Next Issue
Volume 9, March
Previous Issue
Volume 8, September

Diseases, Volume 8, Issue 4 (December 2020) – 12 articles

Cover Story (view full-size image): Sickle cell disease (SCD) is a group of life-threatening inherited disorders with multiple aspects, such as public health and clinical aspects. Textual data structures (such as words, sentences, and data tables) in expert/evidence reports on SCD management present prospects for constructing qualitative and quantitative datasets. We have constructed datasets and associated interactive visualizations to conduct interactive analytics of textual data structures on public health and clinical aspects of sickle cell disease. Our report presents unique data products (https://bit.ly/scddata) that include landmark expert reports from the year 2020. Interactive analytics can support individual and team expertise for effective community-based research and practice on SCD. View this paper.
  • Issues are regarded as officially published after their release is announced to the table of contents alert mailing list.
  • You may sign up for e-mail alerts to receive table of contents of newly released issues.
  • PDF is the official format for papers published in both, html and pdf forms. To view the papers in pdf format, click on the "PDF Full-text" link, and use the free Adobe Readerexternal link to open them.
Order results
Result details
Select all
Export citation of selected articles as:
Open AccessCommunication
Use of Population-Based Health Informatics Research to Improve Care for Patients with Cardiovascular Diseases
Diseases 2020, 8(4), 47; https://0-doi-org.brum.beds.ac.uk/10.3390/diseases8040047 - 17 Dec 2020
Viewed by 503
Abstract
There are common clinical scenarios in chronic heart disease where no randomized controlled data exist to guide management, and it is likely that well-designed observational studies will have to be used to inform clinical practice. Showing the clinical applicability of this type of [...] Read more.
There are common clinical scenarios in chronic heart disease where no randomized controlled data exist to guide management, and it is likely that well-designed observational studies will have to be used to inform clinical practice. Showing the clinical applicability of this type of study design, using record linkage of population electronic health records, we have provided key observational evidence that use of renin–angiotensin-system (RAS) blockers is associated with better outcomes in patients with aortic stenosis and that metformin could be used safely as an antiglycemic drug in patients with diabetes and heart failure. Each of these pieces of underpinning research has made a major contribution to relevant international clinical practice guidelines, helped the Food and Drug Administration in their decision making and changed prescribing practice. Full article
Show Figures

Figure 1

Open AccessReview
Fertility and Reproduction after Recovery from Anorexia Nervosa: A Systematic Review and Meta-Analysis of Long-Term Follow-Up Studies
Diseases 2020, 8(4), 46; https://0-doi-org.brum.beds.ac.uk/10.3390/diseases8040046 - 16 Dec 2020
Viewed by 587
Abstract
Reproductive health is compromised during anorexia nervosa (AN). However, it is still unclear whether this medical complication is reversible after recovery from AN. The purpose of this paper was to conduct a systematic review of the major reproductive health outcomes in females after [...] Read more.
Reproductive health is compromised during anorexia nervosa (AN). However, it is still unclear whether this medical complication is reversible after recovery from AN. The purpose of this paper was to conduct a systematic review of the major reproductive health outcomes in females after recovery from AN. The review was conducted in adherence to preferred reporting items for systematic review and meta-analyses (PRISMA) guidelines. Data were collated using meta-analysis and a narrative approach. Of the 1186 articles retrieved, five studies met the inclusion criteria and were reviewed. These studies monitored weight-restored females who had recovered from AN for a follow-up period of between six and 18 years. Their narrative analysis revealed that appropriate treatment of AN leads to the normalization of reproductive function, especially in terms of fertility, pregnancy, and childbirth rates. The meta-analysis confirmed this finding, where the pooled odds of childbirth rates between the AN group and the general population was not statistically significant (OR = 0.75, 95% CI: 0.43–1.29, p = 0.41). We conclude that if patients undergo appropriate eating-disorder treatment and weight restoration, it appears to be unlikely that reproductive health is affected by AN. However, since this finding is derived from only a few studies, it requires replication and confirmation. Full article
(This article belongs to the Special Issue The Relationship between Nutrition and Diseases)
Show Figures

