Diseases (Basel, Switzerland)最新文献

{"title":"Quality Management Outweighs Pandemic: Retrospective Analysis Shows Improved Quality of Care for <i>Staphylococcus aureus</i> Bacteremia Despite SARS-CoV-2.","authors":"Lena Jakoby, Ernst Molitor, Nico T Mutters, Ruth Weppler, Dominic Rauschning, Manuel Döhla","doi":"10.3390/diseases13040104","DOIUrl":"https://doi.org/10.3390/diseases13040104","url":null,"abstract":"<p><strong>Background: </strong><i>Staphylococcus aureus</i> bacteremia (SAB) is of great clinical relevance, as it is the most common type of bacteremia. Several studies show that the quality of care and thus the outcome can be positively influenced by the involvement of infectious disease specialists and structured programs like Antimicrobial Stewardship (AMS). In 2020, the SARS-CoV-2 pandemic occurred, which dominated the healthcare system and global events during this time. At the same time, a standard operational procedure (SOP) for SAB quality management (SABQM) was introduced in a German maximum-care hospital with 500 beds. Additionally, voluntary AMS team consultations were introduced in June 2021. This work addresses whether the introduction of SABQM has led to an improvement in the quality of care for SAB, despite the possible negative influences of the pandemic.</p><p><strong>Methods: </strong>Retrospective statistical analyses were conducted on all 145 cases coded as SAB at this hospital during the \"pre-pandemic\" period (2017 to 2019, 75 cases) and the pandemic period (2020 to 2022, 70 cases). Population parameters and quality management parameters were extracted from the clinical patient documentation. In a first analysis, the SARS-CoV-2 status served as a discriminatory parameter to determine its influence on the quality of care within the \"pandemic period\". In a second analysis, the period served as a discriminatory parameter to determine its influence on the quality of care. In a third analysis, the use of AMS team consultation served as a discriminatory parameter to determine its influence on the quality of care in a subgroup of 42 cases from June 2021 to 2022.</p><p><strong>Results: </strong>The SARS-CoV-2 status had no influence on the population parameters or the quality management parameters. Between both analyzed periods, there was an improvement in the quality management parameters, with statistically significant higher rates of follow-up blood cultures, transthoracic echocardiography and adequate antibiotic therapy. AMS team consultation led to a relevant, but not statistically significant improvement in the quality management indicators.</p><p><strong>Conclusions: </strong>An SOP for SABQM leads to an improvement in the quality of care, even under the possible negative influences of a pandemic. AMS team consultations further strengthen this positive influence, even if this is not statistically significant due to the small number of cases in the subgroup analyzed.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"13 4","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12025857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054662","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":"Phytochemicals as Chemo-Preventive and Therapeutic Agents Against Bladder Cancer: A Comprehensive Review.","authors":"Orestis Porfyris, Paraskevi Detopoulou, Theodora Adamantidi, Alexandros Tsoupras, Dimitris Papageorgiou, Anastasios Ioannidis, Andrea Paola Rojas Gil","doi":"10.3390/diseases13040103","DOIUrl":"https://doi.org/10.3390/diseases13040103","url":null,"abstract":"<p><p>Bladder cancer has a high incidence worldwide and is characterized by a high recurrence rate, metastatic potential, and a significant socioeconomic burden. Conventional treatment modalities usually exhibit serious adverse complications, which also negatively affect patients' quality of life. In the context of exploring new treatment approaches with fewer side effects, the utilization of natural compounds as alternative and/or complementary therapeutic options seems appealing. In the present study, the potential use and effects of various bioactive phytochemicals, including curcumin, resveratrol, epigallocatechin, genistein, and several others, in bladder cancer treatment are thoroughly reviewed. A special focus is given to their potential to beneficially modulate important molecular signaling pathways and mechanisms affecting cell survival, proliferation, migration, and apoptosis, which play a crucial role in the pathogenesis of bladder cancer, such as the PI3K/AKT/mTOR, Ras/Raf/MEK/MAPK, Wnt/β-Catenin, Notch, Hedgehog, Hippo, JAK2/STAT3, and PAF/PAF-receptor pathways. Nevertheless, most studies have been conducted in cell cultures and animal models. Due to differences in genetics and metabolism, more clinical trials are needed to ensure the bio-efficacy of these phytochemicals in humans.