Diseases (Basel, Switzerland)最新文献

Background: Chronic pain is defined as any persistent or recurring pain lasting longer than 3 months that significantly affects a person's quality of life. Millions worldwide are impacted by chronic pain, but its subjective nature makes it difficult to quantify and compare between individuals.

Methods: This retrospective analysis aimed to examine the differences in pain perception and reporting between male and female patients, as well as how their pain was managed. Data from 1995 patients who met the inclusion criteria were selected from the Advocate Illinois Masonic Pain Clinic database. The types of pain assessed in this study included lower back pain, neck pain, and osteoarthritis.

Results: The findings indicate that females suffer more from chronic pain conditions than males, where lower back pain had the highest prevalence in both sexes (63.7% reported). Baseline Numeric Rating Scale (NRS) scores at the first inpatient visit were statistically higher in females than males (7.95 ± 1.35 vs. 7.72 ± 1.46, p = 0.006). After 1 year of treatment, both sexes reported a clinical improvement in their symptoms. With regards to medication, females reported a higher use of medications such as muscle relaxants, benzodiazepines, and tricyclic antidepressants, while males reported a higher use of opioids (measured in MMEs).

Conclusions: This study reveals a significant sex difference in the reporting of non-cancer-related chronic pain, with females reporting higher pain intensity than males.

Objectives: Marburg virus disease (MVD) is on the WHO list for pandemic-prone pathogens. The current outbreak in Rwanda provides an opportunity to map outbreaks and generate information to inform policymaking, resource mobilization, and guide the implementation of cost-effective response strategies.

Methods: We synthesized available information about MVD to build holistic, up-to-date evidence to inform policymakers, public health leaders, and healthcare and public health services providers in their development and implementation of cost-effective preparedness, prevention, and control measures.

Results: We have identified 20 outbreaks of MVD that occurred in 14 countries between 1967 and 2024; these outbreaks led to 580 confirmed cases and 423 deaths in total. We summarize the available information about the main clinical signs, diagnostic tools, primary reservoir, transmission dynamics, and case management protocol. We also document the best practices in the prevention and control of MVD outbreaks, including the implementation of a multisectoral One Health strategy for preparedness, prevention, and response to MVD outbreaks that incorporates the strict implementation of WASH and infection prevention measures, contact tracing, and the isolation of infected and suspected humans and animals, and enhances the implementation of the International Health Regulations, particularly efficient cross-country coordination.

Conclusions: In the absence of a licensed treatment or vaccine for MVD, the response strategy to MVD should focus on preventive measures, including community engagement to promote the reduction in contact between humans and reservoirs, the supportive care and isolation of patients, and proper waste management. High risk populations such as frontline responders, including healthcare providers and community health workers, should be prioritized so that they can access all currently available protection measures.

People of all ages can contract pneumonia, and it can cause mild to severe disease and even death. In addition to being a major cause of death for elderly people and those with prior medical conditions such as diabetes, it isthe world's biggest infectious cause of death for children. Diabetes mellitus is a metabolic condition with a high glucose level and is a leading cause of lower limb amputation, heart attacks, strokes, blindness, and renal failure. Hyperglycemia is known to impair neutrophil activity, damage antioxidant status, and weaken the humoral immune system. Therefore, diabetic patients are more susceptible to pneumonia than people without diabetes and linked fatalities. The absence of quick, precise, simple, and affordable ways to identify the etiologic agents of community-acquired pneumonia has made diagnostic studies' usefulness contentious. Improvements in biological markers and molecular testing techniques have significantly increased the ability to diagnose pneumonia and other related respiratory infections. Identifying the risk factors for developing severe pneumonia and early testing in diabetic patients might lead to a significant decrease in the mortality of diabetic patients with pneumonia. In this regard, various risk factors, traditional testing techniques, and pathomechanisms are discussed in this review. Further, biomarkers and next-generation sequencing are briefly summarized. Finding biomarkers with the ability to distinguish between bacterial and viral pneumonia could be crucial because identifying the precise pathogen would stop the unnecessary use of antibiotics and effectively save the patient's life.

Background: Pulmonary lobe resection is a common surgical intervention for various benign lung diseases, including tuberculosis (TB), bronchiectasis, and benign lung nodules. While immediate clinical outcomes are well documented, the impact on patients' quality of life (QoL) remains less explored. This study aims to evaluate QoL before and after pulmonary lobe resection over a 6-month period among patients with benign lung diseases.

Objectives: To assess and compare changes in QoL among patients undergoing pulmonary lobe resection for TB, bronchiectasis, and benign lung nodules, and to identify factors influencing QoL outcomes.

Methods: This prospective study included 84 patients who underwent pulmonary lobe resection for benign lung diseases, divided into three groups: TB (n = 22), bronchiectasis (n = 31), and benign lung nodules (n = 31). QoL was assessed using the SF-36 and WHOQOL-BREF questionnaires preoperatively and at 6 months postoperatively. Anxiety and depression were evaluated using the Hospital Anxiety and Depression Scale (HADS), and perceived stress was measured using the Perceived Stress Scale (PSS-10). Statistical analyses included paired t-tests, ANOVA, and Pearson's correlation, with p-values < 0.05 considered significant.

