Risk Of Illness Research Articles

Psychological Interventions to Improve Elite Athlete Mental Wellbeing: A Systematic Review and Meta-analysis

Abstract Background Mental wellbeing, one continuum alongside mental illness in a dual-continua mental health model, has attracted less attention compared with substantial studies concerning mental illness amongst elite athletes. Notably, the promotion and protection of mental wellbeing contribute to not only a positive status of flourishing but also a reduction in the future risk of mental illness, which can potentially facilitate a status of complete mental health. Despite the critical role of wellbeing promotion and protection, there are limited evidence-based strategies to design and implement wellbeing interventions in elite athletes. Objective This review aims to identify the different types of interventions to improve mental wellbeing amongst elite athletes and meta-analyse their effects. Further, the study aims to narratively identify the factors affecting implementation success in elite athletes. Methods Peer-reviewed articles were systematically searched through five electronic databases (SPORTDiscus, PsycINFO, PSYCArticles, Academic Search Complete and MEDLINE) in July 2023 and updated in May 2024. To enrich the overall findings and reduce the risk of publication bias, grey literature was also included in this review. Dissertations and theses were the main foci and were searched in September 2023 and updated in May 2024. Standardised mean differences (SMDs) with 95% confidence intervals (CIs) were calculated to estimate the effects of the different types of interventions on mental wellbeing. Further, a narrative synthesis under the Consolidated Framework for Implementation Research was conducted to identify the potential factors that influenced the implementation success. Results A total of 27 studies were found from peer-reviewed and grey literature, of which 15 studies were subject to meta-analyses. Results indicated that psychological skills training (SMD = 0.78, 95% CI 0.24, 1.32), third-wave interventions (SMD = 0.32, 95% CI 0.01, 0.63) and positive psychology interventions (SMD = 0.58, 95% CI 0.31, 0.85) were all potentially effective in improving overall wellbeing amongst elite athletes. However, when quasi-experimental studies in the third-wave interventions were removed for the sensitivity analysis, the effect was no longer significant. Further, 11 facilitators and 3 barriers to implementation success were identified, of which adaptability, coach and teammate support, and instructor’s capacity to connect with athletes were the key facilitators, and busy schedules and complex intervention contents were the main barriers. Conclusions This review indicated that psychological skills training, third-wave interventions and positive psychology interventions could be potentially effective for elite athlete mental wellbeing, but more studies with robust experimental designs are needed in future to increase confidence in the favourable results. Moreover, future researchers and practitioners need to be aware of context-specific implementation facilitators and barriers, optimising elite athletes’ engagement and uptake of interventions. PROSPERO CRD42023437986.

Dietary and Nutritional Aspects of Metabolic Syndrome Management: An Overview

Sedentary lifestyles and prolonged physical inactivity are often linked to poor mental and physical health as well as an increased risk of a number of chronic illnesses, including cancer, obesity, type 2 diabetes, and cardiovascular problems. Metabolic Syndrome (MetS), as the new disease, has emerged as the world's leading cause of illness. Despite having its roots in the West, this issue has now completely globalized due to the development of the Western way of life throughout the world. It currently affects almost one-fifth of the American and European populations, and its incidence has increased in Southeast Asian nations as well. Comparing patients with metabolic syndrome to the general population, it is estimated that they have a 5-fold greater risk of diabetes mellitus and a 2-fold increased risk of atherosclerotic cardiovascular illnesses. MetS is a chronic or prevalent condition associated with various lifestyle conditions characterized by abdominal obesity, low HDL-c cholesterol, insulin resistance, high blood pressure, and dyslipidemia. It has been suggested that insulin resistance, chronic inflammation, and neurohormonal activation are the factors behind the development of metabolic syndrome. In lieu of an upsurge in the complications associated with MetS in modern society, many alternative approaches apart from medicine are being constantly explored. Effects of vivid dietary patterns and nutritional interventions have been thoroughly researched, although the most effective dietary approach remains undetermined. This review discussed different etiological aspects of MetS and brought forth the role of nutritional approaches, micro- and macronutrient intake, lifestyle changes, and herbal intervention in its management.

