Diseases (Basel, Switzerland)最新文献

{"title":"Transcriptomic and miRNA-Target Pathway Analysis of the DLK1-DIO3 Imprinted microRNA Cluster in Chronic Lymphocytic Leukemia.","authors":"Georgios S Markopoulos, Yannis V Simos, Konstantinos I Tsamis, Lampros Lakkas, Eleftheria Hatzimichael, Eleni Kapsali, Dimitrios Peschos, Leonidas Benetatos","doi":"10.3390/diseases14090320","DOIUrl":"10.3390/diseases14090320","url":null,"abstract":"<p><strong>Background/objectives: </strong>Chronic lymphocytic leukemia (CLL) is a heterogeneous B-cell malignancy in which B-cell receptor signaling, microenvironmental interactions, genomic lesions, and epigenetic deregulation cooperate to shape disease behavior. The imprinted DLK1-DIO3 locus at chromosome 14q32 contains the largest human miRNA cluster and has been implicated in cancer-related regulatory networks; however, its contribution to CLL remains incompletely defined.</p><p><strong>Methods: </strong>In the present study, we investigated the potential involvement of DLK1-DIO3 miRNAs in CLL biology by integrating public transcriptomic datasets with miRNA-centered pathway analysis. GSE70830 was used as a discovery dataset and GSE66117 as a supportive validation cohort to identify genes consistently downregulated in CLL compared with normal B cells.</p><p><strong>Results: </strong>The analyses identified 1236 and 2145 downregulated genes, respectively, and their intersection yielded a 345-gene consensus set. The overlap was significantly greater than expected by chance (odds ratio 2.33; <i>p</i> = 1.55 × 10^-31). This set was used as gene-filter input for DIANA-miRPath v3.0 analysis of the DLK1-DIO3 miRNA cluster, identifying eight KEGG pathways mainly involving B-cell receptor/NF-κB signaling, cell adhesion, leukocyte transendothelial migration, and glycan-related processes. DIANA-miRPath v4.0 provided pathway-centered refinement. GSE216258 miRNA analysis did not show generalized locus-wide upregulation, while a GSE12366 sensitivity analysis showed that 32 of the 345 genes overlapped the strongest naïve-memory B-cell differentiation signatures. The absence of uniform locus-wide upregulation suggests that these data do not establish a direct link between DLK1-DIO3 activation and generalized repression of the 345-gene set. Future studies are needed to identify gene- and pathway-specific effects.</p><p><strong>Conclusions: </strong>Overall, our findings support an association between DLK1-DIO3 miRNA target/pathway annotations and CLL-relevant transcriptional programs, providing a hypothesis-generating framework that warrants further experimental validation.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"14 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13605451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042238","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":"Sequential Application of Time-Stratified Demographic, Vital, Clinical-Laboratory, and Microbiology Variables for Accurate and Rapid Identification of Sepsis.","authors":"Krupa Arun Navalkar, José Garnacho-Montero, María Luisa Cantón-Bulnes, José Luís García-Garmendia, Ángel Estella, Adela Fernández-Galilea, Isidro Blanco, Maria Antonia Estecha-Foncea, Marina Gordillo-Resina, Jorge Rodríguez-Gómez, Juan Jesús Pineda-Capitán, Carmen Martínez-Fernández, Ana Escoresca-Ortega, Rosario Amaya-Villar, Juan Mora-Ordóñez, Sara González-Soto, Antonio Gutierrez-Pizarraya, Robert Balk, Russell R Miller, John P Burke, Gourang Patel, Jorge P Parada, Marcus J Schultz, Brendon P Scicluna, Emily Blodget, Santhi Kumar, Dayle Sampson, Thomas D Yager, Roy F Davis, Silvia Cermelli, Richard B Brandon","doi":"10.3390/diseases14090319","DOIUrl":"10.3390/diseases14090319","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Accurate early identification of sepsis remains a major clinical challenge due to its heterogeneous presentation and overlap of clinical signs with the non-infectious systemic inflammatory response syndrome (SIRS). Timely differentiation is crucial for improving patient outcomes, meeting sepsis bundle requirements and reducing inappropriate antimicrobial use. We hypothesized that clinical-laboratory data available within the first three hours of patient presentation could be used to identify patients with sepsis at a clinically useful level of diagnostic accuracy, in lieu of traditional microbiology results which would not become available until at least 12-24 h. Data from two independent studies were used to quantify the diagnostic value of demographic, vital, clinical-laboratory, and microbiological data available at three time points for distinguishing retrospectively diagnosed critically ill patients with either sepsis or non-infectious SIRS. A particular focus of this work was an assessment of the utility of SeptiCyte RAPID (Immunexpress Inc., Seattle, WA, USA) as an aid to sepsis diagnosis, producing actionable data within one hour.