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"13 4","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12026019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035989","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":"Yield of Multimodal Imaging in Iris Amelanotic Lesions: A Masked Case-Control Study.","authors":"Rachel Shemesh, Iris Moroz, Meira Neudorfer, Vicktoria Vishnevskia-Dai","doi":"10.3390/diseases13040099","DOIUrl":"https://doi.org/10.3390/diseases13040099","url":null,"abstract":"<p><strong>Objectives: </strong>To examine the yield of multimodal imaging of iris amelanotic lesions and evaluate the clinical relevance of these imaging techniques.</p><p><strong>Methods: </strong>In this masked case-control study, imaging, including slit lamp photos, ultrasound biomicroscopy (UBM), and anterior segment optical coherence tomography (AS-OCT) scans of patients diagnosed with iris amelanotic lesions were examined. Seven patients diagnosed with an iris amelanotic lesion were matched by gender and age to seven melanotic iris nevi of similar size and location. Two ocular imaging experts assessed the images in a masked manner and identified which lesion was melanotic and which was amelanotic based on their characteristics.</p><p><strong>Results: </strong>From 2010 to 2021, seven patients were diagnosed with amelanotic iris lesions. All were female; the mean (±SD) age at presentation was 46.3 years (±18). These patients were matched with seven female patients with pigmented iris lesions, with a mean (±SD) age of 49.8 years (±20). Hypopigmented lesions were hyporreflective and had minimal shadowing of the iris behind them, and the basement membrane of the iris could be seen on AS-OCT. Hypopigmented lesions could be delineated from the iris stroma on AS-OCT. In contrast, hyperpigmented lesions were hyperreflective, with significant shadowing blocking the basement membrane and iris stroma.</p><p><strong>Conclusions: </strong>AS-OCT is non-touch and provides substantial information about diagnosing amelanotic nevi. It is more widely available and, in many countries, it is performed by technicians, thus freeing the physician's time and increasing productivity.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"13 4","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12025390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060034","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":"Impacts of Forest Bathing (Shinrin-Yoku) in Female Participants with Depression/Depressive Tendencies.","authors":"Qing Li, Norimasa Takayama, Masao Katsumata, Hiroshi Takayama, Yukako Kimura, Shigeyoshi Kumeda, Takashi Miura, Tetsuya Ichimiya, Ruei Tan, Haruka Shimomura, Amane Tateno, Tsunemi Kitagawa, Yoichiro Aoyagi, Michiko Imai","doi":"10.3390/diseases13040100","DOIUrl":"https://doi.org/10.3390/diseases13040100","url":null,"abstract":"<p><strong>Background: </strong>It has been reported that forest bathing significantly reduced negative emotions and increased the positive feelings in both healthy males and females, as well as increasing blood serotonin in healthy males, indicating the potential for a beneficial effect on depressive status. However, an improvement effect of forest bathing on participants with depression has not been reported so far. Therefore, in order to fill this gap, this study examined the effect of forest bathing on depression in female participants with depression/depressive tendencies.</p><p><strong>Methods: </strong>Thirty-one females aged 40.1 ± 2.4 years with depression/depressive tendencies were recruited after obtaining informed consent. The study employed a randomized crossover design to compare forest bathing with city walking. They participated in day trips to a Japanese cypress forest park and to a city area of Nagano Prefecture as a control in June 2023. On both trips, they walked 2.5 km (for 90 min) in the morning and afternoon, respectively, for a total of 5.0 km per day. Blood samples were taken at 4 pm for the measurements before forest bathing on the first day and after the walking in forest and unban sites on the second and third days, at the same hospital. Concentrations of oxytocin, IGF-1, serotonin and lactic acid in blood were measured. SDS scores were calculated and the POMS test and questionnaires for subjective fatigue symptoms and sleep quality were administered before and after each trip. Temperature, humidity and illuminance were also measured in the forest and urban environments. The Nippon Medical School Central Ethics Committee approved this study.