Diseases (Basel, Switzerland)最新文献

{"title":"Cost-Utility Analysis of PCSK9 Inhibitors and Quality of Life: A Two-Year Multicenter Non-Randomized Study.","authors":"José Seijas-Amigo, Maria José Mauriz-Montero, Pedro Suarez-Artime, Mónica Gayoso-Rey, Francisco Reyes-Santías, Ana Estany-Gestal, Antonia Casas-Martínez, Lara González-Freire, Ana Rodriguez-Vazquez, Natalia Pérez-Rodriguez, Laura Villaverde-Piñeiro, Concepción Castro-Rubinos, Esther Espino-Paisán, Octavio Cordova-Arevalo, Diego Rodriguez-Penas, Begoña Cardeso-Paredes, Marta Ribeiro-Ferreiro, Moisés Rodríguez-Mañero, Alberto Cordero, José R González-Juanatey, Memogal Investigators","doi":"10.3390/diseases12100244","DOIUrl":"https://doi.org/10.3390/diseases12100244","url":null,"abstract":"<p><p>The primary objective of this study was to conduct a cost-utility analysis of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors in real-world, comparing their use with standard care for managing cardiovascular disease. A multicenter prospective study was conducted across 12 Spanish hospitals from May 2020 to April 2022, involving 158 patients with hypercholesterolemia or atherosclerotic cardiovascular disease. This study assessed health-related quality of life (QoL) using the EQ-5D-3L questionnaire. The cost-utility analysis evaluated the economic impact of PCSK9 inhibitors when used with standard care compared to standard care alone, calculating the incremental cost-effectiveness ratio (ICER). This study included 158 patients with an average age of 61 years, male (66.5%). For patients initiating PCSK9 inhibitors, the treatment cost was EUR 13,633.39, while standard therapy cost EUR 3638.25 over two years. QoL for PCSK9 inhibitors stood at 1.6489 over two years, compared to 1.4548 for standard therapy. The results revealed favorable cost-utility outcomes, with an ICER of EUR 51,427.72. Significant improvements were observed in the domains of mobility, self-care, daily activities, pain/discomfort, and anxiety/depression (<i>p</i> < 0.001). This study presents the first real-world cost-utility analysis of PCSK9 inhibitors, supporting their economic rationale and highlighting their benefits in clinical practice. Healthcare decision-makers can use these results to inform their decisions and reimbursement policies concerning PCSK9 inhibitors. Trial Registration clinicaltrials.gov Identifier: NCT04319081.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11506820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514010","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":"Hemophagocytosis of the Hilar Pulmonary Lymph Nodes Is a More Sensitive Indicator of the Severity of COVID-19 Disease than Bone Marrow Hemophagocytosis.","authors":"Amira Jusovic-Stocanin, Elke Kaemmerer, Hannah Ihle, Angelina Autsch, Sandra Kleemann, Juliane Sanft, Michael Hubig, Gita Mall, Nikolaus Gassler","doi":"10.3390/diseases12100241","DOIUrl":"https://doi.org/10.3390/diseases12100241","url":null,"abstract":"<p><p>In systemic hyper-inflammation, as in severe COVID-19 disease, there are pronounced disorders of the hematological and lymphatic systems with prognostically relevant hemophagocytosis of the bone marrow. The current work aimed to address the importance of hemophagocytosis in the lymph nodes of patients with severe COVID-19 disease. From 28 patients who died of severe COVID-19 infection, samples of the vertebral bone marrow and lymph nodes from the cervical, hilar, para-aortic, mesenteric and inguinal locations were morphologically and immunohistologically (CD163, CD68, CD61, CD71, CD3, CD20, CD138) examined for the possible presence of hemophagocytosis. In the single-center study at the University Hospital Jena, a total of 191 hemophagocytes were found in the bone marrow and a total of 780 hemophagocytes in the lymph nodes in a standardized area of 21,924 mm² per tissue sample. With 370 hemophagocytes, hilar lymph nodes were most frequently affected (370/780; 47.44%; 95%-CI: [43.94, 50.95]), followed by cervical lymph nodes (206/780; 26.41%; 95%-CI: [23.41, 29.59]), para-aortic lymph nodes (125/780; 16.03%; 95%-CI: [13.58, 18.73]) and inguinal/mesenteric lymph nodes (79/780; 10.13%; 95%-CI: [8.155, 12.4]). Based on the standard area (21,924 mm²), the difference in the number of hemophagocytes in the bone marrow and in the hilar lymph nodes was statistically significant (<i>p</i> < 0.05), while this did not apply to the lymph nodes from the other locations. In fatal COVID-19 disease, hemophagocytosis is particularly found in the hilar lymph nodes and is therefore a better indicator of the severity of the disease than hemophagocytosis in the bone marrow. The findings provide some evidence for the concept of compartmentalized human host responses to life-threatening infections.