

Cancers 2023, 15(4), 1139; https://doi.org/10.3390/cancers15041139 - 10 Feb 2023

Cited by 2 | Viewed by 2076

Abstract

Even though clinically small ‘early’ cancers represent many millions of cells biologically, when removed surgically, these often never recur or regrow, nor reduce the individual’s lifespan. However, some early cancers remain quiescent and indolent; while others grow and metastasize, threatening life. Distinguishing between [...] Read more.

Even though clinically small ‘early’ cancers represent many millions of cells biologically, when removed surgically, these often never recur or regrow, nor reduce the individual’s lifespan. However, some early cancers remain quiescent and indolent; while others grow and metastasize, threatening life. Distinguishing between these different clinical behaviours using clinical/pathological criteria is currently problematic. It is reported that many suspicious lesions and early cancers are being removed surgically that would not threaten the patient’s life. This has been termed ‘overdiagnosis’, especially in the sphere of cancer screening. Although a controversial and emotive topic, it poses clinical and public health policy challenges. The diagnostic differentiation between ‘non-lethal’ and ‘lethal’ tumor forms is generally impossible. One perspective gathering evidential support is that a dynamic balance exists between the immune response and malignant processes governing ‘lethality’, where many more cancers are produced than become clinically significant due to the immune system preventing their progression. Higher medical screening “diagnosis” rates may reflect lead-time effects, with more ‘non-progressing’ cancers detected when an early immune-cancer interaction is occurring. We present a model for this immune-cancer interaction and review ‘excess’ or ‘overdiagnosis’ claims that accompany increasingly sensitive diagnostic and screening technologies. We consider that immune tools should be incorporated into future research, with potential for immune system modulation for some early cancers. Full article

(This article belongs to the Topic New Insights on Chronic Illness: Pathogenesis, Prevalence, Prevention, and Systemic Therapies)

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11 pages, 1056 KiB  

Open AccessArticle

The Prolonged Effect of Shift Work and the Impact of Reducing the Number of Nightshifts on Arterial Stiffness—A 4-Year Follow-Up Study

by Marit Skogstad, Elisabeth Goffeng, Øivind Skare and Erika Zardin

J. Cardiovasc. Dev. Dis. 2023, 10(2), 70; https://doi.org/10.3390/jcdd10020070 - 6 Feb 2023

Cited by 4 | Viewed by 2377

Abstract

Aim: To assess changes in blood pressure (BP) and arterial stiffness among 84 rotating shift and 25 dayworkers (control subjects) at two industrial plants during a 4-year follow-up, and to assess changes in outcome variables among shift workers at the two plants after [...] Read more.

Aim: To assess changes in blood pressure (BP) and arterial stiffness among 84 rotating shift and 25 dayworkers (control subjects) at two industrial plants during a 4-year follow-up, and to assess changes in outcome variables among shift workers at the two plants after a reduction in the number of night shifts during the last year of follow-up in one of the plants. Methods: We collected demographic data using a questionnaire, examined systolic and diastolic blood pressure (sBP, dBP), central systolic and diastolic aorta pressure (cSP, cDP), augmentation pressure (AP), central pulse pressure (cPP), and pulse wave velocity (PWV). We registered sleep quality. The last 4–14 months of follow-up one plant implemented a 12-week shift plan reducing the total number of night shifts and consecutive night shifts from 16.8 to 14 and from 7.2 to 4. To assess differences in change of outcomes between study groups we applied linear mixed models. Results: The dayworkers were older, more hypertensive, reported less sleep disturbance, and smoked/snuffed less than the shift workers did. The adjusted annual increase in PWV was 0.34 m/s (95%CI, 0.22, 0.46) among shift workers and 0.09 m/s (95%CI, −0.05, 0.23) in dayworkers, yielding a significant difference of change of 0.25 m/s (95%CI, 0.06, 0.43). No significant differences were found between the two groups of shift workers in any cardiovascular disease (CVD) outcome during the last year of follow-up. Conclusions: Shift work in industry is associated with arterial stiffness, reflecting an increased risk of future CVD. No significant changes in arterial stiffness were identified as a consequence of a small reduction in the number of night shifts and consecutive night shifts. Full article

(This article belongs to the Topic New Insights on Chronic Illness: Pathogenesis, Prevalence, Prevention, and Systemic Therapies)

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Open AccessArticle

Construction and Validation of a Nomogram Clinical Prediction Model for Predicting Osteoporosis in an Asymptomatic Elderly Population in Beijing

by Jialin Wang, Chao Kong, Fumin Pan and Shibao Lu

J. Clin. Med. 2023, 12(4), 1292; https://doi.org/10.3390/jcm12041292 - 6 Feb 2023

Cited by 3 | Viewed by 2033

Abstract

Background: Based on the high prevalence and occult-onset of osteoporosis, the development of novel early screening tools was imminent. Therefore, this study attempted to construct a nomogram clinical prediction model for predicting osteoporosis. Methods: Asymptomatic elderly residents in the training (n = [...] Read more.