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Data from two independent study cohorts were analyzed. The \"510(k) cohort\" consisted of 419 adult patients in intensive care (ICU) (MARS, VENUS, and NEPTUNE studies). The \"Andalusian cohort\" consisted of 353 ICU patients from the PANGEA study. Logistic regression models, selected by a greedy search algorithm and validated by repeated cross-validation, were used to determine the contributions of different variables to diagnostic accuracy. Diagnostic performance was quantified by the area under the receiver operating characteristic curve (AUC).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;For the 510(k) cohort, a baseline AUC of 0.69-0.73 was observed using five to seven vital and demographic variables assessed immediately upon presentation (time T1). The addition of clinical-laboratory variables, in particular SeptiCyte RAPID, within one to three hours post-presentation (time T2) increased the AUC to 0.85-0.86. Finally, the addition of microbiological data 12-24 h post-presentation (time T3) further improved the AUC to 0.90-0.91. Similar results were obtained for the Andalusian cohort. AUC values at the three time points were as follows: At time T1, AUC = 0.67 based solely on vital signs and demographics; at time T2, AUC = 0.87 based on vitals + demographics + SeptiCyte RAPID ± other clinical-laboratory data; at time T3, AUC = 0.93 based on vitals + demographics + SeptiCyte RAPID ± other clinical-laboratory data + microbiology results. For both cohorts, the most significant variables included temperature, mean arterial pressure, respiratory rate, suspected infection site, SeptiCyte RAPID, procalcitonin, confirmed bacterial infection and positive blood culture confirmation. In summary, the AUC for diagnosing sepsis rose progressively from T1 (510(k) 0.69-0.73; And","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"14 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13605279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041612","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":"Mental Health and Health-Related Behavioral Patterns Surrounding a Major International Sporting Event: An Observational Study.","authors":"Gustavo A Hernández-Fuentes, Mario A Alcalá-Pérez, Uriel Díaz-Llerenas, Marcos E Guerrero-Verduzco, Nancy A Reyes-Méndez, Laura A Larios-Gómez, Dalila G Virgen-Aguilar, Jessica C Romero-Michel, Verónica M Guzmán-Sandoval, Fabian Rojas-Larios, Pedro J Flores-Moreno, Osval A Montesinos-López, Marina Delgado-Machuca, Iván Delgado-Enciso","doi":"10.3390/diseases14090318","DOIUrl":"10.3390/diseases14090318","url":null,"abstract":"<p><strong>Background/objectives: </strong>Acute collective emotional events may coincide with variation across multiple dimensions of mental health and health-related behaviors. This study compared mental health outcomes and recent alcohol consumption between assessments conducted before and after a major international sporting event and explored factors associated with psychological and behavioral outcomes among young adults.</p><p><strong>Methods: </strong>An observational study was conducted among 146 adult students in western Mexico who participated in assessments surrounding the 2026 FIFA World Cup match between Mexico and England. Assessments were conducted approximately 10 h before kick-off and 11 h after completion of the match. Because individual responses could not be linked across assessment periods, comparisons were analyzed as repeated cross-sectional marginal comparisons rather than paired longitudinal analyses. Psychological outcomes were assessed using standardized instruments, and recent alcohol consumption was defined as alcohol use during the eight hours preceding each assessment.</p><p><strong>Results: </strong>Anxiety-related symptom scores were lower at the post-event assessment, whereas depressive-related symptoms remained relatively stable. Emotional well-being was also lower at the post-event assessment, while recent alcohol consumption during the eight hours preceding the assessment was substantially more frequent post-event than pre-event (41.1% vs. 0.7%). The small difference observed in sexual-attitude scores was considered exploratory. Post-event multivariable analyses identified several factors associated with psychological outcomes and recent alcohol consumption; these associations were interpreted as cross-sectional.