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11506861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514014","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":"Unraveling Pneumomediastinum in COVID-19 Patients: Insights from a High-Volume-Center Case-Control Study.","authors":"Khrystyna Kuzmych, Marcello Covino, Mattia Paratore, Annalisa Campanella, Ludovico Abenavoli, Giuseppe Calabrese, Antonio Giulio Napolitano, Carolina Sassorossi, Stefano Margaritora, Filippo Lococo","doi":"10.3390/diseases12100242","DOIUrl":"https://doi.org/10.3390/diseases12100242","url":null,"abstract":"<p><strong>Background: </strong>Pneumomediastinum (PNM) is a severe complication in COVID-19 patients, potentially exacerbating morbidity and requiring heightened clinical attention. This study aims to identify risk factors, clinical characteristics, and outcomes associated with PNM in COVID-19 patients hospitalized for respiratory failure in our institution.</p><p><strong>Methods: </strong>Among 4513 patients admitted in our institution and testing positive for COVID-19 infection during the peak of the COVID-19 pandemic in Italy (1 March 2020 to 31 July 2020), we conducted a single-center, retrospective case-control study focusing our analysis on those with severe disease (respiratory failure). The cohort included a total of 65 patients (32 with PNM and 33 without PNM in the same period). Data were retrospectively collected from hospital records, including demographics, comorbidities, smoking history, clinical and laboratory findings, and imaging results. Statistical analyses were performed using Fisher's exact test and Student's <i>t</i>-test, with significance set at α = 0.05.</p><p><strong>Results: </strong>Patients with PNM were significantly younger (54.9 ± 18.5 vs. 65.4 ± 14.3 years, <i>p</i> = 0.0214) and exhibited higher inflammatory markers, particularly white blood cells count (WBC) at admission (11.4 ± 5.4 vs. 6.5 ± 4.1, <i>p</i> < 0.0001). Although smoking status, body mass index (BMI), and major comorbidities did not differ significantly between groups, COPD was more prevalent in the PNM group (46.9% vs. 15.1%, <i>p</i> = 0.0148). Radiologically, ground-glass opacities (GGOs) and consolidations were more frequent in PNM patients (93.7% vs. 51.5%, <i>p</i> = 0.0002; 78.1% vs. 42.2%, <i>p</i> = 0.0051, respectively). PNM was associated with longer hospital stays (28.5 ± 14.9 vs. 12.0 ± 7.2 days, <i>p</i> < 0.0001) and a higher need for invasive mechanical ventilation (53.1% vs. 30.3%, <i>p</i> = 0.0619). However, mortality rates did not differ significantly between groups.</p><p><strong>Conclusions: </strong>PNM in patients with severe COVID-19 infection is associated with younger age, elevated inflammatory markers, and extensive lung involvement, contributing to increased morbidity and prolonged hospitalization. Early detection and tailored management strategies, including optimized respiratory support and aggressive anti-inflammatory therapies, are crucial in mitigating the adverse outcomes associated with PNM. Further research is needed to validate these findings and improve clinical protocols for managing this complication.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11506847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514085","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":"The Impact of Environmental and Housing Factors on the Distribution of Triatominae (Hemiptera, Reduviidae) in an Endemic Area of Chagas Disease in Puebla, Mexico.","authors":"Miguel Ortega-Caballero, Maria Cristina Gonzalez-Vazquez, Miguel Angel Hernández-Espinosa, Alejandro Carabarin-Lima, Alia Mendez-Albores","doi":"10.3390/diseases12100238","DOIUrl":"https://doi.org/10.3390/diseases12100238","url":null,"abstract":"<p><strong>Background: </strong>Chagas disease (CD), a Neglected Tropical Disease caused by <i>Trypanosoma cruzi</i>, affects millions of people in Latin America and the southern US and spreads worldwide. CD results from close interactions between humans, animals, and vectors, influenced by sociodemographic factors and housing materials.</p><p><strong>Methods: </strong>This study aimed to evaluate how these factors, along with seasonal changes, affect the distribution of CD vectors in an endemic community near Puebla, Mexico, using a cross-sectional survey. A total of 383 people from this area, known for the presence of major vectors such as <i>Triatoma barberi</i> and <i>Triatoma pallidipennis</i>, were surveyed.</p><p><strong>Results: </strong>As a result of the survey, it was found that only 27.4% of respondents knew about CD, and 83.3% owned potential reservoir pets; additionally, the quality of the wall, roof, and floor significantly influenced vector sightings, while the seasonal pattern showed less of an association. Chi-square tests confirmed these associations between vector sightings and housing materials (<i>p</i> < 0.001); vector sightings versus seasonal patterns showed less of an association (<i>p</i> = 0.04), and land use changes did not show an association (<i>p</i> = 0.27).