Diseases (Basel, Switzerland)最新文献

{"title":"Investigating the Variables Associated with Having a Functional Limitation Among Adults with Long COVID: A Cross-Sectional Database Study Using the United States Medical Expenditure Panel Survey.","authors":"David R Axon, Stephanie Fenwick","doi":"10.3390/diseases14090339","DOIUrl":"10.3390/diseases14090339","url":null,"abstract":"<p><strong>Background/objectives: </strong>Functional limitations are one of many potential clinical consequences for people living with long COVID. However, medical, health, and demographic variables associated with functional limitations in this population have not been fully characterized. The objective of this study was to identify variables associated with having a functional limitation among United States (US) adults with long COVID in a nationally representative dataset.</p><p><strong>Methods: </strong>This was a cross-sectional analysis of US adults in the 2023 Medical Expenditure Panel Survey (MEPS). A multivariable logistic regression model was created to identify factors associated with reporting functional limitations versus no functional limitations in people with MEPS-defined long COVID.</p><p><strong>Results: </strong>In this study, 26% of adults with MEPS-defined long COVID reported functional limitations. Factors that were associated with functional limitations in people with long COVID included non-married status versus married (odds ratio [OR] = 1.8), having 2-4 chronic health conditions versus 0-1 conditions (OR = 2.8), being unemployed versus employed (OR = 3.5), having public health insurance versus uninsured (OR = 5.3), and reporting pain interference versus no pain (little pain interference, OR = 2.3; moderate interference, OR = 8.8; extreme/quite a bit of interference, OR = 16.9). No other associations were found.</p><p><strong>Conclusions: </strong>Functional limitations are common in people experiencing long COVID. Several factors were associated with functional limitations in this population of individuals with long COVID, although whether the functional limitation was caused by long COVID or another problem was unknown. Further research is needed to better understand factors associated with long COVID and to explore the scope and severity of functional limitations in long COVID.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"14 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13605161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Body Mass Index-Related Alterations in Gonadotropin Secretion Among Women with Polycystic Ovary Syndrome Compared with Healthy Controls.","authors":"Saad Al-Fawaeir","doi":"10.3390/diseases14090341","DOIUrl":"10.3390/diseases14090341","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To investigate the association between body mass index (BMI) and gonadotropin secretion, including serum luteinizing hormone (LH), follicle-stimulating hormone (FSH), and the LH/FSH ratio, among women with polycystic ovary syndrome (PCOS), and to compare these parameters with healthy women.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Patients and methods: &lt;/strong&gt;This comparative cross-sectional analytical study included 400 women aged 18-35 years recruited from outpatient gynecology and endocrinology clinics at private-sector medical centers in Irbid, Jordan, between June 2025 and April 2026. The study included 200 women diagnosed with PCOS according to the Rotterdam criteria and 200 age-comparable healthy controls. The PCOS group was stratified into four BMI categories (&lt;25, 25-&lt;28, 28-&lt;31, and ≥31 kg/m&lt;sup&gt;2&lt;/sup&gt;), with 50 women in each category. Clinical and anthropometric characteristics were assessed, and serum LH and FSH concentrations were measured. The LH/FSH ratio was calculated for each participant. Differences between groups were evaluated using appropriate statistical tests, while one-way analysis of variance was used to compare PCOS subgroups according to BMI. Pearson's correlation analysis was used to assess associations between BMI and gonadotropin parameters.