Diseases (Basel, Switzerland)最新文献

{"title":"Examining Romosozumab Adherence and Side Effects in Osteoporotic Patients After Surgical Fracture Fixation: A Comparative, Descriptive, and Hypothesis-Generating Study with Non-Fractured Controls.","authors":"Amarildo Smakaj, Umberto Tarantino, Riccardo Iundusi, Angela Chiavoghilefu, Lorenzo Abbondante, Chiara Salvati, Chiara Greggi, Elena Gasbarra","doi":"10.3390/diseases13050148","DOIUrl":"10.3390/diseases13050148","url":null,"abstract":"<p><strong>Objectives: </strong>The study aims to evaluate adherence to Romosozumab treatment in osteoporotic patients after surgical fracture fixation and compare side effects with non-fractured controls on the same therapy.</p><p><strong>Methods: </strong>This retrospective case-control study was conducted at the Orthopaedic Department of Policlinico Universitario di Roma \"Tor Vergata\", following the principles of the Declaration of Helsinki. It included postmenopausal women aged over 60, with the case group receiving Romosozumab after fracture fixation, and the control group consisting of women on Romosozumab therapy without fracture fixation. Exclusion criteria included psychiatric conditions, contraindications to Romosozumab, high-energy trauma, or other bone metabolism disorders. Data on fractures, surgeries, FRAX (Fracture Risk Assessment Tool) scores, BMD (Bone Mineral Densit) values, and follow-up details were collected. Side effects, including nasopharyngitis and severe events like hypocalcemia, stroke, and myocardial infarction, were recorded. Adherence was assessed via pharmacy records and patient interviews during routine clinical follow-up visits. Statistical analysis was performed using descriptive statistics, t-tests, and chi-square tests.</p><p><strong>Results: </strong>The study included 25 patients, with 12 in the surgical group and 13 in the conservative treatment group. The surgical group had a mean age of 67.3 years and a follow-up of 374 days, while the conservative group had a mean age of 76.4 years and a follow-up of 287 days. The surgical group underwent various fracture treatments, including femoral, humeral, and distal radius fractures, while the conservative group was treated with immobilization. There were no significant differences in FRAX scores or BMD values between the two groups. Vitamin D levels increased significantly in both groups after supplementation, but parathyroid hormone levels showed no difference. No new fractures occurred, and surgical patients had no delayed union or nonunion, though two had superficial wound infections.</p><p><strong>Conclusions: </strong>Both groups adhered well to Romosozumab therapy, with no severe side effects; minor side effects included myalgia in the surgical group and shoulder arthralgia in the conservative group. Romosozumab is well-tolerated and adherent in osteoporotic patients after osteosynthesis surgery, with adverse events similar to non-fractured individuals. While the study design is appropriate, multicenter trials would improve the sample size and allow for subgroup analysis based on fracture type and demographics.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"13 5","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12110741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152801","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":"Long-Term Trends in Respiratory Syncytial Virus A Infections (2007-2024) in Korea.","authors":"Jeong Su Han, Sung Hun Jang, Jae-Sik Jeon, Jae Kyung Kim","doi":"10.3390/diseases13050147","DOIUrl":"10.3390/diseases13050147","url":null,"abstract":"<p><strong>Background/objectives: </strong>Respiratory syncytial virus A (RSV A) is the leading cause of respiratory infections, particularly in vulnerable populations. This study aimed to investigate the long-term epidemiological trends of RSV A infection in the Republic of Korea over an 18-year period (2007-2024), with emphasis on age, sex, and seasonal differences.</p><p><strong>Methods: </strong>A total of 23,284 nasopharyngeal swab specimens were analyzed by multiplex real-time PCR. Statistical comparisons were performed using the chi-square test.</p><p><strong>Results: </strong>The RSV A-positivity rate was highest in 2007 (19.7%) and lowest in 2021 (0.1%) (<i>p</i> < 0.001). Infants (0 years) exhibited the highest infection rate (18.5%, 95% CI: 17.3-19.6), whereas adults aged 20-64 years and older adults showed significantly lower rates (0.7% and 0.9%, respectively). Seasonal peaks occurred in winter (15.3%) and autumn (14.7%), indicating earlier onset of RSV A circulation. No significant difference was found between sexes (<i>p</i> = 0.196).