</p><p><strong>Conclusions: </strong>Construction materials play an important role in the sighting of triatomines in homes, so important actions should be taken to improve homes. However, further experimental or longitudinal studies are needed to establish causality.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11506842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514034","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":"A Real-World Longitudinal Study in Non-Functioning Pituitary Incidentalomas: A PRECES Micro-Adenomas Sub-Analysis.","authors":"Mihai Costachescu, Claudiu Nistor, Ana Valea, Oana-Claudia Sima, Adrian Ciuche, Mihaela Stanciu, Mara Carsote, Mihai-Lucian Ciobica","doi":"10.3390/diseases12100240","DOIUrl":"https://doi.org/10.3390/diseases12100240","url":null,"abstract":"<p><p><b>Background.</b> Incidentalomas have an increasing incidence all over the world due to a larger access to imaging assessments, and endocrine incidentalomas make no exception in this matter, including pituitary incidentalomas (PIs). <b>Objective.</b> Our objective was to analyse the dynamic changes amid a second computed tomography (CT) scan after adult patients were initially confirmed with a PI (non-functioning micro-adenoma). <b>Methods.</b> This was a multi-centric, longitudinal, retrospective study in adults (aged between 20 and 70 y) amid real-world data collection. We excluded patients who experienced baseline pituitary hormonal excess or deficiency or those with tumours larger than 1 cm. <b>Results.</b> A total of 117 adults were included (94.02% females) with a mean age of 43.86 ± 11.99 years, followed between 6 and 156 months with a median (M) of 40 months (Q1 Q3: 13.50, 72.00). At the time of PI diagnosis, the transverse diameter had a mean value of 0.53 ± 0.16 cm, the longitudinal mean diameter was 0.41 ± 0.13 cm, and the largest diameter was 0.55 ± 0.16 cm. No PI became functioning during follow-up, neither associated hypopituitarism nor increased >1 cm diameter. A total of 46/117 (39.32%) patients had a larger diameter during follow-up (increase group = IG) versus a non-increase group (non-IG; N = 71, 60.68%) that included the subjects with stationary or decreased diameters. IG had lower initial transverse, longitudinal, and largest diameter versus non-IG: 0.45 ± 0.12 versus 0.57 ± 0.17 (<i>p</i> < 0.0001), 0.36 ± 0.11 versus 0.43 ± 0.13 (<i>p</i> = 0.004), respectively, 0.46 ± 0.12 versus 0.6 ± 0.16 (<i>p</i> < 0.0001). IG versus non-IG had a larger period of surveillance: M (Q1, Q3) of 48 (24, 84) versus 32.5 (12, 72) months (<i>p</i> = 0.045) and showed similar age, pituitary hormone profile, and tumour lateralisation at baseline and displayed a median diameter change of +0.14 cm versus -0.03 cm (<i>p</i> < 0.0001). <b>To conclude</b>, a rather high percent of patients might experience PI diameter increase during a longer period of follow-up, including those with a smaller initial size, while the age at diagnosis does not predict the tumour growth. This might help practitioners with further long-term surveillance protocols.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11507025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514066","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":"Ocular Manifestations of Pediatric Rhinosinusitis: A Comprehensive Review.","authors":"Antonino Maniaci, Caterina Gagliano, Salvatore Lavalle, Nicolien van der Poel, Luigi La Via, Antonio Longo, Andrea Russo, Marco Zeppieri","doi":"10.3390/diseases12100239","DOIUrl":"https://doi.org/10.3390/diseases12100239","url":null,"abstract":"<p><p><i>Background:</i> Rhinosinusitis is a common childhood illness that may result in a number of ocular problems. The goal of this thorough analysis is to compile the available data regarding the kinds, prevalence, and treatment of ocular problems related to juvenile rhinosinusitis. <i>Methods:</i> A comprehensive analysis of electronic databases, such as PubMed, Embase, and Cochrane Library, was carried out to pinpoint pertinent research articles written in English and published between the beginning and August of 2023. Included were studies that discuss ocular problems in young children suffering from rhinosinusitis. Study characteristics, ocular complication kinds, occurrence rates, and management approaches were the main topics of data extraction. <i>Results</i>: A significant number of pertinent research on ocular problems related to juvenile rhinosinusitis was found through the literature search. Preliminary searches indicated that orbital cellulitis, subperiosteal abscess, cavernous sinus thrombosis, and optic neuritis are probably the most often reported ocular problems. It is expected that