Diseases (Basel, Switzerland)最新文献

Background: Leptin is a peptide hormone produced by white adipose tissue and is essential for the regulation of appetite and energy homeostasis. Evidence suggests that leptin concentrations may vary according to emotional and psychosocial conditions, such as occupational stress, particularly in vulnerable populations, including female workers. Accordingly, this study aimed to examine the association between occupational stress and altered serum leptin levels among female workers.

Methods: A cross-sectional design was applied to a sample of 302 female workers employed in plastic manufacturing plants in southern Brazil. Serum leptin concentrations were quantified, and values exceeding 15.2 ng/mL were considered elevated. Occupational stress was measured using the short version of the Job Stress Scale. Associations between occupational stress and elevated leptin levels were estimated using Poisson regression models with robust variance adjustment.

Results: The mean age of the participants was 35.4 years (SD [standard deviation] = 10.1). Elevated serum leptin levels were observed in 78.1% of the sample (95% CI: 73.5-82.8), whereas 21.9% (95% CI: 17.2-26.5) were classified as experiencing occupational stress. After controlling for relevant confounding variables, including obesity, women experiencing occupational stress showed a 15% higher probability of elevated leptin levels compared with those without occupational stress (prevalence ratio [PR] = 1.15; 95% CI: 1.02-1.30; p = 0.022).

Conclusions: Occupational stress was independently linked to increased serum leptin concentrations among female workers, suggesting that psychosocial stressors in the workplace may play a role in the disruption of leptin regulation in this population.

Background/Objectives: The efficacy of antidiabetic drugs is determined by intracellular target exposure rather than solely by plasma concentrations. This review synthesizes current evidence regarding subcellular drug distribution and its clinical significance. Methods: A structured review of the literature published between 2015 and 2025 identified 73 relevant studies. Data were categorized by drug class, factors influencing distribution, and analytical methodologies. Results: Drug distribution patterns differ by class. Biguanides accumulate in mitochondria, thiazolidinediones localize in cell nuclei, and GLP-1 agonists are found in endosomes. Variations in transporter genes, such as OCT1, influence the extent of drug delivery to these subcellular targets. Conclusions: Investigations into intracellular drug movement elucidate their mechanisms of action. However, standardized human studies are required before these findings can inform clinical practice or regulatory decisions.

Background/objectives: Homeostatic (nervous, immune and endocrine) systems and their communications network are crucial for health and aging rate. We previously reported behavioral and peritoneal leukocyte function alterations and oxidative-inflammatory stress in young female triple-transgenic (3xTg) mice for Alzheimer's disease (AD). Here, the deterioration of the homeostatic systems and their interplay was investigated, in an integrated way, at prodromal stages and in both sexes of 3xTg-AD mice.

Methods: An integrative analysis of the behavioral profile, peripheral immune splenic and thymic leukocyte functions, splenic oxidative-inflammatory state, and plasmatic corticosterone in both sexes of 3xTg-AD mice at 4 months of age was compared to that of age- and sex-matched NTg counterparts.

Results: The prodromal stage of 3xTg-AD, characterized by anxiety-like behaviors and disrupted exploration, was aligned with reduced chemotaxis, natural killer activity, and lymphoproliferation-especially in the spleen. In addition, 3xTg-AD mice exhibited lower anti-inflammatory (IL-10) and higher pro-inflammatory (IL-2, IL-1β, and TNF-α) cytokine concentrations and oxidative stress (higher oxidants and lower antioxidants). Several of these alterations displayed sex-dependent differences (worse in males). However, no differences in corticosterone were found.

Conclusions: These findings suggest that neuroimmune and redox-inflammatory dysfunctions, indicative of premature aging, emerge at the prodromal stage of AD, preceding corticosterone changes, unveiling a time lag in the neuroimmunoendocrine alterations in these animals. They may act as early indicators of premature aging in AD pathology and provide potential targets for sex-specific prodromal intervention.

Long COVID is defined as "the continuation or development of new symptoms 3 months after the initial SARS-CoV-2 infection, with these symptoms lasting for at least 2 months with no other explanations", as reported by the World Health Organization. A growing number of people are dealing with a variety of lingering symptoms even after recovering from an acute infection. These can include fatigue, muscle pain, shortness of breath, headaches, cognitive issues, neurodegenerative symptoms, anxiety, depression, and a feeling of hopelessness, and therapeutic options for long COVID are investigated. The potential of hyperbaric oxygen therapy (HBOT) to improve chronic fatigue, cognitive impairments, and neurological disorders has been established; therefore, the use of HBOT to treat long COVID has also been studied. The aim of this literature search is to analyze the state of the art of a potential role of HBOT to improve chronic fatigue, cognitive impairments and neurological disorders. A literature analysis was performed, focusing on the clinical efficacy of HBOT for treating long COVID symptoms. The results from January 2021 to October 2025, using a standard registry database, showed 21 studies, including one case report, ten randomized controlled trial, eight systematic reviews and three studies regarding the molecular mechanism and markers changing after HBOT. They suggested that HBOT can improve quality of life, fatigue, cognition, neuropsychiatric symptoms and cardiopulmonary functions. HBOT is a safe treatment and has shown some benefits for long COVID symptoms. To precisely define indications, protocols, and post-treatment evaluations, we need to conduct more in-depth, large-scale studies.

