Medical sciences (Basel, Switzerland)最新文献

{"title":"Impact of the SARS-CoV-2 Pandemic on the Prevalence and Incidence of Enteric Protozoa in a Spanish Tertiary-Care Hospital and a Referral Center for Tropical Diseases, 2019-2023.","authors":"Alfredo Maldonado-Barrueco, Fernando de la Calle-Prieto, Marta Díaz-Menéndez, Marta Arsuaga, Julio García-Rodríguez, Guillermo Ruiz-Carrascoso","doi":"10.3390/medsci13010023","DOIUrl":"10.3390/medsci13010023","url":null,"abstract":"<p><strong>Objetive: </strong>The aim of this study was to describe the impact of non-pharmaceutical interventions (NPIs) against SARS-CoV-2 in patients with symptoms of enteric protozoa (EP), including <i>Blastocystis</i> spp., <i>Dientamoeba fragilis</i>, <i>Giardia lamblia</i>, <i>Cryptosporidium</i> spp., <i>Entamoeba histolytica</i>, and <i>Cyclospora cayetanensis</i>, in the overall population and in patients who were consulted at a National Referral Center for Imported Tropical Diseases (NRCITD patients) from a healthcare area in Madrid (Spain).</p><p><strong>Method: </strong>Data on patients with positive RT-PCR results for EP were collected. The periods analyzed were prepandemic (P0, 1 April 2019-31 March 2020), and the first (P1, 1 April 2020-31 March 2021), second (P2, 1 April 2021-31 March 2022), and third (P3, 1 April 2022-31 March 2023) pandemic years. We compared the prevalence, median age, absolute incidence (EP per 100,000 population of each period), and patient profile (NRCITD vs. non-NRCITD) during the study periods using Fisher's test (<i>p</i> < 0.05) and the T-test (<i>p</i> < 0.001).</p><p><strong>Results: </strong>During P0, 24.8%, [95% CI: 23.9-25.6] of patients tested for EP RT-PCR were positive, 22.6% [95% CI: 21.5-23.7] were positive in P1, 20.4%, [95% CI: 19.5-21.3] were positive during P2, and 20% [95% CI: 19.2-20.9] of patients tested during P3 were positive. During the study, there was no difference in the median ages. The prevalence and absolute incidence of EP showed a decreasing trend during the pandemic for the NRCITD and non-NRCITD patients (<i>p</i> < 0.05).</p><p><strong>Conclusion: </strong><i>Blastocystis</i> spp. and <i>D. fragilis</i> showed a lower decrease in prevalence during P1 (<i>p</i> > 0.05) due to the higher detection of colonized patients during the SARS-CoV-2 pandemic. However, <i>G. lamblia</i> and <i>Cryptosporidium</i> spp. showed the highest decrease in prevalence and absolute incidence during P2 (<i>p</i> < 0.05) because of the NPIs implemented during the SARS-CoV-2 pandemic. The NTRCID patients showed a higher prevalence of <i>Blastocystis</i> spp. than the non-NTRCID patients during every period studied (<i>p</i> < 0.001). <i>E. histolytica</i> and <i>C. cayetanensis</i> showed a homogeneous trend.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712537","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":"Misdiagnosis of Acute Limb Ischemia from Non-Vascular Specialists Results in a Delayed Presentation and Negatively Affects Patients' Outcomes.","authors":"Michalis Pesmatzoglou, Stella Lioudaki, Nikolaos Kontopodis, Ifigeneia Tzartzalou, Konstantinos Litinas, George Tzouliadakis, Christos V Ioannou","doi":"10.3390/medsci13010021","DOIUrl":"10.3390/medsci13010021","url":null,"abstract":"<p><strong>Background/objectives: </strong>Acute Limb Ischemia (ALI) is a vascular emergency which is accompanied by a significant risk of limb loss or even death. Rapid restoration of arterial perfusion using surgical and/or endovascular techniques is crucial for limb salvage. Undeniably, an accurate and prompt diagnosis is the first step to improve patient prognosis. The typical clinical presentation is not always present and the variety of symptoms may result in non-vascular specialists missing the diagnosis.</p><p><strong>Methods: </strong>In this single-center retrospective descriptive study, we reviewed all patients hospitalized between January 2018 and January 2024 for ALI. Patients who were initially misdiagnosed, causing a delayed diagnosis > 24 h, and who therefore did not receive timely treatment, were identified. Moreover, patients with a timely diagnosis of ALI who were treated in our institution during the same time period were collected.</p><p><strong>Results: </strong>Among 280 ALI patients, 14 were initially misdiagnosed. The median time from initial symptoms to definite diagnosis was 38.8 days (range 1.5-365). Several specialties such as orthopedic surgeons, neurologists, and general practitioners were involved in patients' initial assessment. Three patients underwent primary amputation due to irreversible ALI, while nine underwent revascularization and one conservative treatment. Thirty-day limb salvage rate was 9/14 and thirty-day mortality was observed in one patient. Secondary interventions were needed in 65% of these cases. Patients with a delayed ALI diagnosis, when compared to those with a timely diagnosis, presented a significantly lower limb salvage rate (65% vs. 89%, <i>p</i>-value = 0.02) and a significantly higher rate of reinterventions (65% vs. 18%, <i>p</i>-value < 0.001).