Diseases (Basel, Switzerland)最新文献

{"title":"Oral Structural and Functional Impairment in Relation to Depressive Outcomes in Older Adults: A Systematic Review and Meta-Analysis of Observational Studies.","authors":"Lavinia-Alexandra Moroianu, Laurentiu Dragus, Stefan Rosca, Magdalena Rusu Negraia, Valeriu Ardeleanu, Rares Nicolae Vadana, Ionelia State, Georgel Mihu, Madalina Nicoleta Matei, Simona Dana Mitincu Caramfil","doi":"10.3390/diseases14090309","DOIUrl":"10.3390/diseases14090309","url":null,"abstract":"<p><strong>Background/objectives: </strong>Oral structural and functional impairment and depressive outcomes frequently coexist in older adults, but the strength and interpretation of their association remain uncertain. This systematic review and meta-analysis evaluated whether poorer oral status or function is associated with depressive outcomes in older populations.</p><p><strong>Methods: </strong>Six databases were searched for observational studies published from 1 January 2016 to 5 January 2026, with an update on 19 April 2026. Eligible studies examined oral impairment as the exposure and depressive outcomes as the endpoint in older adults. Risk of bias was assessed using Newcastle-Ottawa criteria and certainty using GRADE. Comparable adjusted odds ratios (ORs) were pooled using random-effects meta-analysis with restricted maximum likelihood and Hartung-Knapp adjustment; non-comparable metrics were synthesized separately.</p><p><strong>Results: </strong>Thirty studies were included; fifteen contributed to the primary OR meta-analysis. In the primary model, poorer oral status or function was associated with higher odds of adverse depressive outcomes (OR = 1.61, 95% CI: 1.31-1.99), although between-study heterogeneity was substantial (I² = 88.1%). In the trim-and-fill sensitivity analysis, the pooled estimate decreased to OR = 1.29 (95% CI: 0.99-1.69; <i>p</i> = 0.0584) and no longer reached conventional statistical significance. The certainty of the primary evidence was very low.</p><p><strong>Conclusions: </strong>Poorer oral structural or functional status is associated with worse depressive outcomes in older adults, but the magnitude is heterogeneous and sensitive to small-study-effect assumptions. The evidence remains observational and of very low certainty and should be interpreted as hypothesis-generating rather than causal or treatment evidence.</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/PMC13605695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042440","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":"Iontophoresis Drug Delivery to the Macula of Lutein for Age Related Macular Degeneration.","authors":"Maria Letizia Salvetat, Francesco Pellegrini, Marco Zeppieri, Matteo Capobianco, Alessandro Avitabile, Ludovica Cannizaro, Giuseppe Gagliano, Francesco Cappellani, Caterina Gagliano","doi":"10.3390/diseases14090310","DOIUrl":"10.3390/diseases14090310","url":null,"abstract":"<p><strong>Background: </strong>Age-related macular degeneration (AMD) represents a leading cause of irreversible vision loss worldwide, driven by intricate interactions among oxidative stress, low-degree chronic inflammation, and macular pigment depletion in aging retinas. Lutein, a component of the macular pigment, has attracted significant attention in AMD management for its antioxidant and blue-light filtering properties. Its oral supplementation, however, although showing potential in slowing AMD progression, requires daily intake and results in variable macular absorption. Trans-scleral iontophoresis (TSI) is a non-invasive technique using low-intensity electric currents to deliver charged molecules into biological tissues and represents an innovative method to deliver lutein into the retina.</p><p><strong>Methods: </strong>The present narrative review synthesizes and discusses the results of lutein supplementation in AMD patients; the ocular iontophoresis basal principles, efficacy, safety and limitations in treating different ophthalmic pathologies; and the evolving clinical evidence supporting lutein TSI in the AMD management.</p><p><strong>Results: </strong><i>Ex-vivo</i> studies have shown that lutein TSI may provide efficient, localized, rapid, and sustained retinal supplementation of macular pigment, overcoming oral intake limitations. Recent preliminary clinical studies have demonstrated that this technique is well-tolerated and effective in enhancing macular pigment optical density and improving some visual functions in AMD patients.</p><p><strong>Conclusions: </strong><i>Ex-vivo</i> and pilot clinical studies highlight the capacity of TSI to deliver lutein inside the retina, overcoming physiological barriers that may limit the efficacy of lutein oral administration. The demonstration of the efficacy of the procedure in preserving/improving visual functions and delaying disease progression in AMD patients requires further long-term randomized controlled clinical studies.