Zoonotic diseases awareness and food safety practices among livestock farmers in Nepal

Interactions between humans and livestock could increase the risk of zoonotic disease transmission. In addition, limited knowledge of zoonoses and foodborne diseases among livestock farmers could heighten the risks of foodborne illness and outbreaks of zoonotic diseases. This study evaluated the awareness of zoonotic diseases and preventive practices for zoonotic and foodborne diseases among livestock farmers of the Chitwan, Rupandehi, and Tanahun districts of Nepal by conducting a cross-sectional survey of 280 livestock farmers. They were recruited using the purposive sampling method from October to December 2022. Descriptive statistics revealed that most (72.1%; n = 202/280) livestock farmers were aware of zoonosis. None of the farmers knew about the zoonotic nature of leptospirosis. Two-thirds of pig farmers (67%; n = 12/18) were aware of zoonotic transmission of swine flu, and more than half of the poultry (58%; 50/86) farmers knew about zoonotic avian influenza. The majority of the farmers who had dogs (83%) and cats (89.4%) in their homes or farms knew that rabies can be transmitted to humans from dogs or cats. The multivariable logistic regression analysis revealed that farmers from the Rupandehi district (aOR: 5.56; 95% CI: 2.18–14.22) and Chitwan (aOR: 6.52; 95% CI: 2.46–17.25) had a higher odds of having good preventive practices than those from Tanahun. Also, farmers who had no sickness in the past 6 months after consumption of animal products were three times (aOR: 2.98; 95% CI: 1.48–6.01) more likely to have better practices. Furthermore, secondary education (aOR: 3.64; 95% CI: 1.41–9.44) was a significant positive predictor of good zoonotic diseases and food safety preventive practices. Our study underscores the necessity to enhance Nepalese livestock farmers’ awareness and practices regarding zoonotic and foodborne diseases. It emphasizes the importance of understanding risks, effective behavioral change strategies, and engaging farmers in developing zoonotic disease and foodborne illness prevention programs.

Mental Illness and Substance Use Disorder Stigma: Mapping Pathways Between Structures and Individuals to Accelerate Research and Intervention.

Researchers, interventionists, and clinicians are increasingly recognizing the importance of structural stigma in elevating the risk of mental illnesses (MIs) and substance use disorders (SUDs) and in undermining MI/SUD treatment and recovery. Yet, the pathways through which structural stigma influences MI/SUD-related outcomes remain unclear. In this review, we aim to address this gap by summarizing scholarship on structural MI/SUD stigma and identifying pathways whereby structural stigma affects MI/SUD-related outcomes. We introduce a conceptual framework that describes how structural-level stigma mechanisms influence the MI/SUD treatment cascade via (a) interpersonal- and individual-level stigma mechanisms and (b) mediating processes among people with MI/SUD (i.e., access to resources, psychological responses, behavioral responses, social isolation). We consider intersections between MI/SUD stigma and stigma based on race/ethnicity, gender identity, and sexual orientation. Finally, we discuss the implications of this review for future research, interventions, and clinical practice.

Lacto-Fermented Fruits and Vegetables: Bioactive Components and Effects on Human Health.

Lacto-fermented fruits and vegetables (FVs) such as kimchi, sauerkraut, and fermented olives and nonalcoholic juices have a long history as dietary staples. Herein, the production steps and microbial ecology of lacto-fermented FVs are discussed alongside findings from human and laboratory studies investigating the health benefits of these foods. Lacto-fermented FVs are enriched in bioactive compounds, including lactic and acetic acids, phenolic compounds, amino acid derivatives such as indole-3-lactic acid, phenyl-lactic acid, γ-aminobutyric acid, and bacteriocins, and beneficial live microbes. At least 11 human studies have been performed on kimchi, whereas others have been investigated in only one or two trials. Besides exploring the health benefits, it is imperative to ensure that these foods made either commercially or at home have minimal risk for foodborne illness and exposure to undesired compounds like biogenic amines. Development of starter-culture strains and production protocols can lead to lacto-fermented FVs designed for specific health benefits.

Infants of diabetic mothers: epidemiology, pathophysiology, fetal heartassessment, structural and functional heart consequences: A narrative review.

Infants of diabetic mothers are neonates born to a woman who had periodic hyperglycaemia during pregnancy. Consequently, infants of diabetic mothers are at higher risks of illness besides morbidity and mortality due to teratogenic effects on the fetal cardiovascular system, causing most frequent CHDs. The primary purpose of this review is to present, on this topic, a better-comprehended review covering pertinent material and data to be informed of severe risks to a newborn's cardiac system and function. These conditions can affect maternal, fetal, neonatal, and future adult health. Further research should be addressed towards the early detection of diabetes, its magnitude, and management. Immediate interventions should be proposed to lessen the diabetes burden and its adversative effects during the prenatal period.