Figure 1

Open AccessCommunication
Did the Physical and Psychological States of Outpatients Receiving Rehabilitation at a Geriatric Health Services Facility Decline during the State of Emergency Caused by the COVID-19 Pandemic?
Diseases 2020, 8(4), 45; https://0-doi-org.brum.beds.ac.uk/10.3390/diseases8040045 - 10 Dec 2020
Viewed by 666
Abstract
Many Geriatric Health Services Facilities in Japan may have continued outpatient rehabilitation by taking measures against infection even during the state of emergency caused by Coronavirus disease 2019 (COVID-19). The present study aimed to determine differences in physical and psychological states in rehabilitation [...] Read more.
Many Geriatric Health Services Facilities in Japan may have continued outpatient rehabilitation by taking measures against infection even during the state of emergency caused by Coronavirus disease 2019 (COVID-19). The present study aimed to determine differences in physical and psychological states in rehabilitation outpatients (age, 83.5 ± 8.4 years) at a Geriatric Health Services Facility between the pre- and post-nationwide state of emergency in Japan. Physical outcomes were assessed with gait speed (GS), timed up and go test (TUG), handgrip strength (HG), and maximum phonation time (MPT). We used the Japanese version of the five-level EuroQoL five-dimensional questionnaire (EQ-5D-5L) to assess patients’ quality of life (QoL) as the psychological state. The physical (GS, pre, 0.92, post, 0.92 s, p = 0.875; TUG, pre, 14.09, post, 14.14 s, p = 0.552; HG, pre, 19.42, post 19.70 kgf, p = 0.807; MPT, pre, 13.6, post, 13.8 s, p = 0.861) and psychological (EQ-5D-5L, pre, 0.73, post, 0.81, p = 0.064) states of the participants did not change significantly between the pre- and post-nationwide state of emergency. This was likely due to the continuance of outpatient rehabilitation in accordance with the facility’s policy while taking adequate safety precautions against COVID-19 infection. Full article
Open AccessReview
Can Melatonin Be a Potential “Silver Bullet” in Treating COVID-19 Patients?
Diseases 2020, 8(4), 44; https://0-doi-org.brum.beds.ac.uk/10.3390/diseases8040044 - 26 Nov 2020
Cited by 5 | Viewed by 13057
Abstract
The therapeutic potential of melatonin as a chronobiotic cytoprotective agent to counteract the consequences of COVID-19 infections has been advocated. Because of its wide-ranging effects as an antioxidant, anti-inflammatory, and immunomodulatory compound, melatonin could be unique in impairing the consequences of SARS-CoV-2 infection. [...] Read more.
The therapeutic potential of melatonin as a chronobiotic cytoprotective agent to counteract the consequences of COVID-19 infections has been advocated. Because of its wide-ranging effects as an antioxidant, anti-inflammatory, and immunomodulatory compound, melatonin could be unique in impairing the consequences of SARS-CoV-2 infection. Moreover, indirect evidence points out to a possible antiviral action of melatonin by interfering with SARS-CoV-2/angiotensin-converting enzyme 2 association. Melatonin is also an effective chronobiotic agent to reverse the circadian disruption of social isolation and to control delirium in severely affected patients. As a cytoprotector, melatonin serves to combat several comorbidities such as diabetes, metabolic syndrome, and ischemic and non-ischemic cardiovascular diseases, which aggravate COVID-19 disease. In view of evidence on the occurrence of neurological sequels in COVID-19-infected patients, another putative application of melatonin emerges based on its neuroprotective properties. Since melatonin is an effective means to control cognitive decay in minimal cognitive impairment, its therapeutic significance for the neurological sequels of SARS-CoV-2 infection should be considered. Finally, yet importantly, exogenous melatonin can be an adjuvant capable of augmenting the efficacy of anti-SARS-CoV-2 vaccines. We discuss in this review the experimental evidence suggesting that melatonin is a potential “silver bullet” in the COVID 19 pandemic. Full article
(This article belongs to the Special Issue Novel Melatonin Based Therapies)
Show Figures