Background: Based on the high prevalence and occult-onset of osteoporosis, the development of novel early screening tools was imminent. Therefore, this study attempted to construct a nomogram clinical prediction model for predicting osteoporosis. Methods: Asymptomatic elderly residents in the training (n = 438) and validation groups (n = 146) were recruited. BMD examinations were performed and clinical data were collected for the participants. Logistic regression analyses were performed. A logistic nomogram clinical prediction model and an online dynamic nomogram clinical prediction model were constructed. The nomogram model was validated by means of ROC curves, calibration curves, DCA curves, and clinical impact curves. Results: The nomogram clinical prediction model constructed based on gender, education level, and body weight was well generalized and had moderate predictive value (AUC > 0.7), better calibration, and better clinical benefit. An online dynamic nomogram was constructed. Conclusions: The nomogram clinical prediction model was easy to generalize, and could help family physicians and primary community healthcare institutions to better screen for osteoporosis in the general elderly population and achieve early detection and diagnosis of the disease. Full article

(This article belongs to the Topic New Insights on Chronic Illness: Pathogenesis, Prevalence, Prevention, and Systemic Therapies)

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12 pages, 1788 KiB  

Open AccessArticle

Therapeutic Potential of Capsaicin against Cyclophosphamide-Induced Liver Damage

by Mohammad Firoz Alam, Ahmed O. Ajeibi, Majed H. Safhi, Ahmad J. A. Alabdly, Saeed Alshahrani, Hina Rashid, Marwa Qadri, Abdulmajeed M. Jali, Saud Alqahtani, Yousra Nomier, Sivakumar S. Moni, Mohammad Khalid and Tarique Anwer

J. Clin. Med. 2023, 12(3), 911; https://doi.org/10.3390/jcm12030911 - 24 Jan 2023

Cited by 18 | Viewed by 3674

Abstract

Cyclophosphamide (CPM) is a classical alkylating agent used in different cancer chemotherapy regimens and is restricted due to severe adverse effects, including hepatotoxicity. Natural or plant-derived antioxidants such as capsaicin were utilized in this study to examine the hepatoprotective benefits against cyclophosphamide-induced hepatotoxicity. [...] Read more.

Cyclophosphamide (CPM) is a classical alkylating agent used in different cancer chemotherapy regimens and is restricted due to severe adverse effects, including hepatotoxicity. Natural or plant-derived antioxidants such as capsaicin were utilized in this study to examine the hepatoprotective benefits against cyclophosphamide-induced hepatotoxicity. The rats were divided into five groups: a normal control group, a toxic group (CPM), an intraperitoneal injection of a single dose of 200 mg/kg b.w. on the fourth day, a pretreated group with two doses of CPS (10 mg and 20 mg/kg b.w.) orally for six consecutive days, and an intraperitoneal administration of 200 mg/kg b.w. on the fourth day of treatment. The fifth group was administered with the highest dose of CPS (20 mg/kg b.w.) orally for six consecutive days. After 24 h of administration of CPS, the rats were anesthetized, blood was collected, and the serum enzyme toxicity was evaluated. After the blood sampling and euthanasia of all the animals, the liver was isolated for further toxicity and histopathological examination. The results revealed that serum liver markers (AST, ALT, ALP, BLI) significantly increased after CPM administration, but were subsequently restored after CPS treatment with both doses. In addition, lipid peroxidation (MDA), inflammatory cytokines (IL-1β, TNF-α), and apoptotic markers (Caspase-3) increased, and antioxidant enzymes (GSH, CAT, SOD) were significantly decreased after CPM administration, and it was re-established by CPS treatment. However, CPS effectively protected against the CPM-induced histopathological architects of liver tissues. In conclusion, CPS attenuates CPM-induced hepatotoxicity via modulating oxidative stress, apoptotic signals, and cytokine pathway. Therefore, CPS could play a significant role as a supplement during the chemotherapy of patients. Full article

(This article belongs to the Topic New Insights on Chronic Illness: Pathogenesis, Prevalence, Prevention, and Systemic Therapies)

