Reduced Quality Of Life Research Articles

Health-related quality of life predicts prognosis in individuals with COPD hospitalized with community-acquired pneumonia – a prospective cohort study

Community-acquired pneumonia (CAP) in chronic obstructive pulmonary disease (COPD) often result in sudden and persistent reduction in health-related quality of life (HRQoL), which may be alleviated with palliative care. Among individuals with COPD, we aimed to investigate potential associations between HRQoL at admission with CAP and the risk of re-hospitalization and mortality and potential associations between specific HRQoL domains and CAP treatment outcomes. HRQoL was assessed at admission and the participants were grouped into tertiles based on the HRQoL utility index and specific domains. The results revealed that participants in the middle and highest tertiles of HRQoL had a lower 90-day re-hospitalization risk compared to those in the lowest tertile, whereas no differences in re-hospitalization risk were observed 30 and 180 days after discharge. Almost one in four had severe pain or discomfort at admission and the domain pain or discomfort emerged as a predictor of re-hospitalization. In addition, participants in the middle and highest tertiles had lower risk of 180-day mortality compared to those in the lowest, while no differences were observed in 30-day or 90-day mortality risk. An increased focus on in-hospital palliative care could alleviate the pain and discomfort reported by many participants with potential to reduce re-hospitalization rates.

Efficacy of Autologous Micrografting Technology in Managing Osteoarthritis Pain: A Pilot Study

Osteoarthritis (OA) is one of the most common joint diseases worldwide, predominantly present in elderly people. Being a major source of pain for patients, it is debilitating and leads inevitably to a reduction in quality of life. The management of OA needs a personalized and multidimensional approach, resulting in the emergence of new regenerative and non-invasive methods, such as the use of micrografts. In this pilot study, Rigenera® Technology was employed to obtain micrografts of cartilage tissue to be injected into the knees of 10 patients with osteoarthritic pain. To assess the efficacy of the treatment concerning pain reduction at this site, patients were asked to complete KOOS and WOMAC questionnaire and a VAS test before and after the procedure. The results presented in this article show how Rigenera® treatment can potentially improve OA symptoms, alleviating pain in patients.

Quality of life, physical symptoms, and psychological symptoms according to the status of chronic vestibulopathy.

Symptomatic vestibulopathy impairs patients' lives. However, few studies have explored the lives of patients with compensated or asymptomatic vestibulopathy. This study investigated the quality of life (QOL), psychological health, and physical function of patients with vestibulopathy. Using the eighth Korea National Health and Nutrition Examination Survey database, we included individuals with data on demographic factors, diabetes, hypertension, dizziness experiences, pure-tone audiometry, video head impulse test (vHIT), Health-related Quality of Life Instrument with 8 Items, General Anxiety Disorder 7-item scale, stress, and walking and sitting times. Participants were classified into the following groups: an uncompensated group with abnormal vHIT result and chronic dizziness, a compensated group with abnormal vHIT result and a history of dizziness, an asymptomatic group with abnormal vHIT result and no history of dizziness, and a normal group without abnormal vHIT result or a history of dizziness. Uncompensated vestibulopathy was more common in older individuals and women. The uncompensated group showed impairments in climbing stairs (P < 0.001), pain (P < 0.001), vitality (P = 0.001), working (P < 0.001), depression (P < 0.001), sleep (P = 0.001), happiness (P = 0.002), anxiety (P = 0.006), and stress (P = 0.003). The compensated group showed deficits in pain (P < 0.001), work (P = 0.006), sleep (P = 0.001), and happiness (P = 0.001). The asymptomatic group had no deficits in QOL, psychological health, or physical function. These tendencies were similar after controlling for age and gender. Vestibulopathy with a history of dizziness has a long-lasting impact on QOL and emotional status, even after compensation. Uncompensated vestibulopathy has a significant effect on QOL and mental health. Notably, though, the compensated group also showed a reduction in QOL. Appropriate interventions for each category of patients should be provided based on their impaired functions.