</p><p><strong>Conclusions: </strong>Psychological and behavioral outcomes exhibited distinct patterns between assessment periods surrounding the sporting event. Given the observational design, inability to link individual responses, and presence of unmeasured co-occurring exposures, these differences should not be interpreted as within-participant changes or as effects attributable specifically to the match.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"14 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13605560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042405","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":"Safety and Exploratory Pre-Post Changes Associated with an Orally Disintegrating Three-Strain Probiotic Tablet in Older Adults with Functional Constipation: A Single-Center, Open-Label, Single-Arm Study.","authors":"Daisuke Asaoka, Tsutomu Takeda, Yasuhisa Jimbo, Eiji Kamba, Yusuke Nomoto, Osamu Nomura, Daiki Abe, Kumiko Ueda, Hiroya Ueyama, Hiroyuki Isayama, Mariko Hojo, Akihito Nagahara","doi":"10.3390/diseases14090317","DOIUrl":"10.3390/diseases14090317","url":null,"abstract":"<p><strong>Background/objectives: </strong>Functional constipation is common in older adults and impairs quality of life. Evidence for multi-strain orally disintegrating (OD) probiotic formulations in this population remains limited.</p><p><strong>Methods: </strong>In this single-center, open-label, single-arm pre-post study, adults aged 65-90 years meeting the Rome IV criteria for functional constipation were administered an OD tablet containing <i>Bacillus subtilis</i> TO-A, <i>Enterococcus faecium</i> T-110, and <i>Clostridium butyricum</i> TO-A for 8 weeks. The primary endpoint was change in the defecation score based on a modified Bristol Stool Form Scale. Secondary endpoints included stool frequency, straining, JPAC-QOL, the modified Constipation Scoring System, Izumo Scale, Dietary Variety Score (DVS), selected metabolic/nutritional variables, and exploratory gut microbiota analyses.</p><p><strong>Results: </strong>Fifty participants provided consent, and 49 were included in the full analysis set; 45 participants completed the 8-week intervention and were included in the paired primary endpoint analysis. The defecation score showed a nominally significant change toward normalization of stool form at week 8 (IQR: -1.0, 7.0; 95%CI: -9.6, -4.2). Stool frequency did not change significantly, whereas constipation-related quality of life and symptom burden significantly changed. DVS increased modestly, and HbA1c decreased slightly; however, these secondary findings should be interpreted as exploratory because no adjustment for multiplicity was performed. Four patients withdrew from this study: one was due to death, but a causal relationship with the study drug was not confirmed. Two gastrointestinal adverse events could have been related to the study product. Exploratory subgroup analyses suggested a larger change in participants not receiving acid-suppressive therapy.</p><p><strong>Conclusions: </strong>The three-strain OD probiotic tablet was associated with changes in stool form and constipation-related symptom burden in older adults with functional constipation. Because this was a single-arm, open-label study without multiplicity adjustment for secondary endpoints, the findings should be regarded as exploratory and hypothesis-generating. Given the absence of a control group, causal efficacy cannot be inferred, and placebo effects, natural symptom fluctuation, or other time-varying confounders cannot be excluded; therefore, the most robust conclusion is that the preparation appeared safe and well tolerated for over 8 weeks in this population.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"14 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13605162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042392","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":"Safety and Effectiveness of Probiotic Preparations: A Contemporary Review.","authors":"Erik Shorabaev, Amankeldi Sadanov, Baiken Baimakhanova, Irina Ratnikova, Gulzakira Xetayeva, Sholpan Akhelova, Aknur Turgumbayeva","doi":"10.3390/diseases14090316","DOIUrl":"10.3390/diseases14090316","url":null,"abstract":"<p><strong>Background/objectives: </strong>Probiotic preparations have attracted increasing attention because of their potential to modulate the gut microbiota and improve health outcomes in a wide range of gastrointestinal and extraintestinal diseases. However, their efficacy and safety are strain-specific and remain inconsistent across many clinical indications. The aim of this review was to evaluate current evidence regarding the efficacy, safety, mechanisms of action, and clinical applications of probiotic preparations.