Diseases (Basel, Switzerland)最新文献

{"title":"Is Lung Disease a Risk Factor for Sudden Cardiac Death? A Comparative Case-Control Histopathological Study.","authors":"Ioana Radu, Anca Otilia Farcas, Septimiu Voidazan, Carmen Corina Radu, Klara Brinzaniuc","doi":"10.3390/diseases13010008","DOIUrl":"10.3390/diseases13010008","url":null,"abstract":"<p><strong>Background/objectives: </strong>Sudden cardiac death (SCD) constitutes approximately 50% of cardiovascular mortality. Numerous studies have established an interrelation and a strong association between SCD and pulmonary diseases, such as chronic obstructive pulmonary disease (COPD). The aim of this study is to examine the presence of more pronounced cardiopulmonary histopathological changes in individuals who died from SCD compared to the histopathological changes in those who died from violent deaths, in two groups with comparable demographic characteristics, age and sex.</p><p><strong>Methods: </strong>This retrospective case-control study investigated the histopathological changes in cardiac and pulmonary tissues in two cohorts, each comprising 40 cases of SCD and 40 cases of violent death (self-inflicted hanging). Forensic autopsies were conducted at the Maramureș County Forensic Medicine Service, Romania, between 2019 and 2020.</p><p><strong>Results: </strong>The mean ages recorded were 43.88 years (SD 5.49) for the SCD cohort and 41.98 years (SD 8.55) for the control cohort. In the SCD cases, pulmonary parenchyma exhibited inflammatory infiltrate in 57.5% (23), fibrosis in 62.5% (25), blood extravasation in 45% (18), and vascular media thickening in 37.5% (15), compared to the control cohort, where these parameters were extremely low. In myocardial tissue, fibrosis was identified in 47.5% (19) and subendocardial adipose tissue in 22.5% (9) of the control cohort.</p><p><strong>Conclusions: </strong>A close association exists between SCD and the histopathological alterations observed in the pulmonary parenchyma, including inflammation, fibrosis, emphysema, blood extravasation, stasis, intimal lesions, and vascular media thickening in intraparenchymal vessels. Both the histopathological modifications in the pulmonary parenchyma and vessels, as well as those in myocardial tissue, were associated with an increased risk of SCD, ranging from 2.17 times (presence of intimal lesions) to 58.50 times (presence of interstitial and perivascular inflammatory infiltrate in myocardial tissue).</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"13 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11765224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034153","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":"Robotic Surgery from a Gynaecological Oncology Perspective: A Global Gynaecological Oncology Surgical Outcomes Collaborative Led Study (GO SOAR3).","authors":"Faiza Gaba, Karen Ash, Oleg Blyuss, Dhivya Chandrasekaran, Marielle Nobbenhuis, Thomas Ind, Elly Brockbank","doi":"10.3390/diseases13010009","DOIUrl":"10.3390/diseases13010009","url":null,"abstract":"<p><strong>Background/objectives: </strong>For healthcare institutions developing a robotic programme, delivering value for patients, clinicians, and payers is key. However, the impact on the surgeon, training pathways, and logistics are often overlooked. We conducted a study on the impact of robotic surgery on surgeons, access to robotic surgical training, and factors associated with developing a successful robotic programme.</p><p><strong>Method: </strong>In our international mixed-methods study, a customised web-based survey was circulated to gynaecological oncologists. The Wilcoxon rank-sum test and Fisher's exact test, tested the hypothesis of the differences in continuous and categorical variables. Multiple linear regression was used to model the effect of variables on outcomes adjusting for gender, age, and postgraduate experience. Outcomes included situational awareness, surgeon fatigue/stress, and the surgical learning curve. Qualitative data were collected via in-depth semi-structured interviews using an inductive theoretical framework to explore access to surgical training and logistical considerations in the development of a successful robotic programme.</p><p><strong>Results: </strong>In total, 94%, 45%, and 48% of survey respondents (n = 152) stated that robotic surgery was less physically tiring/mentally tiring/stressful in comparison to laparoscopic surgery. Our data suggest gender differences in the robotics learning curve with men six times more likely to state robotic surgery had negatively impacted their situational awareness in the operating theatre (OR = 6.35, <i>p</i> ≤ 0.001) and 2.5 times more likely to state it had negatively impacted their surgical ability due to lack of haptic feedback in comparison to women (OR = 2.62, <i>p</i> = 0.046). Women were more risk-averse in case selection, but there were no self-reported differences in the intra-operative complication rates between male and female surgeons (OR = 1, <i>p</i> = 0.1). In total, 22/25 robotically trained surgeons interviewed did not follow a structured curriculum of learning. Low and middle income country centres had less access to robotic surgery. The success of robotic programmes was measured by the number of cases performed per annum, with 74% of survey respondents stating that introducing robotics increased the proportion of surgeries performed by minimal access surgery. There was a distinct lack of knowledge on the environmental impact of robotic surgery.