A Bibliometric Analysis of Juvenile Crimes and Psychological Well-Being: Trends, Patterns, and Gaps in Research

Introduction: Adolescent criminal behaviour is considered to be a serious global societal concern, with adverse physical and psychological effects for both the victims as well as the perpetrators. According to studies, incarcerated adolescents experience a greater risk of mental illnesses than the overall juvenile population. Approximately 14% to 20% of young individuals in the general population are diagnosed with a mental condition, with 9% to 13% experiencing severe emotional distress. The current study aims to find the patterns of previously existing literature associating Juvenile Crimes and Psychological Well-Being.Methods: After screening the units through a Prisma model, 1068 documentary units were included for further analysis. The documentary units were analysed using VOS Viewer Software and Hazing’s Publish and perish software.Results: From the results it was found that the United States secured the top ranking in terms of the number of papers and citations with over 862 papers and 26544 citations with medicine being the top contributing area. The current study also identified top authors, journals and research papers that were the major contributors in the area. Further bibliometric analysis showed the collaboration between different authors, journals, themes and organizations.Conclusion: The study gives an overall understanding about the various research as well as various aspects with which researchers have studied the current area. The research gap is evident from the number of publications as well as the areas in which the research has been looked into which thereby lays the platform for future studies

The Valemee Visual System Helps Reduce Risk for Chronic Illness by Promoting Physical Fitness, Self-Efficacy and Independence in Adults With Intellectual Disabilities.

Sedentary behaviour among individuals with intellectual disabilities, driven by barriers such as limited access to adapted programs and low self-efficacy, contributes to chronic health conditions. This study evaluates the effectiveness of the Valemee Visual System (VVS), a novel tool offering visual support and structured exercise programming, in improving physical fitness and promoting exercise independence in this population. A repeated measures design was employed with an 8-week intervention involving 22 participants aged 22-44 with mild to moderate intellectual disabilities. The program utilised the VVS for total body fitness training. Participants demonstrated significant improvements in grip strength, sit-to-stand performance, bench press capacity, 400-m walk time, and flexibility. Self-efficacy increased, and reduced reliance on prompts indicated greater exercise independence and autonomy. The VVS shows promise in enhancing physical fitness, accessibility, and adherence in adults with intellectual disabilities, supporting long-term health and reducing chronic disease risk.

Volatile hydrocarbon exposures and immune-related illnesses among Deepwater Horizon oil spill workers.

Despite evidence from experimental studies linking some petroleum hydrocarbons to markers of immune suppression, limited epidemiologic research exists on this topic. The aim of this cross-sectional study was to examine associations of oil spill related chemicals (benzene, toluene, ethylbenzene, xylene, and n-hexane (BTEX-H)) and total hydrocarbons (THC) with immune-related illnesses as indicators of potential immune suppression. Subjects comprised 8601 Deepwater Horizon (DWH) oil spill clean-up and response workers who participated in a home visit (1-3 years after the DWH spill) in the Gulf Long-term Follow-up (GuLF) Study. Cumulative exposures to THC and individual BTEX-H constituents during the oil spill clean-up were estimated using a job-exposure matrix linking air measurement data to detailed participant work histories. Study outcomes included post-spill occurrence and/or frequency of illnesses ascertained at the home visit, including colds, flu, cold sores, pneumonia, and shingles. Frequent cold and frequent flu were defined as ≥4 colds and ≥2 episodes of flu since the spill, respectively. We examined an aggregate outcome of frequent colds, any flu, cold sores, or pneumonia since the spill. In single pollutant models, we used multivariable log-binomial regression to estimate prevalence ratios (PR) and 95% confidence intervals (CI) for associations between quartiles of THC and BTEX-H exposures with each outcome. We used quantile g-computation to estimate the joint effect of the BTEX-H mixture. We observed positive associations of increasing quartiles of THC and BTEX-H with all outcomes except shingles, with evidence of an exposure-response for most outcomes. Strongest associations were observed for frequent flu (range of PR: 1.41-1.67). The BTEX-H mixture was associated with small to modest elevations in PRs for most outcomes. This study is the first to our knowledge to demonstrate an association between oil spill BTEX-H exposures and multiple immune-related illnesses as measures of potential immune suppression. Increasing oil spill-related volatile hydrocarbon exposures may increase the risk of multiple immune-related illnesses, especially frequent cold and frequent flu. Future research on this topic using more robust measures of immune function would advance existing evidence on this relationship.

