Common Chronic Conditions Research Articles

Advances in asthma and allergic disease genetics.

Asthma and allergic disease are common chronic conditions affecting individuals of all ages. The contribution of genetics to the risk of asthma and allergic diseases is well established, yet the mechanisms through which genetic variation contribute to risk continues to be investigated. This review focuses on recent advances made in genetic studies of asthma and allergic disease phenotypes. Progress has been made at expanding genetic studies of asthma and allergic diseases in more diverse and non-European populations, and genetic associations have been made with loci and more refined phenotypes associated with these conditions. Among the 11 large genome-wide association studies or admixture mapping studies published recently, 52 novel associations were identified for asthma and allergic disease phenotypes. As in previous studies, variant- and genome-based heritability remains relatively low. The use of polygenic risk scores in asthma and allergic diseases has increased and reinforces the remarkable overlap of the genetic risk of these conditions. Whole genome and exome sequencing has led to associations of specific genes with these conditions, including rare STAT6 gain-of-function mutations that were identified in individuals with multiple, severe and early life allergic diseases and asthma. Overall, we have learned that asthma and allergic diseases phenotypes are highly polygenic and have considerable overlap in their genetic landscapes.

Knowledge, attitudes and practices among patients with periodontal disease toward disease management

IntroductionPeriodontal disease is a common chronic inflammatory condition that affects oral health and carries broader public health implications. This study aimed to assess the levels of knowledge, attitudes and practices (KAP) among patients with periodontal disease toward disease management.MethodsThis cross-sectional web-based study was conducted between March 2022 and March 2023. A self-administered questionnaire was designed to evaluate KAP toward disease management.ResultsA total of 514 questionnaires were collected. Among the patients, 313 (60.89%) of them were female, 309 (60.12%) resided in urban areas and 130 (25.29%) reported having severe periodontal disease. The mean scores of knowledge, attitudes and practices were 3.05 ± 2.03 (possible range: 0–8), 18.71 ± 3.64 (possible range: 6–30), and 14.85 ± 3.63 (possible range: 5–25), respectively. The knowledge item with highest correctness rate was the link between periodontal disease and systemic health (60.70%), while the lowest correctness rate was seen for understanding disease classification (36.96%). Pearson’s analysis revealed positive correlations between knowledge and attitude (r = 0.31, p < 0.001), knowledge and practices (r = 0.23, p < 0.001) attitudes, as well as attitudes and practices (r = 0.17, p < 0.001). Multivariate logistic regression analysis showed that knowledge (OR = 1.30, 95% CI: 1.14–1.49, p < 0.001), age ≥ 33 years old (OR = 0.33, 95% CI: 0.18–0.62, p = 0.001), housewife/househusband (OR = 0.41, 95% CI: 0.17–0.95, p = 0.037) and student (OR = 0.43, 95% CI: 0.20–0.92, p = 0.029) were independently associated with practices.ConclusionPatients with periodontal disease had insufficient knowledge, negative attitudes, and passive practices toward disease management. Further efforts could be directed toward enhancing patient education on periodontal disease to improve knowledge, thereby positively influencing attitudes and disease management practices.

Volatile Oil of Magnolia biondii Pamp. for Transnasal Administration: Its Preparation, Characterization, and Mechanism of Action in the Treatment of Allergic Rhinitis.