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The mean age was comparable between women with PCOS and healthy controls (26.31 ± 5.36 vs. 26.47 ± 5.16 years; &lt;i&gt;p&lt;/i&gt; = 0.23). Women with PCOS had significantly higher BMI than controls (27.85 ± 3.47 vs. 22.81 ± 2.29 kg/m&lt;sup&gt;2&lt;/sup&gt;; &lt;i&gt;p&lt;/i&gt; &lt; 0.001). Among women with PCOS, menstrual irregularity, hirsutism, acne, infertility, and polycystic ovarian morphology were observed in 87.5%, 79.5%, 78.5%, 70.0%, and 100%, respectively. Serum LH was significantly higher in women with PCOS than in controls (8.44 ± 2.61 vs. 6.53 ± 1.16 IU/L; &lt;i&gt;p&lt;/i&gt; &lt; 0.001), whereas FSH was significantly lower (4.64 ± 0.98 vs. 7.96 ± 1.18 IU/L; &lt;i&gt;p&lt;/i&gt; &lt; 0.001), resulting in a higher LH/FSH ratio (1.84 ± 0.50 vs. 0.83 ± 0.20; &lt;i&gt;p&lt;/i&gt; &lt; 0.001). Within the PCOS group, LH progressively decreased across increasing BMI categories, from 11.58 ± 1.26 IU/L in women with BMI &lt; 25 kg/m&lt;sup&gt;2&lt;/sup&gt; to 5.40 ± 1.29 IU/L in those with BMI ≥ 31 kg/m&lt;sup&gt;2&lt;/sup&gt; (&lt;i&gt;p&lt;/i&gt; &lt; 0.001). Similarly, the LH/FSH ratio decreased from 2.46 ± 0.18 to 1.28 ± 0.23 across these BMI categories (&lt;i&gt;p&lt;/i&gt; &lt; 0.001), whereas FSH did not differ significantly (&lt;i&gt;p&lt;/i&gt; = 0.07). BMI showed strong inverse correlations with LH (r = -0.870, &lt;i&gt;p&lt;/i&gt; &lt; 0.001) and the LH/FSH ratio (r = -0.869, &lt;i&gt;p&lt;/i&gt; &lt; 0.001), but not with FSH (r = -0.126, &lt;i&gt;p&lt;/i&gt; = 0.075).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Women with PCOS demonstrated a distinct gonadotropin profile characterized by higher LH and LH/FSH ratio and lower FSH compared with healthy controls. Among women with PCOS, increasing BMI was strongly associated with lower LH concentrations and LH/FSH ratios. These findings highlight the importance of considering BMI","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"14 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13605847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High HAM-A-Detected Prevalence of Anxiety in Parkinson's Disease, but No Correlation with Severity of Motor Disease.","authors":"Khaoula Elcadi, Oussama Cherkaoui Rhazouani, Nissrine Louhab, Najib Kissani, Mohamed Chraa","doi":"10.3390/diseases14090338","DOIUrl":"10.3390/diseases14090338","url":null,"abstract":"<p><strong>Background: </strong>In Parkinson's disease (PD), non-motor symptoms especially anxiety represent a significant and underappreciated burden. Despite the lack of particular validation in this demographic, the Hamilton Anxiety Rating Scale (HAM-A) is widely used in clinical and research contexts.</p><p><strong>Methods: </strong>A cross-sectional study of 200 Parkinson's disease patients (mean age 62.77 ± 8.32 years; 118 men and 82 females) was conducted. The Hoehn & Yahr (H&Y) scale was used to grade motor severity, whereas the HAM-A was used to measure anxiety.</p><p><strong>Results: </strong>Of the patients, 52.5% of people (<i>n</i> = 105; mean score 13.85 ± 6.09) had anxiety (HAM-A ≥ 14). Age (r = 0.032; <i>p</i> = 0.657), disease duration (r = 0.115; <i>p</i> = 0.105), H&Y stage (r = -0.073; <i>p</i> = 0.305), and sex (<i>p</i> = 0.856) did not significantly correlate with the HAM-A score.</p><p><strong>Conclusion: </strong>Although the HAM-A shows a high incidence of anxiety in Parkinson's disease (PD), its consistent lack of connection with clinical illness markers raises serious concerns about construct validity, which are probably caused by somatic item overlap. It is best to use disease-specific tools like the GAD-7 or Parkinson Anxiety Scale (PAS).</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"14 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13605081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Liver Biomarker Levels in Farmers Occupationally Exposed to Pesticides: A Cross-Sectional Study.","authors":"Hung The Dang, Thoa Phuong Nguyen, Thu Thi Yen Pham, Chinh Thi Luu, Ha Thi Thu Nguyen, Oanh Thi Kieu Nguyen, Oanh Thi Phuong Ngo, Chinh Thi Tuyet Do, Ha Thi Ngoc Bui, Quan Hong Duong","doi":"10.3390/diseases14090337","DOIUrl":"10.3390/diseases14090337","url":null,"abstract":"<p><strong>Background/objectives: </strong>Occupational pesticide exposure is a recognized hepatotoxic hazard; however, biomonitoring data characterizing liver function among Vietnamese agricultural workers remain scarce. This study compared serum hepatic biomarkers between pesticide-exposed fruit farmers (exposed group) and a non-exposed reference group (unexposed group) in a northern province in Vietnam, and evaluated whether biomarker alteration varied with cumulative exposure duration.