</p><p><strong>Methods: </strong>A narrative literature review was conducted using the PubMed, Scopus, and Web of Science databases to identify publications addressing the efficacy, safety, and clinical applications of probiotic preparations. The literature search was last updated in July 2026. No publication-year restrictions were applied; the studies included in this review were published between 2000 and 2026. Priority was given to systematic reviews, meta-analyses, randomized controlled trials, international clinical practice guidelines, and mechanistic studies.</p><p><strong>Results: </strong>The reviewed evidence indicates that probiotics may contribute to intestinal homeostasis through modulation of the gut microbiota, enhancement of intestinal barrier function, and regulation of immune responses. The strongest evidence supports the use of selected probiotic strains for the prevention of antibiotic-associated diarrhea, whereas evidence for the prevention of necrotizing enterocolitis is generally favorable but depends on the specific probiotic preparation, product quality, and clinical setting. Evidence for most other gastrointestinal and extraintestinal disorders remains heterogeneous and strain-specific. Although probiotics generally exhibit a favorable safety profile, rare infectious complications have been reported in high-risk patients.</p><p><strong>Conclusions: </strong>Current evidence indicates that the efficacy and safety of probiotics depend on the specific strain, clinical indication, and patient characteristics. Further high-quality, strain-specific clinical studies are needed to optimize their use in medical practice.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"14 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13605352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042374","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":"Cognitive Tunneling in Obstetrics and Gynecology: A Critical Review of Implications for Clinical Practice and Mitigation Strategies.","authors":"Dan Boitor, Mihai Surcel, Cristina Ioana Rotar, Gheorghe Cruciat, Georgiana Nemeti, Andreea Florian, Daniel Muresan, Mihaela Oancea","doi":"10.3390/diseases14090315","DOIUrl":"10.3390/diseases14090315","url":null,"abstract":"<p><p>Cognitive tunnelling poses significant risks in OB/GYN, where rapid clinical deterioration and time-pressured decision-making are common. This critical review synthesized evidence from a comprehensive literature search across multiple databases, yielding 414 unique papers examining cognitive tunnelling mechanisms, patient safety consequences, and mitigation strategies in obstetric and gynecological contexts. Medicolegal analysis reveals that cognitive tunnelling contributes to malpractice exposure and that adoption of structured safety programs addresses root causes and strengthens the clinical record for forensic review. Mitigation strategies were critically evaluated: metacognition and individual cognitive forcing strategies such as DECLARE (Differential, Examine, Consider, List, Assess, Review, Evaluate) and Pivot-and-Cluster show theoretical promise but depend on intact executive capacity that is depleted under the very conditions that precipitate tunnelling; debriefing demonstrates consistent improvements in team situational awareness and latent threat identification but requires organizational just culture and psychological safety; and hierarchical closed-loop communication systems provide the strongest evidence of reducing preventable adverse events by distributing attentional load across teams, though authority gradients risk suppressing junior-staff dissent. Despite growing recognition, significant knowledge gaps remain regarding measurement methodologies, obstetric-specific research, intervention effectiveness, and the integration of emerging artificial intelligence technologies. Addressing cognitive tunneling through quality studies with patient-centered outcomes and validated measures is essential for reducing medical errors and enhancing patient safety in women's healthcare.