</p><p><strong>Results: </strong>Forest bathing significantly decreased SDS scores compared to city walk and the baseline, and the effect lasted for one week after forest bathing. Forest bathing also significantly increased the concentrations of blood serotonin in participants who were not taking antidepressants, significantly increased the levels of oxytocin and IGF-1 in blood, significantly increased the scores for positive feelings, and reduced the scores for negative emotions compared with city walking in the POMS test. In addition, forest bathing reduced subjective fatigue symptoms and improved sleep quality.</p><p><strong>Conclusions: </strong>These findings provided scientific evidence to contribute to understanding forest bathing as a potential intervention for preventing depression, and future research on males should further explore these effects.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"13 4","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12026234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063311","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":"An Analysis of Primary Hyperparathyroidism in Individuals Diagnosed with Multiple Endocrine Neoplasia Type 2.","authors":"Ana-Maria Gheorghe, Claudiu Nistor, Alexandru-Florin Florescu, Mara Carsote","doi":"10.3390/diseases13040098","DOIUrl":"https://doi.org/10.3390/diseases13040098","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Background:&lt;/b&gt; Primary hyperparathyroidism (PHPT) represents a multi-faced disease with a wide spectrum of manifestations. Familial forms of PHPT (affecting up to 10% of the cases) involve a particular category that encompasses a large range of hereditary syndromes, including parathyroid hyper-function, frequently in the setting of a multi-glandular disease. &lt;b&gt;Objective&lt;/b&gt;: The aim was to analyze the most recent findings regarding PHPT in multiple endocrine neoplasia type 2 (MEN2) to a better understanding of the timing with respect to the associated ailments, MEN2-related PHPT (MEN2-PHPT) clinical and genetic particularities, optimum diagnostic, and overall management, particularly, surgical outcomes. &lt;b&gt;Methods:&lt;/b&gt; This was a PubMed-based compressive review with regard to the latest data published in English from January 2020 until January 2025, using the following keywords: \"primary hyperparathyroidism\" and \"multiple endocrine neoplasia\", \"multiple endocrine neoplasia type 2\", \"MEN2\", or \"MEN2A\". We included original full-length studies of any study design that provided clinically relevant data in MEN2-PHPT and excluded reviews, meta-analysis, and case reports/series. &lt;b&gt;Results:&lt;/b&gt; A total of 3783 individuals confirmed with MEN2 or &lt;i&gt;RET&lt;/i&gt; pathogenic variants carriers were analyzed across 14 studies that provided data on PHPT. The prevalence of MEN2-PHPT subjects varied between 7.84% and 31.3%, with particularly low rates in non-index patients (3.8%). PHPT was the first syndrome manifestation in 0.9% of MEN2 patients. In terms of gender distribution, females represented 42.85% or 54.9% (similar rates between women and men, and only a single cohort showed a female rate up to 80%). Most subjects were diagnosed with PHPT and underwent surgery in the third or fourth decade of life. The highest median age at MEN2 diagnosis was 42 years. The youngest patients were &lt;i&gt;RET&lt;/i&gt; pathogenic variants carriers who underwent (genetic) screening with median ages of 12 or 14 years. &lt;i&gt;RET&lt;/i&gt; pathogenic variants analysis (n = 10/14 studies) showed that 16.67% of patients with p.Cys634Arg and 37.5% of those with p.Cys611Tyr had symptomatic PHPT, while those with p.Cys618Phe and p.Leu790Phe were asymptomatic. Timing analysis with respect to the medullary thyroid carcinoma diagnosis showed synchronous PHPT diagnosis in 80% and metachronous in 10% of MEN2 patients; with respect to MEN2-pheochromocytoma, synchronous diagnosis of PHPT was found in 56%, while pheochromocytoma was identified before PHPT in 22% of the cases and after PHPT in 22%. Studies (n = 10/14, N = 156 subjects with MEN2-PHPT) on parathyroidectomy identified that 72.7% to 100% of the individuals underwent surgery, typically performed in adulthood, at ages spanning from a mean of 34.7 to 48.5 years. The post-surgery outcomes varied (e.g., the rate for persistent PHPT was of 0%, 8% to 16.7%; recurrent PHPT of 12.5% to 23%; permanent hypoparathyroidism of 33% to 46%; permanent unil","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"13 4","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12025385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999327","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":"Impact of Cardiovascular-Kidney-Metabolic Syndrome Staging on Myocardial Infarction Outcomes: A