Allergic Rhinitis (AR) is a common chronic nasal condition usually caused by allergens. The immune system overreacts when the body is exposed to allergens, releasing a lot of tissue chemicals that cause congestion, more secretions, and an inflammatory reaction in the nasal mucosa. In clinical practice, it remains a significant public health issue. Modern pharmacological studies have demonstrated that Magnolia Volatile Oil (MVO) has good anti-inflammatory, antibacterial, immunomodulatory, and other pharmacological effects. Previous research and literature reports have reported that MVO has good therapeutic effects on allergic rhinitis. However, due to the poor water solubility of Magnolia, its bioavailability is low. The purpose of this present work is to develop a new microemulsion formulation to improve the stability and bioavailability of MVO. The droplet size, PDI, and zeta potential of Magnolia volatile oil microemulsion (MVOME) were characterized along with its physical characteristics, and these values were found to be 14.270.03 nm, 0.09410.31, and -0.35850.12 mV, respectively, demonstrating the successful formation of microemulsion. In OVA-induced AR rats, MVO-ME dramatically reduced the serum levels of TNF-α, IL-1β, and IL-6 inflammatory factors. In addition, MVO-ME significantly inhibited the expression of protein levels of PPAR-γ and P65 in the nasal mucosa of AR rats. In this regard, we hypothesized that MVO-ME may play a therapeutic role in AR by activating the PPAR signaling pathway as well as inhibiting the activation of the NF/κB signaling pathway. MVO-ME has systematic advantages, such as high solubility, bioavailability, etc. It is expected to be an efficient nano-drug delivery system for the clinical treatment of allergic rhinitis.

The impact of COVID-19 on referrals among general practitioners and specialists in Shanghai, China.

The COVID-19 pandemic has impacted patient's visits to general practitioners (GPs). However, it is unclear what the impact of COVID-19 has been on the interaction among the local primary care clinics, the GP Department within the hospital and specialists. The interaction among GPs referring to hospital-based specialists and specialists to local doctors was determined, comparing pre-pandemic 2019 and 2020 during the pandemic. Reduced referrals from GPs to specialists were consistent with the reduction in specialist referrals back to the local doctors, which dropped by approximately 50% in 2020, particularly in the two most common chronic conditions (hypertension and diabetes mellitus). Reduced referral of patients from local clinics to Tongren Hospital is probably due to the extensive online training provided to the local GPs to become more competent in handling local patients via telehealth. Our data provide some insight to assist in combatting the pandemic of COVID-19, offering objective evidence of the impact of COVID-19 on patient management by GPs.

Occupational Noise Exposure and Incident Risk of Hypertension Among Construction Workers in the Greater Toronto Area (GTA)

Occupational noise poses a significant health risk, particularly for blue-collar workers, with potential consequences ranging from hearing loss to cardiovascular diseases. This research addresses the growing concern of hypertension among male construction workers in the Greater Toronto Area (GTA) due to occupational noise pollution, an issue exacerbated by the expected increase in construction industry employment. Hypertension, a major risk for cardiovascular diseases, is a common chronic condition with substantial societal implications. In Ontario, where 7.2% of the workforce is employed in construction, the need to understand and mitigate the impact of noise pollution on hypertension is urgent. This designed study, conducted over a 10-year period, will employ a cohort design, quantitatively measuring noise exposure levels using audio dosimeters by industrial hygienists and categorized into three levels: high, intermediate, and low. Annual physician evaluations will monitor incident cases of hypertension among male construction workers aged 16-65, comparing them to office workers in the same company. Existing research relies heavily on self-reported data and lacks longitudinal monitoring within the construction industry. By employing a rigorous quantitative approach, this study design aims to establish a clear association between occupational noise exposure and hypertension. The implications of the findings extend beyond individual health, impacting families, communities, and public health policies. The study's multidisciplinary approach ensures accessibility to a wide audience, emphasizing its relevance and potential to inform preventive strategies in addressing the global burden of hypertension among blue-collar workers.

The Association Between Chronic Obstructive Pulmonary Disease (COPD) and Migraine: Systematic Review and Meta-Analysis.

