Current Issue : October-December Volume : 2025 Issue Number : 4 Articles : 5 Articles
Objective: The use of transcatheter aortic valve implantation (TAVI) has expanded in patients with severe aortic stenosis who are deemed inoperable. However, sarcopenia may be a determining factor in their survival. The aim of our study is to assess the impact of sarcopenia, evaluated by computed tomography (CT), on mortality in this patient population. Methods: Patients with severe aortic stenosis undergoing follow-up after TAVI at Hospital Universitario de la Princesa were recruited. Body composition was analyzed using routine CT scans and open-source software. Survival analysis was performed, and correlations between body composition parameters at the T12 and L3 vertebral levels were assessed. Results: Our sample comprised 97 subjects. Time to mortality was associated with diabetes mellitus (p = 0.050), atrial fibrillation (p = 0.02), and respiratory disease (p = 0.03). Interestingly, sarcopenia (p = 0.039) and normal-density muscle area (p = 0.025) were also associated with time to mortality, with the association between sarcopenia and time to mortality becoming stronger after adjusting for covariates (p < 0.001). The correlation between different body composition parameters at the T12 and L3 vertebral levels was substantial and statistically significant. Conclusions: The use of CT to assess sarcopenia in patients with severe aortic stenosis undergoing TAVI is highly valuable and can predict time to mortality. Sarcopenia should be considered as a relevant parameter in the comprehensive evaluation of these patients....
Background/Objectives: Erectile dysfunction (ED) is a prevalent condition worldwide that significantly affects men’s sexual health and overall quality of life. ED is often associated with both psychological and organic factors and may serve as an early indicator of underlying health conditions such as diabetes mellitus, hypertension, and cardiovascular diseases. This study aimed to assess the attitudes and help-seeking behaviors of patients with ED who attended primary healthcare centers for non-urological reasons. Methods: A cross-sectional survey was conducted among 384 men aged 18 years and older who attended primary care clinics. Erectile dysfunction was evaluated using a structured questionnaire designed to assess patients’ attitudes toward ED, help-seeking behaviors, and treatment preferences. Results: Approximately half of the participants (49.5%) acknowledged the necessity of seeking treatment. However, the majority (53.1%) had not consulted specialized clinics, primarily due to social stigma and a preference for self-medication. Concerning sources of information on ED treatment, 30.7% of participants relied on their partners and healthcare providers. Conclusions: The study underscores critical barriers to ED management, including social stigma and reliance on self-medication, which may impede optimal treatment engagement and access to specialized care....
Amyotrophic lateral sclerosis (ALS) is a heterogeneous disease that involves progressive loss of voluntary muscle and ultimately, respiratory function, which is the primary cause of death in ALS patients. Respiratory vital capacity (VC) measurements are objective, reproducible, and directly related to survival. Respiratory function is known to be negatively affected in individuals with excess abdominal fat contributing to a chronic innate immune inflammatory state. To test whether ALS patients might have a body mass index (BMI) related VC response to the innate immune system regulator NP001, clinical results from two NP001 phase 2 trials were evaluated in an intent-to-treat manner, stratified by BMI measurements. Slowing of progressive VC loss and extension of overall survival (OS) occurred primarily in ALS patients who were overweight with a BMI ≥ 25 (70% of patients in the phase 2 trials). Innate immune dysfunction is a characteristic of ALS patients ≤ 65 years of age, and in this group both VC and OS changes in response to NP001 were most significant. This study represents a novel approach to ALS, wherein VC and OS were both significantly improved through immunologic, not neurologic modulation with NP001, a precursor to the dominant regulator of inflammation, taurine chloramine....
The Leucine-rich repeat-containing G protein-coupled receptor 4 (LGR4) is a member of the G protein-coupled receptor family and plays an important role in bone metabolism and tumor bone metastasis. LGR4 affects bone metabolism by regulating the differentiation and activity of osteoblasts and osteoclasts, and is involved in the balance between bone resorption and bone formation. Deficiency of LGR4 leads to osteoporosis, whereas the up-regulation of LGR4 may help to alleviate the development of traumatic osteoarthritis. Furthermore, in breast cancer and multiple myeloma, LGR4 promotes tumor cell metastasis to bone tissue by activating related signaling pathways. Therefore, LGR4 may be a potential target for the treatment of bone metabolic diseases and tumor bone metastasis....
Background: Vasculonecrotic reactions in leprosy are typically associated with type 2 reactions. Differentiating between necrotizing erythema nodosum leprosum (nENL) and Lucio’s phenomenon (LP) can be difficult, as overlapping clinical and histopathological features have been reported. Mycobacterium lepromatosis, a recently identified species causing leprosy, has been sporadically linked to LP. While type 1 reactions are more commonly observed in HIV-coinfected individuals, reports of LP or ENL occurring outside the context of immune reconstitution inflammatory syndrome (IRIS) remain rare. Methods: We report a case of a vasculonecrotic leprosy reaction due to M. lepromatosis in an antiretroviral-naive patient with advanced HIV infection. Results: The patient presented with a two-month history of papules and nodules that progressed to painful necrotic ulcers, accompanied by systemic symptoms. Clinically, the presentation was consistent with nENL; however, histopathological analysis supported a diagnosis of LP. The patient rapidly deteriorated, developing septic shock and dying shortly thereafter. To our knowledge, this is the first reported case of a leprosy-associated vasculonecrotic reaction caused by M. lepromatosis in an HIV-infected individual not associated with IRIS. Conclusions: Vasculonecrotic reactions in leprosy are life-threatening emergencies due to their potential for rapid clinical deterioration and sepsis. In individuals with advanced HIV infection, recognition of these reactions may be challenging, as they can mimic other opportunistic infections, including fungal diseases, malignant syphilis, and disseminated mycobacterial infections. Early identification and prompt treatment are critical to improving outcomes....
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