Neurotrophic and synaptic effects of GnRH and/or GH upon motor function after spinal cord injury in rats

Thoracic spinal cord injury (SCI) profoundly impairs motor and sensory functions, significantly reducing life quality without currently available effective treatments for neuroprotection or full functional regeneration. This study investigated the neurotrophic and synaptic recovery potential of gonadotropin-releasing hormone (GnRH) and growth hormone (GH) treatments in ovariectomized rats subjected to thoracic SCI. Employing a multidisciplinary approach, we evaluated the effects of these hormones upon gene expression of classical neurotrophins (NGF, BDNF, and NT3) as well as indicative markers of synaptic function (Nlgn1, Nxn1, SNAP25, SYP, and syntaxin-1), together with morphological assessments of myelin sheath integrity (Klüver-Barrera staining and MBP immunoreactivity) and synaptogenic proteins (PSD95, SYP) by immunohystochemistry (IHC) , and also on the neuromotor functional recovery of hindlimbs in the lesioned animals. Results demonstrated that chronic administration of GnRH and GH induced notable upregulation in the expression of several neurotrophic and synaptogenic activity genes. Additionally, the treatment showed a significant impact on the restoration of functional synaptic markers and myelin integrity. Intriguingly, while individual GnRH application induced certain recovery benefits, the combined treatment with GH appeared to inhibit neuromotor recovery, suggesting a complex interplay in hormonal regulation post-SCI. GnRH and GH are bioactive and participate in modulating neurotrophic responses and synaptic restoration under neural damage conditions, offering insights into novel therapeutic approaches for SCI. However, the intricate effects of combined hormonal treatment accentuate the necessity for further investigation that conduce to optimal and novel therapeutic strategies for patients with spinal cord lesions.

FIBROMIALGIA E DEPRESSÃO: IMPACTOS NA QUALIDADE DE VIDA

This work investigates the relationship between fibromyalgia and depression, two conditions that significantly affect individuals' quality of life and are often interconnected. Fibromyalgia is characterized by widespread chronic pain, fatigue, and sleep disturbances, while depression manifests as persistent feelings of sadness, loss of interest, and changes in appetite and sleep. The main objective of the research was to analyze how these conditions relate to and influence each other. The methodology involved a literature review of studies on the topic, including scientific articles, theses, and research reports. The analysis focused on the prevalence of depressive disorders in patients with fibromyalgia, the interactions between physical and psychological symptoms, and the treatment strategies aimed at improving the quality of life of affected individuals. The results revealed a strong relationship between fibromyalgia and depression, with a high prevalence of depressive disorders in patients suffering from chronic pain. Depression not only intensifies the perception of pain but can also lead to the worsening of physical symptoms and a reduction in quality of life. The simultaneous diagnosis of these conditions is often challenging, as the symptoms overlap, making it difficult to choose the appropriate treatment. Furthermore, conventional treatments, which often focus solely on pain relief, are not entirely effective. Another important aspect identified was the role of social support in coping with both conditions. Patients who receive support from family and the community tend to have a better response to treatment, highlighting the importance of care that considers both physical and emotional aspects. The concluding considerations indicate that the interaction between fibromyalgia and depression is complex and requires integrated attention that includes not only medical care but also psychological and social support. It suggests that a broader approach to treating these conditions can lead to more positive outcomes, improving patients' quality of life. Finally, the need to raise awareness about the importance of social support and integrated treatment is emphasized to facilitate recovery and proper management of fibromyalgia and depression.

Dialysis modality and quality of life: more answers yet more questions

Persons with end-stage kidney disease treated with dialysis experience distressing reductions in quality of life and increased mortality. Few large, randomized trials in nephrology have reported on health-related quality of life. Rose etal. report beneficial effects of high-volume hemodiafiltration versus high-flux hemodialysis on secondary end points of health-related quality of life in the CONVINCE trial (Comparison of High Dose Hemodiafiltration with High Flux Hemodialysis Trial). These results raise questions regarding hemodiafiltration as a potential modality to preserve health-related quality of life in end-stage kidney disease.

