Chronic Disease Research Articles

Psychosocial Self-efficacy and its Association with Selected Potential Factors Among Adults with Type 1 Diabetes: A Cross-Sectional Survey Study.

The management of type 1 diabetes, a non-preventable chronic disease, leads to a high physical and psychological burden on the individual. Digital health technology can improve a person's psychosocial self-efficacy and thereby contribute to improved diabetes self-care. The aim of this study was to explore associations between psychosocial self-efficacy and demographic-, disease specific-, well-being as well as digital health technology (DHT) related factors among adults with type 1 diabetes. A primarily web-based cross sectional survey was conducted among adults with type 1 diabetes in Sweden (n = 301). Psychosocial self-efficacy was assessed using the Swedish version of the Diabetes Empowerment Scale, Swe-DES-23. The survey also contained questions related to demographic-, disease specific-, well-being as well as digital health technology related variables. Higher well-being scores and lower HbA1c levels were associated with higher psychosocial self-efficacy in multiple linear regression analysis. In multivariate analysis, gender, body mass index, well-being scores, and HbA1c levels showed association with psychosocial self-efficacy. None of the DHT factors were found associated with psychosocial self-efficacy. In this study, higher well-being score and lower self-reported HbA1c levels were associated with higher psychosocial self-efficacy in both univariate- and multivariate analysis and accounted for 30% of the variation in psychosocial self-efficacy in the regression model. Thus, measures to improve psychosocial self-efficacy in adults with type 1 diabetes may help maintain their psychological well-being and blood glucose control.

Non-obese lipedema patients show a distinctly altered quantitative sensory testing profile with high diagnostic potential.

Lipedema is a widespread severe chronic disease affecting mostly women. Characterized by painful bilateral fat accumulation in extremities sparing hands and feet, objective measurement-based diagnosis is currently missing. We tested for characteristic psychometric and/or sensory alterations including pain and for their potential for medical routine diagnosis. Pain psychometry was assessed using the German Pain Questionnaire. Sensory sensitivity toward painful and nonpainful stimuli was characterized in non-obese lipedema patients and matched controls using the validated quantitative sensory testing (QST) protocol of the German Research Network on Neuropathic Pain. Lipedema patients showed no overt psychometric abnormalities. Pain was reported as somatic rather than psychosomatic aversive. All QST measurements were normal, but the z-score of pressure pain thresholds (PPT) was twofold reduced and the z-score of vibration detection thresholds (VDT) was two and a half times increased. Both thresholds were selectively altered at the affected thigh but not the unaffected hand. Receiver operating characteristic analysis of the combination of PPT and VDT of thigh vs hand into a PVTH score (PPT, VDT, thigh, hand-score) shows high sensitivity and specificity, categorizing correctly 95.8% of the participants as lipedema patients or healthy controls. Bayesian inference analysis corroborated the diagnostic potential of such a combined PVTH score. We propose to assess PPT and VDT at the painful thigh and the pain-free hand. Combination in a PVTH score may allow a convenient lipedema diagnosis early during disease development.

Alzheirmer-Demans, Post CPR, worsening health status due to underlying chronic diseases patients: What we did in level 3 ICU and what we should do in the future for those patients?

Alzheirmer-Demans, Post CPR, worsening health status due to underlying chronic diseases patients: What we did in level 3 ICU and what we should do in the future for those patients?

Antiviral Compounds to Address Influenza Pandemics: An Update from 2016-2022.