</p><p><strong>Conclusions: </strong>Many patients with ALI are primarily referred to non-vascular specialties. Misdiagnosed and mistreated ALI negatively affects outcomes.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11944238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712538","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":"Correlation Between Blood Coagulation Profile and Viscosity: Clinical Laboratory Observational Study.","authors":"Ezekiel U Nwose, Phillip T Bwititi","doi":"10.3390/medsci13010020","DOIUrl":"10.3390/medsci13010020","url":null,"abstract":"<p><p>Whole blood viscosity is a test for blood stasis and is an ideal evidence-based pathology parameter that is largely undervalued and retrogressing in clinical utilization. Coagulation profiles as indices of haemostasis are available but limited to central or referral laboratories and often involve long turn-around time. It is therefore important to study the correlation between the index of stasis and indices of haemostasis.</p><p><strong>Objective: </strong>To investigate the correlation of index of stasis with indices of haemostasis.</p><p><strong>Method: </strong>The clinical laboratory observational research method, using archived pathology data. Indices of haemostasis including activated partial thromboplastin time (APTT) and prothrombin time (PT), the international normalization ratio (INR), and plasma D-dimer were evaluated. On the other hand, the index of blood stasis used was the estimated whole blood viscosity (eWBV) and derived haematocrit and serum protein levels. All (N = 193) tests were collected within a calendar year from the same pathology service, and further, for the correlation, each set of variables from the same blood sample collection was used.</p><p><strong>Results: </strong>The haemostasis data are skewed (skewness > 2.0), while eWBV and platelet count are normal (skewness < 2.0). Haemostasis indices have an inverse association with eWBV (<i>p</i> < 0.001). The concordance and correlation of eWBV with platelet count is positive, weak, and significant (<i>p</i> < 0.001), but negative and negligible with PT and APTT.</p><p><strong>Conclusion: </strong>There are limitations to the possible correlation between eWBV and haemostasis indices. However, haemostasis indices have inverse associations with eWBV, and the latter can aid in the evaluation of haemostasis hence could be utilized as an alternative or complementary test to haemostasis tests. Research may normalize skewed data to obtain better correlation; therefore, further study is required to advance discourse, giving cognizance to clinical practice.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11843925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470127","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":"Outcomes in Acute Decompensated Congestive Heart Failure Admissions with Chronic Liver Disease: A Nationwide Analysis Using the National Inpatient Sample.","authors":"Vivek Joseph Varughese, Vignesh Krishnan Nagesh, Pratiksha Moliya, Nelson Gonzalez, Emelyn Martinez, Hata Mujadzic, Maggie James, Abraham Lo, Simcha Weissman","doi":"10.3390/medsci13010019","DOIUrl":"10.3390/medsci13010019","url":null,"abstract":"<p><strong>Aim: </strong>The aim of our study was primarily to analyze hospital outcomes for acute decompensated heart failure (ADHF) admissions with a comorbid diagnosis of chronic liver disease (CLD).</p><p><strong>Methods: </strong>The NIS was used to select ADHF admissions. The population characteristics of general ADHF admissions were compared with ADHF admissions with a comorbid diagnosis of CLD. Multivariate probit logistic regression was used to analyze the association between a documented diagnosis of CLD/alcoholic liver disease and all-cause mortality in ADHF admissions. Confounders were accounted for. Propensity scoring and nearest neighbor matching were conducted to select a matched cohort with and without CLD from ADHF admissions to further look at mortality outcomes.</p><p><strong>Results: </strong>ADHF admissions with a comorbid diagnosis of CLD had a significantly higher proportion of all-cause mortality, 0.054 (0.053-0.057), a higher length of hospital stay, 6.95 days (6.84-7.06), and a higher mean of total hospital charges, USD 88,068.1, when compared to ADHF admissions without a comorbid diagnosis of CLD: all-cause mortality, 0.045 (0.044-0.046); length of hospital stay, 6.18 days (6.13-6.23); and mean total hospital charges, USD 79,946.21. A comorbid diagnosis of CLD had a significant association with all-cause mortality in ADHF admissions: OR 1.23 (1.17-1.29) after accounting for confounders. In the propensity-matched cohorts, the cohort with a diagnosis of CLD from the ADHF admissions had a higher proportion of all-cause mortality, 0.042 (0.036-0.049), when compared to the cohort without a diagnosis of chronic liver disease, 0.027 (0.022-0.033).