</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/PMC13605606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042430","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":"Exercise-Based Rehabilitation Following Lower-Limb Revascularisation in Patients with Peripheral Arterial Disease: A Scoping Review.","authors":"Shinichi Watanabe, Takayasu Koike, Kenji Tsujimoto, Ryoma Tahara, Tomohiko Kamo, Katsuyoshi Suzuki, Keisuke Suzuki","doi":"10.3390/diseases14090311","DOIUrl":"10.3390/diseases14090311","url":null,"abstract":"<p><p><b>Objective:</b> Exercise therapy is recommended for patients with peripheral arterial disease (PAD) to improve walking capacity and functional outcomes. However, rehabilitation programmes after lower-limb revascularisation remain poorly defined. We aimed to map the existing literature on exercise-based rehabilitation following lower-limb revascularisation in patients with PAD and summarise key intervention features and reported outcomes. <b>Data Sources:</b> PubMed/MEDLINE, Embase, the Physiotherapy Evidence Database (PEDro), and the Cochrane Central Register of Controlled Trials were systematically searched from inception to identify relevant studies. <b>Review Methods:</b> This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). Studies involving adult patients with PAD or chronic limb-threatening ischaemia who underwent lower-limb revascularisation and participated in postoperative exercise or rehabilitation programmes were included. Two reviewers independently screened studies and extracted data on study characteristics, intervention components, and outcomes. Findings were synthesised descriptively and presented in tables and narrative summaries. <b>Results:</b> Fourteen studies were included. Rehabilitation programmes showed substantial heterogeneity in exercise modality, timing of initiation, intensity, supervision, and duration. Walking-based exercise was the most commonly reported modality. Sessions typically lasted 20-60 min. Exercise frequency ranged from daily inpatient mobilisation or 6 days/week during early rehabilitation to two to five sessions/week in outpatient or home-based programmes, and programme length ranged from inpatient-only rehabilitation to 12 months. The most frequently reported outcomes were measures of walking capacity, including treadmill walking distance and the 6 min walk test. In contrast, limb-related outcomes (e.g., wound healing, limb salvage, and reintervention) and safety outcomes were less frequently reported. <b>Conclusions:</b> Exercise-based rehabilitation after lower-limb revascularisation in patients with PAD demonstrates considerable variability in programme characteristics and outcome measures. Although most studies focus on walking performance, key outcomes-particularly limb-related events and safety-remain underreported. Future research should establish standardised postoperative rehabilitation protocols and evaluate a broader range of clinically relevant outcomes, especially in patients with chronic limb-threatening ischaemia.</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/PMC13605395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042416","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 HARP (Hemoglobin-Albumin-C-Reactive Protein) Index: A Biologically Designed Composite Biomarker for Continuous Prognostic Modeling in Locally Advanced Nasopharyngeal Carcinoma.","authors":"Erkan Topkan, Efsun Somay, Sibel Bascil, Duriye Ozturk, Ugur Selek","doi":"10.3390/diseases14090306","DOIUrl":"10.3390/diseases14090306","url":null,"abstract":"<p><strong>Background/objectives: </strong>To evaluate the prognostic significance of the novel hemoglobin-albumin-C-reactive protein (HARP) index in patients with locally advanced nasopharyngeal carcinoma (LANPC) treated with definitive concurrent chemoradiotherapy (CCRT).</p><p><strong>Methods: </strong>This retrospective study included 248 patients with LANPC treated with definitive CCRT between 2011 and 2020. The HARP index [hemoglobin × (albumin ÷ C-reactive protein)] was calculated using pretreatment laboratory values. Prognostic associations between HARP and survival outcomes were evaluated using continuous and categorical Cox regression analyses, restricted cubic spline modeling, receiver operating characteristic analyses, and bootstrap-based internal validation.