Diseases (Basel, Switzerland)最新文献

Background/Objectives: Olaparib, a poly ADP ribose polymerase inhibitor, has been effective in prolonging progression-free survival in platinum-sensitive recurrent ovarian cancer. The clinicopathological factors that predict a favorable prognosis remain unclear. Therefore, we retrospectively analyzed the prognostic effect of clinicopathological factors in the patients treated with olaparib for platinum-sensitive recurrent ovarian cancer. Methods: A total of 16 patients were treated with olaparib from 2018 to 2023. We categorized these patients into the responder (five cases who had not relapsed within 2 years) and non-responder groups (11 cases who had relapsed within 2 years). Clinical factors, including age, number of platinum drug courses, platinum-free interval, and CA125 value before olaparib treatment, were compared between the responder and non-responder groups. Results: The age of the responder group was significantly younger than that of the non-responder group (52 vs. 69 years old, p = 0.02). The CA125 value of the responder group was significantly lower than that of the non-responder group (14.2 vs. 82.7 U/mL, p = 0.02). Conclusions: The good predictive factors that enabled continued olaparib administration without recurrence were younger age and a lower CA125 value before olaparib treatment. The younger group (<65 years old) and the low CA125 value group (<20 U/mL) in PSR may be treated with olaparib for a long period, suppressing disease progression. Providing this information to patients with PSR may help in decision-making regarding performing maintenance therapy with olaparib.

Background: Metabolic syndrome (MetS) is a common comorbidity associated with hypertension that occurs more often in primary aldosteronism (PA). Our work aims to investigate the prevalence of MetS and its determinants in unilateral PA and bilateral PA, as confirmed by adrenal venous sampling (AVS).

Methods: This was a retrospective, cross-sectional study. We investigated metabolic indicators in 160 cases of PA, categorized by AVS-82 with unilateral PA and 78 with bilateral PA. A control group of 80 non-PA patients with essential hypertension, matched for age and sex, was also included.

Results: Unilateral PA had a higher aldosterone-renin ratio and lower serum potassium levels than bilateral PA. Nevertheless, bilateral PA exhibited a higher prevalence of MetS (41% vs. 30.5%; p = 0.001), obesity, BMI, LDL hypercholesterolemia, and hypertriglyceridemia than unilateral PA.

Conclusions: Bilateral PA presents a greater incidence of MetS than unilateral PA, in spite of the latter showing a higher aldosterone-renin ratio and lower serum potassium levels. The results suggest that the mechanisms underlying MetS may differ between unilateral and bilateral PA.

Background: Plantar warts, caused by the human papillomavirus (HPV), are a common skin condition characterized by painful lesions on the soles of the feet. These lesions can significantly impact skin appearance, quality of life, and, in severe cases, mobility. Traditional treatment methods, such as chemical cauterization or pharmaceutical therapies, are often painful and require multiple visits to achieve complete wart removal and skin regeneration. This study aims to assess the clinical effectiveness of the needling technique as an alternative treatment. This method involves repeatedly puncturing the lesion under local anesthesia or posterior tibial nerve block to trigger an immune response and promote wart clearance.

Methods: A total of 26 patients underwent the needling procedure, which included puncturing the wart under local anesthesia, followed by wound dressing and topical application of iodopovidone to facilitate scab formation. Follow-up visits were scheduled until full wart resolution was observed. Analgesics were provided for moderate pain management when necessary.

Results: After 30 days, a success rate of 57.7% was achieved. Patients reported mild pain, which subsided within a few days, and expressed high levels of satisfaction with the treatment outcome.

Conclusions: The needling technique emerges as an effective alternative to chemical treatments, offering a notable wart clearance rate. Its use under local anesthesia enhances patient comfort and reduces treatment-associated anxiety compared to conventional therapies.

Background: Cervical spondylitis is accompanied by segmental instability and sagittal imbalance. The purpose of this work is to conduct a search of correlation between sagittal parameters and clinical outcomes in cervical spondylitis.

Materials and methods: The monocentric cohort study encompassed the clinical and radiological data of 59 patients who underwent reconstructive surgeries on the suboccipital, subaxial, and cervicothoracic spine. We evaluated local cervical sagittal parameters: cervical sagittal vertical axis (CSVA), T1 slope (T1S), Health-Related Quality of Life-HRQOL (Oswestry Disability Index-ODI)-and others pre- and postoperatively.

Results: The duration of the therapeutic pause and T1S correlated with HRQOL. It revealed the direct relationship between the age of the patient and the value of CSVA. A significant predictor of postoperative complications is the level of comorbidity with an index of 7 or more on the Charlson scale.