Results: At 6 months postoperatively, all groups showed significant improvements in physical and mental QoL scores (p < 0.05). The TB group exhibited the greatest improvement in physical health domains, while the bronchiectasis group showed significant enhancement in social functioning. Anxiety and depression scores decreased significantly in all groups, with the TB group showing the most substantial reduction (p < 0.01). Perceived stress levels also decreased across all groups. Comparisons revealed that the TB group had significantly higher QoL improvement compared to the other groups (p < 0.05).

Conclusions: Pulmonary lobe resection for benign diseases significantly improves QoL over a 6-month period, particularly in patients with TB. The findings suggest that surgical intervention not only alleviates physical symptoms but also enhances psychological well-being. These results underscore the importance of considering QoL outcomes in the management of benign lung diseases requiring surgical intervention.

Purpose: To evaluate the ability of acoustic radiation force impulse (ARFI) elastography in differentiating benign from malignant etiologies of splenomegaly based on differences in splenic stiffness.

Materials and methods: Between September 2020 and November 2022, we evaluated 40 patients with splenomegaly-defined by a splenic long axis greater than 13 cm and/or a short axis greater than 6 cm, without visible focal or infiltrative mass lesions-using abdominal ultrasound at our university hospital. Each patient also underwent a standardized ARFI elastographic assessment of the enlarged spleen, with data collected prospectively. We then retrospectively analyzed the cases with confirmed etiologies of splenomegaly from their final medical reports. Mean ARFI velocities (MAV) were compared across patients with splenomegaly due to malignant infiltration (MIS) from hematological malignancy, congestive splenomegaly (CS) due to portal or splenic vein congestion/occlusion, and immune-related splenomegaly (IRS) associated with systemic infectious or autoimmune diseases.

Results: Among the 40 patients with splenomegaly, 21 (52.5%) were diagnosed with malignant infiltrative splenomegaly (MIS), 11 (27.5%) with congestive splenomegaly (CS), and 8 (20%) with immune-related splenomegaly (IRS). The mean ARFI velocities (MAV) for the MIS, CS, and IRS groups were 3.25 ± 0.68 m/s, 3.52 ± 0.47 m/s, and 2.84 ± 0.92 m/s, respectively. No significant differences were observed in splenic stiffness (MAV) among these groups.

Conclusions: Differentiating between benign and malignant etiologies of splenomegaly based on stiffness differences observed in ARFI elastography is not feasible. Larger prospective studies are necessary to validate these findings.

Background. Childhood brain tumor survivors (CCSs) are at high risk of developing metabolic syndrome (MetS) and sarcopenia. To date, a tool able to predict any body composition changes or detect them early and increased adiposity (and, therefore, increased likelihood of MetS onset) is still lacking in this population. Objective. The objective was to analyze differences in a bioelectrical impedance analysis (BIA) of body composition between male childhood brain tumor cancer survivors and healthy controls. Methods. In this pilot, prospective, observational study, 14 male CCSs were compared to 14 healthy controls matched for sex and age. Results. CCSs showed statistically significant lower mean values in terms of their body metabolic rate (BMR), body cell mass index (BCMI), fat-free mass (FFM), skeleton muscle mass (SM), skeletal muscle mass index (SMI), and appendicular skeletal muscular mass (ASMM). CCSs also showed a statistically significantly higher mean value of resistance when compared with controls. The BMR, BCM, FFM, and ASMM were significantly correlated with total doses of carboplatin (Tau = -0.601; p = 0.018; Tau = -0.599, p = 0.025; Tau = -0.601, p = 0.018; Tau = -0.509, p = 0.045, respectively). Conclusion. A BIA allows for the detection of changes in body composition in survivors of childhood brain tumors, revealing either the presence of central obesity correlated with the risk of MetS or signs of sarcopenia that deserve early treatment.

Background: Elderly patients, particularly those over 75 years old, have been disproportionately affected by COVID-19, exhibiting higher rates of severe outcomes, such as ICU admissions and mortality. This study aimed to evaluate and compare the effectiveness of various clinical scoring systems-qSOFA, PRIEST, PAINT, and ISARIC4C-in predicting ICU admission, the need for mechanical ventilation, and mortality among elderly COVID-19 patients.

Methods: In this retrospective cohort study conducted at two tertiary care hospitals, 131 elderly patients (aged ≥ 75) and 226 younger controls (aged < 65) with confirmed COVID-19 were included. Clinical scores were computed at admission and five days after symptom onset. Kaplan-Meier survival analysis and Receiver Operating Characteristic (ROC) curve analysis were performed to assess the predictive performance of the scores regarding severe outcomes.

Results: Kaplan-Meier analysis indicated significantly lower survival probabilities for elderly patients with high scores at admission. Those with an ISARIC4C score above 11.8 had a survival probability of 25% compared to 74% for those below this threshold (p < 0.001). Similarly, elderly patients with a qSOFA score above 2.1 had a survival probability of 36% compared to 72% for those with lower scores (p < 0.001). The PRIEST and PAINT scores also demonstrated predictive validity; patients with a PRIEST score above 6.3 and a PAINT score above 6.5 at admission showed comparable decreases in survival probabilities. ROC analysis at five days post-symptom onset revealed that the ISARIC4C score had the highest area under the curve (AUC) of 0.772, suggesting excellent predictive validity for severe outcomes, including mortality. The optimal cutoffs identified were 11.2 for ISARIC4C, 6.3 for PRIEST, and 6.5 for PAINT, each displaying high sensitivity and specificity.