</p><p><strong>Results: </strong>Lower pretreatment HARP values were independently associated with inferior progression-free survival (PFS) and overall survival (OS). In continuous Cox analyses, increasing HARP values were associated with reduced risks of mortality and disease progression (both <i>p</i> < 0.001). ROC analysis identified 3.2 as the exploratory cut-off value for clinical stratification. Patients with HARP ≥ 3.2 (n = 112) had significantly better outcomes than those with HARP < 3.2 (n = 136). Median PFS and OS were not reached in the high-HARP group, whereas they were 47.0 and 72.0 months, respectively, in the low-HARP group. Low HARP values were associated with inferior PFS (HR, 3.86; <i>p</i> < 0.001) and OS (HR, 3.06; <i>p</i> < 0.001). Bootstrap internal validation demonstrated stable model discrimination with minimal optimism.</p><p><strong>Conclusions: </strong>The novel HARP index is an independently associated and internally validated prognostic biomarker in patients with LANPC treated with definitive CCRT. HARP may provide a practical tool for improved risk stratification, pending prospective external validation.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"14 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13605612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042072","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":"Molecular Pathogenesis, Tumor Microenvironment and Health Disparities in Select Pediatric Solid Tumors: An Integrative Narrative Review.","authors":"MiaSara Pérez-Salvá, Carolyn M Ruiz-Pérez, Alondra Veloz-Bonilla, Rocío K Rivera-Valentín","doi":"10.3390/diseases14090307","DOIUrl":"10.3390/diseases14090307","url":null,"abstract":"<p><strong>Background/objectives: </strong>Pediatric solid tumors (PST) are a biologically distinct group of malignancies whose developmental origins and molecular drivers differ substantially from those of adult cancers, with direct implications for therapeutic strategy and clinical outcome. This review synthesizes current evidence on molecular pathogenesis, tumor microenvironment biology, and the structural conditions that shape access to care across select PST.</p><p><strong>Methods: </strong>A narrative review of peer-reviewed literature was conducted primarily using PubMed, supplemented by Google Scholar, covering publications from 2000 to 2025. Tumor types were selected based on their prevalence in the pediatric population and the availability of evidence addressing both molecular features and health disparities. Body: Across eight tumor types (neuroblastoma, Ewing sarcoma, pediatric brain tumors, rhabdomyosarcoma, Wilms tumor, retinoblastoma, osteosarcoma, and chondrosarcoma), recurrent molecular alterations including MYCN amplification, EWS-FLI1 fusions, PAX-FOXO1 rearrangements and IDH 1/2 mutations emerge as central determinants of disease behavior and eligibility for treatment. The tumor microenvironment manifests as a shared mediator of immune exclusion and therapeutic resistance across tumor types, with, but not limited to, tumor-associated macrophages, myeloid-derived suppressor cells, and checkpoint molecule expression, identified as recurrent features influencing treatment response. Immunotherapeutic strategies have shown variable efficacy across PST, with the most consistent clinical benefit established in neuroblastoma. A critical and underappreciated pattern stands out across tumor types: children carrying the most aggressive molecular subtypes are disproportionately those with the least access to therapies those subtypes demand, emphasizing an overlap of biological and structural disadvantage that is also amplified in low- and middle-income countries, where late-stage presentation, treatment abandonment and limited access to molecular diagnostics compound the biological disadvantage.</p><p><strong>Conclusions: </strong>Within the eight PST reviewed, the most aggressive molecular subtypes and the greatest structural disadvantages converge in the same children; those carrying MYCN amplification, PAX-FOXO1 fusions, or EWS-FLI1 fusions are disproportionately those with the least access to the therapies their biology demands. Genomic and immunologic advances will only reach their full clinical potential when paired with inclusive trial data, diversified genomic databases, and most importantly, equitable access to biomarker-specialized therapies across all populations.