</p><p><strong>Methods: </strong>A cross-sectional study using convenience sampling was conducted from April to October 2022 among 150 adults, comprising 100 fruit farmers with ≥1 year of direct occupational pesticide exposure and 50 unexposed controls. Serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), total and indirect bilirubin, alpha-fetoprotein (AFP), and glucose were quantified using clinical laboratory assays. Multivariable linear regression models, adjusting for age, sex, and body mass index (BMI), were used to evaluate associations between pesticide exposure duration and biomarker levels.</p><p><strong>Results: </strong>Pesticide-exposed farmers had significantly higher mean concentrations of ALT (28.88 vs. 22.36 U/L, <i>p</i> = 0.002), AFP (3.06 vs. 1.16 ng/mL, <i>p</i> < 0.001), total bilirubin (9.93 vs. 7.74 μmol/L, <i>p</i> < 0.001), and indirect bilirubin (8.40 vs. 5.26 μmol/L, <i>p</i> < 0.001) than unexposed controls. While mean AST did not differ (<i>p</i> = 0.105), the proportion of abnormal AST cases was significantly higher among exposed individuals (23% vs. 8%, <i>p</i> = 0.043). After adjustment for age, sex, and BMI in multivariable linear regression models, prolonged exposure (>10 years) remained modestly associated with higher AFP and bilirubin levels (<i>p</i> < 0.05), while associations with ALT and AST were not statistically evident (<i>p</i> > 0.05).</p><p><strong>Conclusions: </strong>These findings suggest a possible association between occupational pesticide exposure and subclinical hepatic alterations, supporting calls for regular health surveillance and enhanced protective measures among fruit farmers.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"14 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13604953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Morphology to Biomarkers: Optical Coherence Tomography in Corneal Disease.","authors":"Lanxing Fu, Yvonne H-L Luo, Nick Kopsachilis, Matteo Capobianco, Irene Gattazzo, Francesco Cappellani, Fabiana D'Esposito, Caterina Gagliano, Marco Zeppieri","doi":"10.3390/diseases14090336","DOIUrl":"10.3390/diseases14090336","url":null,"abstract":"<p><strong>Background: </strong>Optical coherence tomography (OCT) has been recognised as a non-invasive imaging modality capable of offering high-resolution visualisation of the corneal tissue.</p><p><strong>Objective: </strong>This review evaluates the role of OCT in chronic corneal disease, focusing on how descriptive imaging has progressed to quantitative imaging biomarkers with translational potential.</p><p><strong>Methods: </strong>A comprehensive review of the published literature on OCT imaging in corneal disease was conducted, emphasising structural features, quantitative parameters, and biomarkers.</p><p><strong>Results: </strong>OCT facilitates detailed visualisation of corneal microstructure, including variations in epithelial thickness, stromal reflectivity patterns, corneal thickness distribution, and interface abnormalities. These morphological observations are converted into quantitative measures that function as imaging biomarkers for disease severity, progression, and therapeutic effectiveness. In conditions such as keratoconus, chronic infectious keratitis, and corneal dystrophies, OCT-derived parameters offer valuable information for phenotyping and longitudinal monitoring. Additionally, advances in automated image analysis and artificial intelligence further increase the potential of OCT for biomarker discovery and evidence-based clinical decision-making.</p><p><strong>Conclusions: </strong>The development and validation of robust OCT-based biomarkers have the potential to enable earlier diagnosis, improved disease monitoring, and personalised treatment strategies. Future research that integrates quantitative imaging, computational analysis, and longitudinal clinical data will be essential to fully realise the translational potential of OCT in corneal disease management.