Assessment and ascertainment in psychiatric molecular genetics: challenges and opportunities for cross-disorder research.

Psychiatric disorders are highly comorbid, heritable, and genetically correlated [1-4]. The primary objective of cross-disorder psychiatric genetics research is to identify and characterize both the shared genetic factors that contribute to convergent disease etiologies and the unique genetic factors that distinguish between disorders [4, 5]. This information can illuminate the biological mechanisms underlying comorbid presentations of psychopathology, improve nosology and prediction of illness risk and trajectories, and aid the development of more effective and targeted interventions. In this review we discuss how estimates of comorbidity and identification of shared genetic loci between disorders can be influenced by how disorders are measured (phenotypic assessment) and the inclusion or exclusion criteria in individual genetic studies (sample ascertainment). Specifically, the depth of measurement, source of diagnosis, and time frame of disease trajectory have major implications for the clinical validity of the assessed phenotypes. Further, biases introduced in the ascertainment of both cases and controls can inflate or reduce estimates of genetic correlations. The impact of these design choices may have important implications for large meta-analyses of cohorts from diverse populations that use different forms of assessment and inclusion criteria, and subsequent cross-disorder analyses thereof. We review how assessment and ascertainment affect genetic findings in both univariate and multivariate analyses and conclude with recommendations for addressing them in future research.

Risk for exertional heat illness among US army enlistees: climate indexes, intrinsic factors and their interactions.

To characterise intrinsic and extrinsic (climatic) risks for mild and severe exertional heat illness (EHI) among first-year army enlistees. We examined 337 786 soldiers who enlisted between 2012 and 2019. Survival models were used to predict incident EHI from intrinsic factors (demographics, healthcare utilisation, chronic conditions, body mass index (BMI), Army Physical Fitness Test (APFT), upper/lower respiratory tract infections (URTI and LRTI), skin and soft-tissue infections (SSTI), extrinsic factors (geographical region, daily mean Universal Thermal Climate Index (UTCI), wet bulb globe temperature (WBGT)) and interactions. There were 1390 cases of mild and 359 cases of severe EHI. Females had a higher risk for mild (adjusted OR (aOR) 1.78; 95% CI 1.57 to 2.02) but a lower risk for severe (aOR 0.61; 95% CI 0.38 to 0.87) EHI. Obesity was associated with severe EHI (aOR: 1.76; 95% CI 1.09 to 2.84) but not mild EHI (aOR: 1.03; 95% CI 0.76 to 1.39). URTI was associated with severe (aOR: 2.44; 95% CI 1.12 to 5.30) and mild (aOR 3.72, 95% CI 2.84 to 4.87) EHI, as were LRTI (severe, aOR: 11.40; 95% CI 6.09 to 21.32; mild, aOR 2.06; 95% CI 1.22 to 3.46), but not SSTI. UTCI outperformed WBGT in predicting EHI. Outside the Southern USA, EHI risk was elevated at lower UTCI. Associations varied over climate conditions and generally did not increase with climatic heat stress. Respiratory infections were associated with the highest risk for EHI in soldiers. Risk mitigation strategies may include monitoring prevention and recovery from respiratory infections. Female sex and obesity may have different associated risks over climate conditions.

Applications of Metal Nanoparticles in Healthcare and Food Safety

The increased world population has led to a rise in pollution, raising the risk of food contamination and foodborne illness. It is often said that illness enters by the mouth. Food spoilage has always been a great hazard to human health. Therefore, ensuring the safety of food is essential in the pursuit of good health. The advent of nanotechnology has sparked potential in the food industry. Nanotechnology has also shown its ability to reduce cases of foodborne diseases, thereby improving global food security from the root. With the introduction of nanoparticles (NPs), particularly metal NPs like gold and silver, food processing and delivery methods have been further refined. These NPs have demonstrated effective resistance against pathogens. Their antimicrobial abilities play a vital role in nano materials for food packaging. The main mechanism of metal NPs involves their interaction with bacterial cell walls, which enhances cell wall permeability and achieves cell wall damage. At the same time, toxic radicals are released from the NPs and can be dissolved to be absorbed by bacteria. These results in the leakage of cellular contents, inhibiting cell replication, and ultimately, cell death. The application of metal-based NPs significantly contributes to food safety. Therefore, in this work, the applications of various nanomaterials in food safety and healthcare are discussed in detail. This work will contribute to promoting the deep application of nanomaterials in food safety and healthcare.