Conclusions: The ISARIC4C, qSOFA, PRIEST, and PAINT scores are robust predictors of severe outcomes in elderly COVID-19 patients over 75 years old, as confirmed by Kaplan-Meier and ROC analyses. These tools can be crucial for early identification of patients at high risk of adverse outcomes, guiding clinical decision making, and optimizing resource allocation. The use of these scoring systems should be encouraged in clinical settings to enhance the management of elderly COVID-19 patients. Further research is necessary to validate these findings across different populations and settings.

Background/objectives: Sleep disorders, such as short sleep, are common comorbidities in individuals with autism spectrum disorder (ASD). Sleep quality and duration are directly associated with quality of life (QOL). Clarifying the influence of ASD on the association between short sleep duration and life satisfaction is an efficient way to improve the QOL of patients with ASD.

Methods: To clarify the influence of ASD on the association between short sleep duration and life satisfaction scale scores, we conducted a web-based cross-sectional study involving 3823 Japanese adults aged 20-64 years.

Results: In all the participants, a significant inverse association was observed between short sleep duration and life satisfaction. The adjusted odds ratio (OR) and 95% confidence interval (CI) of short sleep for one standard deviation (SD), the increment of life satisfaction scale (2.5 for men and 2.4 for women), was 0.76 (0.70, 0.82). When the analyses were stratified by ASD status, a significant inverse association was observed only among participants without ASD. The corresponding ORs (95% CIs) were 0.73 (0.67, 0.80) and 1.08 (0.85, 1.39) for those with and without ASD. Patients with ASD also showed a significant interaction effect on the association between short sleep duration and life satisfaction.

Conclusions: Only participants without ASD showed a significant inverse association between short sleep duration and life satisfaction. Although further investigations are necessary, these results can help clarify the mechanism underlying the association between QOL, short sleep duration, and ASD.

Background: The COVID-19 pandemic significantly impacted mental health and substance use patterns, particularly among young adults.

Objective: This study aimed to assess changes in anxiety, depression, self-esteem, and substance use among university students in Mexico before, during, and after the pandemic.

Methods: Using a repeated cross-sectional design, this study was conducted with university students in Mexico across three periods: pre-pandemic (2017 and 2019); during the pandemic (2021); and post-pandemic (2023). A total of 2167 students were interviewed during one of the three periods. Standardized scales measured anxiety, depression, self-esteem, Erotic Response and Sexual Orientation Scale (EROS), and substance use.

Results: showed a marked and significant increase in the proportion of students with anxiety (40.0%, 71.7%, and 79.6%) and depression (14.4%, 61.9%, and 62.6%) during the pre-pandemic, pandemic, and post-pandemic periods, respectively. Self-esteem significantly decreased during and after the pandemic, compared to pre-pandemic, particularly among females. The proportion of students categorized as moderate/high-risk for their substance use changed over time, showing a reduction in alcohol use (from 29.9% to 20.2%) and tobacco use (from 26.0% to 18.2%) but an increase in sedative use (from 7.1% to 11.7%), before vs after the pandemic, respectively. Multivariate analysis revealed that anxiety, low self-esteem, and increased sedative use were consistently linked to a heightened risk of depression during and after the pandemic. Notably, anxiety and depression levels remained in a proportion significantly elevated even in the post-pandemic period.

Conclusions: These findings underscore the enduring impact of the COVID-19 pandemic on the mental health of university students, highlighting the urgent need for targeted interventions, early detection strategies, and customized educational programs to effectively support students' mental well-being in the ongoing post-pandemic era.

The spinous processes act as a lever for attachments of muscles and ligaments. Spinal imaging is commonly performed as a diagnostic test for pain and radiculopathy. A myriad of incidental or unexpected findings, both potentially asymptomatic and symptomatic, may be encountered during the interpretation of these images, which commonly comprise radiographs, Computed Tomography (CT) and Magnetic Resonance Imaging (MRI). Isolated lesions of the spinous process, although less common, are some of the lesions that may be encountered and can present a diagnostic dilemma. These can range from congenital abnormalities, traumatic lesions, neoplasms and lesions of inflammatory, infective and metabolic aetiology. The literature specifically reviewing these lesions is sparse. The article reviews a range of pathologies affecting the spinous process, along with their pertinent imaging features, based on isolated pathologies of spinous process lesions identified on imaging by the authors at a tertiary orthopaedic centre over a 10-year period. A search on the hospital Picture Archive and Communication System (PACS) and Radiology Information System (RIS) was performed using the keyword "spinous process" and a list of the isolated pathologies of the spinous process based on the imaging reports was compiled for the purpose of this narrative review. It is important that radiologists consider these lesions when they are identified on routine imaging of the spine.