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"14 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13605556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042124","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":"Perceived Stress and Disordered Eating Behaviors in Emerging Adulthood: A Multidimensional Pilot Study of Dietary and Genetic Factors.","authors":"Evgeniya Klein, Daria Velina, Irina Stanislavovna Kolesnikova, Valeriy Vladimirovich Polunovskiy, Nina Vitalievna Panteleeva, Dmitry Alexandrovich Kulikov, Alla Nikolaevna Stolyarova, Igor Nikitin","doi":"10.3390/diseases14090314","DOIUrl":"10.3390/diseases14090314","url":null,"abstract":"<p><strong>Background: </strong>Subclinical disordered eating behaviors (DEBs) are common among young women and are thought to result from complex interactions between psychological, dietary, and genetic factors. While chronic stress and unhealthy dietary habits have been implicated in the development of DEBs, the independent and interactive contributions of perceived stress, added sugar intake, and genetic susceptibility remain insufficiently understood. This pilot study investigated these associations using a two-stage case-control design.</p><p><strong>Methods: </strong>A total of 100 female university students (18-27 years) completed the Dutch Eating Behavior Questionnaire (DEBQ) during the first stage of the study. Based on DEBQ scores, 20 participants with the highest risk of DEBs and 20 with the lowest risk were selected for the second stage, forming case and control groups. Perceived stress was assessed using the Perceived Stress Scale (PSS-14), and added sugar intake was estimated using a semi-quantitative food frequency questionnaire (FFQ). Participants were also genotyped for four candidate polymorphisms (5-HTTLPR, rs6295, rs6265, and rs1800497). Group differences, correlation analyses, binary logistic regression models adjusted for BMI, and gene-environment interaction analyses were performed.</p><p><strong>Results: </strong>Perceived stress emerged as the strongest and most consistent predictor of belonging to the upper DEBQ quintile, with each one-point increase on the PSS-14 associated with a 44% increase in the odds of high-risk status after adjustment for BMI (OR = 1.44; 95% CI: 1.120-1.853; <i>p</i> = 0.004). Added sugar consumption did not withstand correction for multiple comparisons (<i>p</i> = 0.030, Bonferroni-adjusted α = 0.025). No significant main effects or gene-environment interactions were detected for any of the investigated polymorphisms or the cumulative genetic risk score.</p><p><strong>Conclusions: </strong>These preliminary findings highlight perceived stress as the important modifiable risk factor for subclinical disordered eating behaviors in young women, suggesting that stress-reduction and emotional regulation interventions may be more effective than dietary approaches in this population. However, the lack of significant associations for the genetic variants studied should be interpreted with caution given the limited sample size and statistical power. Replication in larger, longitudinal cohorts is warranted to confirm these findings and explore developmental trajectories.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"14 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13605610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042403","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":"Pneumonitis Associated with Immune Checkpoint Inhibitors and Targeted Anticancer Therapies: A Retrospective Case Series of 12 Patients.","authors":"Claudia Lucia Toma, Ștefania Florina Oprea, Ștefan Dumitrache-Rujinski, Ionela Nicoleta Belaconi, Daniela Jipa-Dună, Cristian Cojocaru, Alexandra Maria Cristea, Camelia Cristina Diaconu, Dragos Cosmin Zaharia","doi":"10.3390/diseases14090313","DOIUrl":"10.3390/diseases14090313","url":null,"abstract":"<p><strong>Background: </strong>Immunotherapy and targeted therapy have gained ground over conventional chemotherapy in treating various cancers. While pulmonary toxicity associated with these agents is rare, it represents a significant factor in both mortality and morbidity and may influence the overall success of cancer treatment. This case series report adds to the emerging evidence of cancer therapy-induced pneumonitis features and corticotherapy outcomes.