In recent decades, the world has gained experience of the dangerous effects of pandemic events caused by emerging respiratory viruses. In particular, annual epidemics of influenza are responsible for severe illness and deaths. Even if conventional influenza vaccines represent the most effective tool for preventing virus infections, they are not completely effective in patients with severe chronic disease and immunocompromised and new small molecules have emerged to prevent and control the influenza viruses. Thus, the attention of chemists is continuously focused on the synthesis of new antiviral drugs able to interact with the different molecular targets involved in the virus replication cycle. To date, different classes of influenza viruses inhibitors able to target neuraminidase enzyme, hemagglutinin protein, Matrix-2 (M2) protein ion channel, nucleoprotein or RNA-dependent RNA polymerase have been synthesized using several synthetic strategies comprising the chemical modification of currently used drugs. The best results, in terms of inhibitory activity, are in the nanomolar range and have been obtained from the chemical modification of clinically used drugs such as Peramivir, Zanamivir, Oseltamir, Rimantadine, as well as sialylated molecules, and hydroxypyridinone derivatives. The aim of this review is to report, covering the period 2016-2022, the most recent routes related to the synthesis of effective influenza virus inhibitors.

Employee Dietary Initiative Improved Chronic Symptoms

With the awareness that the Standard American Diet is a critical contributor to chronic diseases, this initiative aimed to assess the effects of a 28-day dietary challenge health care improvement project on health system employee energy level, sleep quality, gastrointestinal function, ability to concentrate, and aches/pains, including the impact of adherence level, during a period of restricted intake of gluten, dairy, and sugar offered annually from 2021 to 2023. A total of 754 employees completed the pre-challenge survey; analyses included 354 employees who completed both pre-challenge and post-challenge surveys in at least 1 year of this project. Wilcoxon signed rank tests compared presurvey and postsurvey responses to self-reported energy level, sleep quality, gastrointestinal function, ability to concentrate, and aches/pains. Analysis of variance with Tukey’s honestly significant difference tests compared self-reported adherence level with change scores, with η2 representing effect size. In each challenge year, the mean rank levels of energy, sleep quality, gastrointestinal function, concentration, and aches/pains improved significantly between pre-surveys and post-surveys (all P<.001). Although an association between significant positive change and diet adherence level was found for all items in at least 1 challenge year, those who mostly or completely adhered to the challenge diet restrictions reported significantly greater positive change in energy levels and gastrointestinal symptoms than those who did not or minimally adhered in all challenge years, with small to medium effect sizes. In conclusion, Essentia Health’s employee challenge appeared to improve self-reported outcomes in 5 symptom domains, with energy levels and gastrointestinal symptoms correlating most favorably to adherence to the challenge. These findings have health and cost implications, which could be confirmed by formal research in employee and other populations.

The effects of diabetes, hypertension and subsequent health control behavior on the survival of a Taiwan cohort aged over 50 years

PurposeThis study used the Taiwan Longitudinal Study in Aging from 1996 to 2011 to investigate the effects of diabetes, hypertension, and healthy living behaviors of those aged over 50 years on the survival status in Taiwan. MethodsAmong the 5,131 participants aged 50 years and above in the 1996 survey were included in this study. Cox’s proportional hazards model was used to examine the incidence of diabetes, hypertension, and related mortality risk in those aged over 50 years. ResultsAfter adjusting for age, gender, education level, diabetes, hypertension, health behavior, and leisure activity, results from the Cox model show that the elderly without diabetes have a lower mortality risk than those with diabetes. Regular exercise was associated with a lower risk of mortality. The hazard ratios of elderly with regular exercise were 0.78 (95 % CI: 0.64–0.96) for two times a week or less, 0.81 (95 % CI: 0.69–0.96) for 3–5 times a week, and 0.84 (95 % CI: 0.77–0.93) for 6 + times a week, respectively. On the other hand, leisure activity positively reduces mortality risk. For example, the hazard ratios of the elderly with watching TV and reading were 0.63 (95 % CI: 0.55–0.72) and 0.80 (95 % CI: 0.72–0.89), respectively. Moreover, smoking can increase mortality risk 23 % whether the elderly are with diabetes or hypertension or not. ConclusionsRegarding preventing and controlling chronic diseases in the future, continuously encouraging improvement in health behavior and engaging in leisure activities for the middle-aged and over should be considered essential markers.