Retrospective Analysis of 2.7 Million Patients.","authors":"Ronny Shabtai, Marlon Villaga Gatuz, Adam Folman, Maguli S Barel, Rami Abu-Fanne, Dmitry Abramov, Mamas A Mamas, Ariel Roguin, Ofer Kobo","doi":"10.3390/diseases13040097","DOIUrl":"https://doi.org/10.3390/diseases13040097","url":null,"abstract":"<p><p><b>Background</b>: Cardiovascular-kidney-metabolic (CKM) syndrome, recently defined by the American Heart Association, encompasses the interplay between obesity, diabetes, chronic kidney disease, and cardiovascular disease. This study aimed to investigate the impact of CKM syndrome severity on outcomes in patients with acute myocardial infarction (AMI). <b>Methods</b>: A retrospective analysis was conducted using the National Inpatient Sample database from 2016 to 2019. Adult patients hospitalized with AMI were stratified into CKM Stages 0-4 based on ICD-10 codes. Multivariable logistic regression models were used to examine associations between CKM stages and in-hospital procedures and outcomes. <b>Results</b>: The study analyzed 2,768,154 AMI cases. Advanced CKM stages were associated with older age and a higher proportion of males. Patients with severe CKM were more likely to undergo invasive procedures. Coronary angiography showed the strongest association in CKM Stage 4A (aOR: 6.86, 95% CI: 6.73-6.99, <i>p</i>-value < 0.001) and Stage 4B (aOR: 3.87, 95% CI: 3.80-3.95, <i>p</i>-value < 0.001). Similarly, the likelihood of PCI was highest in Stage 4A (aOR: 5.93, 95% CI: 5.79-6.08, <i>p</i>-value < 0.001) and Stage 4B (aOR: 4.14, 95% CI: 4.04-4.24, <i>p</i>-value < 0.001). Notably, patients with CKM Stage 0 demonstrated higher odds of adverse outcomes compared to other stages. <b>Conclusions</b>: This study reveals a complex relationship between CKM syndrome severity and AMI outcomes. Patients with advanced CKM stages were more likely to undergo invasive procedures, and those without CKM risk factors unexpectedly showed worse outcomes. Among Stages 1-4B, no consistently graded association emerged between the CKM stage and adverse outcomes. These findings warrant further investigation into underlying mechanisms and long-term prognosis.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"13 4","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12026123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059147","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":"Effectiveness of Intraoperative Facial Nerve Monitoring in Submandibular Gland Surgery: A Retrospective Study of a Single Institution.","authors":"Maria Giulia Cristofaro, Francesco Ferragina, Giuseppe Tarallo, Angelo Ruggero Sottile, Maria Grazia Ioppolo, Antonella Arrotta, Teresa Chiara De Bartolo, Ida Barca","doi":"10.3390/diseases13040096","DOIUrl":"https://doi.org/10.3390/diseases13040096","url":null,"abstract":"<p><strong>Background: </strong>Intraoperative facial nerve monitoring (IFNM) is becoming increasingly prevalent as an established intraoperative aid in parotid gland surgery. To date, however, there are few scientific studies on the postoperative outcomes of submandibular gland surgery, particularly on the postoperative injury of the marginalis mandibulae branch (MMB) of the facial nerve (FN). This branch represents the most frequent and feared complication of this surgery, with an incidence of 1-7% of cases.</p><p><strong>Objective: </strong>This retrospective study aims to evaluate the incidence of postoperative MMB paralysis in patients undergoing submandibular sialoadenectomy for benign conditions from 2014 to 2023, focusing on the role of IFNM.</p><p><strong>Materials and methods: </strong>The patients were divided into two groups: the subjects of Group 1 (G1) had undergone submandibular sialoadenectomy after identification and clamped facial vessels, without the aid of IFNM (from 1 January 2014 to 31 December 2018). Conversely, subjects in Group 2 (G2) underwent IFNM procedures (from 1 January 2019 to 31 December 2023). The classification of any FN malfunctions was conducted following the House-Brackmann grading system. A descriptive analysis was performed, and univariate and multivariate logistic regressions were used to examine the impact of IFNM on surgical timing and the association between G2 deficit (vs. G1) corrected for age, sex, and smoking status.