Association Between Adolescent Violence Exposure and the Risk of Suicide: A 15-Year Study in Taiwan

Background/Objectives: According to the 2023 Ministry of Health and Welfare statistics, the suicide rate among adolescents aged 15 to 24 has steadily increased since 2018, from 3.7 to 5.5 per 100,000 populations, reaching a recent high. Although previous studies have pointed out that the future risk of suicide of those who had suffered from abuse was higher than that of the general population, researchers seldom focused on adolescent groups. Therefore, the aim of this study was to explore the risk of suicide after youth violence and the impact of subsequent comorbid mental illness and suicide risk. Methods: This retrospective matched cohort study analyzed data from the NHIRD, covering the period from 2000 to 2015. A total of 976 cases aged 10–18 who had experienced violence were included in this study. Controlled grouping was conducted by 1:10 matching based on gender, age, and the time of medical treatment, and a control group who had not experienced violence was selected for comparison. We used the Cox proportional hazards model to analyze the risk of suicide among adolescents after exposure to violence. Results: The suicide rate among adolescents who have experienced violence was significantly higher than that of the control group after 15 years of follow-up (1.0% vs. 0.5%). The prevalence of mental illness or disorders in adolescents exposed to violence was significantly higher than in the control group (45.2% vs. 40.1%). Among adolescents who had experienced violence, the methods of suicide included poisoning (solid and liquid) (53.6% vs. 43.2%), hanging (1.2% vs. 0.6%), firearms (2.4% vs. 0%), and cutting instruments (27.4% vs. 22.8%), all of which were significantly higher than in the control group. After adjusting for gender, age, residential area, and mental health comorbidities, the risk of suicide in those who had experienced violence was 1.475 times that of the control group (95% CI = 1.125–1.933; p = 0.005). Conclusions: In this study, female, younger age, and comorbid mental disorders were identified as risk factors for suicide among the adolescent victims of violence. Exposure to youth violence was associated with an increased prevalence of emotional disorders, including depression and social isolation, which subsequently elevated the suicide risk. These findings underscore the urgent need for governmental attention to the mental health of adolescent victims of violence. Implementing targeted psychological support and intervention programs could play a crucial role in mitigating the risk of suicide among this vulnerable population.

The role of childhood traumas, psychological resilience and autonomic nervous system reactivity in cardiovascular diseases

ABSTRACT Objective Early life experiences significantly impact an individual's health. Stressful events during childhood increase the risk of chronic illnesses, including cardiovascular diseases (CVD). This study examines the connection between childhood traumatic experiences (CTE) and CVD, focusing on the roles of psychological resilience (PR) and Autonomic Nervous System Reactivity (ANSR). Method The hierarchical logistic regression model was tested on data collected using self-report questionnaires from 327 participants (164 with CVD, 163 healthy). Result Psychological neglect (PN) emerged as the primary predictor of CVD among CTE factors. Incorporating PR and ANSR into the analysis showed they had a minimal impact on the CVD–CTE relationship. Additionally, over protection/over control (OP–OC) was significantly associated with CVD. Discussion The link between CVD, PR and CTE warrants more attention. Psychological interventions are essential to help high-risk populations by either reducing the onset or mitigating long-term effects of CVD.

Preparation Methods and Perceived Risk of Foodborne Illness Among Consumers of Prepackaged Frozen Vegetables - United States, September 2022.