</p><p><strong>Conclusions: </strong>This study provides the first long-term retrospective analysis of RSV A trends in the Republic of Korea and reveals a shift toward an earlier seasonal onset. These findings support the need for earlier preventive strategies and optimized vaccination timing, particularly for high-risk groups, such as infants. These findings underscore the importance of seasonal variation and the potential influence of environmental factors, such as ambient temperature, relative humidity, and geographic latitude, on RSV A transmission patterns in Korea, although these variables were not directly analyzed in the present study and warrant further investigation.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"13 5","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12110253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152770","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":"Bacterial Superinfections After SARS-CoV-2 Pneumonia: Antimicrobial Resistance Patterns, Impact on Inflammatory Profiles, Severity Scores, and Clinical Outcomes.","authors":"Petrinela Daliu, Iulia Bogdan, Ovidiu Rosca, Alexandra Laura Aelenei, Ioan Sîrbu, Mihai Calin Bica, Monica Licker, Elena Hogea, Delia Muntean","doi":"10.3390/diseases13050145","DOIUrl":"10.3390/diseases13050145","url":null,"abstract":"<p><p><b>Background and Objectives:</b> Secondary bacterial pneumonia can substantially worsen the clinical trajectory of patients hospitalized for Coronavirus Disease 2019 (COVID-19). This study aimed to characterize bacterial superinfections in COVID-19, including pathogen profiles, resistance patterns, inflammatory responses, severity scores, and ICU admission risk. <b>Methods:</b> In a retrospective cohort design, we reviewed 141 patients admitted to a single tertiary-care hospital between February 2021 and December 2024. A total of 58 patients had laboratory-confirmed bacterial superinfection by sputum, bronchoalveolar lavage, or blood cultures (superinfection group), whereas 83 had COVID-19 without any documented bacterial pathogens (COVID-only group). We collected detailed microbiological data from sputum, bronchoalveolar lavage (BAL), and blood cultures. Antibiotic sensitivity testing was performed using standard breakpoints for multidrug resistance (MDR). Inflammatory markers (C-reactive protein, procalcitonin, neutrophil-to-lymphocyte ratio, and systemic immune-inflammation index) and the severity indices Acute Physiology and Chronic Health Evaluation (APACHE) II, Confusion, Urea, Respiratory rate, Blood pressure (CURB), and National Early Warning Score (NEWS) were measured at admission. Primary outcomes included intensive care unit (ICU) admission, mechanical ventilation, and mortality. <b>Results:</b> Patients in the superinfection group showed significantly elevated inflammatory markers and severity scores compared to the COVID-only group (mean APACHE II of 17.2 vs. 13.8; <i>p</i> < 0.001). Pathogens most frequently isolated from sputum and BAL included <i>Klebsiella pneumoniae</i> (27.6%) and <i>Pseudomonas aeruginosa</i> (20.7%). Multidrug-resistant strains were documented in 32.8% of isolates. The superinfection group had higher ICU admissions (37.9% vs. 19.3%; <i>p</i> = 0.01) and more frequent mechanical ventilation (25.9% vs. 9.6%; <i>p</i> = 0.01). Mortality trended higher among superinfected patients (15.5% vs. 7.2%; <i>p</i> = 0.09). A total of 34% of the cohort had prior antibiotic use, which independently predicted MDR (aOR 2.6, <i>p</i> = 0.01). The presence of MDR pathogens such as <i>Klebsiella pneumoniae</i> (OR 2.8), <i>Pseudomonas aeruginosa</i> (OR 2.5), and <i>Staphylococcus aureus</i> (OR 2.1) significantly increases the risk of ICU admission. <b>Conclusions:</b> Bacterial superinfection exacerbates inflammation and worsens outcomes in COVID-19 patients, such as a higher risk of ICU admission.