Evidence and Prospects of Lycopene as Powerful Red Superfood: Modern Approach to Food Science

Abstract: Lycopene is a plant-derived important nutrient belonging to a group of pigments identified as carotenoids. Lycopene has distinctive chemical and structural features contributing to definite biological properties. Lycopene is a powerful antioxidant and prevents cells and tissues from damage caused by singlet oxygen or free radicals. Research studies have shown the healthpromoting potential of lycopene or its metabolites in the prevention of chronic diseases like diabetes, cancer, asthma, metabolic syndrome, arthritis, and cardiovascular diseases. Lycopene is stable for processing like other natural compounds when present in the plant tissue matrix. Over the last few years, the global lycopene market has increased in different sectors like pharmaceuticals, cosmetics, food and dairy products, and other dietary supplements. The most important aspect of lycopene as a superfood is its synergistic nature with other nutrients. The main aim of this review article is to study chemistry, biosynthetic pathways, biotransformation, sources, and acceptable daily intake. Its characterization as a superfood, therapeutic potential, and wide range of applications in the food industry are also studied.

Early Prediction of Liver Disease

Abstract: Chronic liver disease (CLD) poses a substantial global health challenge, leading to considerable morbidity and mortality. The timely identification of CLD is imperative to enhance patient outcomes and ensure effective disease management. This research introduces an innovative machine learning framework designed to predict liver disease at an early stage, utilizing a wide range of clinical data resources. By integrating demographic information, laboratory test results, imaging findings, and patient medical history, our model aims to accurately forecast the onset and progression of CLD. Advanced classification algorithms, including Random Forest and Gradient Boosting, are employed for feature selection and model development. Performance evaluation is conducted on a comprehensive dataset comprising longitudinal patient records. The results demonstrate promising accuracy, sensitivity, and specificity, highlighting the potential of machine learning in enhancing CLD risk assessment and enabling timely interventions.

Intelligent Document Processing for Disease Detection

Abstract: This project endeavors to develop an intelligent document processing pipeline tailored specifically for medical reports, with a primary focus on samples from Dr Lal Path lab and targeting prevalent diseases leading to kidney failures such as glomerulonephritis, chronic kidney disease, polycystic kidney disease, hypertensive nephropathy, and lupus nephritis. The proposed pipeline integrates cutting-edge technologies including the YOLOv8 object detection model for precise cropping of tabular data, Paddle OCR for accurate extraction of information from tabular images, and Fuzzy Wuzzy NLP library for filtering pertinent data from the extracted information necessary for the subsequent machine learning model. The goal is to employ a neural network model to predict potential kidney failure based on the processed medical data. This holistic approach amalgamates advanced computer vision, natural language processing, and machine learning techniques to streamline the analysis of medical reports, potentially enhancing diagnostic accuracy and clinical decision-making in nephrology.

Deep Learning Techniques for Chronic Kidney Disease Risk Prediction

Abstract: Chronic kidney disease (CKD) and itssymptoms are mild and gradual, often go unnoticedfor years only to be realized lately. Bade, a Local Government of Yobe state in Nigeria has been a center of attention by medical practitioners due to the prevalence of CKD. Unfortunately, a technical approach In culminating the disease is yet to be attained. We obtained a record of 400 patients with 10 attributes as our dataset from Bade General Hospital. We used DNN model to predict the absence or presence of CKD in the patients. The model produced an accuracy of 98%. Furthermore, we identified and highlighted the Featuresimportance to provide the ranking of the features used in the prediction of the CKD. The outcome revealed that two attributes; Creatinine and Bicarbonate have the highest influence on the CKDprediction.

Chronic Kidney Disease Prediction by using Naive Bayes

Abstract: Chronic kidney disease CKD is a chronic kidney problem that affects the human kidneys and causes it to not work properly or causes complete kidney failure, leads to dialysis or causes other related diseases and reduces the quality of life symptoms of this disease cannot be identified in the preliminary stage, only very few people are aware of this disease and can predict symptoms at an early stage, an earlier CKD predictor model should be available improved with higher prediction accuracy and precision, hence the need for a decision support system that helps nephrologists in times of emergency therefore, in this research, a naive Bayesian classifier is used for classification along with Hierarchy based selection nb cb h nb classifier works efficiently with huge datasets and reduces computational complexity speed of prediction and disease severity analysis with nbare extremely higher