Photobiomodulation as a Potential Treatment for Alzheimer’s Disease: A Review Paper

Background: Alzheimer’s disease (AD), the most prevalent form of dementia, is a leading neurodegenerative disorder currently affecting approximately 55 million individuals globally, a number projected to escalate to 139 million by 2050. Despite extensive research spanning several decades, the cure for AD remains at a developing stage. The only existing therapeutic options are limited to symptom management, and are often accompanied by adverse side effects. The pathological features of AD, including the accumulation of beta-amyloid plaques and tau protein tangles, result in progressive neuronal death, synaptic loss, and brain atrophy, leading to significant cognitive decline and a marked reduction in quality of life. Objective: In light of the shortcomings of existing pharmacological interventions, this review explores the potential of photobiomodulation (PBM) as a non-invasive therapeutic option for AD. PBM employs infrared light to facilitate cellular repair and regeneration, focusing on addressing the disease’s underlying biomechanical mechanisms. Method: This paper presents a comprehensive introduction to the mechanisms of PBM and an analysis of preclinical studies evaluating its impact on cellular health, cognitive function, and disease progression in AD.The review provides a comprehensive overview of the various wavelengths and application methods, evaluating their efficacy in mitigating AD-related symptoms. Conclusions: The findings underscore the significant potential of PBM as a safe and effective alternative treatment for Alzheimer’s disease, emphasizing the necessity for further research and clinical trials to establish its therapeutic efficacy conclusively.

Association Between Irritable Bowel Syndrome and Lower Urinary Tract Symptomatology: A Cross-sectional Study in Mexican Population.

This study aimed to investigate the clinical phenotype of urinary symptoms in patients diagnosed with irritable bowel syndrome, the factors associated with this overlap, and the impact of urinary symptoms on their quality of life. Irritable bowel syndrome is a common disorder, affecting up to 3.8% of the population. The overlap with other disorders of the gut-brain interaction, psychiatric disorders, and other somatic disorders is common. Moreover, the association between irritable bowel syndrome and urinary symptoms has been recognized, but the clinical phenotype remains unclear. This cross-sectional study involved patients with irritable bowel syndrome according to Rome IV. Lower urinary tract symptoms were classified using the International Continence Society's classification. Data on demographics, medical history, medication use, anxiety, depression, and quality of life were collected and analyzed using logistic regression analysis. The study included 428 subjects, 86 diagnosed with irritable bowel syndrome. Patients exhibited a higher prevalence of lower urinary tract symptoms (60.5%, 95% CI: 50.5-71.9). Multivariate analysis revealed associations between irritable bowel syndrome and lower urinary tract symptoms (OR: 2.49, 95% CI: 1.48-4.18, P=0.001), particularly storage urinary symptoms (OR: 1.94, 95% CI: 1.10-3.40, P=0.021). Patients with urinary symptoms reported significantly lower quality of life compared with those without these symptoms (50.8±17.2 vs. 76.7±21.8, P<0.001). Irritable bowel syndrome is associated with lower urinary tract symptoms, contributing to a significant reduction in quality of life. Clinicians should consider referring patients with irritable bowel syndrome and lower urinary tract symptoms to experts in urodynamics to provide targeted management.

Natural Products and Their Neuroprotective Effects in Degenerative Brain Diseases: A Comprehensive Review.

As the global population ages, the incidence of neurodegenerative diseases such as Alzheimer's and Parkinson's is rapidly rising. These diseases present a significant public health challenge, as they severely impair cognitive and motor functions, ultimately leading to a substantial reduction in quality of life and placing a heavy burden on healthcare systems worldwide. Although several therapeutic agents have been developed to manage the symptoms of these diseases, their effectiveness is often limited, and there remains an urgent need for preventive strategies. Growing evidence indicates that bioactive compounds from natural products possess neuroprotective properties through antioxidant and anti-inflammatory effects, modulating key pathways such as phosphatidylinositol 3-kinase/protein kinase B (PI3K/AKT) and brain-derived neurotrophic factor-tropomyosin receptor kinase B-cAMP response element-binding protein (BDNF-TrkB-CREB), which are crucial for neuronal survival. These compounds may also reduce amyloid-beta and tau pathology, as well as enhance cholinergic neurotransmission by inhibiting acetylcholinesterase activity. By targeting oxidative stress, neuroinflammation, and neurodegeneration, natural products offer a promising approach for both prevention and treatment. These findings suggest that natural products may be promising for preventing and treating neurodegenerative diseases. This review aims to explore the pathogenesis of neurodegenerative diseases, the limitations of current therapies, and the potential role of natural products as therapeutic agents.