</p><p><strong>Results: </strong>The study population comprised a total of 101 patients with a mean age of 55 ± 16 years. The sample population comprised 50 subjects assigned to Group 1 (49.5%, 24 females and 26 males) and 51 subjects assigned to Group 2 (50.5%, 21 males and 30 females). Postoperative paralysis of the MMB occurred in 23 subjects (22.77%), including 12 of G1 (4 had a grade II and 8 grade III dysfunction) and 11 of G2 (8 had a grade II and 3 grade III dysfunction). A six-month evaluation revealed that only five patients in G1, previously diagnosed with grade II dysfunction, exhibited a residual deficit. The mean surgical time for the entire patient cohort was 99 ± 44 min: 110 ± 43 min for Group 1 and 92 ± 42 min for Group 2 (Beta = -19; 95% CI -37 at -0.16; <i>p</i>-value = 0.048). Furthermore, a longer operative time was observed in smokers than in non-smokers (<i>p</i>-value = 0.008), suggesting that smoking affects the length of surgery (Beta = 0.32; 95% CI -0.08 to -0.55).</p><p><strong>Discussion and conclusions: </strong>MMB paralysis is one of the most prevalent complications that may arise in submandibular gland surgery. IFNM provides surgeons with a valuable tool for identifying MMB in submandibular sialoadenectomy. The efficacy of IFNM as an aid is contingent upon the expertise of the operating surgeon.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"13 4","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12025571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042504","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":"Low-Carbohydrate (Ketogenic) Diet in Children with Obesity: Part 1-Diet Impact on Anthropometric Indicators and Indicators of Metabolic Syndrome and Insulin Resistance.","authors":"Ivanka N Paskaleva, Nartsis N Kaleva, Teodora D Dimcheva, Petya P Markova, Ivan S Ivanov","doi":"10.3390/diseases13040094","DOIUrl":"https://doi.org/10.3390/diseases13040094","url":null,"abstract":"<p><strong>Background: </strong>The ketogenic diet has been successfully used in the last 100 years in the treatment of epilepsy and other neurological disorders. In recent decades, it gained wider application in the treatment of obesity, metabolic syndrome, and type 2 diabetes. However, there have been only a few studies on its use in children with obesity and associated metabolic disorders.</p><p><strong>Objectives: </strong>To determine the clinical and metabolic effects of a well-formulated low-carbohydrate (ketogenic) diet in children with obesity.</p><p><strong>Methods: </strong>One hundred children with obesity and metabolic disorders underwent initial anthropometric, laboratory, and ultrasound examinations. They were placed on a well-formulated ketogenic diet and monitored for 4 months. The 58 patients who completed the study underwent follow-up examinations to assess the effects of the diet on anthropometric, clinical, and laboratory markers of metabolic syndrome and insulin resistance, cardiovascular risk factors, and certain hormone levels. Compliance with the diet, common difficulties in adhering to it, side effects, and positive changes in the patients' health were analyzed.</p><p><strong>Results: </strong>At the end of the study, the average weight loss for the entire group was 6.45 kg, with a reduction in BMI of 3.12 kg/m². Significant improvements were also observed in insulin resistance indicators, including fasting insulin levels, HOMA-IR index, QUICKI (<i>p</i> < 0.0001), and adiponectin (<i>p</i> = 0.04). The cases of hepatosteatosis decreased twofold, the number of patients with arterial hypertension was significantly reduced, as well as the number of children receiving antihypertensive therapy. Additionally, the number of patients meeting the criteria for metabolic syndrome decreased threefold.</p><p><strong>Conclusions: </strong>A well-formulated short-term ketogenic diet is effective in treating obesity, metabolic syndrome, and related comorbidities, and can be part of a comprehensive approach for these patients.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"13 4","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12026416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051615","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":"Quality of Life and Stress-Related Psychological Distress Among Families Caring for Children with Cardiac Malformations Under Conservative Treatment: A Cross-Sectional Study Using the 36-Item Short Form Health Survey, the Perceived Stress Scale, and the Parental Burnout Assessment Scale.","authors":"Andrada Ioana Dumitru, Mirabela Dima, Marioara Boia","doi":"10.3390/diseases13040095","DOIUrl":"https://doi.org/10.3390/diseases13040095","url":null,"abstract":"<p><p>Families caring for children with congenital cardiac malformations under conservative management frequently experience psychological distress, which can compromise their overall quality of life (QoL). Despite growing recognition of the psychosocial burdens these families face, few studies have quantitatively assessed their QoL and stress-related outcomes. We aimed to evaluate the QoL, perceived stress, and parental burnout in caregivers of pediatric patients with cardiac malformations under conservative treatment.