Figure 1

Open AccessArticle
The Emotion of Disgust among Medical and Psychology Students
Diseases 2020, 8(4), 43; https://0-doi-org.brum.beds.ac.uk/10.3390/diseases8040043 - 15 Nov 2020
Viewed by 591
Abstract
The emotion of disgust evolved as a way to protect oneself from illness and is associated with aspects of disease avoidance. Disgust Scale–Revised (DS-R) (Olatunji et al., 2008) measures the disgust propensity of three kinds of disgust (core, animal reminder, contamination). Contextual factors, [...] Read more.
The emotion of disgust evolved as a way to protect oneself from illness and is associated with aspects of disease avoidance. Disgust Scale–Revised (DS-R) (Olatunji et al., 2008) measures the disgust propensity of three kinds of disgust (core, animal reminder, contamination). Contextual factors, such as academic background, might influence DS-R scoring, especially among medical students, where the notion of disease is central. We examined DS-R scoring and the choice of postgraduate studies in medical (n = 94) and psychology (n = 97) students. In an anonymous web-based survey, participants completed the DS-R and a questionnaire including plans for postgraduate studies. Females outnumbered males and scored higher in total DS-R score (p = 0.003). Psychology students scored higher in all three kinds of disgust (p < 0.001 for core disgust and animal reminder, p = 0.069 for contamination disgust), indicating a higher level of disease avoidance. Medical students willing to follow Internal Medicine scored higher in core disgust (p < 0.05), while psychology students willing to study Experimental Psychology scored lower in the animal reminder subscale (p = 0.019 and p < 0.001 for the association between these subscales and the orientation of Medical and Psychology Students, respectively). In conclusion, disgust propensity as rated by DS-R is related to academic background and orientation preferences in postgraduate studies. Full article
Open AccessFeature PaperReview
Precision Medicine in Rare Diseases
Diseases 2020, 8(4), 42; https://0-doi-org.brum.beds.ac.uk/10.3390/diseases8040042 - 13 Nov 2020
Cited by 1 | Viewed by 679
Abstract
Rare diseases are those that have a low prevalence in the population (less than 5 individuals per 10,000 inhabitants). However, infrequent pathologies affect a large number of people, since according to the World Health Organization (WHO), there are about 7000 rare diseases that [...] Read more.
Rare diseases are those that have a low prevalence in the population (less than 5 individuals per 10,000 inhabitants). However, infrequent pathologies affect a large number of people, since according to the World Health Organization (WHO), there are about 7000 rare diseases that affect 7% of the world’s population. Many patients with rare diseases have suffered the consequences of what is called the diagnostic odyssey, that is, extensive and prolonged serial tests and clinical visits, sometimes for many years, all with the hope of identifying the etiology of their disease. For patients with rare diseases, obtaining the genetic diagnosis can mean the end of the diagnostic odyssey, and the beginning of another, the therapeutic odyssey. This scenario is especially challenging for the scientific community, since more than 90% of rare diseases do not currently have an effective treatment. This therapeutic failure in rare diseases means that new approaches are necessary. Our research group proposes that the use of precision or personalized medicine techniques can be an alternative to find potential therapies in these diseases. To this end, we propose that patients’ own cells can be used to carry out personalized pharmacological screening for the identification of potential treatments. Full article
(This article belongs to the Section Rare Syndrome)
Show Figures

Figure 1

Open AccessReview
Newly Reported Studies on the Increase in Gastrointestinal Symptom Prevalence with COVID-19 Infection: A Comprehensive Systematic Review and Meta-Analysis
Diseases 2020, 8(4), 41; https://0-doi-org.brum.beds.ac.uk/10.3390/diseases8040041 - 10 Nov 2020
Viewed by 746
Abstract
Background and Aim: Although constitutional and respiratory symptoms such as cough and fever are the most common symptoms in patients infected with COVID-19, gastrointestinal (GI) tract involvement has been observed by endoscopic biopsies. Multiple GI symptoms, including diarrhea, nausea or vomiting and abdominal [...] Read more.
Background and Aim: Although constitutional and respiratory symptoms such as cough and fever are the most common symptoms in patients infected with COVID-19, gastrointestinal (GI) tract involvement has been observed by endoscopic biopsies. Multiple GI symptoms, including diarrhea, nausea or vomiting and abdominal pain, have also been reported. This review aims to present the currently available data regarding the GI symptoms of COVID-19 patients, and to compare the frequency of GI symptoms in early stage (Eastern) mostly Chinese data to the current stage (Western) non-Chinese data. Methods: We performed a systematic literature search to identify both published studies by using PubMed, Google Scholar, and CNKI (Chinese medical search engine), and yet unpublished studies through medRxiv and bioRxiv. We also reviewed the cross references of the detected articles. We conducted a Medical Subject Headings (MeSH) search up until 20 September 2020. We pooled the prevalence of symptoms of diarrhea, anorexia, nausea, vomiting, and abdominal pain by using the Freeman–Tukey’s transforming random effect model. Results: A total of 118 studies were included in the systematic review and 44 of them were included in the meta-analysis. There was a significant heterogeneity between the studies; therefore, the random effects model was used. The pooled prevalence estimate of any GI symptoms reported was found to be 0.21 (95%CI, 0.16–0.27). Anorexia was the most commonly reported GI symptom at 18% (95%CI, 0.10–0.27) followed by diarrhea at 15% (95%CI, 0.12–0.19). Diarrhea, abdominal pain, nausea/vomiting, and respiratory symptoms were more common in non-Chinese studies. The prevalence of abdominal pain was lower in the “inpatient-only” studies when compared with studies that included outpatients only and those including both inpatients and outpatients. Conclusions: In this comprehensive systematic review and meta-analysis study, we observed higher rates of diarrhea, nausea/vomiting, and abdominal pain in COVID-19 infected patients among non-Chinese studies compared to Chinese studies. We also observed a higher prevalence of GI symptoms in Chinese studies than was reported previously. Non-respiratory symptoms, including GI tract symptoms, should be more thoroughly and carefully evaluated and reported in future studies. Full article
Show Figures