Association of adverse events and quality of life in patients with unresectable hepatocellular carcinoma.

Hepatocellular carcinoma (HCC) is the third-leading cause of cancer-related deaths globally. Patients are often diagnosed with advanced disease, in which systemic and locoregional therapies are commonly used as first-line treatment. Such treatments can cause adverse events (AEs) that negatively affect quality of life (QoL), which is particularly undesirable where prognosis is poor. The aim of the present study was to evaluate the impact of common AEs on QoL in patients with HCC. Data from the SARAH randomized controlled trial (RCT) were analyzed. Given the large number of distinct AEs that occurred in the trial, AEs were grouped as in the SARAH trial and prioritized using principal component analysis (PCA). Linear mixed-effects models were then applied with age, ECOG status, and AEs as predictors of the QoL change as measured with the EORTC Core Quality of Life Questionnaire (QLQ-C30). The PCA resulted in the selection of 28 AEs for inclusion in the linear mixed-effects models. Of the 28 AEs, diarrhea, decreased appetite, abdominal pain, and palmar-plantar erythrodysesthesia syndrome (hand-foot syndrome) were significant drivers of reductions in QoL as measured using the QLQ-C30 global health status scale. Diarrhea, abdominal pain, and hand-foot syndrome were also significant drivers of reduced QoL outcomes. The present analysis showed that diarrhea, decreased appetite, abdominal pain, and palmar-plantar erythrodysesthesia were significantly associated with reduced QoL in patients with unresectable HCC. Reducing the incidence and/or severity of these AEs should therefore be a key focus when selecting the optimal treatments for these patients.

Chemotherapy-induced cognitive impairment and its long-term development in patients with breast cancer: results from the observational CICARO study.

Chemotherapy-induced cognitive impairment (CICI) is a well-recognized side effect of breast cancer treatment. However, prospective long-term evaluations of CICI using standardized neuropsychological tests are scarce. This prospective longitudinal cohort study investigated cognitive dysfunction and its impact on quality of life and everyday functioning in patients with breast cancer receiving first-line chemotherapy compared to patients with breast cancer without chemotherapy. Assessment occurred prior to chemotherapy, postchemotherapy (median 6 months), and 2-3 years later. We used standardized neuropsychological tests, questionnaires, and scales to assess patients' quality of life and functioning. Additionally, serum analysis for neurodegenerative markers and autoantibodies was conducted. We included n = 53 patients. Overall cognitive function declined statistically significantly (P = .046) postchemotherapy compared to control patients, mostly driven by a reduced figural memory (P = .011). Patients who received chemotherapy showed a greater reduction in quality of life (increased fatigue symptoms, P = .023; reduced Karnofsky index, P<.001); however, without a statistically significant effect on cognitive decline. The neurodegenerative markers Neurofilament light chain (NfL) and phosphorylated Neurofilament heavy chain (pNfH) increased statistically significantly (P<.001) postchemotherapy and pNfH correlated with overall cognitive function. After 2-3 years, both cognitive performance and quality of life were comparable between chemotherapy-treated and control patients. Our findings suggest that chemotherapy statistically significantly contributes to overall cognitive dysfunction in patients with breast cancer, which disappears after 2-3 years, indicating a recovery in both objectively measurable cognitive function and subjective quality of life. Future research should examine larger sample sizes and explore screening indicators, particularly pNfH.

Development and Validation of a Prediction Model for Dysphagia in Community-Dwelling Older Adults.