Conclusions: The factors influencing HRQOL in this pathology are the duration of the therapeutic pause and the magnitude of T1S compensation. Anterior reconstruction of the cervical spine in the presence of spondylitis yields a correction of the sagittal balance parameters. The leading predictors of complications from the surgical treatment of cervical spondylitis are the Charlson comorbidity index and the variant of anterior reconstruction.

Background: The aim of this study was to analyze data on pediatric cases of COVID-19 admitted to a tertiary referral hospital in northwest Greece.

Methods: A retrospective analysis was conducted on the most common clinical manifestations and laboratory findings, stratified by age group and SARS-CoV-2 strain.

Results: A total of 254 children were hospitalized, with a mean age of 4.5 years. Underlying conditions were present in 10.2% of cases; two children required pediatric intensive care unit (PICU) admission, and one child died. The most common hematological manifestations, in general, were neutropenia (30%) and lymphopenia (23%), whereas the findings varied when the children were stratified by age group. Eight children developed multisystem inflammatory syndrome (MIS-C), with the most common findings being anemia (75%), lymphopenia (50%), and thrombocytopenia (25%). Analysis of the SARS-CoV-2 strains revealed the proportions of the dominant strain over time. Fever was the predominant symptom across all strains, particularly in the Omicron group, which also had a high incidence of gastrointestinal symptoms. The longest hospital admission occurred in children with the Omicron strain, followed by the Wuhan, Alpha, and Delta strains.

Conclusions: Fever was the most consistent symptom across all age groups and virus strains. The most common hematological manifestations were neutropenia (30%) and lymphopenia (23%). The Omicron strain was associated with the longest hospital stay.

Background: The impact of biomass fuel exposure on mental health, along with the associated gender disparities, remains largely unexplored. This study aimed to examine the association between biomass fuel use and depressive symptoms in the population of Oaxaca, Mexico, while also identifying gender differences in this relationship.

Methods: This study used data from the 2022 National Health and Nutrition Survey (ENSANUT). Depressive symptoms, the outcome variable, were assessed using the Center for Epidemiologic Studies Depression Scale (CESD). The primary predictor variable was biomass fuel use, with gender, age, and residency stratum included as covariates. First, a binary logistic regression model was developed to estimate the dichotomous variable "depression symptoms". Subsequently, a second binary logistic regression model was constructed to evaluate potential interactions between the covariates and the predictor variable.

Findings: The sample included 1.4 million adults from Oaxaca, with a prevalence of depressive symptoms of 15%. Biomass fuel was used by 15.4% of the population. The first logistic regression model showed that women (Odds Ratio (OR): 1.249; 95% CI: 1.235-1.263; p < 0.001), individuals aged 60 years and older compared to the younger population group (OR: 12.192; 95% CI: 12.064-12.321; p < 0.001), those residing in rural areas (OR: 1.245; 95% CI: 1.232-1.259; p < 0.001), and individuals using firewood or charcoal for cooking (OR: 1.674; 95% CI: 1.651-1.697; p < 0.001) had higher odds of depressive symptoms. In the second binary logistic regression model, all associations and OR coefficients retained their direction, although the coefficients underwent a slight adjustment following the introduction of the interaction term, indicating the presence of an interaction.

Conclusions: The study findings suggest a gendered association between biomass fuel exposure and depressive symptoms in the adult population of Oaxaca, with older women and women dwelling in rural areas being the most vulnerable. Interventions aimed at reducing biomass air pollution exposure and strengthening mental health support for women are strongly recommended.

Background: Chronic stress, driven by the persistent activation of the body's stress response system-including the sympathetic nervous system and hypothalamic-pituitary-adrenal (HPA) axis-has far-reaching effects on both physical and mental health. This study examines the combined effects of social and behavioral factors on a latent variable consisting of stress and depressive symptoms, using a comprehensive framework to explore the complex interactions of these factors.

Methods: Leveraging data from the United States Centers for Disease Control and Prevention's (CDC's) National Health and Nutrition Examination Survey (NHANES), we operationalized allostatic load-a measure of cumulative physiological stress-through 10 biomarkers spanning cardiovascular, inflammatory, and metabolic systems. Depressive symptoms were measured via the Patient Health Questionnaire-9 (PHQ-9), and a latent variable capturing the shared variance between stress and depressive symptoms was derived using factor analysis. To assess the influence of social (income and education) and behavioral (alcohol consumption and smoking) factors on this latent variable, we employed Bayesian Kernel Machine Regression (BKMR), allowing us to examine potential non-linear and interactive effects among these predictors.