these problems will occur at a wide range of incidence rates, from somewhat unusual to more prevalent. Depending on the severity of the consequences, management techniques are expected to require a combination of surgical and medicinal procedures. Healthcare professionals will benefit from the findings since they will improve knowledge of the clinical presentation, diagnosis, and treatment of these potentially blinding consequences. The evaluation also assists in identifying knowledge gaps and guides future directions for this field of study, both of which are critical to enhancing patient outcomes. <i>Conclusions:</i> The wide range of topics included in this study will help to better understand the burden of ocular consequences related to juvenile rhinosinusitis and will make it easier to build preventative and treatment plans that work better.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11507393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514019","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":"Retrospective Investigator-Initiated Trial on Tocopherol Acetate Vaginal Administration in Pre-and Postmenopausal Women.","authors":"Noemi Venditti, Giulio Petronio Petronio, Antonio Guarnieri, Laura Pietrangelo, Angela Spicciato, Alessio Colalillo, Giovanna Paola Sabusco, Dionisio Franco Barattini, Aldo Di Franco, Stefano Papini, Francesco Cosentino, Roberto Di Marco","doi":"10.3390/diseases12100237","DOIUrl":"https://doi.org/10.3390/diseases12100237","url":null,"abstract":"<p><strong>Background: </strong>Menopause, a natural phase in a woman's life, often adversely affects physical, mental, sexual, and emotional well-being due to low estrogen levels. This study examines the impact of vaginal ovules with tocopherol acetate (Filme Gyno-V^® ovules, manufactured by Panin Srl and distributed by Hulka Srl, Italy), 500 mg per ovule, on vaginal health in pre- and menopausal women.</p><p><strong>Methods: </strong>Fifty women aged 50-70 were divided into menopausal (28) and premenopausal (22) cohorts and treated with the ovules for two weeks, with assessments before and after treatment.</p><p><strong>Results: </strong>The findings showed that distressing symptoms of vaginal atrophy, such as dryness, itching, and pain during intercourse, were resolved post-treatment. A molecular analysis revealed a reduction in <i>Escherichia coli</i> in both cohorts and an increase in three species of <i>Lactobacillus</i> in premenopausal patients.</p><p><strong>Conclusions: </strong>This study concludes that Filme Gyno-V ovules may benefit vaginal health by alleviating atrophy symptoms and promoting healthy vaginal microbiota.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11506818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514031","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":"iCan, Empowering Recovery: Evaluating a Patient-Centred Cancer Rehabilitation Programme across the Cancer Care Continuum.","authors":"Thomas A Loweth, Suzan R Taylor, Gareth Mapp, Kim Bebbington, Naomi Atkin, Chris Kite","doi":"10.3390/diseases12100236","DOIUrl":"https://doi.org/10.3390/diseases12100236","url":null,"abstract":"<p><strong>Background/objectives: </strong>The adverse effects of cancer and the long-term sequelae of associated treatments result in reduced quality of life and increased mortality for patients. Supporting patients with cancer to mitigate adverse outcomes is an important aspect of oncology care and the primary purpose of cancer rehabilitation. A retrospective service evaluation was conducted to evaluate the effectiveness of the core iCan patient-centred cancer rehabilitation service.</p><p><strong>Methods: </strong>At the beginning and end of a five-week programme, a series of questionnaires evaluating changes in mental health and wellbeing, and physical activity performance/attitudes, and functional capacity were administered to participants.</p><p><strong>Results: </strong>Following iCan, we found that functional capacity was improved (30 s sit-to-stand: +6.3 repetition; <i>d</i> = -1.00, <i>p</i> < 0.001) and that self-reported physical activity was increased (~1173 MET-mins/wk; <i>d</i> = -0.76, <i>p</i> < 0.001); participants also perceived greater capability, opportunity, and motivation to be active. Mental wellbeing was also improved (SWEMWBS: <i>d</i> = -0.69, <i>p</i> < 0.001), whilst fatigue was reduced (FACIT: <i>d</i> = -0.77, <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>It appears that iCan has beneficial effects upon the physical/functional and psychological health of its participants. Where data are available, there appear to be clinically significant improvements across the range of measured functional, wellbeing, and activity/sedentariness outcomes, which suggest that participation in iCan is instrumental in adding value to the health and wellbeing of patients.