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"14 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13605135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discordance Between BMI-Defined Overweight/Obesity and Waist-to-Height Ratio-Defined Central Obesity Among Adults with Type 2 Diabetes in Malawi: A Multicenter Cross-Sectional Study.","authors":"Alexander Thomas Mboma, Elias Peter Mwakilama, Alexander Archippus Kalimbira, Duc Minh Cap, Tuyen Van Duong, Rong-Hong Hsieh","doi":"10.3390/diseases14090334","DOIUrl":"10.3390/diseases14090334","url":null,"abstract":"<p><p><b>Background:</b> Body mass index (BMI) does not capture abdominal fat distribution and may classify adiposity differently from central-obesity indicators. We quantified discordance between BMI-defined overweight/obesity and waist-to-height ratio (WHtR)-defined central obesity among adults with type 2 diabetes mellitus (T2DM) in Malawi. <b>Methods:</b> This multicenter cross-sectional study included 1356 adults attending diabetes clinics at three tertiary hospitals. Overweight/obesity was BMI ≥ 25 kg/m². Central obesity was defined by waist circumference (WC ≥ 94/80 cm, men/women), waist-to-hip ratio (WHR ≥ 0.90/0.85), and WHtR ≥ 0.50. BMI and WHtR were cross-classified into four phenotypes, and agreement between the two classifications was summarized using observed agreement and Cohen's kappa. Logistic and multinomial logistic regression models estimated (adjusted) odds ratios with 95% CIs; sensitivity analyses added study site as a fixed effect and modified Poisson models with robust variance provided adjusted prevalence ratios for the common binary outcomes. <b>Results:</b> Prevalence of BMI-defined overweight/obesity was 60.8%; central obesity was 67.5% (WC), 65.3% (WHR), and 80.1% (WHtR). Cross-classification showed 23.7% had central obesity only and 56.3% had combined overweight/obesity and central obesity; observed agreement between the two classifications was 71.8% and Cohen's kappa was 0.35 (95% CI 0.30-0.40). Overweight/obesity was associated with older age (aOR 2.95), female sex (aOR 2.19), and physical inactivity (aOR 1.93). WC-defined central obesity was strongly associated with female sex (aOR 10.16), although the corresponding adjusted prevalence ratio was considerably smaller (aPR 2.25). WHR-defined central obesity was associated with older age, and anxiety. WHtR-defined central obesity was associated with older age, female sex, ever-married status, and late-evening eating behavior (aOR 1.36), although the association did not persist when study site was added. The combined phenotype was associated with age, sex, marital status, meal frequency, and physical inactivity. <b>Conclusions:</b> Overweight/obesity and central obesity were highly prevalent, with WHtR identifying the greatest burden and a substantial central-obesity-only phenotype that BMI alone would not detect. Incorporating WHtR alongside BMI may improve anthropometric assessment of adiposity in diabetes care, particularly among older and female patients.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"14 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13605006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Popliteal Artery Injuries in Orthopedic Knee Surgery: A Narrative Review with an Italian Medico-Legal Perspective.","authors":"Giulia Colonna, Giulio Nittari, Taurino Francesco, Pasqualino Sirignano, Giovanna Ricci, Paolo Bailo","doi":"10.3390/diseases14090335","DOIUrl":"10.3390/diseases14090335","url":null,"abstract":"<p><strong>Objectives: </strong>To provide a narrative overview of popliteal artery injury (PAI) associated with orthopedic knee surgery, focusing on its mechanisms, risk factors, diagnostic challenges, treatment strategies, and medico-legal appraisal within the Italian civil healthcare liability framework.</p><p><strong>Methods: </strong>A non-systematic literature review was conducted using PubMed, Scopus, and Web of Science, including articles published up to December 2025. Original studies, reviews, case series, and case reports addressing vascular anatomy, mechanisms of injury, diagnosis, treatment, and outcomes were selected. During revision, a separate targeted medico-legal search was conducted in PubMed, Scopus, and Web of Science on 7 September 2026, and Italian statutory, judicial, and deontological sources were examined for the civil healthcare liability analysis.</p><p><strong>Results: </strong>The clinical synthesis included 47 studies. Popliteal artery injury was identified as a rare but serious complication of procedures such as total knee arthroplasty, ligament reconstruction, arthroscopy, osteotomies, and hardware removal. Injury mechanisms included thrombosis, arterial incision, pseudoaneurysm formation, and arteriovenous fistulae. Computed tomography angiography emerged as the preferred imaging modality in uncertain cases, while both open surgical and endovascular treatments showed satisfactory results when performed promptly. Delayed diagnosis was consistently associated with worse functional outcomes and increased risk of limb loss. The targeted medico-legal search found only sparse literature directly addressing PAI; the Italian analysis therefore focused on professional conduct, causal attribution, informed consent, and evidentiary reconstruction rather than treating the adverse event itself as evidence of liability.