Advanced Ensemble Framework for Diabetes Outcome Forecasting

Abstract: Diabetes is one of the chronic diseases, which is increasing from year to year. Developing an automated system that can detect diabetes patients plays an important role in medical science. A stack classifier model is designed for the detection of diabetes by combining three base estimators such as Random Forest Classifier, LightGBM Classifier, and K-Nearest Neighbors Classifier, and Logistic Regression as meta-classifiers. The data preprocessing includes transforming categorical variables into numerical format. Each base learner is trained on the preprocessed data and predictions are made. In the meta learner stage, Logistic Regression is trained to make predictions based on the predictions of the base learners. The goal of the meta learner is to learn how to combine the predictions of the base learners to make a more accurate final prediction on whether the patient is diabetic or not. The use of a stacking classifier improves prediction accuracy compared to using a single classifier. The developed model gives an accuracy of 98%. The 5-fold cross validation is used to get a more robust estimation of generalization error. Thus, the developed model offers a means to enhance early detection and elevate the quality of care for diabetic patients.

Biological profile of secondary hyperparathyroidism in chronic renal failure patients

Secondary hyperparathyroidism (SHPT) is a common complication of chronic kidney disease, especially in hemodialysis patients. It is characterized by overproduction of parathyroid hormone in response to chronic deterioration of renal function. The aim of this retrospective study was to determine the average time to develop secondary hyperparathyroidism, analyze the initial phosphocalcic profiles, and evaluate the evolution of these profiles in hemodialysis patients, following the recommendations of the KDOQI 2003 and KDIGO 2009 groups. The study included 134 hemodialysis patients from two private dialysis centers. Data were collected from patients' medical records and analyzed using SPSS software. The results showed that the average time to develop secondary hyperparathyroidism was 3.15 years according to KDOQI recommendations and 4.64 years according to KDIGO recommendations based on parathyroid hormone levels. The initial assessment revealed an imbalance in phosphocalcic metabolism in approximately 20.1% to 22.5% of patients, a proportion that increased to 27.5% during follow-up, according to both sets of recommendations. In conclusion, secondary hyperparathyroidism is an inevitable complication of chronic kidney disease, affecting the vital and functional prognosis of hemodialysis patients. Diagnosis primarily relies on parathyroid hormone levels, associated with phosphocalcemia, vitamin D, and PAL analyses. Treatment aims mainly to maintain blood levels of calcium, phosphorus, and vitamin D within recommended limits and to reduce parathyroid response to phosphocalcic disturbances.

Hazard functioning modeling for dextrose fluids associated hemodilution; Cox-regressional analysis for patients’ Hematocrit Hemoglobin Ratio

Aims: This study looks at the cox-regressional relationships between hematocrit to hemoglobin ratio (HHR) and a group of outcomes of interest (cOI). These outcomes include death from any cause, acute myocardial infarction, stroke, and severe dilutional hyponatraemia incidence. Additionally other outcome of interest in this study will be prolongation of admission days, infection rate, acute kidney injury, and mandating the transition to the critical unit and mechanical ventilation intubation. The study also will investigate the performances of the tested ratio and will explore their sensitivity, specificity, and accuracy indexes. Methods: Between 2018 and 2022, a retrospective study was conducted at the King Hussein Medical Centre in Amman, Jordan, involving 926 patients. The study aimed to determine the potential risk of dilution of red blood cells in circulation caused by dextrose-containing fluids in patients with chronic kidney disease. The study aimed to determine the ideal threshold levels of the investigated ratio (HHR) to enhance clinical outcomes and safety margins, particularly in patients with severe renal impairment or chronic kidney disease in a hospital setting. The study included patients with fluctuating kidney function, renal replacement therapy, uncontrolled diabetes, and conditions necessitating specific fluid regimens. The study used binary logistic regression and cox-regression proportional hazard modelling to examine the correlation between the hematocrit to haemoglobin ratio and the composite outcomes of interest (cOI) in patients from Jordan. The findings suggest that higher cOI likelihood indicates a more advantageous condition, while lower values suggest a less advantageous condition. Results: A retrospective study at the KHMC in Amman, Jordan, involved 1306 patients from 2018 to 2022. The study focused on the hematocrit to haemoglobin ratio (HHR) and achieved correct classification rates of 70.8%. The best HHR was 2.555:1, with a 42.8% chance of occurring at this level. Cox-Regression Proportional Hazard Modelling revealed a censored percentage of 83.4% in HHR&gt;2.555 stratum and 51.5% in HHR≤2.555 stratum. The study found a high percentage of HD patients processed in the analysis. Conclusion: Intravenous dextrose fluids associated hemodilutional state is linked to all-cause mortality in admitted medically and surgically patients and cardiovascular death. Low ratio increases the risk. Factors such as malnutrition and kidney function loss contribute to prognosis. Future studies should focus on mechanistic pathways, optimal targets, age, and sociodemographic factors.