Background/Objectives: Migraine and chronic obstructive pulmonary disease (COPD) are both common chronic conditions that may share underlying pathophysiological mechanisms despite presenting with distinct clinical features. Understanding the association between these two conditions could enhance treatment strategies and improve patient outcomes. This review aims to evaluate the relationship between COPD and migraine, highlighting shared risk factors and identifying gaps in the existing literature. Methods: A search was conducted across four electronic databases (PubMed, Ovid Medline, ScienceDirect, and Web of Science) following PRISMA guidelines up to January 2024. The search identified 85 studies, of which five met the inclusion criteria: observational studies, cohort studies, case-control studies, and randomized controlled trials examining the association between migraine and COPD. Studies not published in English and irrelevant study designs were excluded. The risk of bias was assessed using the JBI Critical Appraisal Tool, which evaluated aspects such as study design, participant selection, measurement methods, and the handling of confounding factors. Results: The review included five studies comprising 184,817 patients. All studies identified a significant association between COPD and migraine, with varying methodologies for diagnosing the conditions. Notably, COPD patients had an increased risk of migraine compared to controls, and migraine patients also demonstrated a higher risk of developing COPD. However, the evidence was marked by high heterogeneity and potential confounding factors. Conclusions: The findings suggest a significant association between COPD and migraine, potentially driven by shared mechanisms such as systemic inflammation. However, the predominance of cross-sectional studies limits causal inference. Future research should prioritize longitudinal studies to clarify the directionality and causality of the relationship between COPD and migraine while thoroughly addressing potential confounding factors.

Correlation between benign prostatic hyperplasia and comorbidities: a systematic analysis integrating global burden of disease and mendelian randomization study

BackgroundBenign prostatic hyperplasia (BPH) is a common chronic condition in elderly men. Observational studies have identified several comorbidities associated with BPH. However, these studies are limited by various confounding factors and do not clearly explain the association between BPH and its comorbidities. We investigated the association between BPH and comorbidities using the Global Burden of Disease (GBD) database combined with Mendelian randomization (MR) methods.MethodsThrough an extensive PubMed search, we identified 22 diseases associated with BPH and selected 9 significant comorbidities from the GBD database for a detailed correlation analysis. We also considered socio-economic and environmental influences on BPH. Utilizing the GWAS database, we gathered data on BPH and 20 comorbidities, employing the Linkage Disequilibrium Score Regression (LDSC) method to unearth genetic connections. Causality was determined through both univariable and multivariable bidirectional MR analyses, supplemented by Steiger directionality tests to confirm causation. The study’s integrity was fortified by employing various MR models and conducting rigorous sensitivity analyses. The synthesis of GBD data with LDSC and MR findings offered a nuanced understanding of the BPH-comorbidity nexus. Additionally, we explored the genetic basis and the role of mediating factors between BPH and comorbidities through phenome-wide association studies (PheWAS), colocalization analysis, and mediation MR.ResultsCorrelation analysis of GBD data found associations of prostate cancer, chronic kidney disease and depression with BPH. LDSC results indicated that prostatitis and bladder cancer are related to BPH. Two associations were replicated in bidirectional univariable MR, linking BPH with a higher risk of prostatitis and prostate cancer. conducted sensitivity analyses to confirm the robustness of the results and all Steiger directionality tests were correct. Multiple multivariable MR models validated these results. PheWAS analysis showed that outliers in MR do not significantly impact MR results. Through colocalization analysis, three shared loci between BPH and both prostatitis and prostate cancer were identified. Mediation analysis found that, after adjusting for BPH, fruit consumption was associated with a lower risk of prostatitis, and morning person and chronotype were associated with a lower risk of prostate cancer.ConclusionsThis study uncovered associations between BPH and various comorbidities, emphasizing the causal relationships between BPH, prostatitis, and prostate cancer. Our research provides a new perspective in understanding the comorbid associations of BPH.

Liver knockout of MCU leads to greater dysregulation of lipid metabolism in MAFLD

Metabolic-associated fatty liver disease (MAFLD) is a common chronic condition that poses a significant threat to human health. Mitochondrial dysfunction, particularly involving the mitochondrial Ca2+ uniporter (MCU), plays a key role in its pathogenesis. This study aimed to investigate the impact of the MCU gene on hepatic lipid metabolism in mice fed a high-fat diet. Using MCU knockout and wild-type mice, subjected to either a high-fat or normal diet for 14 weeks, we observed notable Steatosis and liver weight gain in MCU-deficient mice. Liver function markers, serum triglycerides, very low-density lipoprotein (VLDL) levels, and ApoB protein expression were all significantly elevated. Mechanistic studies revealed that MCU deletion led to mitochondrial dysfunction, increased oxidative stress. These findings highlight the critical role of the MCU gene in maintaining hepatic lipid balance and suggest its potential as a therapeutic target for managing nonalcoholic fatty liver disease.