Listeria monocytogenes causes listeriosis, a serious infection, with a high mortality rate for persons at higher risk for listeriosis. The first Listeria outbreak linked to frozen vegetables occurred in 2016 and resulted in three deaths. Many frozen vegetables are intended to be consumed after cooking. However, data on consumer behavior are sparse. We characterized consumers' perceptions of contamination of prepackaged frozen vegetables, and preparation methods of prepackaged frozen vegetables to help inform prevention strategies. During September 1-24, 2022, Porter Novelli Public Services conducted the FallStyles survey using the Ipsos KnowledgePanel. Data were weighted to be representative of the U.S. population. Point estimates and 95% CIs were calculated and differences between respondents were determined using Wald chi square tests. Among 3,008 respondents reporting a preparation and consumption method for frozen vegetables, 8.7% (95% CI = 7.4%-10.0%) reported ever consuming the product raw. Respondents who reported having children <18 years old were more likely to report ever consuming frozen vegetables raw compared with respondents who did not (12.5% vs. 7.4%, p<0.01). The most reported raw preparation method was adding them directly to a blender for smoothie or juice (5.6%; 95% CI = 4.6%-6.7%). Among respondents who reported eating frozen vegetables, 59.6% (95% CI = 57.6%-61.6%) reported following package instructions. A third (34.1% [95% CI = 32.2%-35.9%]) of respondents agreed that frozen vegetables can be contaminated with germs (like Salmonella, E. coli, and Listeria), with a greater proportion of people with cancer disagreeing compared to those without cancer (32.5% vs 23.4%, p=0.041). These findings show that some consumers may not be cooking frozen vegetables before eating them. Second, consumers might not be reading instructions on packaging. Both findings highlight the critical importance of preventive controls in the production of frozen vegetables prior to reaching the consumer.

Status of Inappropriate Complementary Feeding and Its Associated Factors Among Infants of 9-23 Months.

Background: Inappropriate complementary feeding during the first two years of life significantly impacts children's health, increasing risks of malnutrition and illness. Methods: This study investigates factors influencing early feeding patterns among 600 mothers of children aged 9-23 months in selected hospitals in Punjab, Pakistan. Using a structured questionnaire, data were collected and analyzed, with associations measured by odds ratios (ORs) and 95% confidence intervals (CIs). Results: The results showed the key indicators of inappropriate complementary feeding among young children, including timely complementary feeding, minimum meal frequency, dietary diversity, and acceptable diet. The rates for these factors were found to be 60.3%, 32.7%, 24.6%, and 48.5%, respectively. The study identified several significant factors influencing these practices. Key predictors of inappropriate feeding included the order of birth, the mother's employment status, parental education, the number of children, household income, maternal knowledge, and maternal health. Conclusion: The findings underscore that maternal education, employment, and health significantly influence complementary feeding. Targeted interventions and education programs are essential to support healthy feeding behaviors, especially for mothers facing challenges related to education, work, or health conditions. Addressing these practices can improve child health outcomes, contributing to economic growth and a healthier future for Pakistan's youngest population.

CLINICAL PROFILE AND OUTCOME AMONG ADULT COVID-19 PATIENTS ADMITTED IN SELECTED LEVEL 1 HOSPITAL IN QUIRINO PROVINCE: A RETROSPECTIVE STUDY

The COVID-19 pandemic has posed unprecedented challenges to healthcare systems worldwide, necessitating a thorough understanding of its impact on patient demographics, clinical presentations, and outcomes. Thus, this study was conducted to investigate the demographic and clinical profiles, as well as outcomes, of COVID-19 patients admitted to Quirino Province Medical Hospital from 2021 to 2022. The patient population exhibited a diverse age distribution, with a concentration in the 58-67 age group, indicating potential higher risks for severe illness among older adults. Respiratory issues were predominant. Also, there were patients experiencing moderate disease severity and facing severe disease. Despite most patients having no comorbidities, cardiovascular conditions led among those with comorbidities, emphasizing the need for cardiac health monitoring. As to clinical outcomes large number of patients were discharged alive, Significant differences in clinical status and outcomes were observed when grouped by age, sex, civil status, and occupation. Age and civil status demonstrated notable associations with disease severity, while sex and occupation had less influence. These findings underscore the importance of tailored healthcare strategies, proactive planning, and early detection to effectively manage COVID-19 patients and promote health equity. Further research is essential to adapt and improve healthcare approaches in this dynamic landscape. KEYWORDS: Clinical Profile, Clinical Outcome, Comorbidity, COVID-19, Severity

Illness Perception and Risk Management Behaviors Among Patients With Gynecologic Cancer at Risk of Lower Extremity Lymphedema.