</p><p><strong>Conclusions: </strong>In analyzing the mortality and healthcare utilization outcomes for ADHF admissions, the comorbid diagnosis of CLD is shown to have significantly higher all-cause mortality, higher length of hospital stay, and higher mean total charges when compared to ADHF admissions without a diagnosis of CLD. A documented diagnosis of CLD had a statistically significant association with all-cause mortality in ADHF admissions after accounting for confounding factors.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11843908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470111","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 Success and Safety of Endoscopic Retrograde Cholangiopancreatography in Surgically Altered Gastrointestinal Anatomy.","authors":"Samuel Han, Jennifer M Kolb, Steven A Edmundowicz, Augustin R Attwell, Hazem T Hammad, Sachin Wani, Raj J Shah","doi":"10.3390/medsci13010018","DOIUrl":"10.3390/medsci13010018","url":null,"abstract":"<p><strong>Background/objectives: </strong>Performing endoscopic retrograde cholangiopancreatography (ERCP) in surgically altered gastrointestinal anatomy remains challenging, frequently necessitating the use of forward-viewing endoscopes. Given the challenge in endoscope selection based on the type of altered anatomy, the aim of this study was to examine ERCP success rates by specific endoscopes for different anatomy types.</p><p><strong>Methods: </strong>This single-center retrospective study examined ERCPs performed in patients with surgically altered gastrointestinal anatomy during an 18-year period. Enteroscopy success, cannulation success, and intervention success rates were compared between the different anatomy and endoscope types.</p><p><strong>Results: </strong>This study included a total of 334 adult patients (665 total ERCPs) with altered anatomy. The pediatric colonoscope was most frequently utilized (32.2%), and the majority of procedures were performed for biliary indications. Enteroscopy success was 82.2% in Roux-en-Y gastric bypass (RYGB), 97% in Billroth II, 91.5% in Whipple, and 93.2% in Roux-en-Y hepaticojejunostomy (RYHJ). Cannulation success was 90.5% in RYGB, 90.5% in Billroth II, 83.6% in Whipple, and 90.6% in RYHJ. Intervention success was 88.2% in Billroth II, 65.1% in RYGB, 81.6% in Whipple, and 87.5% in RYHJ. In patients with RYGB and RYHJ, SBE was utilized most frequently, with rotational enteroscopy having the highest success rates. The overall adverse event rate was 5.1%, with the majority of these being mild in severity.</p><p><strong>Conclusions: </strong>This large retrospective study found ERCP with forward-viewing endoscopes to be safe and effective for a variety of surgically altered anatomy types. Despite recent advances seen with endoscopic ultrasound-guided drainage procedures, this study advocates for ERCP as the initial approach for pancreaticobiliary access in surgically altered anatomy.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11843866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470195","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":"Radiological and Clinical Outcome Differences Between Standard and Short Stem in Reverse Total Shoulder Arthroplasty: A Systematic Review.","authors":"Mauro Ciuffreda, Antongiulio Lentini, Giuseppe Francesco Papalia, Domenico Grasso, Pierangelo Za, Rocco Papalia, Giacomo Rizzello","doi":"10.3390/medsci13010016","DOIUrl":"10.3390/medsci13010016","url":null,"abstract":"<p><strong>Background: </strong>In recent years, the use of short cementless humeral components in reverse total shoulder arthroplasty (RTSA) has increased. This systematic review aimed to compare the radiological and clinical outcomes of uncemented RTSA using short versus standard humeral stems and assess the impact of these radiological changes on clinical outcomes.</p><p><strong>Methods: </strong>A systematic electronic search was performed by two independent reviewers using PubMed, Scopus, and Cochrane Library databases on 10 December 2024. Inclusion criteria involved studies that assessed the radiological and clinical outcomes and overall complication rates of cementless RTSA with short or standard stems in patients with osteoarthritis, cuff tear arthropathy, post-traumatic, and rheumatoid arthritis with a follow-up of at least 1 year. The following data were extracted: radiological parameters of stems including implant subsidence, humeral loosening, and humeral osteolysis and clinical outcomes as Visual Analog Scale pain, American Shoulder and Elbow Surgeons score, Constant Score and Single Assessment Numeric Evaluation score.