Figure 1

Open AccessBrief Report
Incidence of Myocardial Injury in COVID-19-Infected Patients: A Systematic Review and Meta-Analysis
Diseases 2020, 8(4), 40; https://0-doi-org.brum.beds.ac.uk/10.3390/diseases8040040 - 27 Oct 2020
Viewed by 861
Abstract
Introduction: The incidence of acute myocardial injury (AMI) among Coronavirus Disease 19 (COVID-19)-infected patients remain unclear. We aimed to conduct a systematic review and meta-analysis to further explore the incidence AMI in these patients. Methods: We comprehensively searched the MEDLINE, EMBASE and Cochrane [...] Read more.
Introduction: The incidence of acute myocardial injury (AMI) among Coronavirus Disease 19 (COVID-19)-infected patients remain unclear. We aimed to conduct a systematic review and meta-analysis to further explore the incidence AMI in these patients. Methods: We comprehensively searched the MEDLINE, EMBASE and Cochrane databases from their inception to August 2020. The included studies were prospective or retrospective cohort studies that reported the event rate of AMI in COVID-19 patients. Data from each study were combined using random-effects to calculate the pooled incidence with 95% confidence intervals. Results: We identified twenty-seven studies consisting of 8971 hospitalized COVID-19-infected patients. The study demonstrated that 20.0% (95% CI 16.1–23.8% with substantial heterogeneity (I2 = 94.9%)) of hospitalized COVID-19 patients had AMI. In addition, our meta-regression suggested that older age, male and comorbidities were associated with a higher risk of AMI. Conclusion: The incidence of COVID-19-related myocardial injury ranges from 16.1–23.8%. Further larger studies are anticipated, as the pandemic is still ongoing. Full article
Open AccessArticle
Integrating Datasets on Public Health and Clinical Aspects of Sickle Cell Disease for Effective Community-Based Research and Practice
Diseases 2020, 8(4), 39; https://0-doi-org.brum.beds.ac.uk/10.3390/diseases8040039 - 26 Oct 2020
Viewed by 736
Abstract
Sickle cell disease (SCD) is a genetic disease that has multiple aspects including public health and clinical aspects. The goals of the research study were to (1) understand the public health aspects of sickle cell disease, and (2) understand the overlap between public [...] Read more.
Sickle cell disease (SCD) is a genetic disease that has multiple aspects including public health and clinical aspects. The goals of the research study were to (1) understand the public health aspects of sickle cell disease, and (2) understand the overlap between public health aspects and clinical aspects that can inform research and practice beneficial to stakeholders in sickle cell disease management. The approach involved the construction of datasets from textual data sources produced by experts on sickle cell disease including from landmark publications published in 2020 on sickle cell disease in the United States. The interactive analytics of the integrated datasets that we produced identified that community-based approaches are common to both public health and clinical aspects of sickle cell disease. An interactive visualization that we produced can aid the understanding of the alignment of governmental organizations to recommendations for addressing sickle cell disease in the United States. From a global perspective, the interactive analytics of the integrated datasets can support the knowledge transfer stage of the SICKLE recommendations (Skills transfer, Increasing self-efficacy, Coordination, Knowledge transfer, Linking to adult services, and Evaluating readiness) for effective pediatric to adult transition care for patients with sickle cell disease. Considering the increased digital transformations resulting from the COVID-19 pandemic, the constructed datasets from expert recommendations can be integrated within remote digital platforms that expand access to care for individuals living with sickle cell disease. Finally, the interactive analytics of integrated expert recommendations on sickle cell disease management can support individual and team expertise for effective community-based research and practice. Full article
Show Figures