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7 pages, 857 KiB  

Open AccessArticle

Calcineurin-Inhibitor-Induced Hypomagnesemia in Kidney Transplant Patients: A Monocentric Comparative Study between Sucrosomial Magnesium and Magnesium Pidolate Supplementation

by Lucia Federica Stefanelli, Marianna Alessi, Giovanni Bertoldi, Valentina Rossato, Valentina Di Vico, Federico Nalesso and Lorenzo A. Calò

J. Clin. Med. 2023, 12(3), 752; https://doi.org/10.3390/jcm12030752 - 17 Jan 2023

Cited by 4 | Viewed by 2502

Abstract

Magnesium (Mg) contributes to DNA stability, protein synthesis and cardiac excitability, while Mg deficiency leads to increased cardiovascular mortality, diabetes, hyperparathyroidism and risk of fractures. In kidney transplant patients, calcineurin inhibitors (CNIs) downregulating Mg channel TRPM6 in the distal collecting tubule induce early [...] Read more.

Magnesium (Mg) contributes to DNA stability, protein synthesis and cardiac excitability, while Mg deficiency leads to increased cardiovascular mortality, diabetes, hyperparathyroidism and risk of fractures. In kidney transplant patients, calcineurin inhibitors (CNIs) downregulating Mg channel TRPM6 in the distal collecting tubule induce early hypomagnesemia (HypoMg), which is associated with a faster decline in allograft function. A new formulation, sucrosomial Mg (SucrMg), for oral supplements encapsulates Mg oxide in a phospholipid membrane covered by a sucrester matrix, enhancing gastric and intestinal Mg absorption. This study has evaluated Mg bioavailability, effectiveness and tolerance of SucrMg compared to the conventional preparation of Mg pidolate (PidMg). The association of blood Mg with risk of post-transplant dysglycemia and hyperparathyroidism has also been investigated. Forty hypomagnesemic adult single, double or combined kidney–pancreas or kidney–liver transplant recipients within 2 years from transplantation were recruited. In total, 16 patients received PidMg and 27 received SucrMg. Blood Mg was measured at baseline (T0), after 15 days (T1) and after 6 months (T2) of treatment. PTH, fasting glucose and calcium were measured at baseline and after 6 months of treatment. The tolerance was evaluated at the ambulatory visits. SucrMg compared to PidMg was more efficient at increasing Mg bioavailability at T1: p < 0.0001 vs. p = 0.72 ns, respectively, with a ∆% increase of 12.4% vs. 5.4%, p = 0.04. Both preparations increased blood Mg at T2, p < 0.0001 and p = 0.002, respectively. SucrMg was better tolerated. No difference was observed for fasting plasma glucose, PTH and calcium. On one hand, our study is the first among transplant patients to evaluate the efficacy of SucrMg in the correction of HypoMg, which might justify the limited number of patients enrolled and the short observation time; on the other hand, our results could serve as a useful working hypothesis for further studies with a larger number of transplant patients and an extended study duration to confirm the benefits observed with SucrMg. Full article

(This article belongs to the Topic New Insights on Chronic Illness: Pathogenesis, Prevalence, Prevention, and Systemic Therapies)

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8 pages, 662 KiB  

Open AccessArticle

Risk of Chronic Kidney Disease in Pneumoconiosis: Results from a Retrospective Cohort Study (2008–2019)

by Chao-Hsuan Wei, Chia-Hsiang Li, Te-Chun Shen, Yu-Tung Hung, Chih-Yen Tu, Te-Chun Hsia, Wu-Huei Hsu and Chung Y. Hsu

Biomedicines 2023, 11(1), 150; https://doi.org/10.3390/biomedicines11010150 - 6 Jan 2023

Cited by 6 | Viewed by 2139

Abstract

Background: Pneumoconiosis has considerable comorbidities, most notably pulmonary and cardiovascular diseases. However, the relationship between pneumoconiosis and chronic kidney disease (CKD) is largely unknown. The present study aimed to use a retrospective cohort study design to further clarify the association between pneumoconiosis and [...] Read more.