PREVALENCE OF DENTAL CARIES AMONG SMOKERS OF A TERTIARY CARE HOSPITAL OF LAHORE

Dental caries is a common chronic oral health condition globally, with an increased prevalence among smokers. Smoking contributes to caries risk by affecting saliva production, oral microbiota, and oral hygiene practices. In Pakistan, where smoking is prevalent. Objective: This study aims to assess the prevalence of dental caries among smokers attending a tertiary care hospital in Lahore. Methods: A cross-sectional study was conducted at Jinnah Hospital, Lahore, from January to July 2024. The sample included 100 adult smokers aged 18 years and above. Data on demographics, smoking frequency, oral hygiene practices, and dental caries were collected using structured interviews and clinical examinations. Caries severity was assessed using the Decayed, Missing, and Filled Teeth (DMFT) index. Statistical analyses, including chi-square tests, were conducted to explore associations between smoking habits and caries prevalence. Results: The majority of participants were aged 26-35 (30%), with 35% smoking 6-10 cigarettes daily. Oral hygiene practices were suboptimal, with only 25% brushing twice daily, and 15% reporting no regular hygiene routine. The prevalence of dental caries was strongly correlated with smoking frequency and duration. Participants smoking more than 21 cigarettes daily had an 80% caries prevalence, while those with a smoking history of over 16 years had a mean DMFT score of 7.6. These results align with previous studies linking smoking with higher caries risk and severity. Conclusion: The study highlights a high prevalence of dental caries among smokers, with significant associations between smoking frequency, duration, and caries severity. These findings underscore the need for preventive dental health interventions, including smoking cessation programs and targeted oral hygiene education, to mitigate the burden of dental caries in this high-risk population.

A Case Report of Ocular Toxoplasmosis Associated with Chagas Disease and Literature Review

Introduction: Ocular toxoplasmosis (OT) is one of the most frequent clinical manifestations of toxoplasmosis infection. Likewise, another relatively common chronic parasitic condition in Colombia is Chagas disease (CD). At present, there is little information about patients living with CD and other chronic parasitic conditions such as toxoplasmosis; therefore, this report aims to present a case of OC in a patient with chronic CD. Clinical case: A patient recently diagnosed with CD, chronic phase with cardiac involvement, consulted for decreased visual acuity accompanied by placoid chorioretinitis in the macula with an active retinitis zone adjacent to the placoid chorioretinitis. 2+ vitreous cells were present with a headlight in the fog sign. Anterior chamber cells were 1+. As serology (IgM, IgG) for toxoplasmosis was positive, OT was diagnosed. With this diagnosis, treatment was started with trimethoprim-sulfamethoxazole, clindamycin, and prednisone, after which the lesion resolved, leaving an atrophic scar. Visual acuity improved. During 24 months of follow-up, no recurrences were observed. The patient continued clinical follow-up for CD. Conclusion: The clinical features of this patient appear to be similar to those without this coinfection. It also shows several commonly encountered features of OC and the resolution of symptoms using a relatively standard therapy.

Vitamin E and Non-alcoholic Fatty Liver Disease: Investigating the Evidence Through a Systematic Review.