Results: Our results revealed a significant positive association between allostatic load and depressive symptoms across the sample, regardless of ethnic background. Alcohol consumption emerged as a key behavioral factor, with significant positive associations with stress. Conversely, education showed a protective effect, with higher education levels associated with decreased stress and depressive symptoms.

Conclusions: These findings underscore the importance of addressing both social determinants and behavioral risk factors in mitigating the cumulative impacts of stress and depressive symptoms. By highlighting the roles of alcohol consumption and education, this study provides insights that can inform public health strategies aimed at promoting resilience and reducing stress-related health disparities.

Background/objectives: The COVID-19 pandemic is behind us, but the experiences gained during its course can serve as a framework for preventive actions in future crises. The main objectives were to examine the predictors of loneliness in older adults during the pandemic and to explore the mediating effects of emotional stability between pandemic-specific stressors and loneliness. To achieve the set objectives, we developed a questionnaire to measure pandemic-specific stressors in older adults.

Methods: A cross-sectional research design was used. A total of 578 participants of both genders (38.9% male, 61.1% female) aged 65 and above (M = 74.09, SD = 6.72) participated in this study. The self-reported measures used included the following: The Ten-Item Personality Inventory, The Revised Loneliness Scale, The Clinical Outcomes in Routine Evaluation, and The Pandemic-Specific Stressors Questionnaire for Older Adults.

Results: Using exploratory factor analysis, two factors were extracted, providing evidence of face and convergent validity, together explaining 71.3% of the variance. The results of the confirmatory factor analysis indicated a good model fit. Hierarchical regression analysis indicated the greatest contribution of the psychological factors to loneliness in older adults during the pandemic, while marital status and pandemic-specific stressors had a minor but still significant impact. Mediation analysis revealed that emotional stability mediated the association between social distancing experiences and loneliness.

Conclusions: In future global pandemics, it is necessary to pay full attention to psychological factors to preserve the mental health of older people. The newly-constructed questionnaire identifies pandemic-specific stressors in older adults, aiding their mitigation and easing recovery from the pandemic crisis.

Objective: This study assesses the associations between dendritic cells, HPV 6 and 11, and Recurrent Respiratory Papillomatosis (RRP) aggressiveness.

Methods: The Derkay score was calculated using information obtained from the medical records. Biopsies from 36 patients with juvenile RRP (JRRP) and 43 adult RRP (ARRP) patients were analyzed under light microscopy, and their clinical data were collected. Immunohistochemical analysis using antibodies against CD83, CD1a, Factor XIIIa, and S100 was performed, and inflammatory cells were quantified. Data obtained were analyzed using the chi-squared test, in addition to the Mann-Whitney and Z tests for two proportions, considering a confidence interval of 95% and p < 0.05 as statistically significant.

Results: A higher quantity of S100 was identified in the epithelium (p < 0.001) and in the conjunctive tissue (p = 0.027) among the ARRP cases, while CD83 (p = 0.025) and Factor XIIIa (p = 0.018), both in the epithelium, were identified among the JRRP cases. We observed significant association between a higher quantity of CD83 in the epithelium in the juvenile group with a low Derkay index (p = 0.034) and with HPV 6 (p = 0.039).

Conclusions: An increased quantity of dendritic cells is present in individuals diagnosed with RRP, regardless of age, and this may be related to the lower Derkay index, regardless of the HPV type detected.

Background/Objectives: Dupilumab is an interlekin-4 receptor antibody that exerts its efficacy by inhibiting the signaling pathway of interleukin-4/interleukin-13, and it is currently used clinically as a highly potent therapeutic for atopic dermatitis. However, there have been few reports on the therapeutic effect of dupilumab using long-term real-world data. To accumulate further real-world data through long-term use of dupilumab, we performed a retrospective study on the courses of patients with atopic dermatitis who were treated with dupilumab for at least 104 weeks in our university hospital. Methods: We examined the treatment courses of 30 adult patients. Results: Subjective (e.g., itch visual analog scale and Dermatology Life Quality Index) and objective (e.g., Eczema Area and Severity Index) indices and some biomarkers showed improvements over time with dupilumab treatment, even in cases with poor early response to dupilumab treatment. As for the therapeutic effect on anatomical regions, although the therapeutic effect on the head and neck region was weak in the early stages, it improved over time, and at 104 weeks, it showed a therapeutic effect that was comparable to other regions. Conclusions: Therefore, our study demonstrated the advantages of prolonged administration of dupilumab in atopic dermatitis.