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"13 5","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12109590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144153087","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 Prevalence of Emphysema in Patients Undergoing Lung Cancer Screening in a Middle-Income Country.","authors":"Marija Vukoja, Dragan Dragisic, Gordana Vujasinovic, Jelena Djekic Malbasa, Ilija Andrijevic, Goran Stojanovic, Ivan Kopitovic","doi":"10.3390/diseases13050146","DOIUrl":"10.3390/diseases13050146","url":null,"abstract":"<p><p><b>Background:</b> Chronic obstructive pulmonary disease (COPD) and lung cancer are the leading causes of death globally, which share common risk factors such as age and smoking exposure. In high-income countries, low-dose computed tomography (LDCT) lung cancer screening programs have decreased lung cancer mortality and facilitated the detection of emphysema, a key radiological indicator of COPD. This study aimed to assess the prevalence of emphysema during a pilot LDCT screening program for lung cancer in a middle-income country with a high smoking prevalence. <b>Methods:</b> A secondary analysis of the Lung Cancer Screening Database of the Autonomous Province of Vojvodina, Serbia, from 20 September 2020 to 30 May 2022. Persons aged 50-74 years, with a smoking history of ≥30 pack-years/or ≥20 pack-years with additional risks (chronic lung disease, prior pneumonia, malignancy other than lung cancer, family history of lung cancer, and professional exposure to carcinogens) were offered LDCT. <b>Results:</b> Of 1288 participants, mean age of 62.1 ± 6.7 years and 535 males (41.5%), 386 (30.0%) had emphysema. The majority of patients with emphysema (301/386, 78.0%) had no prior history of chronic lung diseases. Compared to the patients without emphysema, the patients with emphysema reported more shortness of breath (140/386, 36.3% vs. 276/902, 30.6%, <i>p</i> = 0.046), chronic cough (117/386, 30.3% vs. 209/902, 23.17% <i>p</i> = 0.007), purulent sputum expectoration (70/386, 18.1% vs. 95/902, 10.53%, <i>p</i> < 0.001), and weight loss (45/386, 11.7% vs. 63/902, 7.0%, <i>p</i> = 0.005). The patients with emphysema had more exposure to smoking (pack/years, 43.8 ± 18.8 vs. 39.3 ± 18.1, <i>p</i> < 0.001) and higher prevalence of solid or semisolid lung nodules (141/386, 36.5% vs. 278/902 30.8%, <i>p</i> = 0.04). <b>Conclusions:</b> Almost one-third of the patients who underwent the LDCT screening program in a middle-income country had emphysema that was commonly undiagnosed despite being associated with a significant symptom burden. Spirometry screening should be considered in high-risk populations.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"13 5","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12110275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152992","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":"Post-Liver Transplant Kidney Dysfunction: Incidence of Acute Kidney Injury and Chronic Kidney Disease and Risk Factors Related to Chronic Kidney Disease Development.","authors":"Ana Flavia Moura, José A Moura-Neto, Beatriz de Melo Ribeiro, Paula Ribeiro Oliveira, Arthur Guimarães de Freitas, Alessandra Lima Costa, Daniela Moura-Landim, Liana Codes, Paulo Lisboa Bittencourt, Constança Margarida Sampaio Cruz","doi":"10.3390/diseases13050144","DOIUrl":"10.3390/diseases13050144","url":null,"abstract":"<p><p><b>Introduction:</b> Acute kidney injury (AKI) and chronic kidney disease (CKD) are common complications following liver transplantation (LT), significantly impacting graft and patient survival. AKI affects more than 50% of LT recipients, with a subset requiring renal replacement therapy (RRT), while CKD develops in up to 60% of cases, increasing long-term morbidity and mortality. This study aimed to determine the incidence of AKI and CKD post-LT and to identify risk factors associated with CKD development. <b>Methods:</b> All adult cirrhotic patients without concurrent CKD submitted to LT between January 2001 and December 2017 at the main transplant center in Salvador, Bahia, Brazil, with more than 6-month survival were included in the study. AKI was defined by KDIGO criteria within the first 7 days post-LT. CKD was diagnosed in the presence of the estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m² and/or proteinuria ≥ 200 mg/g 1 and 5 years after LT. Clinical and biochemical parameters were analyzed using multivariate logistic regression to identify independent predictors of CKD. <b>Results:</b> A total of 177 LT recipients (72.9% male; mean age 53.6 ± 12.6 years) were studied. AKI occurred in 51.4% of them in the first 7 days after LT, and 10 (11%) required RRT. CKD was diagnosed in 30% of LT recipients