Nonalcoholic fatty liver disease (NAFLD), now recognized as metabolic dysfunction-associated steatotic liver disease (MASLD), is a common chronic liver condition characterized by hepatic steatosisand inflammation, with an increased risk of developing fibrosis and cirrhosis. This systematic review aims to evaluate the effects of vitamin E supplementation on liver enzymes and histological features in patients with NAFLD/MASLD. We conducted a comprehensive literature search from July 14, 2024, to July 30, 2024, across multiple databases, including PubMed, MEDLINE, ScienceDirect, Europe PMC, the Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials.gov, and Embase. The included studies consisted of randomized controlled trials (RCTs), clinical trials, and observational studies that evaluated the effects of vitamin E on liver enzymes (ALT and AST) and histological outcomes (steatosis, inflammation, and fibrosis) in adults diagnosed with NAFLD or NASH. A total of 11 studies were analyzed in the final review. Our results indicate that vitamin E supplementation significantly reduces serum aminotransferases and improves histological parameters such as steatosis and inflammation. However, the evidence regarding its efficacy in enhancing fibrosis remains inconclusive, highlighting a significant gap in the current literature.Vitamin E substantially improves liver function and reduces inflammation in patients with NAFLD/MASLD. However, its role in resolving fibrosis remains uncertain, indicating the need for more rigorous, long-term studies to understand its potential to reverse or halt fibrosis progression fully. Further research is required to determine its long-term effects and therapeutic potential, particularly in advanced stages of liver disease.

When toxicity is not just from gluten: a systematic review on financial toxicity and celiac disease

Abstract Background With an incidence of up to ∼2% globally, Celiac Disease (CD) is probably one of the most life-long common chronic conditions. Although ‘Financial toxicity’ (FT) has been mainly linked to oncology, significant financial burdens have been described across all healthcare domains, even in CD and to the unexpected economic effort resulting from illness and the need for treatments. This study aimed to investigate the potential relationship between CD and FT. Methods A systematic literature review was performed according to the PRISMA Statement 2020 guidelines. The search query queried the following databases: PubMed, Scopus, CINAHL and APA PsycInfo. No time and study design limits were included. Results 105 articles were found, and 25 were included in the review. The main results revealed that CD impacts physical health and imposes a significant financial burden on patients and their families. FT in CD is primarily due to the high costs of diagnosis, lifestyle changes, and expenses for gluten-free foods. Several studies highlighted the scarce adherence to the therapeutic diet due to the cost of food and poor acceptance of CD. Furthermore, since 2007, there has been increased attention to the difficulty of finding gluten-free products and their expensive fees. All these aspects, even for low-income countries, were faced differently globally, as documented by the heterogeneity of government subsidy policies highlighting the health inequity. Conclusions Considering the prevalence, a comprehensive health assessment with a global health approach should consider clinical, social, and economic aspects. This regard could improve the quality of life for CD patients and ensure fair and personalised access to care, regardless of their geographical location or financial situation. This review has highlighted the fragmentation of resources available internationally, underlining the relevance from a public health point of view. Key messages • Celiac Disease is one of the most common life-long disorders, and financial toxicity is an aspect that should be taken into account also from a public health point of view to ensure health equity. • The gluten-free diet represents an important therapeutic choice in CD; the related expensive fees could increase scarce adherence and worse health outcomes.

The effect of war and siege on children with diabetes admitted to ayder comprehensive specialized hospital in mekelle, tigray, ethiopia: a cross-sectional study

The armed conflict in Tigray, which spanned from November 2020 to November 2022, along with the accompanying siege, led to the near-total collapse of Tigray’s healthcare system. Type 1 Diabetes Mellitus, the most common chronic condition in children, requires significant lifestyle adjustments, including daily insulin injections, regular glucose monitoring, and dietary modifications; all of which are severely impacted by war and siege. This study compared Type 1 diabetes care for children at the Ayder Comprehensive Specialized Hospital, Tigray, during the conflict and siege period with that of the pre-war period. We conducted a retrospective cross-sectional survey, analyzing data from September 2019 to August 2020 (pre-war period) and comparing it with data from September 2021 to August 2022 (war and siege period). Descriptive statistics, including frequencies and percentages, were employed, and Pearson’s or Spearman’s correlation analyses were used to evaluate correlations where appropriate. We identified 143 pediatric patients admitted (56 during the pre-war period and 87 during the war and siege period), with a mean age of 109 months in both periods. During the war and siege, a higher proportion of diabetes admissions were due to diabetic ketoacidosis (DKA) (90%) compared to the pre-war period (75%). In the pre-war period, the most common trigger for DKA was infections (35%), while in the war and siege period, it shifted to malnutrition (47%), infections (46%), lack of access to healthcare facilities (31%), and running out of medicines (24%). Complications such as death, renal failure, cerebral edema, and shock were more prevalent during the war and siege periods. The case fatality rate was significantly higher during the war and siege (9%) compared to the pre-war period (0%), correlating strongly with the severity of DKA, the degree of hypokalemia, the presence of complications, and admission during the war and siege. Our study showed the negative impact of war and siege on diabetes care in children demonstrating a high rate of DKA admissions with increased severity, complications, malnutrition, and case fatality rates. People with diabetes especially type 1 deserve great attention during such a crisis as the lack of insulin could lead to severe complications including death.