</p><p><strong>Conclusions: </strong>Although uncommon, PAI remains a potentially limb-threatening complication of knee surgery. Thorough anatomical knowledge, early recognition, and timely vascular intervention remain central to clinical management. Within the Italian civil liability framework, the occurrence of a recognized complication neither establishes nor excludes negligence. Medico-legal appraisal should distinguish the primary vascular event from any additional harm attributable to delayed recognition or treatment and should address informed consent and documentation as separate issues.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"14 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13605625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI Revolution in Upper GI: Endoscopic Diagnosis of Gastric Cancers and Premalignant Neoplasms.","authors":"Ivan Shun Fai Lau, Hon Chi Yip, Philip Wai Yan Chiu, Martin Chi Sang Wong, Louis Ho Shing Lau","doi":"10.3390/diseases14090333","DOIUrl":"10.3390/diseases14090333","url":null,"abstract":"<p><p><b>Background</b>: Discrepancies between endoscopic and pathological diagnoses commonly occur. From pre-malignant neoplasms to early gastric cancers (EGC), this inconsistency often leads to significant alteration of management. AI (artificial intelligence) assisted diagnostic tools have the potential to mitigate the differences. From optimizing endoscopic examination through standardizing quality and risk stratification by identifying at-risk populations to enhancing EGC detection and characterization guiding therapeutic interventions, AI-assisted endoscopy has shown potential to overcome current limitations in standard care. <b>Methods</b>: In this state-of-the-art narrative review, we synthesize the current evidence and prevailing paradigm, discuss existing limitations, and outline the future directions of AI-assisted endoscopy in EGC. <b>Results</b>: AI models demonstrate potential in enhancing all steps of the EGC management pathway, from optimizing endoscopy quality, identification of at-risk populations, and lesion detection, lesion characterization, to endoscopic resection guidance and lymph node metastasis prediction. Yet, existing evidence largely remains retrospective, with interventional data demonstrating heterogeneity. The conflicting data largely stems from inherent fundamental limitations of AI research in EGC, such as the lack of standardized objective performance metrics, inconsistent methodologies, and reporting standards. These issues fundamentally hinder generalizability and implementation in routine clinical practice. <b>Conclusions</b>: AI-enhanced endoscopy demonstrates potential to overcome current limitations in EGC management. Despite this promising future, there are obstacles to validation, implementation, and mitigating disparities owing to inherent fundamental issues.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"14 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13605178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demographic Vulnerability and Mental Health in Older Adults with Type 2 Diabetes: A Lifespan-Informed Analysis of Diabetes Distress.","authors":"Adriana Gherbon, Deiana Roman, Marioara Nicula-Neagu, Mirela Frandes","doi":"10.3390/diseases14090332","DOIUrl":"10.3390/diseases14090332","url":null,"abstract":"<p><strong>Background: </strong>Diabetes distress is a key mental health dimension of type 2 diabetes (T2D) and a growing concern as populations age, yet its determinants in older adults remain insufficiently characterized. The independent contributions of demographic and metabolic factors to severe distress and their implications for multidisciplinary screening across the lifespan remain unclear.</p><p><strong>Methods: </strong>In this cross-sectional study, we assessed 453 adults with T2D using the 17-item Diabetes Distress Scale (DDS-17). We categorized participants as experiencing low (<2), moderate (2-2.9), or severe (≥3) distress. We compared categories using the Kruskal-Wallis H test and chi-square tests. Logistic regression models were constructed with severe distress (DDS ≥ 3) as the outcome, adjusting for sex, educational level, and HbA1c.