</p><p><strong>Conclusions: </strong>Whilst robotic surgery is considered a landmark innovation in surgery, it must be responsibly implemented through effective training and waste minimisation, which must be a key metric in measuring the success of robotic programmes.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"13 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11765035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034778","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":"Advanced Glycation End-Product-Modified Heat Shock Protein 90 May Be Associated with Urinary Stones.","authors":"Takanobu Takata, Shinya Inoue, Kenshiro Kunii, Togen Masauji, Junji Moriya, Yoshiharu Motoo, Katsuhito Miyazawa","doi":"10.3390/diseases13010007","DOIUrl":"10.3390/diseases13010007","url":null,"abstract":"<p><strong>Background: </strong>Urinary stones (urolithiasis) have been categorized as kidney stones (renal calculus), ureteric stones (ureteral calculus and ureterolith), bladder stones (bladder calculus), and urethral stones (urethral calculus); however, the mechanisms underlying their promotion and related injuries in glomerular and tubular cells remain unclear. Although lifestyle-related diseases (LSRDs) such as hyperglycemia, type 2 diabetic mellitus, non-alcoholic fatty liver disease/non-alcoholic steatohepatitis, and cardiovascular disease are risk factors for urolithiasis, the underlying mechanisms remain unclear. Recently, heat shock protein 90 (HSP90) on the membrane of HK-2 human proximal tubular epithelium cells has been associated with the adhesion of urinary stones and cytotoxicity. Further, HSP90 in human pancreatic and breast cells can be modified by various advanced glycation end-products (AGEs), thus affecting their function. Hypothesis 1: We hypothesized that HSP90s on/in human proximal tubular epithelium cells can be modified by various types of AGEs, and that they may affect their functions and it may be a key to reveal that LSRDs are associated with urolithiasis. Hypothesis 2: We considered the possibility that Japanese traditional medicines for urolithiasis may inhibit AGE generation. Of Choreito and Urocalun (the extract of <i>Quercus salicina</i> Blume/<i>Quercus stenophylla</i> Makino) used in the clinic, Choreito is a Kampo medicine, while Urocalun is a characteristic Japanese traditional medicine. As Urocalun contains quercetin, hesperidin, and <i>p</i>-hydroxy cinnamic acid, which can inhibit AGE generation, we hypothesized that Urocalun may inhibit the generation of AGE-modified HSP90s in human proximal tubular epithelium cells.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"13 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11764404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034922","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":"Exploring microRNA-Mediated Immune Responses to Soil-Transmitted Helminth and Herpes Simplex Virus Type 2 Co-Infections.","authors":"Roxanne Pillay, Pragalathan Naidoo, Zilungile L Mkhize-Kwitshana","doi":"10.3390/diseases13010006","DOIUrl":"10.3390/diseases13010006","url":null,"abstract":"<p><p>Over the last two decades, the field of microRNA (miRNA) research has grown significantly. MiRNAs are a class of short, single-stranded, non-coding RNAs that regulate gene expression post-transcriptionally. Thereby, miRNAs regulate various essential biological processes including immunity. Dysregulated miRNAs are associated with various infectious and non-infectious diseases. Recently co-infection with soil-transmitted helminths (STHs) and herpes simplex virus type 2 (HSV-2) has become a focus of study. Both pathogens can profoundly influence host immunity, particularly in under-resourced and co-endemic regions. It is well known that STHs induce immunomodulatory responses that have bystander effects on unrelated conditions. Typically, STHs induce T-helper 2 (Th2) and immunomodulatory responses, which may dampen the proinflammatory T-helper 1 (Th1) immune responses triggered by HSV-2. However, the extent to which STH co-infection influences the host immune response to HSV-2 is not well understood. Moreover, little is known about how miRNAs shape the immune response to STH/HSV-2 co-infection. In this article, we explore the potential influence that STH co-infection may have on host immunity to HSV-2. Because STH and HSV-2 infections are widespread and disproportionately affect vulnerable and impoverished countries, it is important to consider how STHs may impact HSV-2 immunity. Specifically, we explore how miRNAs contribute to both helminth and HSV-2 infections and discuss how miRNAs may mediate STH/HSV-2 co-infections. Insight into miRNA-mediated immune responses may further improve our understanding of the potential impact of STH/HSV-2 co-infections.