</p><p><strong>Results: </strong>A total of 13 studies including 1485 shoulders in 1460 patients were analyzed with a median age at surgery of 74.5 years. The short stem group recorded worse radiological outcomes examined such as humeral loosening, lucencies around the implants, and osteolysis. No significant differences were observed in the clinical outcomes and overall complications between the two types of stems.</p><p><strong>Conclusions: </strong>Both short and standard stems are valid options in cementless RTSA. Minimal differences in radiological outcomes were found in favor of RTSA implanted with short stems, while postoperative clinical outcomes were similar between the two types of implants.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11843935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470185","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":"Rheumatoid Arthritis Prevalence and Risk Factors in Korean Adults: A Focus on Age and Sex Differences.","authors":"Do-Youn Lee","doi":"10.3390/medsci13010017","DOIUrl":"10.3390/medsci13010017","url":null,"abstract":"<p><p>Rheumatoid arthritis (RA) is a chronic autoimmune disorder that affects the joints, causing swelling, pain, stiffness, and functional decline. This study aims to clarify the prevalence and risk factors of RA based on sex and age among Korean adults, providing essential data for targeted prevention and management strategies. We analyzed data from the Korea National Health and Nutrition Examination Survey 2016-2021, comprising 25,166 participants aged 20 and older. Sociodemographics, health status, and behavior factors were evaluated, with RA defined based on self-reported diagnosis. A complex sampling design was utilized to ensure representative results and multiple logistic regression was employed to determine the risk factors linked to RA. The overall prevalence of RA among Korean adults was 1.1%, showing a significant sex-based disparity: 0.6% and 1.7% in men and women, respectively. RA prevalence increased with age, peaking at 3.5% in individuals over 70. This study identified education level, subjective health status, and age as key predictors of RA. Among men, significant predictors of RA included education level and subjective health status, with a higher risk observed in men with only elementary education and poor perceived health. For women, age and subjective health status were the main risk factors, with RA risk increasing markedly in older age groups, particularly in those aged 70 and above. This study highlights the distinct prevalence and risk factors for RA among Korean adults by sex and age. Key predictors-education level, subjective health status, and age-suggest that tailored health interventions addressing these factors are crucial to reducing the RA burden and enhancing health outcomes among affected populations.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11843861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470191","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 Scoping Review on Cognition in Myelodysplastic Syndromes: Advances and Challenges.","authors":"Anna Tsiakiri, Konstantinos Frigkas, Pinelopi Vlotinou, Menelaos Papoutselis, Foteini Christidi, Efstratios Karavasilis, Ioannis Kotsianidis, Nikolaos Kourkoutsakis, Konstantinos Vadikolias, Konstantinos Liapis","doi":"10.3390/medsci13010015","DOIUrl":"10.3390/medsci13010015","url":null,"abstract":"<p><strong>Background/objectives: </strong>Myelodysplastic syndromes (MDS) are clonal hematopoietic disorders characterized by ineffective hematopoiesis and a risk of progression to acute myeloid leukemia (AML). Cognitive impairments, including deficits in memory, attention, and executive function, are frequently reported in MDS patients. These impairments are linked to systemic inflammation, neurotoxic treatment effects, and the psychological burden of chronic disease. This review synthesizes existing evidence on cognitive dysfunction in MDS, highlighting knowledge gaps and opportunities for future research.</p><p><strong>Methods: </strong>A scoping review was conducted following PRISMA-ScR guidelines. MEDLINE and Scopus databases were searched for studies examining cognition in MDS patients, using terms like \"myelodysplastic syndromes\" and \"cognition.\" Inclusion criteria were original, English-language studies reporting cognitive outcomes in MDS. Reviews, animal studies, and abstracts were excluded. Data on study design, patient characteristics, cognitive tests, and outcomes were extracted and descriptively analyzed.