Figure 1

Open AccessArticle
Exposing Empirical Links between COVID-19 Situation Report and Available Data: The Case of Nigeria
Diseases 2020, 8(4), 38; https://0-doi-org.brum.beds.ac.uk/10.3390/diseases8040038 - 20 Oct 2020
Viewed by 546
Abstract
Ever since the index case of COVID-19 was announced in Nigeria, the number of confirmed cases has gradually increased to 46,140 (about 4.5% of total confirmed cases in Africa) as the time of writing this article. This seemingly low number of confirmed cases [...] Read more.
Ever since the index case of COVID-19 was announced in Nigeria, the number of confirmed cases has gradually increased to 46,140 (about 4.5% of total confirmed cases in Africa) as the time of writing this article. This seemingly low number of confirmed cases has provoked heated debates among researchers. This cross-sectional study explores the Nigerian COVID-19 report to expose some links between the number of confirmed cases, testing, and some environmental conditions. The findings reveal that there is no state in Nigeria which has up to 12 confirmed cases per 10,000 population. That means, the number of confirmed COVID-19 cases is less than 0.15% of the population of people across each state in Nigeria. On the flip side, it was revealed that the proportion of samples tested for COVID-19 is low compared to the population. The percentages ranging from less than 0.1% to a maximum of 0.7% of each state population in which 23 states out of the 37 states are within the less than 0.1% range. Furthermore, there is a substantial correlation (ρ (37)=0.903, p< 0.001) between the confirmed cases and testing. In contrast, no substantial correlation was found between the former with either average temperature or rainfall. Full article
Show Figures

Graphical abstract

Open AccessArticle
Hepatitis C Virus Infection Increases Fatigue in Health Care Workers
Diseases 2020, 8(4), 37; https://0-doi-org.brum.beds.ac.uk/10.3390/diseases8040037 - 15 Oct 2020
Viewed by 603
Abstract
Fatigue is a common state associated with a weakening or depletion of one’s physical and mental resources, that leads to the inability to continue the individual functioning at a normal level of activity. Frequently, fatigue represents a response to infections, inflammation and autoimmune [...] Read more.
Fatigue is a common state associated with a weakening or depletion of one’s physical and mental resources, that leads to the inability to continue the individual functioning at a normal level of activity. Frequently, fatigue represents a response to infections, inflammation and autoimmune diseases. The scope of this study was to evaluate the fatigue in healthcare workers with and without hepatitis C virus (HCV) infection. Mental, physical and severity fatigue were evaluated through Krupp, Wessely and Powell fatigue scale. Anti-HCV antibodies, HCV RNA and HCV genotypes were also measured. Physical, mental and severity fatigue were higher in healthcare workers with HCV infection than the healthcare workers without infection (p < 0.01). Our data showed a direct link between fatigue and HCV infection in healthcare workers. Further studies are needed to evaluate HCV antiviral treatments on fatigue severity and on quality of life in healthcare workers Full article
(This article belongs to the Special Issue Biomarkers in Neuropsychiatric Disorders)
Show Figures

Figure 1

Open AccessBrief Report
Serological Tests for SARS-CoV-2 Coronavirus by Commercially Available Point-of-Care and Laboratory Diagnostics in Pre-COVID-19 Samples in Japan
Diseases 2020, 8(4), 36; https://0-doi-org.brum.beds.ac.uk/10.3390/diseases8040036 - 23 Sep 2020
Cited by 2 | Viewed by 693
Abstract
The number of COVID-19 patients in Japan is considered low, compared with U.S. and European countries. However, recent serological survey reported that several percent of population showed IgG positive to SARS-CoV-2. Specificity in the assays might influence the estimate, and possibility of overdiagnosis [...] Read more.
The number of COVID-19 patients in Japan is considered low, compared with U.S. and European countries. However, recent serological survey reported that several percent of population showed IgG positive to SARS-CoV-2. Specificity in the assays might influence the estimate, and possibility of overdiagnosis should be investigated. Serological tests for SARS-CoV-2 coronavirus were performed in pre-COVID-19 sera in Japan (400 healthy subjects in 2012–2015). Lateral flow assay (LFA) and enzyme-linked immunosorbent assay (ELISA) showed 1.5% (6/400) and 1.75% (7/400) IgG positives, respectively. Among those false positive samples, only one sample was positive in both LFA and ELISA (0.25%; 95% CI: 0.006–1.39%). Possible bias from pooling method was examined by Monte Carlo method and the possibility was unlikely at low false positive rate. Previous surveys might overestimate COVID-19 seroprevalence in several populations of Japan. These false positives could be excluded by combination of different diagnostics. Nonetheless, the result of seroprevalence should be carefully interpreted in less prevalent areas. Full article
(This article belongs to the Section Infectious Disease)
Show Figures

Figure 1

Previous Issue
Next Issue
Back to TopTop