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"14 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13605055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042352","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":"Comparative Dosimetry of Single and Hybrid ¹⁷⁷Lu, ¹⁶¹Tb, and ⁹⁰Y in PSMA-Targeted Therapy.","authors":"Olatunde Michael Oni, Tim A D Smith","doi":"10.3390/diseases14090305","DOIUrl":"10.3390/diseases14090305","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Patient-specific targeted radionuclide therapy (TRT) requires consideration not only of administered activity but also of the spatial distribution of radiopharmaceutical uptake and radionuclide-specific energy deposition. This study developed a voxel-based computational workplan to compare &lt;sup&gt;177&lt;/sup&gt;Lu, &lt;sup&gt;161&lt;/sup&gt;Tb and &lt;sup&gt;90&lt;/sup&gt;Y, together with hybrid radionuclide models, using patient-specific PSMA PET-derived tumour activity distributions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;PSMA PET/CT data from 20 patients with prostate cancer, comprising 10 &lt;sup&gt;18&lt;/sup&gt;F-PSMA and 10 &lt;sup&gt;68&lt;/sup&gt;Ga-PSMA examinations, were processed to obtain 2285 quality-filtered lesions. Radionuclide-specific dose-point kernels (DPKs) were generated in water using OpenGATE and applied to voxel-wise lesion activity distributions to reconstruct absorbed-dose maps. Kernel characteristics were evaluated using radial energy-containment metrics, and &lt;sup&gt;177&lt;/sup&gt;Lu, representing &lt;sup&gt;161&lt;/sup&gt;Tb simulations, was subjected to grid-convergence testing and external comparison with a published DPK. Lesion dosimetry was assessed using Dmean, D90, D95, equivalent uniform dose (EUD) and tumour control probability (TCP), with uncertainty quantified using patient-cluster bootstrap confidence intervals. Kinetic sensitivity and diagnostic tracer subgroup analyses were additionally performed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The study showed that &lt;sup&gt;161&lt;/sup&gt;Tb produced the highest median lesion-level Dmean, D90, D95 and EUD at 182.79, 136.28, 132.07 and 148.53 Gy, respectively, with a median TCP of 0.981. Corresponding values for &lt;sup&gt;177&lt;/sup&gt;Lu were 141.33, 105.42, 102.10 and 114.78 Gy (TCP 0.930), while &lt;sup&gt;90&lt;/sup&gt;Y produced lower local dose metrics but the broadest radial dose distribution, consistent with its longer-range β-particle crossfire. &lt;sup&gt;161&lt;/sup&gt;Tb remained the highest-ranking radionuclide across the investigated kinetic cases and within both diagnostic tracer subgroups. Hybrid &lt;sup&gt;161&lt;/sup&gt;Tb/&lt;sup&gt;90&lt;/sup&gt;Y kernels provided a controllable compromise between localised energy deposition and extended crossfire; a 70:30 model increased central dose localisation while retaining an R90 and R95 of 6 and 7 mm, respectively. Grid-convergence and published-DPK comparisons supported the numerical adequacy of the kernel methodology. Radionuclide emission characteristics substantially influence the transformation of heterogeneous tumour uptake into spatial absorbed-dose distributions. Within this model, &lt;sup&gt;161&lt;/sup&gt;Tb provided the strongest overall lesion-level dosimetric performance, whereas the extended range of &lt;sup&gt;90&lt;/sup&gt;Y may offer complementary crossfire for selected bulky or heterogeneous lesions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The findings support phenotype-informed radionuclide comparison and provide a computational basis for investigating hybrid strategies. However, the absolute dose estimates and proposed radionuclide c","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"14 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13605149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042332","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":"Inflammasome-Interferon Convergence in Elite HIV Controllers and Autoimmune Diseases: A Critical Integrative Reflection.","authors":"Ariel Torres, Paloma González, Martha Fors, Gisselle Trujillo","doi":"10.3390/diseases14080304","DOIUrl":"10.3390/diseases14080304","url":null,"abstract":"<p><strong>Background: </strong>Elite HIV controllers exhibit persistent immune activation despite sustained viral suppression, a phenomenon that challenges the traditional view of immunological equilibrium. In parallel, autoimmune diseases are characterised by chronic inflammation driven by dysregulated immune responses.</p><p><strong>Objective: </strong>This study aimed to analyse the potential pathophysiological convergence between both conditions and to identify a shared inflammatory axis with possible translational implications.</p><p><strong>Methods: </strong>A critical narrative and integrative reflection was conducted using a purposive, concept-driven selection of evidence from PubMed/MEDLINE, Scopus, and Web of Science. A total of 43 sources were included: 28 studies informing mechanistic findings (14 on elite HIV controllers and 14 on autoimmune diseases), 12 addressing modulatory strategies (pharmacological and lifestyle-based), and 3 providing contextual frameworks.