Comorbidities confound metabolomics studies of human disease

The co-occurrence of multiple chronic conditions, termed multimorbidity, presents an expanding global health challenge, demanding effective diagnostics and treatment strategies. Chronic ailments such as obesity, diabetes, and cardiovascular diseases have been linked to metabolites interacting between the host and microbiota. In this study, we investigated the impact of co-existing conditions on risk estimations for 1375 plasma metabolites in 919 individuals from population-based Estonian Biobank cohort using liquid chromatography mass spectrometry (LC–MS) method. We leveraged annually linked national electronic health records (EHRs) data to delineate comorbidities in incident cases and controls for the 14 common chronic conditions. Among the 254 associations observed across 13 chronic conditions, we primarily identified disease-specific risk factors (92%, 217/235), with most predictors (93%, 219/235) found to be related to the gut microbiome upon cross-referencing recent literature data. Accounting for comorbidities led to a reduction of common metabolite predictors across various conditions. In conclusion, our study underscores the potential of utilizing biobank-linked retrospective and prospective EHRs for the disease-specific profiling of diverse multifactorial chronic conditions.

The effectiveness of vitamin D supplementation in patients with end-stage knee osteoarthritis: Study protocol for a double-blinded, randomized controlled trial.

Osteoarthritis (OA) knee is one of the most common chronic degenerative conditions that imposes clinical and economic burdens on individuals and societies worldwide. Previous studies showed vitamin D levels correlated positively with lean muscle mass and grip strength, implying that vitamin D supplementation may improve muscle health in knee OA subjects. This randomized controlled trial (RCT) aims to compare the effects of vitamin D supplementation on knee muscle strength, physical function, pain, and sarcopenia status in patients with end-stage knee OA. Patients and outcome assessors will be blinded to group allocation. Fifty-six end-stage knee OA patients with vitamin D insufficiency fulfilling our inclusion criteria will be invited to participate in this study. Patients will be randomly assigned to take vitamin D supplementation (4,000 IU capsule daily) or placebo for six months. Measurements will be taken at baseline, three and six-month after the commencement of the vitamin D supplement, and 6-month after the interventional period. The primary outcome includes the isometric quadriceps and hamstring muscle strength measured by a hand-held dynamometer. Secondary outcomes include pain, performance-based and self-reported physical function and sarcopenia status. The success of this study will provide scientific evidence of whether the relatively cheap and well-tolerated vitamin D supplement can improve quadriceps muscle strength, physical function, pain symptoms, and sarcopenia status of this increasingly large population for end-stage knee OA patients. The study has great clinical significance given Hong Kong's lengthy and growing waiting list for complete knee replacement procedures. Trial registration: The trial was registered on clinicaltrials.gov (NCT05981534) on 31st July 2023.

The effects of pulsed electromagnetic field therapy on muscle strength and pain in patients with end-stage knee osteoarthritis: a randomized controlled trial.