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"13 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11765296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034924","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 Systematic Review and Meta-Analysis of Prophylactic Vasopressors for the Prevention of Peri-Intubation Hypotension.","authors":"Hollie Saunders, Subekshya Khadka, Rabi Shrestha, Hassan Z Baig, Scott A Helgeson","doi":"10.3390/diseases13010005","DOIUrl":"10.3390/diseases13010005","url":null,"abstract":"<p><strong>Background/objectives: </strong>Peri-intubation hypotension is a known complication of endotracheal intubation. In the hospital setting, peri-intubation hypotension has been shown to increase hospital mortality and length of stay. The use of prophylactic vasopressors at the time of sedation induction to prevent peri-intubation hypotension has been raised. This systematic review and meta-analysis aims to review the safety and efficacy of this practice.</p><p><strong>Methods: </strong>The study was fully registered with PROSPERO on 13 October 2022, and screening for eligibility was initiated on 20 September 2024. Randomized controlled trials, along with retrospective or prospective cohort studies, were included in the search. The terms \"peri-intubation hypotension\", \"vasopressors\", \"intubation\", and \"anesthesia induced hypotension\" were used to search the title/summary in PubMed, Cochrane Library, and Google Scholar databases. An assessment of bias for each study was conducted using the Newcastle-Ottawa Quality Assessment Scale. The primary outcome was the rate of hypotension peri-intubation. Any complications secondary to hypotension or vasopressors were the secondary outcome.</p><p><strong>Results: </strong>We identified 13 studies, which were all randomized controlled studies, to include in the final analysis. The risk ratio for preventing peri-intubation hypotension was 1.6 (95% CI, 1.2-2.14) with the use of prophylactic phenylephrine while giving propofol versus no prophylactic vasopressors and 1.28 (95% CI 1.03-1.60) with the use of ephedrine.</p><p><strong>Conclusions: </strong>These findings suggest that in patients undergoing intubation in the operating room with propofol, prophylactic vasopressors given with induction for intubation decrease the odds of hypotension.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"13 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11764260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034831","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":"Persistent Post-COVID-19 Olfactory Dysfunction and Its Association with Autonomic Nervous System Function: A Case-Control Study.","authors":"Lojine Ayoub, Abeer F Almarzouki, Rajaa Al-Raddadi, Mohamed A Bendary","doi":"10.3390/diseases13010004","DOIUrl":"10.3390/diseases13010004","url":null,"abstract":"<p><strong>Background: </strong>Following the Coronavirus Disease 2019 (COVID-19) pandemic, many patients have reported ongoing smell and taste issues. This study aims to investigate the prevalence of olfactory and gustatory dysfunction among patients with a history of COVID-19 and its association with autonomic dysfunction and disability.</p><p><strong>Patient and methods: </strong>This case-control study included a COVID-19 group (n = 82) and a control group (n = 82). Olfactory dysfunction, including parosmia and taste problems, was explored using self-reports and the Quick Smell Identification Test (QSIT). The association between post-COVID-19 disability severity and taste and smell alterations was also analyzed. Moreover, autonomic function was evaluated using the Composite Autonomic Symptom Scale-31 (COMPASS-31) to assess the association between autonomic and olfactory dysfunction.</p><p><strong>Results: </strong>Significantly higher rates of ongoing smell (26.8%) and taste (14.6%) dysfunction were reported for the post-COVID-19 group compared to the control group. Post-COVID-19 patients reported 36.6 times more smell issues and 8.22 times more taste issues than controls. Parosmia scores were significantly worse in the post-COVID-19 group, while QSIT scores showed no significant difference between the groups. However, those with worse QSIT scores exhibited significantly more ongoing smell issues. No significant association was observed between disability and altered smell or taste. Higher secretomotor dysfunction scores were significantly associated with abnormal QSIT scores and worse parosmia scores; the other domains of the COMPASS-31 scale showed no significant associations.</p><p><strong>Conclusions: </strong>The findings indicated a potential link between autonomic and olfactory dysfunction. Further studies are needed to elucidate the mechanisms underlying persistent olfactory and autonomic dysfunction in post-COVID-19 patients.