</p><p><strong>Results: </strong>Both conditions demonstrate sustained activation of innate immunity, characterised by elevated pro-inflammatory cytokines (IL-1β, IL-6, TNF, type I interferons), increased inflammatory biomarkers (e.g., sCD14, IP-10), and activation of pathways such as NLRP3 inflammasome and NF-κB signalling. Collectively, these findings suggest convergence towards a potential shared inflammatory axis mediated by the inflammasome-interferon pathway, which may contribute to persistent systemic inflammation and tissue damage. Evidence from pharmacological and non-pharmacological interventions suggests that components of this axis may be susceptible to modulation.</p><p><strong>Conclusions: </strong>The observed convergence supports a conceptual model of shared innate inflammatory activation across both conditions. Rather than implying a unified therapeutic approach, the findings suggest a framework of convergent modulation targeting the inflammasome-interferon axis. This hypothesis warrants further investigation to determine its clinical and translational relevance.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"14 8","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13512596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148835157","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":"Trends and Disparities in Mortality Involving Pancreatic Cancer and Pulmonary Embolism in the United States, 1999-2024: A CDC WONDER Analysis.","authors":"Arkadeep Dhali, Jyotirmoy Biswas, Ali Shan Hafeez, Sajjad Ahmed Khan, Saikat Mandal","doi":"10.3390/diseases14080303","DOIUrl":"10.3390/diseases14080303","url":null,"abstract":"<p><strong>Background: </strong>U.S. mortality trends involving pancreatic cancer and pulmonary embolism (PE) and whether PE is becoming increasingly represented among pancreatic cancer deaths remain incompletely characterized.</p><p><strong>Methods: </strong>We analyzed CDC WONDER Multiple Cause of Death data for adults aged ≥ 25 years from 1999 through 2024. Deaths were included in the primary analysis when pancreatic cancer and PE were both recorded as underlying or contributing causes. Age-adjusted mortality rates (AAMRs) were evaluated using Joinpoint Regression Program version 6.0.1. Forecasting and additional weighted log-linear and segmented regression analyses were performed in R version 4.5. Additional analyses evaluated race/ethnicity, the proportion of pancreatic cancer underlying-cause deaths with PE recorded, and sensitivity to the COVID-19 years.</p><p><strong>Results: </strong>Overall, 18,243 deaths involved both pancreatic cancer and PE. The AAMR increased from 0.19 per 100,000 in 1999 to 0.55 in 2024. Mortality increased by 2.65% annually during 1999-2016 and by 8.54% annually during 2016-2024, with a significantly steeper post-2016 slope (<i>p</i> < 0.001). Rates were consistently higher among males and non-Hispanic Black individuals. Hispanic or Latino mortality increased significantly during 2011-2024, whereas estimates for Asian or Pacific Islander individuals were too sparse or frequently suppressed to support reliable longitudinal trend analysis. Among deaths with pancreatic cancer as the underlying cause, the proportion with PE recorded increased from 1.00% in 1999 to 2.85% in 2024, with significantly faster growth after 2016 (<i>p</i> < 0.001). Excluding 2020-2021 did not materially alter the post-2016 increase.</p><p><strong>Conclusions: </strong>Mortality involving pancreatic cancer and PE increased substantially in the United States, and PE was recorded in a growing proportion of pancreatic cancer deaths. These death-certificate data identify an increasing population-level burden but cannot establish causality or demonstrate the effectiveness of specific clinical interventions.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"14 8","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13511829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148835315","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":"Epidemiology of Human Papillomavirus in the Middle East and North Africa: A Review of Genotypic Prevalence, Vaccination Challenges, and Non-Cervical Clinical Outcomes.","authors":"Maedeh Mirasheh, Zahra Shahabinia, Afrooz Mazidimoradi, Leila Allahqoli, Hamid Salehiniya, Do-Youn Lee","doi":"10.3390/diseases14080302","DOIUrl":"10.3390/diseases14080302","url":null,"abstract":"<p><strong>Background: </strong>Human papillomavirus (HPV) is the most common sexually transmitted infection and the primary etiological agent of cervical cancer. Despite the high global disease burden, the Middle East and North Africa (MENA) region faces substantial challenges in HPV prevention and control. This narrative review aimed to synthesize existing evidence on the prevalence, genotypic distribution, awareness, vaccination status, clinical outcomes, and the role of HPV in non-cervical malignancies in the MENA region.