Objectives. Dysphagia is a geriatric syndrome, which may lead to complications such as dehydration, malnutrition, aspiration, pneumonia, and a significant reduction in quality of life. The purpose of this study was to construct and validate a prediction model for dysphagia in community-dwelling older adults and provide an assessment tool for the prevention and control of dysphagia. Design. Cross-sectional study. Setting. The community-dwelling Chinese older adults. Participants. 3655 participants aged 65 years and older were involved, who were randomly divided into the training set and the validation set. Methods. Data were collected and analyzed from June 2022 to September 2022. Univariate and multivariate logistic regression analysis were used to identify independent risk factors for dysphagia. We applied R software to develop a nomogram model to predict dysphagia in community-dwelling older adults. The predictive value of the model was assessed by the area under the ROC curve (AUC), the calibration curve was used to evaluate the reliability of the nomogram model for predicting dysphagia in community-dwelling older adults. The model's clinical utility was further evaluated using a Decision Curve Analysis (DCA). Results. The incidence of dysphagia was 11.8% (320/3655). Maximum tongue pressure, number of molars, pneumonia, ADL, sarcopenia, age, neurological diseases, and rheumatic immune diseases were selected as risk predictors for dysphagia. The prediction model demonstrated fair discriminative ability with the AUC was 0.709 (95%CI: 0.679-0.739) in the training set and 0.693 (95%Cl: 0.640-0.747) in the validation set, the calibration is adequate, and the Hosmer and Lemeshow test showed p values of 0.163 and 0.415, respectively. The DCA curve of our model shows a positive clinical net benefit. Conclusions. The prediction model established in this study was of a certain predictive value for the risk of dysphagia in community-dwelling older adults. By estimating the likelihood of future outcomes or the onset of certain diseases, it can assist medical personnel in formulating preventive strategies, lessening the workload of nurses, and also diminishing the financial burden on patients, thereby enhancing their overall quality of life.

The Association between Fatty Liver Index and Lower Limb Arterial Calcification in Patients with Type 2 Diabetes Mellitus.

Peripheral arterial calcification is a prevalent condition in patients with type 2 diabetes mellitus (T2DM), resulting in lower-limb amputation and reduced life quality. Non-alcoholic fatty liver disease (NAFLD), which can be simply evaluated using the fatty liver index (FLI), is closely associated with T2DM development. In this study, we aimed to explore the relationship between FLI and lower limb arterial calcification (LLAC) in T2DM patients and to reveal the value of T2DM patients with NAFLD in predicting the occurrence of LLAC. A total of 77 T2DM patients with LLAC who underwent comprehensive physical and health examinations, serological examinations, as well as lower limb computed tomography imaging at Sun Yat-sen Memorial Hospital of Sun Yat-sen University between January 2018 and January 2019 were enrolled in this study. The FLI was calculated using body mass index, waist circumference, triglycerides, and γ-glutamyl transferase. Additionally, LLAC was evaluated using computed tomography with the Agatston scoring algorithm. The patients were divided into three groups based on their FLI values: Non-liver disease group (FLI <30, n = 29), borderline-liver disease group (30 ≤ FLI < 60, n = 32), and NAFLD group (FLI ≥60, n = 16). Univariate and multivariate binary logistic regression analyses were employed to investigate the association between FLI and LLAC in T2DM patients. Furthermore, differences in LLAC among groups were analyzed using post-hoc multiple comparisons and ordinal logistic regression model analysis. Univariate and multivariate analyses showed that age and FLI influenced LLAC severity in T2DM patients. Moreover, T2DM patients in the NAFLD group had significantly lower LLAC scores than those in the Non-liver disease group. The correlation analysis showed that FLI was negatively associated with LLAC scores (R = -0.31, p = 0.006), while age was positively associated (R = 0.361, p = 0.001). Our study revealed an inverse relationship between FLI and the degree of LLAC. This indicates that, based on evidence in the current research, NAFLD may not be reliable as a predictor of LLAC in T2DM patients.