Introduction: Minor digestive ailments are a common reason for individuals to visit pharmacies, and can be efficiently managed through structured pharmaceutical advice. This study aimed to evaluate the effectiveness of advice provided by pharmacists in community pharmacies from the perspectives of both patients and pharmacists. The primary focus of the study was not on assessing the effectiveness of a specific medication, but rather on the pharmaceutical advice provided.

Materials and methods: This prospective multicenter observational study was conducted between January and March 2025 in community pharmacies across Poland among adult patients with dyspepsia without alarm symptoms and included two visits: an initial visit and a follow-up phone call after 7-14 days. Symptom severity across seven domains was assessed using a GSRS-based tool, and data on adherence, treatment regimen, patient satisfaction, and acceptable costs of the two-visit service were collected. Statistical analyses (p < 0.05) using both parametric and non-parametric tests were performed on data from 100 participants who completed the study, with cost data serving as a proxy for willingness to pay.

Results: Most patients (92.7%) reported symptom improvement, with a median time to relief of 3 days and good treatment adherence. The greatest benefits were observed for abdominal pain and flatulence, and higher baseline symptom severity was consistently associated with greater improvement. Service acceptability was high, and patients' reported willingness to pay suggests perceived value and potential economic feasibility of the service.

Conclusions: Structured pharmaceutical advice for digestive ailments (including triage, education, management plans, and monitoring of effects) led to rapid and clinically significant improvements in most patients. This approach demonstrates high adherence rates and positive acceptability. The stability of effects across different demographic groups, along with a predictable pattern of changes in various domains, supports the expansion of this service and customization of educational messages.

Objective: To map and synthesize the published literature on the epidemiological burden of urinary tract infections (UTIs) in adults with spinal cord injury (SCI) or multiple sclerosis (MS) using intermittent catheterization (IC). Methods: We conducted a comprehensive literature review following PRISMA guidelines, searching PubMed, Scopus, and Web of Science for studies published since 2014. A total of 30 studies met the inclusion criteria. Results: Reported UTI incidence varied widely from 24% to 93.1%, highlighting significant heterogeneity across the evidence base. Annually, 15-17% of patients experienced 4-6 UTIs, and up to 16.4% required hospitalization for UTI-related complications. A critical evidence gap was exposed, with only one study focusing specifically on the MS population. Conclusions: Despite its clinical benefits, IC remains underutilized and inconsistently supported. Addressing systemic delivery gaps is essential. UTIs in neurogenic bladder care should be recognized as a modifiable public health issue requiring equity-driven interventions and strengthened implementation frameworks. This review underscores the urgent need for methodologically rigorous research to establish clear best practices.

Background: Tuberculosis (TB) in adolescents is distinct from both childhood and adult TB, particularly in terms of risk factors; however, national-level data assessing these factors in adolescents remain limited despite growing attention to the issue. This study aims to identify factors associated with TB among individuals aged 10 to 18 years.

Methods: This study leverages data from the National Family Health Survey (NFHS-5) conducted in India during the year 2019-2021. A total of 479,674 adolescents were included. We employ a generalized linear mixed-effects logistic regression model to examine the association between household, environmental, demographic and behavioral factors and self-reported TB status among adolescents.

Results: A total of 363 adolescents reported having TB. The results show that adolescents who are male (aOR = 0.735, p < 0.001), living in a nuclear family (aOR = 0.782, p < 0.001), residing in a household without TB cases (aOR = 0.17, p < 0.001), using a traditional mud stove or chullah (aOR = 0.279, p < 0.001), do not have air conditioning or a cooler (aOR = 0.405, p < 0.001), do not use tobacco (aOR = 0.766, p < 0.001), and do not consume alcohol (aOR = 0.912, p < 0.001) have lower odds of TB. Conversely, older age (aOR = 1.136, p < 0.001), absence of a separate kitchen (aOR = 1.395, p < 0.001), belonging to poor (aOR = 2.787, p < 0.005) or middle-income households (aOR = 2.662, p < 0.001), and living in households without cattle (aOR = 1.489, p < 0.001) are associated with higher odds of TB.

Conclusions: Using nationally representative NFHS data, this study identifies multiple household, socioeconomic, and behavioral factors associated with TB among adolescents in India. These findings highlight the need for targeted TB prevention strategies that address household conditions, socio-economic disparities, and adolescent health behaviors.