at 1 year and in 42.9% at 5 years. The majority displayed CKD stage G3 (72.4% at 5 years). Multivariate analysis identified pre-LT serum creatinine (OR 7.74, 95% CI 1.99-30.02) and AKI within 7 days after LT (OR 2.72, 95% CI 1.22-6.06) as independent predictors of CKD development. <b>Conclusions:</b> AKI is highly prevalent in the early post-LT period and is a major determinant of CKD progression. Pre-LT renal function and perioperative AKI were significantly associated with worse long-term nephrological outcomes. Optimized perioperative management and renal monitoring strategies are crucial to minimize progression to end-stage kidney disease in LT recipients.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"13 5","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12109809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152915","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":"Anticancer Mechanisms of Ginsenoside Compound K: A Review.","authors":"Yu-Po Lee, Hui-Ting Chan, Tzu-Hsuan Li, Lichieh Julie Chu, Sheau-Long Lee, Yu-Quan Chang, Robert Yl Wang","doi":"10.3390/diseases13050143","DOIUrl":"10.3390/diseases13050143","url":null,"abstract":"<p><p>Cancer, also known as malignant tumors, is formed due to abnormal mutations and the proliferation of human cells. Cancer cells not only demonstrate accelerated proliferation but also show robust invasive and metastatic potential, disseminating from a primary affected region of the body to multiple areas and potentially culminating in organ dysfunction or failure, thereby jeopardizing the individual's life. The rapid growth of the biopharmaceutical market has given rise to numerous novel medicines, thereby precipitating a paradigm shift in contemporary drug development methodologies. This modification is focused on identifying methodologies that can effectively target cancerous cells while minimizing damage to normal cells. There is an increasing societal movement that supports the utilization of natural ingredients derived from plants. In recent years, traditional herbal medicine has experienced a surge in popularity within the global cancer market. In comparison with the use of more toxic chemotherapy methods, there has been an increasing focus on advanced therapies that exhibit reduced side effects. Ginsenoside compound K (CK) is derived from the natural components in ginseng through biotransformation. The utilization of CK in cancer research is a practice engaged in by numerous scientists. The underlying rationale is that CK exhibits a multitude of effects within the realm of cancer research, including but not limited to the mitigation of inflammation, the suppression of cancerous cell proliferation, and the safeguarding of cardiovascular, hepatic, and renal functions. This review methodically identifies and organizes CK-related journals according to the following key points of cancer treatment: the effects on cancer cells themselves, angiogenesis inhibition, modulation of immune response to identify cancer cells, and inflammation regulation. The intricate interplay between ginsenoside CK and cells is elucidated through a graphical representation. The present review focuses on the results of CK in in vitro tests. It is our hope that the present article will aid future studies on the results of CK in vivo tests, clarify the correlation between cellular mechanisms in vivo and in vitro tests, and assist in the development of drugs.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"13 5","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12110123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144153086","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":"Emergency Presentations of Pediatric Sickle Cell Disease in French Guiana.","authors":"Carine Fankep Djomo, Souam Nguele Sile, Narcisse Elenga","doi":"10.3390/diseases13050142","DOIUrl":"10.3390/diseases13050142","url":null,"abstract":"<p><strong>Background/objectives: </strong>This study aimed to estimate the proportion of pediatric emergency admissions related to sickle cell disease.</p><p><strong>Methods: </strong>This is a cross-sectional study. The data were collected over a period of 9 years, from 1 January 2014 to 31 December 2022.