OAR@UM Collection:

Chronic obstructive pulmonary disease and metabolic syndrome : a Maltese study on biomarkers and clinical implications

Wed, 01 Jan 2025 00:00:00 GMT

Title: Chronic obstructive pulmonary disease and metabolic syndrome : a Maltese study on biomarkers and clinical implications Authors: Gauci, Jonathan; Gauci Pullicino, Stephanie; Caruana, Emma; Petroni Magri, Vanessa; Formosa, Melissa Marie; Fenech, Anthony G.; Fava, Stephen; Montefort, Stephen; Fsadni, Peter Abstract: Purpose: Chronic Obstructive Pulmonary Disease (COPD) and Metabolic Syndrome (MetS) are both characterized by inflammation and appear to be linked. The study aims to characterize COPD in Maltese individuals with diabetes and MetS for the first time. The research project also aims to identify biomarkers that are significantly associated with COPD endpoints in the study population having both COPD and MetS.; Patients and Methods: The study was carried out at Mater Dei Hospital, which is Malta’s main general hospital and is government managed. Research subjects were recruited from the Diabetes Clinic. A respiratory questionnaire was administered, followed by the Six-Minute Walk Test (6MWT), Fractional Exhaled Nitric Oxide (FeNO) testing, spirometry and phlebotomy. The American Heart Association (AHA) and National Heart, Lung, and Blood Institute (NHLBI) criteria were used to diagnose MetS. A postbronchodilator FEV1/FVC ratio of less than 0.7 was necessary to diagnose COPD, as recommended by Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines; Results: The study group consisted of 24 subjects diagnosed with both MetS and COPD. The group showed heterogenous results with a mean St George’s Respiratory Questionnaire for COPD total score of 41.7, mean distance on 6MWT of 359m, mean FeNO of 12.2ppb, and mean Forced Expiratory Volume in 1 second of 64.6%. While 62.5% had a modified Medical Research Council score of ≥2, 95.8% had a COPD Assessment Test score of ≥10. One-fourth of the group were at risk for clinical depression, and 20.8% showed severe fatigue. Blood lymphocyte count, ferritin, triglycerides and glucose were significantly associated with multiple respiratory parameters in diabetic MetS subjects with COPD.; Conclusion: The local diabetic MetS study population with COPD is heterogenous, with high levels of depression and fatigue. The emergence of biomarkers in this population has clinical and therapeutic implications.

Correlation between BMI and severity of acute pancreatitis : a retrospective study

Mon, 01 Jan 2024 00:00:00 GMT

Title: Correlation between BMI and severity of acute pancreatitis : a retrospective study Authors: Muscat, Neil; Soxibova, Firuza; Adnan, Naqqash; Caruana Montaldo, Ben; Taha, Kholoud Abu; Alam, Imran; Alkhazaaleh, Oddai Abstract: Background; Pancreatitis, marked by sterile inflammation of the pancreas, can present as either acute or chronic. It involves the premature activation of proteolytic enzymes, leading to autodigestion, inflammation, and potential systemic effects. This study investigates the impact of obesity on the severity of acute pancreatitis, given its role in systemic inflammation and its association with severe morbidity and mortality. Methods: A retrospective analysis was conducted on patients treated for acute pancreatitis over a five-month period at the Royal Albert Edward Infirmary, Wrightington, Wigan and Leigh (WLL) NHS Foundation Trust, Wigan, United Kingdom. Patients were evaluated using diagnostic criteria such as abdominal pain, elevated serum enzyme levels, and imaging results. The study explored correlations between BMI and pancreatitis severity, hospital length of stay, and complications, applying the Atlanta severity classification. Results: The analysis revealed a weak, statistically insignificant correlation between BMI and the severity of acute pancreatitis, hospital stay length, and complications. This was consistent across various statistical methods, including Pearson correlation coefficients and multiple linear regression. These findings suggest that, while obesity may influence the inflammatory response in acute pancreatitis, it does not have a significant impact on clinical outcomes within this cohort. Conclusions: The study highlights the complex role of obesity in exacerbating pancreatic inflammation but also emphasizes the need for larger, more definitive studies to explore this relationship further. It underscores the importance of early recognition and intervention in managing acute pancreatitis, regardless of BMI status.

Perceived health, psychological distress and quality of life in 8415 adults with congenital heart disease from 32 countries