ANXIETY, DEPRESSION, AND QUALITY OF LIFE OF NURSES WORKING IN PUBLIC HOSPITALS

Nursing is often described as the art of caring, providing holistic patient assistance without time restrictions. However, due to this nature of work, it is common for these professionals to present symptoms of mental illnesses such as anxiety and depression. This results in a reduction in the quality of life at work, directly affecting the efficiency of care provision. This study aimed to verify the presence of anxiety and depression symptoms, as well as the index of quality of life at work among nurses working in the inpatient sector of public hospitals in the city of Aracaju. Among the 128 professionals included in the sample, 46.1% presented anxiety symptoms and 30.5% depression symptoms, according to the HADS scale. Additionally, 66.4% of nurses reported an unsatisfactory quality of life at work index (QLWI). The majority of professionals who presented symptoms of both diseases were female; 17.2% had two employment bonds, and 19.5% reported an unsatisfactory QLWI. Therefore, it is possible to infer that the accumulation of employment bonds and the reduction in quality of life at work may have been determining factors for the development of these symptoms. It is concluded that it is extremely important to improve working conditions, safety, and remuneration, as well as increase the institutional appreciation and recognition of nursing professionals. This would contribute to raising the quality of life indices at work and reducing the need for multiple employment bonds.

Evaluation of akathisia in patients receiving selective serotonin reuptake inhibitors/serotonin and noradrenaline reuptake inhibitors.

Akathisia is an underestimated but disturbing extrapyramidal side effect of antidepressants, which could reduce treatment compliance in mood disorders. This study aimed to investigate the frequency and risk factors in patients treated with selective serotonin reuptake inhibitors/serotonin and noradrenaline reuptake inhibitors (SSRI/SNRI). In addition, we assessed the impact of akathisia on the quality of life (QoL). Patients were aged between 18 and 75 years, receiving an SSRI/SNRI for 4-8 weeks, and were diagnosed with anxiety, depression, or obsessive-compulsive disorder. The Barnes Akathisia Rating Scale was used to assess the severity of the akathisia. QoL was evaluated using the Short Form 36 (SF-36) questionnaire. Akathisia was observed in 25% (50/198) of patients. Smokers and younger patients were more frequent among patients with akathisia. Physical functioning, physical role, vitality, and mental health domains of the SF-36 were reduced in the presence of akathisia. In conclusion, our results suggest that akathisia is not a rare side effect of SSRI/SNRI in patients with mood disorders, especially in smokers and younger patients. In addition, akathisia may reduce treatment compliance owing to a reduction in QoL. Further investigations are needed to confirm the risk factors, frequency, and consequences of treatment compliance for SSRI/SNRI-induced akathisia in patients with mood disorders.

Comparative analysis of nasal endoscopic and radiological findings in chronic rhinosinusitis patients

Background: Chronic rhinosinusitis (CRS) is a complex inflammatory disorder causing significant reduction in quality of life and interfere in day to day activity. Accurate diagnosis is crucial for effective management, typically involving nasal endoscopy and CT imaging to assess the extent of sinus involvement. Methods: This prospective observational study was conducted at Jaipur national university institute of medical sciences and research centre from July 2022 to May 2024. It included 75 patients diagnosed with CRS. Subjective quantification of disease was done using SNOT-22 scoring system. Diagnostic evaluations were performed using nasal endoscopy and CT scans, with findings scored according to the Lund-Kennedy and Lund-MacKay systems. Results: The study highlighted a strong correlation between endoscopic and CT findings, with Pearson correlation coefficients of 0.892 and 0.909 for endoscopic vs. SNOT-22 scores and CT vs. SNOT-22 scores, respectively. Discrepancies between the two diagnostic tools were also noted, emphasizing their complementary roles in CRS management. Conclusions: Integrating nasal endoscopy and CT imaging provides a robust framework for diagnosing and managing CRS, allowing for a detailed assessment of both mucosal and anatomical changes. The combined use of these tools enhances the ability to tailor treatment plans effectively.