Patients with gynecologic cancer who undergo lymphadenectomy are at increased risk of lower extremity lymphedema (LEL). They are encouraged to be alert to the possibility of LEL and take risk-management measures throughout life. However, we know little about the perception for LEL and adherence to risk-management measures of Chinese patients with gynecologic cancer. To assess the illness perception and risk management behaviors of Chinese gynecologic cancer patients and further examine the effect of illness perception on risk management behaviors. This was a cross-sectional study. From June to December 2023, gynecologic cancer patients at risk of LEL were surveyed (n = 223). Questionnaires on illness perception and risk management behaviors specifically for LEL were utilized. Descriptive statistics, Pearson correlation analysis, univariate analysis, and multiple linear regression analysis were used for data analysis. The participants exhibited suboptimal LEL risk management behaviors, with the physical activity dimension receiving the lowest score (3.24 ± 1.02). Patients' self-perceived understanding of LEL was relatively low (2.88 ± 0.83). Multiple linear regression analysis revealed that the identity, cause, and control dimensions of illness perception, as well as several demographic and disease variables, were significant predictors of patients' LEL risk management behaviors. The LEL risk management behaviors of patients with gynecologic cancer need to be improved. Consideration of perceptions of identity, cause, and control is crucial for enhancing LEL risk management behaviors. Health professionals can implement targeted health education based on an assessment of patients' perceptions of LEL, thereby promoting lymphedema risk management.

Lupus and SARS-CoV-2: What have we learned after the pandemic?

After the end of the COVID-19 public health emergency, we analysed the relationship between Systemic Lupus Erythematosous (SLE) and COVID-19 from the virologist's perspective based on recent findings. SLE and COVID-19 co-morbidity present unique challenges, as individuals with SLE may be at increased risk for severe COVID-19 illness due to immune system abnormalities and ongoing therapies. Effective management of both diseases requires careful monitoring, adherence to vaccination programs, preventive measures and approved and patient-tailored therapies. This review covers various aspects, including the clinical outcome of SLE patients infected by SARS-CoV-2, the impact of this infection on SLE onset or flare-ups and the benefits of vaccination for this population. Furthermore, this review presents the most recent recommendations on clinical management of COVID-19 in rheumatic patients, including those with SLE, discussing the currently available therapeutic options. Finally, we explore the most effective tools for SARS-CoV-2 diagnosis in autoimmune conditions and examine prognostic biomarkers in COVID-19 rheumatic patients with potential implications on their clinical oversight. By adopting a comprehensive approach, we address these complexities from the virologist's perspective, aiming to improve health care for this vulnerable population.

The Impact of Diabetes-related Factors on the Severity and Outcome of COVID-19 Infection in Hospitalized Patients: A Descriptive-analytical Study

Introduction: The COVID-19 pandemic is having a devastating impact on public health, with a higher risk of severe illness and mortality in vulnerable groups. Individuals with a history of diabetes are more prone to severe COVID-19. A collection of hyperglycemia, inflammation, and impaired immunity in diabetes, especially in poor glycemic control, notably increases the risk of COVID-19 severity. Hyperglycemia can trigger the release of inflammatory cytokines, highlighting the intricate relationship between glucose metabolism and inflammation, and contributing to cytokine storms that worsen COVID-19 severity. Understanding this relationship enables healthcare providers to develop personalized care strategies for managing blood glucose in diabetic patients, thereby reducing the risk of severe COVID-19 outcomes. This study aims to identify the factors that contribute to the severe outcomes of COVID-19 in patients with diabetes, to better understand and manage this critical combination. Methods: A total of 411 patients with COVID-19 infection referred to the Teaching Hospital of Mazandaran University of Medical Sciences, Sari, were included in this study. The COVID-19 severity was evaluated according to the World Health Organization (WHO) guidelines. All information including demographic, clinical, and laboratory data as well as severity and outcome of the disease were compared between diabetic and non-diabetic patients. Results: The diabetic patients had higher blood glucose (210.3 ±114.9 mg/dl) compared to nondiabetics (118.74 ±3.8 mg/dl) upon admission (p=0.0001). Diabetics also experienced more severe COVID-19 infection (p=0.048). Patients with severe COVID-19 had significantly higher blood glucose (168.5 ±12.8 mg/dl) than those with non-severe infection (136.6± 6.3 mg/dl) (p=0.013). Diabetics had higher erythrocyte sedimentation rates (ESR) compared to non-diabetics (52.25±2.4 vs. 43.81±1.8 mm/h, p=0.006). Diabetic patients taking ACEIs/ARBs had more severe COVID-19 infection (p=0.031). Conclusion: The study discovered a positive relationship between hyperglycemia and COVID-19 severity, as well as a higher risk of severe COVID-19 among patients taking ACEIs or ARBs.