Wed, 01 Jan 2025 00:00:00 GMT

Title: Perceived health, psychological distress and quality of life in 8415 adults with congenital heart disease from 32 countries Authors: Moons, Philip; Kovacs, Adrienne H.; Goossens, Eva; Luyckx, Koen; Ladak, Laila; Leye, Mohamed; van De Bruaene, Alexander; Leong, Ming Chern; Kaneva, Anna; Manso, Paulo Henrique; Araujo, John Jairo; Sasikumar, Navaneetha; Gabriel, Harald; Yadeta, Dejuma; Wang, Jou-Kou; Enomoto, Junko; Areias, Maria Emilia; Kosmidis, Diamantis; Coats, Louise; Valente, Anne Marie; Moon, Ju Ryoung; Ladouceur, Magalie; Thomet, Corina; Jackson, Jamie L.; Sandberg, Camilla; Callus, Edward; Kim, Yuli Y.; Lykkeberg, Birgitte; Alday, Luis; Bredy, Charlène; Saidi, Arwa; Reyes, Fernando Baraona; Menahem, Samuel; Hosson, Michele de; Hlebowicz, Joanna; Christersson, Christina; Zaidi, Ali N; Johansson, Bengt; Andresen, Brith; Ambassa, Jean-Claude; Mattsson, Eva; Constantine, Andrew; Amedro, Pascal; van Melle, Joost P.; Kutty, Shelby; Ortiz, Lucia; Demir, Fatma; Khairy, Paul; Windram, Jonathan; Bouchardy, Judith; Caruana, Maryanne; Jameson, Susan M.; Mahadevan, Vaikom S.; McGrath, Lidija B.; Mwita, Julius Chacha; van Bulck, Liesbet Abstract: Background The global prevalence of congenital heart disease (CHD) is increasing. Research on patient-reported outcomes (PROs) predominantly originates from high-income countries, resulting in an incomplete understanding of the true global burden of CHD from the patient perspective. Therefore, we described perceived health, psychological distress and quality of life (QoL) in a large sample of adults with CHD from the globe and explored the relationship between PROs and the income level of the countries. Methods Assessment of Patterns of Patient-Reported Outcomes in Adults with Congenital Heart Disease—International Study II (APPROACH-IS II) represents an international cross-sectional investigation of PROs in 8415 patients from 53 centres across 32 countries. Patients completed questionnaires to measure perceived health status (RAND-12 Health Survey; EuroQOL-5D Visual Analog Scale); depressive symptoms (Patient Health Questionnaire-8, PHQ-8); anxiety (Generalized Anxiety Disorder Scale-7) and QoL (Linear Analog Scale). Gross National Income per capita in US dollars was used for stratifying countries according to income levels. Results Large intercountry disparities in PROs were observed. Switzerland demonstrated the highest mean scores for physical functioning, self-rated health and QoL, while Senegal had the lowest scores. Patients from Malta demonstrated the highest mean scores for mental health, and Senegal had the lowest scores. With regard to depressive symptoms and anxiety, Pakistan had the lowest mean scores, while Turkey had the highest scores. Patients from high-income nations reported significantly better physical functioning, mental functioning and QoL. Conclusion Large intercountry disparities in PROs were observed. APPROACH-IS II is a pioneering international endeavour that comprehensively evaluated PROs among adults with CHD, drawing participants from nations with different income levels.

Quality of life in adults with transposition of the great arteries with a systemic right or left ventricle

Wed, 01 Jan 2025 00:00:00 GMT

Title: Quality of life in adults with transposition of the great arteries with a systemic right or left ventricle Authors: Ansari Ramandi, Mohammad Mostafa; van Bulck, Liesbet; Ceelen, Daan C.H.; Voors, Adriaan A.; Goossens, Eva; Kovacs, Adrienne H.; Luyckx, Koen; van De Bruaene, Alexander; Gabriel, Harald; Lykkeberg, Birgitte; Thomet, Corina; Hosson, Michèle de; Ladouceur, Magalie; Saidi, Arwa; Kosmidis, Diamantis; Areias, Maria Emília; Miranda, Joana; Sandberg, Camilla; Mandalenakis, Zacharias; Coats, Louise; Amedro, Pascal; Khairy, Paul; Valente, Anne Marie; Johansson, Bengt; Kaneva, Anna; Andresen, Brith; Christersson, Christina; Reyes, Fernando Baraona; Hlebowicz, Joanna; Enomoto, Junko; Kim, Yuli Y.; Menahem, Samuel; Yang, Hsiao-Ling; Moon, Ju Ryoung; Bredy, Charlene; Schmidt, André; Callus, Edward; Araujo, John Jairo; Constantine, Andrew; Zaidi, Ali; Bouchardy, Judith; Jameson, Susan M.; Kutty, Shelby; McGrath, Lidija B.; Leong, Ming Chern; Ortiz, Lucia; Korkmaz, Fatma Demir; Caruana, Maryanne; Leye, Mohamed; Moons, Philip; van Melle, Joost P. Abstract: Advances in medical and surgical care have improved survival in patients with transposition of the great arteries (TGA), shifting focus towards quality of life (QoL). This study evaluates QoL in adults with TGA, including congenitally corrected TGA (ccTGA) and patients with dextro-TGA (d-TGA), by comparing patients with a systemic right ventricle (sRV) and systemic left ventricle (sLV), while identifying mediating factors. Methods This cross-sectional study, part of the APPROACH-IS II study, included 798 adults with TGA from 42 centers worldwide. QoL was assessed using a linear analogue scale (0–100). Regression models identified variables associated with QoL, and mediation analysis examined the effect of sRV on QoL. Results Among participants (median age 34 years, 44.9% women), 504 patients (63.2%) had an sRV (ccTGA or d-TGA with atrial switch), while 294 patients (36.8%) had an sLV (ccTGA with double switch operation or Rastelli and d-TGA with arterial switch or Rastelli). Patients with an sRV reported lower QoL (75 [IQR: 60-85]) compared to those with an sLV (80 [IQR: 70-90], p <0.001). The negative effect of sRV on QoL was mediated for 59% by ventricular dysfunction (B=-2.37, 95%CI: [-3.38- -1.21], p <0.001). Poorer QoL was independently associated with Asian race, employment status (job-seeking, unemployed, or disabled), less social support, New York heart association functional class ≥II, ventricular dysfunction, a greater number of interventional catheterizations and depression/anxiety. Conclusions TGA patients with an sRV experience lower QoL than those with an sLV, mediated mainly by ventricular dysfunction.