Secondary hyperparathyroidism: Update

Secondary hyperparathyroidism is a clinical condition characterized by an increase in the synthesis and secretion of parathyroid hormone (PTH). Its presentation will be conditioned by the development of stimuli such as hyperphosphatemia, hypocalcemia, vitamin D deficiency, and PTH resistance. The most common cause of secondary hyperparathyroidism is chronic kidney disease, a pathological condition in which all the afore mentioned stimuli converge. Secondary hyperparathyroidism is evidenced by an increase in the size of the parathyroid glands, favored by cellular hyperplasia and hypertrophy. At the bone level, there will be an increase in the quantity and activity of osteoblasts and osteoclasts, leading to bone with unusual structural characteristics. Symptoms related to the disease include itching, bone pain, concentration alteration, and depression. In the long term, patients have a higher risk of cardiovascular mortality. Therapeutic options include calcimimetics, phosphate binders, vitamin D supplements, and surgery.

Assessment of muscle dysfunction in COPD patients: A case-control study

Introduction: peripheral muscle dysfunction satellite of chronic obstructive pulmonary disease (COPD) has emerged in recent years as a major factor which limits patients' ability to exercise. Methods: This study is a case-control investigation of the associations between COPD and muscle dysfunction. Cases and control subjects were recruited to evaluate their body composition using bioelectrical impedance (BIA). Quadriceps strength and endurance tests were performed. Dyspnoea was estimated by the mMRC scale. The patients were redirected from the department of pulmonary diseases of Batna, Algeria. The healthy subjects were volunteers without any lung, heart or systemic diseases or handicap in physical effort. Results: 175 patients with stable COPD (9 female and 166 male) aged between 40–86 years, mean FEV1 52 ± 21% and 175 age-and-sex-matched healthy subjects (FEV1: 91± 9%) were included in this study. The cigarette consumption was 35 (20) pack/years in COPD patients vs 15 (15) pack/years in healthy subjects. The classification of airflow limitation showed that 19.43% of patients were classified GOLD I, 30.29% (GOLD II), 33.71% (GOLD III), and 16.57% (GOLD IV). 22. 85% of COPD patients were classified in (category A) ,17.14% (category B) ,16.57% (category C) and 43.42% (category D). fat-free mass index (FFMI) was 19.3 (1.6) kg/m2 in COPD patients vs 18 (4.7) kg/m2 in controls. Quadriceps strength was 109.27 (42.8) Nm in COPD patients vs 141.6 (15) Nm in healthy subjects. The quadriceps endurance was 3.75 (1.14) min in patients vs 16.6 (15) min in controls. Conclusion: This study supports the idea that skeletal muscle mass, quadriceps strength and endurance, were adversely affected in patients with COPD.