Background: Obesity substantially increases cardiovascular risk and contributes to the accumulation of cardiometabolic risk factors. Achieving optimal control of body weight and guideline-recommended targets is essential in high-risk patients, particularly in secondary prevention following acute coronary events. This study aimed to evaluate treatment strategies and lifestyle modifications undertaken by patients with obesity during long-term follow-up.

Methods: This analysis included patients enrolled 6-18 months after acute coronary syndrome or coronary revascularization within the multicentre POLASPIRE II study. Standardized EUROASPIRE methodology was applied to collect clinical, anthropometric, and lifestyle-related data.

Results: A total of 788 patients (mean age 65.4 ± 8.9 years; 25.8% women) were included, of whom 40.6% had obesity. No significant association between sex and BMI was observed (β = -0.48; 95% CI -1.30 to 0.31; p = 0.20). Increasing age was associated with lower BMI (β = -0.05; 95% CI -0.09 to -0.0001; p = 0.044), and higher education correlated with lower BMI (β = -1.10; 95% CI -2.00 to -0.22; p = 0.015). With advancing age (OR 1.02; 95% CI 1.002-1.033; p = 0.023) and increasing BMI (OR 1.11; 95% CI 1.076-1.138; p = 0.001), the number of risk factors and comorbidities increased. Higher BMI was associated with poorer control of medical risk factors (OR 1.06; 95% CI 1.03-1.10; p < 0.001), whereas patients with higher BMI demonstrated better control of lifestyle-related risk factors (OR 0.95; 95% CI 0.919-0.983; p = 0.003).

Conclusions: Obesity is highly prevalent among high-risk cardiovascular patients and is associated with a greater burden of comorbidities and poorer control of medical risk factors. These findings support the need for strengthened, risk-stratified secondary prevention strategies and more personalized therapeutic approaches in patients with obesity.

Background: Glaucoma is a chronic neurodegenerative disorder characterized by the selective vulnerability of retinal ganglion cells (RGCs), in which mitochondrial dysfunction, redox imbalance, and impaired bioenergetic signaling play central pathogenetic roles. Mitochondrial homeostasis in RGCs critically depends on maintaining intracellular NAD⁺ pools, which support oxidative phosphorylation, sirtuin-mediated deacetylation, and antioxidant gene expression. Nicotinamide riboside (NR), a potent NAD⁺ precursor, and berberine (BBR), an AMPK activator derived from Berberis aristata, have recently emerged as synergistic modulators of mitochondrial metabolism and oxidative stress resistance.

Methods: This study retrospectively assessed clinical outcomes associated with combined nutraceutical supplementation of nicotinamide riboside (NR) and berberine (BBR) in patients with primary open-angle glaucoma undergoing stable topical hypotensive therapy. We have included a narrative review in the current literature regarding NAD⁺ biology, AMPK-sirtuin signaling, and oxidative stress responses in retinal ganglion cell (RGC) degeneration. Due to the absence of comparator groups receiving only NR or only berberine in this retrospective cohort, the combined supplementation has been regarded as a biologically complementary strategy, and the potential for synergistic efficacy remains a subject for further investigation.

Results: Translationally, a retrospective clinical cohort receiving combined NR and BBR supplementation showed functional stabilization of the visual field and structural preservation of the retinal nerve fiber layer over a six-month follow-up, in line with the proposed mitochondrial protective mechanisms.

Conclusions: The clinical trends identified in this retrospective cohort have substantiated the translational significance of NR + BBR supplementation as a potential adjunctive approach in glaucoma management. NAD⁺ repletion and engagement of the AMPK-SIRT-NRF2 pathway may enhance mitochondrial resilience in RGCs. Collectively, these findings offer initial clinical evidence advocating for additional controlled studies on NR + berberine supplementation, while mechanistic interpretations have been derived from the existing literature and are hypothesis-generating.

Introduction: Dysmorphic RBC (DysRBC) as a marker of glomerular abnormalities is expected to have added value in screening for glomerular abnormalities along with other examinations, including renal tubular epithelial cells (RTECs) and pathological casts (PathCasts) that indicate tubular abnormalities in lupus nephritis (LN). Therefore, this study intended to assess the diagnostic performance of urinary cell and cast characteristics, including DysRBC, RTECs, and PathCast, as measured by the urine flow cytometry in lupus nephritic children.

Methods: Urine samples from 317 patients (50.47% female and 49.53% male) were collected. The diagnostic value was evaluated using receiver operating characteristic (ROC) analysis.

Results: The ROC analysis demonstrated that all parameters exhibited acceptable discriminatory performance, including %DysRBC (AUC = 0.954, p < 0.001), RTEC (AUC = 0.580, p = 0.001), and PathCast (AUC = 0.664, p = 0.001).

Conclusions: DysRBC, RTECs, and PathCast may have added value in the diagnosis of LN in children, notably with excellent diagnostic value in distinguishing LN in %DysRBC. This promising result warrants evaluation with a large-scale site study.