</p><p><strong>Results: </strong>We recorded 858 emergency department visits related to sickle cell disease out of a total of 135,000 pediatric emergency department visits, giving a prevalence of 6.4 per 1000 children aged up to 18 years. The median age was 12 years (8-16) years. The average waiting time in the emergency department for children with sickle cell disease was 2 h (±1) in 2014 and 45 min (±15) in 2022. Children with sickle cell anemia were more likely than others to have been seen by a consultant in an emergency department. The most commonly associated pathology was asthma, with a frequency of 17%. The risk factors for hospitalization were an age between 5 and 10 years and a severe form of sickle cell disease.</p><p><strong>Conclusions: </strong>The treatment of pain and fever were often delayed. This leads us to suggest that systematic prior communication between the pediatric hematologist and the emergency physician is crucial. However, there is a need to define best practices for the management of children with sickle cell disease presenting to the emergency department with a fever.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"13 5","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12109839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152607","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":"Mortality Risk Analysis of Combination Antiplatelet Therapy in Patients with Ischemic Stroke and Acute Kidney Injury: A Retrospective Cohort Analysis of the MIMIC-IV Database.","authors":"Qiangqiang Zhou, Hongyu Xu, Shengrong Long, Wei Wei, Xiang Li","doi":"10.3390/diseases13050141","DOIUrl":"10.3390/diseases13050141","url":null,"abstract":"<p><strong>Background: </strong>Ischemic stroke (IS), a major cerebrovascular disease, is associated with high disability and mortality rates. Acute kidney injury (AKI) often complicates IS and increases in-hospital mortality. While antiplatelet agents are commonly used for IS treatment, their effectiveness in IS patients with AKI is unclear.</p><p><strong>Methods: </strong>This study, using data from the MIMIC-IV database, divided patients into non-combination (clopidogrel or ticagrelor alone) and combination (with aspirin) groups. The primary outcome was 28-day mortality, with secondary outcomes including 90-day, 1-year, and in-hospital mortality. Multivariable Cox and logistic regression models were used to analyze the relationship between antiplatelet regimens and mortality. Subgroup analyses and interaction tests were conducted.</p><p><strong>Results: </strong>Results showed the combination group had lower 28-day, 90-day, 1-year, and in-hospital mortality risks than the non-combination group (all <i>p</i> < 0.001). Subgroup analysis revealed an interaction effect by AKI stage, with combination therapy not significantly reducing mortality in severe AKI (stages 2 and 3, <i>p</i> = 0.743, <i>p</i> = 0.244).</p><p><strong>Conclusions: </strong>This study demonstrates that combination antiplatelet therapy significantly reduces 28-day, 90-day, 1-year, and in-hospital mortality risks of IS patients with AKI, suggesting its potential benefits in improving both short- and long-term clinical outcomes. However, this does not apply to patients with severe AKI, indicating heterogeneous survival benefits of combination therapy across AKI severity. Clinical decision-making should incorporate AKI stage stratification to evaluate the applicability of combination antiplatelet therapy. Further research is needed to explore the impact of AKI staging on antiplatelet therapy in IS patients.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"13 5","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12110695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152832","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":"Nutrition in Inflammatory Bowel Disease: Strategies to Improve Prognosis and New Therapeutic Approaches.","authors":"Nallely Bueno-Hernández, Jesús K Yamamoto-Furusho, Viridiana Montsserrat Mendoza-Martínez","doi":"10.3390/diseases13050139","DOIUrl":"10.3390/diseases13050139","url":null,"abstract":"<p><p>Inflammatory Bowel Disease (IBD), encompassing Crohn's disease (CD) and ulcerative colitis (UC), is a chronic inflammatory condition of the gastrointestinal tract that significantly impacts nutritional status. Malnutrition is a frequent complication, resulting from reduced nutrient intake, malabsorption, and increased metabolic demands due to chronic inflammation. A comprehensive nutritional assessment encompassing anthropometric, biochemical, and dietary evaluations is crucial for informing personalized interventions. Several