Background: Pneumoconiosis has considerable comorbidities, most notably pulmonary and cardiovascular diseases. However, the relationship between pneumoconiosis and chronic kidney disease (CKD) is largely unknown. The present study aimed to use a retrospective cohort study design to further clarify the association between pneumoconiosis and subsequent CKD risk. Methods: This is a nationwide, population-based, retrospective cohort study that used data from Taiwan’s National Health Insurance Database. Between 2008 and 2018, 17,952 newly diagnosed patients were included in the pneumoconiosis cohort, while 71,808 individuals without pneumoconiosis were included in the comparison cohort, with a propensity score matching for age, gender, and date of pneumoconiosis diagnosis. The development of CKD was monitored until the end of 2019. The risk was assessed using Cox proportional hazard regression models. Results: After controlling for age, gender, and comorbidity, the overall incidence of CKD was 1.69-fold higher in the pneumoconiosis cohort than in the comparison cohort (19.71 vs. 11.76 per 1000 person-years, respectively, p < 0.001), with an adjusted hazard ratio of 1.83 (95% confidence interval: 1.73–1.93). Stratified analyses by age group, gender, and presence of comorbidity revealed that the adjusted hazard ratios of CKD associated with pneumoconiosis remained significant (8/9). Furthermore, pneumoconiosis and tri-high (hypertension, hyperglycemia, and hyperlipidemia) interact positively with CKD development (p < 0.001). Conclusion: Patients with pneumoconiosis had a significantly higher risk of developing CKD than those without. Pneumoconiosis combined with hypertension, hyperglycemia, or hyperlipidemia would increase the risk even further. More studies are required to understand the possible pathophysiological mechanisms. Full article

(This article belongs to the Topic New Insights on Chronic Illness: Pathogenesis, Prevalence, Prevention, and Systemic Therapies)

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10 pages, 1086 KiB  

Open AccessArticle

Pharmacological Treatment of Type-2-Diabetes and Cardiovascular Comorbidities: Differences between Undocumented Migrants and Natives in Italy

by Gianfrancesco Fiorini, Giacomo Pellegrini, Matteo Franchi, Angela Ida Pincelli, Antonello Emilio Rigamonti, Giovanni Corrao, Alessandro Sartorio and Silvano Gabriele Cella

Healthcare 2023, 11(1), 4; https://doi.org/10.3390/healthcare11010004 - 20 Dec 2022

Cited by 1 | Viewed by 2071

Abstract

Diabetes prevalence is growing worldwide, especially in some populations. Though migrations seem to contribute to the presence in host countries of a significant number of patients with diabetes and its comorbidities, very little is known about the health conditions of undocumented migrants. We [...] Read more.

Diabetes prevalence is growing worldwide, especially in some populations. Though migrations seem to contribute to the presence in host countries of a significant number of patients with diabetes and its comorbidities, very little is known about the health conditions of undocumented migrants. We retrospectively studied 838 patients with type 2 diabetes mellitus (T2DM), 425 Italians followed by the diabetes clinic of a university hospital, and 413 undocumented migrants receiving assistance from a non-governmental organization. We analyzed their demographic and clinical data together with the medications they were on. The prevalence of the use of specific classes of drugs was compared between undocumented migrants and Italians by fitting a Poisson regression model, and the results were reported as prevalence rate ratios (PRRs) with a 95% confidence interval. Undocumented migrants with T2DM received fewer medications for cardiovascular (CV) conditions (PRR: 0.68, 0.60 to 0.76) than Italians, after correcting for confounding factors. Only sulfonylureas were more frequently used in undocumented migrants. The causes of these differences are not completely clear, but social, cultural, and economic factors can have an important role. More efforts are needed to provide appropriate treatment of diabetes and its CV comorbidities to undocumented migrants. Full article

(This article belongs to the Topic New Insights on Chronic Illness: Pathogenesis, Prevalence, Prevention, and Systemic Therapies)

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Open AccessArticle

Rate and Risk Factors of Acute Myocardial Infarction after Debut of Chronic Kidney Disease—Results from the KidDiCo

by Jan Dominik Kampmann, James Goya Heaf, Christian Backer Mogensen, Sofie Ronja Petersen, Donna Lykke Wolff, Hans Mickley and Frans Brandt

J. Cardiovasc. Dev. Dis. 2022, 9(11), 387; https://doi.org/10.3390/jcdd9110387 - 9 Nov 2022

Cited by 6 | Viewed by 2579

Abstract

Chronic kidney disease (CKD) is a known risk factor for cardiovascular disease, including acute myocardial infarction. However, whether this risk is only associated with severe kidney disease or is also related to mildly impaired kidney function is still under debate. The incidence rate [...] Read more.