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"13 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11765322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034836","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":"Appendicular Skeletal Muscle Index Is Positively Related to Mediterranean Diet Adherence in University Students.","authors":"Paraskevi Detopoulou, Olga Magni, Ioanna Pylarinou, Despoina Levidi, Vassilios Dedes, Milia Tzoutzou, Konstantina Argyri, Evangelia Fappa, Aristea Gioxari, George Panoutsopoulos","doi":"10.3390/diseases13010003","DOIUrl":"10.3390/diseases13010003","url":null,"abstract":"<p><p>Skeletal muscle is associated with cardiometabolic health. The appendicular skeletal muscle index (aSMI) represents the skeletal muscle mass \"corrected\" for height and constitutes a clinically applicable feature of sarcopenia. The relation of the aSMI with dietary habits is not clear, especially in young adults. The present pilot study aimed to investigate the relationship between the aSMI and Mediterranean diet adherence in young adults. A cross-sectional study of 151 university students was conducted. Anthropometry and bioimpedance analysis (TANITA-MC780) were performed. The aSMI was calculated as the sum of the upper and lower extremity muscle masses divided by height squared. The HPAQ questionnaire was used for physical activity evaluation. A validated food frequency questionnaire was used for dietary assessment, and the Mediterranean Diet Score (MedDietScore) was calculated. Multivariate linear regression models with log-aSMI as a dependent variable were applied. The MedDietScore was positively related to log-aSMI in the total sample (B = 0.009, SE = 0.004, <i>p</i> = 0.05, R² for total model = 71%) irrespective of gender, age, ΒΜΙ, smoking, physical activity, and academic year and in males (B = 0.027, SE = 0.011, <i>p</i> = 0.023 R² for total model = 37%) irrespective οf age and ΒΜΙ. The positive association of the MedDietScore with aSMI supports the importance of the adoption of a Mediterranean dietary pattern-rich in plant proteins and antioxidant/anti-inflammatory compounds-in maintaining/attaining muscle mass in young subjects.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"13 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11765459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034833","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":"Youth Suicide in Japan: Exploring the Role of Subcultures, Internet Addiction, and Societal Pressures.","authors":"George Imataka, Hideaki Shiraishi","doi":"10.3390/diseases13010002","DOIUrl":"10.3390/diseases13010002","url":null,"abstract":"<p><strong>Background: </strong>Youth suicide remains a significant public health concern in Japan, driven by multifaceted factors such as academic pressures, social isolation, bullying, and family dysfunction. Recent societal changes, including the rise of internet addiction and subcultural influences from anime, manga, and gaming, have further shaped the psychological landscape of Japanese youth. The COVID-19 pandemic has exacerbated these challenges, intensifying feelings of loneliness and anxiety about the future.</p><p><strong>Methods: </strong>This study explores the impact of these factors on youth suicide risk through a systematic review of existing literature and statistical data, focusing on trends from 2000 to 2024.</p><p><strong>Results: </strong>In 2023, 513 school-aged youth in Japan died by suicide, marking persistently high rates. High school students accounted for the majority of cases, followed by middle and elementary school students. Key risk factors include intense academic expectations, cyberbullying, and internet addiction, which are often compounded by cultural stigmas surrounding mental health. Subcultures offer both solace and potential alienation, influencing youth emotions in complex ways. The COVID-19 pandemic has also worsened mental health issues and heightened suicide risks among this vulnerable group.</p><p><strong>Conclusions: </strong>The findings highlight the urgent need for comprehensive mental health support systems tailored to Japanese cultural contexts. Recommendations include enhancing access to school-based counseling, promoting family-based interventions, and implementing policies to regulate harmful online content. Additionally, efforts must address cultural attitudes that stigmatize mental health care. Collaborative societal and policy-level interventions are crucial for mitigating youth suicide and fostering a supportive environment for young people in Japan.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"13 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11764159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034852","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":"Serum α1-AT Levels and <i>SERPINA1</i> Molecular Analysis in Breast Cancer: An Experimental and Computational Study.","authors":"Guadalupe Ávalos-Navarro, Luis A Bautista-Herrera, Asbiel Felipe Garibaldi-Ríos, Ramiro Ramírez-Patiño, Marisol Gutiérrez-García, Perla Briseño-Álvarez, Luis Felipe Jave-Suárez, Emmanuel Reyes-Uribe, Martha Patricia Gallegos-Arreola","doi":"10.3390/diseases13010001","DOIUrl":"10.3390/diseases13010001","url":null,"abstract":"<p><strong>Background/objectives: </strong>Breast cancer (BC) is a heterogeneous disease with multifactorial origins, including environmental, genetic, and immunological factors. Inflammatory cytokines, such as alpha 1 antitrypsin (α1-AT), are increased in BC and affect physiological and pathological conditions. This study aimed to evaluate the serum levels of α1-AT and perform a computational analysis of <i>SERPINA1</i> in BC, as well as their association with molecular subtypes and clinical features.