nutritional approaches have been explored to modulate inflammation and the gut microbiota, yielding promising results. The Mediterranean, anti-inflammatory, and low-FODMAP diets have shown potential benefits in symptom control. In contrast, diets high in ultra-processed foods and saturated fats are associated with worsened disease activity. Additionally, stool consistency, assessed using the Bristol Stool Scale, serves as a practical indicator for dietary adjustments, helping to regulate fiber intake and hydration strategies. When dietary modifications alone are insufficient, nutritional support becomes a critical component of IBD management. Enteral nutrition (EN) is preferred whenever possible because it maintains gut integrity and modulates immune responses. It has demonstrated efficacy in reducing postoperative complications and improving disease control. In cases where EN is not feasible, such as in intestinal obstruction, severe malabsorption, or high-output fistulas, parenteral nutrition (PN) is required. The choice between peripheral and central administration depends on treatment duration and osmolarity considerations. Despite growing evidence supporting nutritional interventions, further research is needed to establish standardized guidelines that optimize dietary and nutritional support strategies in managing IBD.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"13 5","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12110586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152838","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":"Labdane Diterpenoids from <i>Leonotis ocymifolia</i> with Selective Cytotoxic Activity Against HCC70 Breast Cancer Cell Line.","authors":"Jane Busisiwe Ncongwane, Vuyelwa Jacqueline Tembu, Comfort Mduduzi Nkambule, Douglas Kemboi, Gerda Fouche, Nyeleti Vukea, Jo-Anne de la Mare","doi":"10.3390/diseases13050140","DOIUrl":"10.3390/diseases13050140","url":null,"abstract":"<p><strong>Background: </strong>Triple-negative breast cancer (TNBC) is an aggressive subtype of breast cancer with limited therapeutic options. <i>Leonotis ocymifolia</i> is a shrub widely used in traditional medicine to alleviate cancer-related symptoms. In a search to find safe and efficacious therapeutic agents from medicinal plants, <i>Leonotis ocymifolia</i> was studied to find compounds with anticancer activity against TNBC.</p><p><strong>Methods: </strong>Compounds from <i>Leonotis ocymifolia</i> were characterized using spectroscopic data such as IR, 1D and 2D NMR, and MS spectrometry and evaluated for cytotoxic activity against triple-negative breast cancer (HCC70), hormone receptor-positive breast cancer (MCF-7), and non-tumorigenic mammary epithelial cell lines (MCF-12A).</p><p><strong>Results: </strong>A previously unreported <i>bis</i>-spirolabdane, 13<i>S</i>-nepetaefolin (<b>1</b>), together with five known labdane diterpenoids, namely nepetaefolin (<b>2</b>), dubiin (<b>3</b>), nepetaefuran (<b>4</b>), leonotin (<b>5</b>), and leonotinin (<b>6</b>), from the genus <i>Leonotis</i> were isolated. Overall, the labdane diterpenoids showed selective activity toward triple-negative breast cancer cells (HCC70). Of the compounds extracted, 13<i>S</i>-nepetaefolin demonstrated the greatest cytotoxic activity with an IC₅₀ of 24.65 µM (SI = 1.08) against HCC70 cells; however, it was equally cytotoxic to non-tumorigenic MCF-12A breast cells (IC₅₀ of 26.55 µM), whereas its isomer (<b>2</b>) showed no activity. This suggests that stereochemistry might have an effect on the cytotoxic activity of the <i>bis</i>-spirolabdane diterpenoids. All the compounds (<b>1</b>-<b>6</b>) demonstrated adsorption, distribution, metabolism, and excretion properties (ADME), while leonotin (<b>5</b>) and leonotinin (<b>6</b>) exhibited lead-like properties and high synthetic accessibility scores.</p><p><strong>Conclusions: </strong>The findings from this study warrant further investigation of <i>L. ocymifolia</i> for potential triple-negative breast cancer (TNBC) therapeutic agents, including potential chemical derivatization of <i>bis</i>-spiro labdane diterpenoid (<b>1</b>) to improve selectivity to TNBC over non-cancer cells.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"13 5","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12110735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152767","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}