</p><p><strong>Methods: </strong>We conducted an observational, cross-sectional study of 78 caregivers (median age of 36 years) whose children (median age was 6.0 months) received conservative management for congenital cardiac malformations. Data were collected at two time points (diagnosis of congenital disease approximately at the time of birth, and six months after diagnosis) using the 36-Item Short Form Health Survey (SF-36), the Perceived Stress Scale (PSS), and the Parental Burnout Assessment (PBA). Statistical analyses included paired t-tests, chi-square tests, and Pearson correlation analyses; <i>p</i>-values < 0.05 were considered statistically significant.</p><p><strong>Results: </strong>Mean SF-36 Physical Component Summary scores significantly increased from 59.7 ± 11.7 at baseline to 63.5 ± 12.1 at six months (<i>p</i> = 0.026). PSS scores decreased from 22.9 ± 6.2 to 20.4 ± 5.9 (<i>p</i> = 0.012), indicating reduced perceived stress. Parental Burnout Assessment total scores also declined from 44.9 ± 8.5 to 40.1 ± 8.0 (<i>p</i> = 0.003). Correlation analyses revealed moderate negative correlations between SF-36 domains and both PSS (r range: -0.40 to -0.58) and PBA (r range: -0.34 to -0.52).</p><p><strong>Conclusions: </strong>Our findings highlight the multifaceted challenges faced by caregivers of children with cardiac malformations under conservative treatment. Improvements in QoL, accompanied by decreased perceived stress and parental burnout over six months, underscore the potential value of both clinical monitoring and targeted psychosocial support. Future research should explore larger, multicenter cohorts and longer follow-up durations to clarify long-term trends. Implementing interventions aimed at alleviating stress and burnout in these families may be pivotal for sustaining well-being and enhancing patient outcome.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"13 4","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12025643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054184","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 Comprehensive Review of Candidemia and Invasive Candidiasis in Adults: Focus on the Emerging Multidrug-Resistant Fungus <i>Candida auris</i>.","authors":"Deobrat Chandra Mallick, Nayanjyoti Kaushik, Lokesh Goyal, Lipika Mallick, Prabhat Singh","doi":"10.3390/diseases13040093","DOIUrl":"https://doi.org/10.3390/diseases13040093","url":null,"abstract":"<p><p>Candidemia and invasive candidiasis represent critical healthcare-associated fungal infections that pose substantial challenges to medical systems worldwide. These conditions arise when fungi from the Candida genus infiltrate the bloodstream or deeper tissues, leading to a range of clinical manifestations. Among the various species, <i>Candida albicans</i> continues to hold its position as the most frequently encountered causative agent, largely due to its prevalence and adaptability within human hosts. However, it is far from the only significant player; other Candida species, such as <i>Candida glabrata</i>, <i>Candida parapsilosis</i>, and the particularly concerning <i>Candida auris</i>, contribute significantly to the disease burden and exhibit varying dominance depending on geographic regions. The clinical presentation of these infections can differ widely, spanning from subtle, almost imperceptible symptoms in some patients to severe, life-threatening fulminant sepsis in others, often accompanied by alarmingly high mortality rates that underscore the urgency of effective management strategies. Several well-established risk factors predispose individuals to developing invasive candidiasis and candidemia. Breaches in the body's natural barriers-such as the skin (cutaneous) or the gastrointestinal (GI) tract-provide entry points for these opportunistic pathogens. Additionally, deficiencies in the host's immune responses, whether due to medical treatments, underlying diseases, or genetic predispositions, heighten vulnerability to infection. Among the diverse Candida species, <i>Candida auris</i> has emerged as an especially troubling entity in recent years. This multidrug-resistant species is notorious for its resistance to standard antifungal therapies, which complicates treatment efforts and contributes to elevated morbidity and mortality rates. Its rapid global spread has positioned it as a formidable public health threat, prompting heightened surveillance and research into its behavior and control.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"13 4","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12026337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057964","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}