</p><p><strong>Results: </strong>The review included 25 studies involving 2390 patients with hematologic malignancies, 493 of whom had MDS. Key findings identified cognitive deficits primarily in attention, executive function, and memory. Systemic inflammation and treatment-related neurotoxicity were significant contributors, with older age compounding these effects. Longitudinal studies demonstrated persistent cognitive challenges post-treatment, though the severity varied by patient demographics and therapeutic regimens.</p><p><strong>Conclusions: </strong>Cognitive impairments in MDS are multifactorial and significantly impact patients' quality of life. Current research highlights the need for routine cognitive assessments and targeted interventions. Future studies should focus on longitudinal designs to explore specific cognitive domains and develop therapeutic strategies to mitigate cognitive decline.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11843857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470054","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":"Acute Hepatic Porphyria Should Be Included in the Diagnostic Work-Up of Patients with Resistant Hypertension or Suspected Secondary Hypertension.","authors":"Paulo de Lima Serrano, Bruno de Mattos Lombardi Badia, João Paulo Barile, Patrícia Marques Mendes, Renan Brandão Rambaldi Cavalheiro, Kaliny Oliveira Peixoto, Igor Braga Farias, Roberta Ismael Lacerda Machado, Daniel Delgado Seneor, Wladimir Bocca Vieira de Rezende Pinto, Acary Souza Bulle Oliveira, Paulo Sgobbi","doi":"10.3390/medsci13010014","DOIUrl":"10.3390/medsci13010014","url":null,"abstract":"<p><p>Secondary hypertension and resistant hypertension may result from potentially treatable acquired or hereditary diseases. Inherited Metabolic Disorders are not routinely included in the differential diagnosis of these contexts associated with hypertension, despite the key importance of diagnosis for several of them which enable the early treatment of them. We aim to discuss the current evidence that indicates that a significant portion of cases of unknown resistant hypertension or suspected secondary hypertension may result from unrecognized Acute Hepatic Porphyria (AHP). Diagnostic work-up for AHP is not routinely performed during the evaluation of patients with resistant or refractory hypertension nor in the investigation of secondary hypertension. AHP may present both with neurological and systemic involvement, and hypertension may be observed as part of acute dysautonomia during acute neurovisceral attacks and as a chronic complication during disease course. As AHP represent a potentially treatable group of metabolic disorders, clinicians should consider the inclusion of this group in the diagnostic evaluation of patients with secondary or resistant hypertension.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11843942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470119","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":"Update on the Complications and Management of Liver Cirrhosis.","authors":"Hiba Fadlallah, Diala El Masri, Hisham F Bahmad, Wassim Abou-Kheir, Jad El Masri","doi":"10.3390/medsci13010013","DOIUrl":"10.3390/medsci13010013","url":null,"abstract":"<p><p>Liver cirrhosis represents the advanced pathological stage of chronic liver disease, characterized by the progressive destruction and regeneration of the hepatic parenchyma over years, culminating in fibrosis and disruption of the vascular architecture. As a leading global cause of morbidity and mortality, it continues to affect millions worldwide, imposing a substantial burden on healthcare systems. Alcoholic/nonalcoholic fatty liver disease and chronic viral hepatitis infection, hepatitis C (HCV) in particular, remain leading causes of cirrhosis. Despite significant advances in understanding the pathogenesis of cirrhosis, its management is still complex due to the multifaceted complications, including ascites, hepatic encephalopathy, variceal bleeding, and hepatocellular carcinoma, all of which severely compromise the patient outcomes and quality of life. This review aims at filling a critical gap by providing a comprehensive summary of the latest evidence on the complications and management of liver cirrhosis. Evidence-based therapies targeting both the etiologies and complications of cirrhosis are essential for improving outcomes. While liver transplantation is considered a definitive cure, advancements in pharmacological therapies offer promising avenues for halting and potentially reversing disease progression. This review summarizes the latest management strategies for cirrhosis and its associated complications, emphasizing the importance of early intervention and novel therapeutic options for improving outcomes and quality of life in affected individuals.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11843904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470199","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}