</p><p><strong>Patients and methods: </strong>This single-center, retrospective case series analyzed 12 consecutive cases of patients undergoing immunotherapy (four receiving nivolumab, four receiving pembrolizumab) or targeted therapy (three receiving obinutuzumab, one receiving abemaciclib) for cancer (seven with lung cancer, three with non-Hodgkin lymphoma, one with breast cancer, one with renal cancer) who developed pneumonitis during their follow-up.</p><p><strong>Results: </strong>The interval from oncological treatment initiation to pneumonitis onset ranged from 6 to 48 months (median = 18.5), and in four patients it occurred after discontinuation of oncologic therapy. In most patients, the diagnosis was established with high probability based only on the clinical presentation, radiologic pattern, and concomitant oncologic therapy. Bronchoscopy with bronchoalveolar lavage analysis was performed in eight of the 12 patients, particularly when onset followed treatment discontinuation. The main symptom was dyspnea (10/12 cases), and three of 12 patients had respiratory failure (SpO₂ ≤ 88%). The CTCAE severity grades were: one mild, seven moderate, three severe, and one life-threatening. The CT scan showed different patterns (7 OP, 4 NSIP-like, and 1 HP). Eleven patients received oral methylprednisolone (0.40 to 0.82 mg/kg) for 5 to 16 weeks. Two patients continued oncologic treatment, and six discontinued. Pneumonitis improved or resolved in 11 of the 12 patients; one patient deteriorated after reintroduction of immunotherapy and subsequently died from cancer-related complications.</p><p><strong>Conclusions: </strong>Immunotherapy- and targeted therapy-induced pneumonitis can express various features and severities, and prompt recognition and diagnosis based on clinical, radiologic and contextual elements are mandatory. In this small, heterogeneous series the individualized corticosteroid regimens used were followed by favorable outcomes. Our observations suggest that, in selected clinically improving patients, follow-up may rely only on clinical assessment and chest X-ray, and extensive tests may be reserved for non-responsive cases.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"14 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13605366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042408","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":"Hospital Readmissions in Patients with Severe Acute Respiratory Syndrome: A Retrospective Study in Northeastern Brazil.","authors":"Raphael Omena Wanderley, Carmina Silva Dos Santos, Karine Ferreira Agra, Francisco Pirauá Alves Gonçalves, Douglas Tenório Paes, Gabriel Borges de Brito, Gabriele Maria de Oliveira Lucena, Lucas de Carvalho Carriço, José Roberto da Silva Junior, Eduardo Jorge da Fonseca Lima","doi":"10.3390/diseases14090308","DOIUrl":"10.3390/diseases14090308","url":null,"abstract":"<p><strong>Background/objectives: </strong>Severe acute respiratory syndrome (SARS) remains an important cause of hospitalization and mortality, particularly among vulnerable populations. Understanding the factors associated with previous hospitalization may support more effective prevention and vaccination strategies. This study aimed to analyze the epidemiological profile of previous hospitalization among patients with SARS in the state of Pernambuco, Brazil.</p><p><strong>Methods: </strong>A quantitative, retrospective, cross-sectional study was conducted using data from the Influenza Epidemiological Surveillance System (SIVEP-Gripe), including 79,852 adult patients (≥18 years) notified with SARS in Pernambuco between 2021 and 2024. Sociodemographic, clinical, and vaccination-related variables were analyzed to identify factors associated with previous hospitalization.</p><p><strong>Results: </strong>The prevalence of previous hospital admission (readmission history) was 6.6%. Patients with previous hospitalization had a significantly higher median age compared to those without previous hospitalization (66 vs. 63 years; <i>p</i> < 0.001). The prevalence of previous hospitalization was higher among individuals with chronic comorbidities, particularly hematologic diseases (prevalence ratio [PR] = 1.95; 95% confidence interval [CI]: 1.51-2.51; <i>p</i> < 0.001) and asthma (PR = 1.67; 95% CI: 1.42-1.96; <i>p</i> < 0.001). Influenza vaccination was associated with a lower prevalence of previous SARS hospitalization (PR = 1.29; 95% CI: 1.03-1.61; <i>p</i> = 0.023). In contrast, COVID-19 vaccination status showed no significant association with previous hospitalization. A history of previous SARS hospitalization was associated with a higher prevalence of death in subsequent hospitalizations (PR = 1.09; 95% CI: 1.01-1.18; <i>p</i> = 0.022).