Polyphenol content, antioxidant and anti-inflammatory activities of Georgian wine and green Tea

This comprehensive study explores the health-promoting properties of Georgian green tea and red wine, focusing on their antioxidant and anti-inflammatory activities, as well as polyphenol content. Utilizing the DPPH and FRAP methods, we observed impressive results, with green tea showcasing a remarkable FRAP activity of 61.2 % of ascorbic acid activity set as 100 %, surpassing red wine at 18.2 %. Comparative assessments against ascorbic acid for antioxidant activity and Sodium diclofenac for anti-inflammatory effects further underscored green tea's prowess. Intriguingly, green tea exhibited a substantial anti-inflammatory activity of 20 % of Sodium diclofenac also set as 100 %, outshining red wine at 3.7 %. Polyphenol content, a key contributor to health benefits, revealed green tea's concentration at 7.5 % (w/w), red wine's - 4.4 % g/l. These findings highlight the potential of green tea and red wine as a potent source of bioactive compounds with implications for cellular health, inflammation mitigation, and chronic disease prevention. The results prompt a closer look at dietary choices, advocating for the incorporation of green tea to harness its multifaceted health benefits. As we delve into the molecular richness of these beverages, our findings provide valuable insights into the potential therapeutic avenues offered by these popular and culturally significant drinks.

Health monitoring system using ECG and PPG techniques

The demand for portable health monitoring systems has grown rapidly in recent years due to the increasing prevalence of chronic diseases and the need for continuous health monitoring. This article introduces the development and implementation of a portable health monitoring system using photo plethysmography (PPG) and electrocardiogram (ECG) technologies. The system integrates the Node MCU ESP8266 microcontroller, AD8232 ECG sensor, and MAX30100 sensor to measure vital signs such as heart rate and blood oxygen saturation level. The proposed system provides a cost-effective and efficient solution for real-time health monitoring, enabling early detection of abnormalities and timely intervention. The feasibility and performance of the system were proven through experimental tests.

Bronchiolite obliterante post-infettiva (PIBO), chi è costei?

The paper presents the case of a 14-month-old child with a persistent respiratory distress with wheezing and diffuse crackles on chest auscultation. Symptoms appeared after a viral pneumonia caused by Adenovirus. The recent history, the clinical manifestations and the lung CT (Computed Tomography) scans, which showed a diffuse mosaic pattern, with air trapping, bronchiectasis and peribronchial inflammation, led to the diagnosis of Post-infectious Bronchiolitis Obliterans (PIBO). PIBO is a rare chronic paediatric pulmonary disease characterized by irreversible fibrotic narrowing of the small airways. It can present with a broad severity spectrum, and the evolution of this condition is not predictable in the single patient. Adenovirus is by far the most common cause of this lung pathology, and during the post Covid-19 pandemic an unprecedented rise in PIBO cases triggered by Adenovirus lower respiratory infections was observed. The treatment of PIBO is empirical, and a defined protocol does not exist yet. Therapeutic approaches range from nil to methylprednisolone pulse therapy, which would seem effective especially if performed early and if peribronchitis is found on imaging. Some studies evaluated the administration of intravenous immunoglobulins, while in more advanced cases showing fibrotic transformation of the parenchyma, the use of antifibrotic drugs (hydroxychloroquine, nintedanib) may be tried

Influence of xanthine oxidase inhibitors on all-cause mortality in adults: a systematic review and meta-analysis.

Xanthine oxidase inhibitors, including allopurinol and febuxostat, are the first-line treatment of hyperuricemia. This meta-analysis investigated the association between urate-lowering therapy and all-cause mortality in different chronic diseases to match its users and non-users in a real-world setting. Overall, 11 studies were included, which reported adjusted hazard ratios for all-cause mortality over at least 12 months. Meta-analysis of all included studies showed no effect of the therapy on all-cause mortality. However, subgroup analyses showed its beneficial effect in patients with chronic kidney disease (14% risk reduction) and hyperuricemia (14% risk reduction), but not in patients with heart failure (28% risk increase). Urate-lowering therapy reduces all-cause mortality among patients with hyperuricemia and chronic kidney disease, but it seems to increase mortality in patients with heart failure and should be avoided in this subgroup.