Osteoarthritis (OA) of the knee is one of the most common chronic degenerative joint conditions affecting aging population. To investigate the effectiveness of a combination of home-based exercise and pulsed electromagnetic field (PEMF) therapy to improve muscle strength, physical function, and pain. Sixty patients were randomly assigned to either home-based exercise alone (control group; n = 30) or combined with PEMF therapy (treatment group; n = 30) twice a week for eight weeks. Knee extension, flexion muscle strength, gait speed (GS), 5 time sit-to-stand test (5STS), Visual Analogue Scale (VAS) pain and Knee Injury and Osteoarthritis Outcome Score (KOOS) were recorded at baseline and 4 and 8 weeks. Significant improvements in symptomatic knee extension muscle strength (SKE, p = 0.001), flexion strength (SKF, p = 0.011), contralateral knee extension muscle strength (CKE, p = 0.002), and flexion strength (CKF, p = 0.009) were observed for the PEMF treatment group at 8 weeks. Significant reductions in VAS pain scores were observed in both the treatment (p < 0.001, partial η2 = 0.505) and control (p < 0.001, partial η2 = 0.268) groups. Significant differences were reported between groups in the 4 (p = 0.010, partial η2 = 0.111) and 8 (p = 0.046, partial η2 = 0.068) week assessment in VAS pain. A significant time difference was found in GS and 5STS between baseline and week 8 (GS: difference 0.051, p = 0.026; 5STS: difference 2.327, p < 0.001) in the treatment group. The significant group difference at week 8 was observed in SKE (p = 0.013) in female patients while pain in male patients (p = 0.026). Patients aged over 70 years have a significantly superior improvement in SKE, SKF, and CKF after 8 weeks of PEMF therapy. The combination of PEMF therapy and home-based exercise superiorly improved knee muscle strength and reduced pain in end-stage knee OA subjects and showed a promising tendency to improve performance-based physical function. PEMF therapy was shown to preferentially benefit knee muscle strength in female patients and patients aged over 70 years, whereas male patients were more responsive to PEMF therapy in the form of pain relief. clinicalTrials.gov, NCT05550428.

Sensorineural hearing loss in post-COVID-19 patients

&lt;b&gt;Background: &lt;/b&gt;Hearing loss (HL) is one of the most common chronic conditions after hypertension and arthritis. Mounting indices suggest that sensorineural hearing loss (SNHL) may be one of the adverse effects of severe acute respiratory syndrome coronavirus 2.&lt;br /&gt; &lt;b&gt;Objective: &lt;/b&gt;This work aimed at studying SNHL in post-COVID-19 patients, alongside with exploring the relationship between severity of the disease and degree of hearing disability.&lt;br /&gt; &lt;b&gt;Materials and methods: &lt;/b&gt;This prospective cross-sectional study was conducted at Al-Azhar University Hospitals, Cairo, Egypt. It included 100 post-COVID-19 patients selected according to the study inclusion and exclusion criteria. Pure tone audiometry was done to confirm the presence of HL and to determine its degree.&lt;br /&gt; &lt;b&gt;Results: &lt;/b&gt;Hundred patients with recent oncent hearing symptoms after documented COVID-19 infection were included. Males (71%) were more affected than females (29%). The most of our cases had bilateral moderate HL (45%). Tinnitus was the most frequently associated otological symptom (96.96%). The time of HL onset varied from days to weeks (55% had time onset between 11-30 days post-confirmed infection). Higher thresholds were detected in all frequencies of affected ears with more deterioration of hearing as frequencies increase. All degrees of HL were detected; mild, moderate, severe and profound. There was no significant correlation between severity of COVID-19 infection and severity of HL.&lt;br /&gt; &lt;b&gt;Conclusions: &lt;/b&gt;SNHL is one of the extrapulmonary complications of COVID-19. COVID-19 patients may develop hearing affection regardless the severity of the infection. It is recommended to assess hearing functions in patients after COVID-19 for early detection and proper management.

Efficacy of Biologic Therapies in the Management of Allergic Rhinitis: A Systematic Review.