Chronic kidney disease (CKD) is a known risk factor for cardiovascular disease, including acute myocardial infarction. However, whether this risk is only associated with severe kidney disease or is also related to mildly impaired kidney function is still under debate. The incidence rate and risk factors of incident acute myocardial infarction (AMI) in patients with CKD are sparse. Potential differences in risk factor profiles between CKD patients with incident AMI and CKD patients with a prior AMI have not been sufficiently investigated. Furthermore, important factors such as albuminuria and socio-economic factors are often not included. The primary aim of this study was to establish the incidence rate of AMI after CKD debut. Secondly, to evaluate the importance of different CKD stages and the risk of having an AMI. Finally, to identify individuals at risk for AMI after CKD debut adjusted for prevalent AMI. Based on data from the kidney disease cohort of Southern Denmark (KidDiCo), including 66,486 CKD patients, we established incidence rates and characteristics of incident AMI among patients within a 5-year follow-up period after CKD debut. A Cox regression was performed to compute the cause-specific hazard ratios for the different risk factors. The incidence rate for CKD stage G3–5 patients suffering acute myocardial infarction is 2.5 cases/1000 people/year. In patients without a previous myocardial infarction, the risk of suffering a myocardial infarction after CKD debut was only significant in CKD stage G4 (HR = 1.402; (95% CI: 1.08–1.81); p-value = 0.010) and stage G5 (HR = 1.491; (95% CI: 1.01–2.19); p-value = 0.042). This was not the case in patients who had suffered an acute myocardial infarction prior to their CKD debut. In this group, a previous myocardial infarction was the most critical risk factor for an additional myocardial infarction after CKD debut (HR = 2.615; (95% CI: 2.241–3.05); p-value < 0.001). Irrespective of a previous myocardial infarction, age, male sex, hypertension, and a low educational level were significant risk factors associated with an acute myocardial infarction after CKD debut. The incidence rate of AMI in patients with CKD stage G3–5 was 2.5 cases/1000 people/year. Risk factors associated with incident AMI in CKD stage G3–5 patients were CKD stage, age, and hypertension. Female sex and higher educational levels were associated with a lower risk for AMI. Prior AMI was the most significant risk factor in patients with and without previous AMI before fulfilling CKD stage G3–5 criteria. Only age, sex, and a medium-long educational level were significant risk factors in this group. Full article

(This article belongs to the Topic New Insights on Chronic Illness: Pathogenesis, Prevalence, Prevention, and Systemic Therapies)

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Open AccessArticle

Association of Transferrin Gene Polymorphism with Cognitive Deficits and Psychiatric Symptoms in Patients with Chronic Schizophrenia

by Pinhong Chen, Dongmei Wang, Meihong Xiu, Dachun Chen, Blake Lackey, Hanjing E. Wu, Lubin Wang and Xiangyang Zhang

J. Clin. Med. 2022, 11(21), 6414; https://doi.org/10.3390/jcm11216414 - 29 Oct 2022

Cited by 3 | Viewed by 1799

Abstract

A large amount of recent literature has focused on impaired iron homeostasis in the pathophysiology of schizophrenia. Specifically, microarray analysis has illustrated associations between the transferrin locus and schizophrenia. To elaborate on the effects of transferrin on schizophrenia and its psychiatric phenotypes, our [...] Read more.

A large amount of recent literature has focused on impaired iron homeostasis in the pathophysiology of schizophrenia. Specifically, microarray analysis has illustrated associations between the transferrin locus and schizophrenia. To elaborate on the effects of transferrin on schizophrenia and its psychiatric phenotypes, our study aimed to investigate whether transferrin gene polymorphism was correlated with cognitive deficits and clinical symptoms in schizophrenia. We recruited 564 patients with chronic schizophrenia and 422 healthy controls (HCs) in a Han Chinese population, collected phenotypic data, and genotyped the rs3811655 polymorphism of the transferrin gene. Our results showed that the rs3811655 polymorphism was related to cognitive performance in both patients and HCs, as well as negative symptoms in patients (all p < 0.05), and patients carrying at least one G-allele showed worsened cognition/severe negative symptoms (all p < 0.05). Further analyses also found that the rs3811655 polymorphism in combination with cognition may exert small but significant contributions to the negative (β = −0.10, t = −2.48, p < 0.05) or total psychiatric symptoms (β = −0.08, t = −1.92, p < 0.05) in patients. Our findings indicated that the rs3811655 polymorphism may be implicated in the cognitive deficits of schizophrenia and HCs as well as psychiatric symptoms in patients, which suggested the possible iron regulatory mechanism in the pathology of schizophrenia. Full article

(This article belongs to the Topic New Insights on Chronic Illness: Pathogenesis, Prevalence, Prevention, and Systemic Therapies)

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