</p><p><strong>Methods: </strong>PubMed, Web of Science, Scopus, and Google Scholar were searched, and 122 studies were included. Findings were synthesized qualitatively and descriptively. Cohort studies, systematic reviews, and meta-analyses were prioritized to support inferences about associations and potential causal relationships.</p><p><strong>Results: </strong>HPV prevalence in the general female population of the MENA region ranged from 4.7% to 53.3%, exceeding 90% in high-risk groups and patients with malignancies. The most common genotypes were HPV16 and HPV18; however, distribution patterns varied across populations. Key risk factors included younger age, multiple sexual partners, early age at first sexual intercourse, smoking, and alcohol consumption. General awareness was low to moderate, and vaccination coverage was very low in most countries. Barriers included lack of knowledge, fear of side effects, religious concerns, and social stigma. Evidence also indicates an association between HPV and non-cervical malignancies (head and neck, esophageal, gastric, breast, and thyroid cancers), with HPV DNA detected in tumor tissues.</p><p><strong>Conclusions: </strong>HPV poses a significant public health challenge in the MENA region, characterized by high prevalence, genotypic diversity, limited knowledge and awareness, and unsatisfactory vaccination coverage. Expanding screening and vaccination through financial support, culturally and religiously appropriate education, and longitudinal studies to monitor genotypic changes and associations with other malignancies are essential measures to reduce the burden of HPV-related diseases in the region.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"14 8","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13512765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148834842","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":"Association Between Serum Leptin Concentrations and Disease Severity Across Airway Disease Phenotypes: A Single-Center Retrospective Observational Study.","authors":"Corina Porr, Valentin-Cristian Iovin, Anca Vidrighin, Emi Marinela Preda, Gabriela Mariana Iancu, Dana M Harris, Cosmina Diaconu","doi":"10.3390/diseases14080301","DOIUrl":"10.3390/diseases14080301","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Leptin is a pleiotropic adipokine linking energy metabolism with innate and adaptive immunity. Its relationship with clinical severity across distinct airway disease phenotypes remains insufficiently characterized. This study examined serum leptin concentrations in adults with allergic rhinitis, non-allergic asthma, and allergic asthma associated with allergic rhinitis. <b>Methods</b>: This single-center retrospective observational study analyzed fully anonymized clinical and laboratory data from 88 adults: patients with allergic rhinitis <i>(n</i> = 31), non-allergic asthma (n = 15), or allergic asthma with allergic rhinitis (n = 22) and healthy controls (n = 20). Serum leptin was measured using a quantitative sandwich enzyme-linked immunosorbent assay. Disease severity was classified using the Allergic Rhinitis and its Impact on Asthma and Global Initiative for Asthma frameworks applicable during the study period. Statistical analyses were performed using IBM SPSS Statistics, version 26.0 (IBM Corp., Armonk, NY, USA), and available original statistical outputs were summarized using retained t statistics and two-sided <i>p</i> values. <b>Results</b>: Stage-specific mean serum leptin concentrations were heterogeneous and non-monotonic. Statistically significant relationships between leptin concentration and disease stage were reported for allergic rhinitis (t = 2.844; <i>p</i> = 0.008), non-allergic asthma (t = 4.240; <i>p</i> = 0.001), and allergic asthma with allergic rhinitis (t = 2.700; <i>p</i> = 0.013). In the allergic rhinitis subgroup, 64.5% of participants had normal weight, 32.3% were overweight, and 3.2% had grade II obesity; weight category was not significantly related to rhinitis stage. <b>Conclusions</b>: The retained analyses indicate statistically significant relationships between serum leptin concentration and clinical disease stage across the investigated airway phenotypes. However, the stage-specific descriptive means were heterogeneous and non-monotonic and therefore do not support a uniform progressive increase in leptin with increasing disease severity. Because complete model outputs and covariate-adjusted estimates were unavailable, these findings should be regarded as exploratory and require prospective validation with appropriate adjustment for adiposity and other relevant metabolic confounders.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"14 8","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13512538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148835358","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}