</p><p><strong>Methods: </strong>For the experimental analysis, we evaluated 255 women with BC and 53 healthy women (HW) in a cross-sectional study. Molecular subtypes were identified by immunohistochemistry and TNM was used for clinical staging. Soluble levels of α1-AT were quantified by ELISA. Computational analysis of <i>SERPINA1</i> expression was performed using GEPIA and cBioPortal.</p><p><strong>Results: </strong>α1-AT was increased in BC women versus HW (75.8 ng/mL vs. 532.2 ng/mL). Luminal A had higher concentration (547.5 ng/mL) than Triple Negative (TN) (484.1 ng/mL), but the levels were not associated with clinical stage. The computational analysis showed that <i>SERPINA1</i> is overexpressed in BC with differential expression among subtypes; its overexpression is associated with a better prognosis, longer disease-free survival, and overall survival.</p><p><strong>Conclusions: </strong>α1-AT levels are increased in women with BC women compared to HW. The Luminal A subtype shows higher soluble protein levels than the TN one. Furthermore, <i>SERPINA1</i> mRNA overexpression in BC is linked to a protective effect.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"13 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11765096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034838","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 Efficacy and Safety of Ferric Carboxymaltose in Heart Failure with Reduced Ejection Fraction and Iron Deficiency: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Inderbir Padda, Sneha Annie Sebastian, Daniel Fabian, Yashendra Sethi, Gurpreet Johal","doi":"10.3390/diseases12120339","DOIUrl":"10.3390/diseases12120339","url":null,"abstract":"<p><p><b>Background:</b> Iron deficiency (ID) often coexists with heart failure (HF), and its prevalence increases with the severity of HF. Intravenous ferric carboxymaltose (FCM) has been associated with improvements in clinical outcomes, functional capacity, and quality of life (QoL) in patients with HF and ID. However, while earlier studies showed favorable results, more recent studies have failed to demonstrate significant improvements in outcomes for patients with heart failure with reduced ejection fraction (HFrEF) and ID. This meta-analysis seeks to provide updated insights into the effectiveness and safety of FCM compared to placebo/standard of care (SoC) among patients with HFrEF and ID/iron deficiency anemia (IDA). <b>Methods:</b> We performed a systematic review and meta-analysis of the literature from inception to December 2023, utilizing databases such as MEDLINE (via PubMed), Google Scholar, the Cochrane Library, ClinicalTrials.gov, and the ScienceDirect portal. A statistical analysis was carried out using RevMan 5.4 with a random-effects model. Dichotomous outcomes were reported as odds ratios (OR), while continuous outcomes were presented as the weighted mean difference (WMD) with corresponding 95% confidence intervals (CI), and heterogeneity was assessed using the <i>I</i>² test. <b>Results:</b> The final analysis included data from six randomized controlled trials (RCTs), comprising 5132 patients. Our findings indicate a significant reduction in total HF hospitalizations among patients with HFrEF and ID/IDA treated with FCM compared to those receiving the placebo or SoC, with an OR of 0.59 (95% CI: 0.40 to 0.88, <i>p</i> < 0.010). However, no statistically significant difference was observed in the total number of deaths between the FCM and placebo/SoC groups (OR: 0.85; 95% CI: 0.70 to 1.03, <i>p</i> = 0.09), non-HF hospitalizations (OR: 0.71; 95% CI: 0.41 to 1.25, <i>p</i> = 0.24), or the composite outcome of cardiovascular hospitalizations and cardiovascular deaths (OR: 0.65; 95% CI: 0.40 to 1.04, <i>p</i> = 0.07). Regarding functional capacity, as assessed by the change in 6-min walk test (6MWT) distance, no significant improvement was found, with a weighted mean difference (WMD) of 14.03 (95% CI: -10.94 to 38.99, <i>p</i> = 0.27). QoL, measured by the Kansas City Cardiomyopathy Questionnaire (KCCQ) score, also did not show significant enhancement, with a WMD of 3.85 (95% CI: -0.55 to 8.24, <i>p</i> = 0.09). Furthermore, the safety analysis revealed no significant difference in the incidence of serious adverse events between the FCM and placebo/SoC groups, with an OR of 0.73 (95% CI: 0.49 to 1.10, <i>p</i> = 0.13). <b>Conclusions:</b> In patients with HFrEF and IDA, treatment with intravenous FCM significantly lowers the risk of total HF hospitalizations but does not appear to affect functional capacity, QoL, or mortality.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"12 12","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11727542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900917","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}