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11506657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514015","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":"Cytokine Storms and Anaphylaxis Following COVID-19 mRNA-LNP Vaccination: Mechanisms and Therapeutic Approaches.","authors":"Toru Awaya, Hidehiko Hara, Masao Moroi","doi":"10.3390/diseases12100231","DOIUrl":"https://doi.org/10.3390/diseases12100231","url":null,"abstract":"<p><p>Acute adverse reactions to COVID-19 mRNA vaccines are a major concern, as autopsy reports indicate that deaths most commonly occur on the same day of or one day following vaccination. These acute reactions may be due to cytokine storms triggered by lipid nanoparticles (LNPs) and anaphylaxis induced by polyethene glycol (PEG), both of which are vital constituents of the mRNA-LNP vaccines. Kounis syndrome, in which anaphylaxis triggers acute coronary syndrome (ACS), may also be responsible for these cardiovascular events. Furthermore, COVID-19 mRNA-LNP vaccines encompass adjuvants, such as LNPs, which trigger inflammatory cytokines, including interleukin (IL)-1β and IL-6. These vaccines also produce spike proteins which facilitate the release of inflammatory cytokines. Apart from this, histamine released from mast cells during allergic reactions plays a critical role in IL-6 secretion, which intensifies inflammatory responses. In light of these events, early reduction of IL-1β and IL-6 is imperative for managing post-vaccine cytokine storms, ACS, and myocarditis. Corticosteroids can restrict inflammatory cytokines and mitigate allergic responses, while colchicine, known for its IL-1β-reducing capabilities, could also prove effective. The anti-IL-6 antibody tocilizumab also displays promising treatment of cytokine release syndrome. Aside from its significance for treating anaphylaxis, epinephrine can induce coronary artery spasms and myocardial ischemia in Kounis syndrome, making accurate diagnosis essential. The upcoming self-amplifying COVID-19 mRNA-LNP vaccines also contain LNPs. Given that these vaccines can cause a cytokine storm and allergic reactions post vaccination, it is crucial to consider corticosteroids and measure IL-6 levels for effective management.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11507195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514012","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":"COVID-19 Pandemic Increases the Risk of Anxiety and Depression among Adolescents: A Cross-Sectional Study in Rural West Bengal, India.","authors":"Amal K Mitra, Sinjita Dutta, Aparajita Mondal, Mamunur Rashid","doi":"10.3390/diseases12100233","DOIUrl":"https://doi.org/10.3390/diseases12100233","url":null,"abstract":"<p><p>About 14% of adolescents experience mental illnesses globally. The rate increased after the COVID-19 pandemic. This study aimed to estimate the prevalence of COVID-related major mental illnesses (depression and anxiety) and their predictors among adolescents. This community-based cross-sectional study was conducted among 350 adolescents aged 10-19 years, recruited from rural communities in West Bengal, India. The study areas included 27 subcenters in the Budge Budge II Block, which comprised 191,709 population and 45,333 households. Data were collected from randomly selected households by trained research assistants through house-to-house interviews. Pretested standardized questionnaires, Patient Health Questionnaire (PHQ) for depression, Generalized Anxiety Disorder (GAD) for anxiety, and a demographic questionnaire were used for data collection. The prevalence of anxiety was 35.7% (125 out of 350), and the prevalence of depression was 30.0% (105 out of 350). Females had significantly higher scores of anxiety (6.67 ± 4.76 vs. 3.42 ± 3.17, respectively, <i>p</i> < 0.001) and depression (5.51 ± 4.99 vs. 3.26 ± 3.86, respectively, <i>p</i> < 0.001) compared to males. Adolescents who had COVID-19 cases or deaths in the family had significantly higher scores of anxiety and depression compared to those who did not have these events. In multivariate analysis, the statistically significant predictors of anxiety were COVID-19 death in the family, COVID-19 cases in the family, female gender, and a lower income group (<i>p</i> < 0.001 for all). For depression, the significant predictors included COVID-19 death in the family, COVID-19 cases in the family, female gender, a lower income group, and a higher age group in adolescents (<i>p</i> < 0.001 for all). Based on the study results, we recommend that immediate attention is needed for adolescents' mental health support and coping with stresses following COVID-19.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11507310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514011","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}