Quality of Life after Open Extremity Trauma (QUINTET) study: An international, multicentric, observational, cohort study of quality of life following lower extremity open fractures

IntroductionOpen lower limb fractures are severe injuries long-lasting consequences. Limited research has been done on the impact of these on quality of life, internationally. MethodsThe Quality of Life after Open Extremity Trauma (QUINTET) study was designed as an international, multi-centre, observational, cohort study of patients admitted with open lower limb fractures. Demographic and clinical information was collected, along with repeated validated quality of life measures. Primary outcomes were SF-12 and EQ-5D-3L and secondary outcomes were soft tissue infection, deep infection, non-union and amputation. ResultsA total 92 patients were enrolled in 8 centres, based in the UK, Spain, Chile and Sudan. Mean age at presentation of 54 years, 47 years for males and 64 years for females. Males presented a higher proportion of road traffic accidents as the underlying mechanism, while for females this was the case for low-energy falls. Participant retention was 71.7% and 73.9% for the 3 and 12-months assessments, respectively. There was a substantial reduction in quality of life after open fracture, which only partially recovered at 12 months. Participants recruited in the UK presented lower quality of life scores compared with patients treated in Spain and Chile. DiscussionFor this study, international patient recruitment proved challenging, leading to most patients being recruited in the UK. Despite this limitation we found significant a statistically significant detriment in self-reported quality of life which did not recover after a year. This study highlights differences in quality-of-life outcomes from a gender and international perspective.

Rational application of the ESPGHAN 2022 recommendations for the follow-up of the paediatric coeliac patient: consensus document of scientific societies (SEGHNP, AEPAP, SEPEAP, SEEC, AEG, SEPD, SEMFYC, SEMG and SEMERGEN)

Coeliac disease is a common condition for which the only current treatment is a gluten-free diet. Adherence to this diet is not always easy and is associated with a reduction in quality of life for the patient and their family. Non-adherence is associated with complications of varying severity. The lack of control at the outpatient care level in a high percentage of these patients evinces the need to improve follow-up protocols and the approach to care delivery with coordination of paediatric gastroenterology units (PGU) and primary care paediatricians. With this aim in mind, the present document was developed by consensus to offer a set of recommendations adapted to our region, based on the recent recommendations published by the European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN), and with participation of the pertinent scientific societies, including those concerning the adult population, for the management and follow-up of adolescents and the transition to adult care.

Austrian consensus statement on the diagnosis and management of hypertrophic cardiomyopathy.

Hypertrophic cardiomyopathy (HCM) is the most common inherited heart disease that is characterized by left ventricular hypertrophy unexplained by secondary causes. Based on international epidemiological data, around 20,000-40,000 patients are expected to be affected in Austria. Due to the wide variety of clinical and morphological manifestations the diagnosis can be difficult and the disease therefore often goes unrecognized. HCM is associated with asubstantial reduction in quality of life and can lead to sudden cardiac death, especially in younger patients. Early and correct diagnosis, including genetic testing, is essential for comprehensive counselling of patients and their families and for effective treatment. The latter is especially true as an effective treatment of outflow tract obstruction has recently become available in the form of afirst in class cardiac myosin ATPase inhibitor, as anoninvasive alternative to established septal reduction therapies. The aim of this Austrian consensus statement is to summarize the recommendations of international guidelines with respect to the genetic background, pathophysiology, diagnostics and management in the context of the Austrian healthcare system and resources, and to present them in easy to understand algorithms.

MMP-12 and Periodontitis: Unraveling the Molecular Pathways of Periodontal Tissue Destruction.

Periodontal disease is a common disorder affecting a wide range of people and has a high prevalence globally. Periodontitis comprises a series of inflammatory conditions affecting periodontal support tissue, which could ultimately lead to tooth loss and reduce life quality and add to the financial burden of society. Matrix metalloproteinase-12 (MMP-12) is an elastase that is produced mostly by macrophages and could degrade a wide spectrum of extracellular matrix (ECM) and also contribute to several systematic pathological conditions. Recently, researchers have reported higher expression of MMP-12 in chronic periodontitis patients. However, there are few reports on the role of MMP-12 in periodontitis pathogenicity, and the interaction between MMP-12, periodontal pathogens, and periodontal tissues remains unclear. In this review, we introduce the potentially unique role of MMP-12 in the context of periodontal inflammation earlier, summarize the possible effects of MMP-12 on the pathological process of periodontitis and the interaction of host response under the challenge of various inflammatory factors, and provide possible diagnostic and therapeutic strategies targeting MMP-12 for the management of periodontitis. Future research and policies should focus on and implement effective chairside testing methods to reduce the prevalence of periodontal diseases.