</p><p><strong>Results: </strong>Severe distress was identified in 19 participants (4.2%). Age differed significantly across DDS categories (Kruskal-Wallis H test, <i>p</i> = 0.003), with the severe group being significantly older (72.95 ± 4.38 years). Emotional burden was the dominant subscale across all groups. In multivariable logistic regression, increasing age (aOR = 1.163 per year; 95% CI: 1.055-1.282; <i>p</i> = 0.002) and lower educational level (high school vs. basic: aOR = 0.187; <i>p</i> = 0.020) were independently associated with severe distress, whereas metabolic variables were not independently associated with severe distress. ROC analysis identified age ≥ 70 years as an exploratory, sample-derived cut-off (AUC = 0.726, 95% CI 0.602-0.827; sensitivity 84%, specificity 55%). Results were robust in sensitivity analyses that excluded patients with diabetes duration < 5 years.</p><p><strong>Conclusions: </strong>Severe diabetes distress is more strongly associated with demographic vulnerability than with metabolic burden. Age ≥ 70 years and lower educational attainment may help identify older adults at increased risk of diabetes-related distress, supporting targeted psychological screening strategies in this lifespan stage.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"14 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13605092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanisms of Mitral Valve Repair Failure in a Redo Cohort: Association with Patient Characteristics and Initial Repair Features.","authors":"Elisa Mikus, Diego Sangiorgi, Mariafrancesca Fiorentino, Niki Bernardoni, Roberto Nerla, Simone Calvi, Elena Tenti, Fausto Castriota, Carlo Savini","doi":"10.3390/diseases14090331","DOIUrl":"10.3390/diseases14090331","url":null,"abstract":"<p><strong>Objective: </strong>Mitral valve repair failure encompasses heterogeneous anatomical patterns requiring redo surgery, yet the factors determining why repaired valves fail through different mechanisms remain poorly understood. We investigated the association of patient characteristics and index repair features with the anatomical mechanisms of failure among patients requiring redo surgery after degenerative mitral valve repair.</p><p><strong>Methods: </strong>We retrospectively reviewed all consecutive patients undergoing redo mitral valve surgery after previous degenerative mitral valve repair between January 2010 and June 2026. To minimize misclassification bias, only patients with complete operative documentation of the index repair and detailed intraoperative information regarding the mechanism of repair failure were included. Operative reports were reviewed to identify the reconstructive techniques used during the initial repair and the anatomical mechanism of failure at reoperation. To account for mutually exclusive clinical outcomes (prolapse recurrence and mitral stenosis), a competing-risks framework was employed.</p><p><strong>Results: </strong>A total of 121 patients constituted the study cohort. Recurrent leaflet prolapse was the most frequent mechanism of repair failure (71.6%) among patients with mitral regurgitation; mitral stenosis was present in 27.3% overall. Leaflet preservation versus resection, implantation of expanded polytetrafluoroethylene (ePTFE) neochordae, edge-to-edge repair, and annuloplasty ring size were not significantly associated with the anatomical mechanism of repair failure. In multivariable analysis, older age at the index operation was independently associated with recurrent prolapse, whereas younger age and female sex independently predicted the development of mitral stenosis. Within this redo cohort, no statistically significant association was observed between the recorded index repair features and the predominant anatomical mechanisms of failure after adjustment for patient characteristics.</p><p><strong>Conclusions: </strong>Among patients requiring redo surgery after degenerative mitral valve repair, the anatomical mechanisms of failure were associated with selected patient characteristics, whereas no significant association was observed with the recorded index repair features. These findings should be interpreted within the context of a selected redo population and do not support conclusions regarding the comparative durability of different repair strategies.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"14 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13605581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}