Allergic rhinitis (AR) is a common chronic condition characterized by nasal congestion, sneezing, and itching, which significantly impacts quality of life. Traditional treatments, including antihistamines and intranasal corticosteroids, often fall short in managing moderate-to-severe cases. Recently, biologic therapies such as omalizumab and dupilumab have emerged as potential alternatives. This systematic review aims to evaluate the efficacy and safety of these biologic therapies in the management of AR. A comprehensive literature search was conducted across PubMed, Embase, Cochrane Library, and Web of Science to identify studies published between 2000 and 2024. Studies included were randomized controlled trials, cohort studies, and post-hoc analyses that assessed the impact of biologics on AR symptoms. Data on study characteristics, population demographics, intervention details, and outcomes were extracted and analyzed. The review included nine studies evaluating omalizumab and dupilumab. Omalizumab demonstrated significant improvements in nasal symptoms and quality of life, with notable efficacy in reducing symptoms and improving asthma control in patients with moderate-to-severe AR. Dupilumab also showed positive outcomes, particularly in patients with comorbid asthma and perennial AR, by reducing severe exacerbations and improving symptom scores. Biologic therapies, including omalizumab and dupilumab, offer promising alternatives for the management of AR, especially in cases that are severe or refractory to conventional treatments. The evidence supports their efficacy in improving symptoms and quality of life. Nevertheless, further research is required to address the limitations identified, including the need for long-term data and clarification of the mechanisms of action. These findings underscore the potential of biologics in advancing the treatment of AR and highlight the importance of ongoing research to optimize patient outcomes.

Complex interplays: Asthma management and maternal‑fetal outcomes in pregnancy (Review).

Asthma, a common chronic respiratory condition, poses unique challenges in pregnancy, impacting both maternal and fetal health. Of note, 8-13% of pregnant women suffer from asthma, a condition that can worsen, stabilize, or improve during pregnancy. These fluctuations necessitate a nuanced management strategy to ensure the health of both the mother and fetus. Adverse outcomes, such as preeclampsia, gestational diabetes and increased cesarean delivery rates are associated with poorly controlled asthma. From a fetal perspective, the risks include preterm birth and a low birth weight. Physiological changes in pregnancy, such as an increased tidal volume and altered drug metabolism due to increased blood volume, complicate the management of asthma. The safety of asthma medications during pregnancy remains a significant concern, with ongoing research into their teratogenic effects. Recent advancements in treatment include the development of biologics and the increased use of personalized medicine, integrating pharmacogenomics and immunological profiling to tailor treatments to individual needs. Digital health tools have also emerged, enabling improved patient monitoring and management. The present review highlights the complex interplay between asthma management and pregnancy outcomes, advocating for comprehensive care approaches that consider the dynamic physiological changes during pregnancy. It underscores the need for ongoing research into the safety of medication and innovative therapeutic strategies to improve health outcomes for pregnant women with asthma and their babies.

DIABEZE: Diabetes self-management among the elderly in a Belgian home for the aged: a best practice implementation project.

The aim of this project was to improve the self-management of diabetes among elderly residents in a Belgian home for the aged. Diabetes is a common chronic condition with significant comorbidity. Incidence is increasing, but a third of patients with diabetes are unaware that they have the disease. The treatment of diabetes requires a multifactorial approach. Treatment guidelines on diabetes recommend involving patients in monitoring their condition because supported self-management improves daily glycemic control. This evidence implementation project used the JBI Evidence Implementation Framework, which follows three phases. In the first phase, the area of change, stakeholders' role, and practice context and readiness for change are investigated. In the second phase, a baseline audit is conducted to compare current practice with best practice. Strategies are then implemented to address any areas of non-compliance with best practice. In the third phase, a follow-up audit is conducted to evaluate changes in practice. At baseline, six criteria had 0% compliance, two criteria had compliance lower than 50%, and only 49% of health care workers were familiar with the procedure for hypoglycemia treatment. Improvement strategies included creating awareness among health workers. In the follow-up audit, one criterion improved from 0% to 100%, three criteria improved from 0% to 85%, two criteria reached the threshold of 50% compliance, and one criterion reached 19%. Further audits are needed to ensure sustainability. This project improved diabetes self-management in elderly people living in a Belgian home for the aged. An in-depth planning phase with internal facilitation and interdisciplinary collaboration between all co-workers addressed barriers related to quality systems, structure, communication, and education. http://links.lww.com/IJEBH/A258.