</p><p><strong>Conclusions: </strong>Older adults and individuals with chronic comorbidities showed a higher prevalence of previous SARS hospitalization in Pernambuco. The findings show an association between influenza vaccination and a lower prevalence of previous SARS hospitalization and highlight the importance of post-discharge follow-up and epidemiological surveillance.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"14 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13605597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042384","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 Pilot Study on the Evaluation of an Inpatient Glycaemic Management Protocol for Enteral Feeding in People with Diabetes.","authors":"Shayna Xueli Lin, Di Zhang, Khee Ling Choo, Qinghua Tan, Puja Sharda, Nur Kalimallah Khairul Anwar, Xin Yi Hannah Luah, Zongwen Wee, Priscilla Chiam Pei Sze, Angela Koh Fang Yung, Sueziani Bte Zainudin, Ling-Jun Chen","doi":"10.3390/diseases14090312","DOIUrl":"10.3390/diseases14090312","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Aims: &lt;/strong&gt;International diabetes guidelines recommend inpatient glycaemic management protocols for bolus enteral feeding in people with diabetes to improve clinical outcomes. This study aims to evaluate before and after hospital-wide implementation of an inpatient bolus enteral feeding protocol: (1) the incidence of hyperglycaemia (&gt;13.9 mmol/L) and hypoglycaemia (&lt;4.0 mmol/L), (2) medication prescribing practices and capillary blood glucose monitoring and (3) health care professionals' knowledge and confidence levels.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We implemented an inpatient glycaemic management protocol for bolus enteral feeding developed by a multidisciplinary team of diabetes nurse educators and endocrinologists and approved by the institutional medical board in July 2024. This before-and-after quality improvement study was conducted over 3 months across eight inpatient wards. Adult inpatients were consecutively enrolled if they met the inclusion criteria: (1) a documented diagnosis of diabetes mellitus, (2) receiving bolus enteral feeding and (3) treatment with glucose-lowering medication. Patients listed as critically ill were excluded. Nurses working in the pilot wards were also recruited. Before implementing the protocol, diabetes nurse educators trained inpatient nurses on understanding and executing the protocol for administering capillary blood glucose monitoring and medications for patients with diabetes on enteral feeding. Nurses' pre- and post-knowledge levels and perceived confidence were assessed using a structured questionnaire. Electronic medical records were reviewed to evaluate the incidence rates of hypoglycaemia and hyperglycaemia before and during the 3 months following protocol implementation. We also assessed adherence to protocol-recommended capillary blood glucose monitoring frequencies based on the diabetes medication regimen.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 31 patients were observed during the 6-week baseline period and 28 patients following protocol implementation. A total of 192 clinical care episodes were audited, comprising 78 in the pre-intervention phase and 114 in the post-intervention phase. The incidence of hyperglycaemia decreased from 43.6% to 10.5%, while hypoglycaemia decreased from 3.8% to 2.6%. After adjusting for protocol adoption rates, protocol implementation was associated with significantly lower odds of hyperglycaemia (odds ratio [OR] 0.22, 95% CI [0.07, 0.65], &lt;i&gt;p&lt;/i&gt; = 0.006). A significant increase in appropriate nursing practices was observed post-intervention (&lt;i&gt;p&lt;/i&gt; &lt; 0.001). Adoption of the protocol by nurses decreased the odds of hyperglycaemia by 70% (&lt;i&gt;p&lt;/i&gt; = 0.014). Nurses' knowledge scores improved significantly from baseline to 3 months post-implementation (&lt;i&gt;p&lt;/i&gt; &lt; 0.001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Implementation of a standardised inpatient glycaemic management protocol for PWD receiving bolus enteral feeding was associated with reduced r","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"14 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13605170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042308","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}