Endocrine, Metabolic & Immune Disorders-Drug Targets (Formerly Current Drug Targets - Immune, Endocrine & Metabolic Disorders) - Volume 22, Issue 13, 2022

Background: Literature focuses on the well-being of patients and little on the wellbeing of nurses who, in turn, should be educated about well-being. On the other hand, the latter often work under serious pressure with inadequate resources and shift organizations, exposing them to health risk factors. Objective: To highlight which relationships exist between diet, physical activity, body mass index (BMI) and mental health in nursing. Methods: The author searched the Medline (PubMed) database for medical subheadings terms and free full text referred to “Diet,” “Mental Health,” “Physical Activity,” and “Nurses” before 31st December 2020. Results: A total of 11 studies were included in this perspective review, which better defined the relationships between diet, physical activity, mental health and the nursing profession. Conclusion: From the studies present in the literature, it emerges that the nursing profession has an inherent imbalance in the regular circadian activity of human nature, as nursing assistance is provided 24 hours a day and during the night. Numerous studies have highlighted significant differences between mental and eating disorder levels among nurses who work at night versus those who only work during the day. Therefore, it is possible to speak of the nursing profession as an “inductive inflammatory-chronic” activity based on the extensive scientific evidence provided by the literature.

Patients with type 1 diabetes (T1D) are at risk of clinical eating disorders (EDs) and disordered eating behaviors (DEBs) than the general population. This burden is related mainly to diabetes-related physical and psychosocial issues especially beginning during childhood. DEBs must be investigated carefully and promptly managed in case of suspicion, as they can evolve into severe clinical EDs over time and are strictly related to poor outcomes. The significant number of scientific articles dealing with the relationship between T1D and DEBs or EDs confirms the complexity of these problems and the difficulties in diagnosis and treatment. This paper examined current scientific literature related to this topic, emphasizing the epidemiological and clinical complexity of the phenomenon and briefly summarizing EDBs management strategy in T1D patients.

Background: In the first section of this review, we examined the neuroanatomical and neurochemical data on hunger and satiety centers, glucose receptors, sensorial influences on eating behavior, and regulation of energy requirements. The second section is devoted to orexigenic and anorexigenic hormones. Objective: This paper aimed to overview and summarize data regarding the role of neuroendocrine regulation of food intake and eating behavior. Methods: Appropriate keywords and MeSH terms were identified and searched in MEDLINE/ PubMed. References of original articles and reviews were examined. Results: Hunger and satiety center are located in the lateral (LH) and ventromedial hypothalamus (VMH). Lasting aphagia has been observed following a lesion of LH, while hyperphagia is induced by LH stimulation. On the other hand, increased food intake after VMH lesion and aphagia following VMH stimulation in hungry animals has also been reported. Intracellular glucopenia triggers food intake by reducing neuronal activity at the satiety center level. Moreover, sensory influences are regulated by food palatability as the positive hedonic evaluation of food and energy requirement indicates the average amount of food energy needed to balance energy expenditure. Orexigenic and anorexigenic hormones secreted from the gastrointestinal tract and adipose tissue regulate brain areas involved in eating behavior via gastric afferent vagal nerve, circumventricular organ area postrema, or transporter system. Finally, oxytocin (OT) plays a role in reward-related eating by inhibiting sugar intake and decreasing palatable food intake by suppressing the reward circuitry in the brain. Moreover, the anorectic effect of nesfatin-1 is abolished by an OT antagonist.

Background: The available antihypertensive drugs are effective and well tolerated agents. However, only about half of patients with treated hypertension achieve appropriate blood pressure control. Genetic and non-genetic factors contribute to the interindividual variability of the therapeutic response. Objective: This review constitutes a comprehensive update of the pharmacogenomics of antihypertensive drugs and their clinical implications in Brazil. Results: Twenty-five studies explored the influence of gene variants on drug response in patients with primary, resistant, or gestational hypertension. Variants in BDKRB2, NOS3, PRKCA, and VEGFA influenced the response to enalapril in patients with primary hypertension. AGT and MMP2 variants were associated with a high risk of resistance to antihypertensive treatment, whereas NOS2 variants were related to low risk. Moreover, NAT2 slow acetylators showed an increased response to hydralazine in patients with resistant hypertension. HMOX1, NAMPT, MMP9, NOS3, and TIMP1 variants might be markers of drug responsiveness in hypertensive or preeclamptic pregnant women. Power and replication of studies, polygenic nature of the response to therapy, and treatment with multiple drugs were important challenges to identify genetic predictors of antihypertensive response in Brazil. Conclusion: Pharmacogenomic studies in Brazilian cohorts provide some evidence of variants, mainly in pharmacodynamics genes, which influence the response to antihypertensive drugs. However, some findings are limited by cohort size or therapeutic scheme and may be influenced by interactions with other genetic and non-genetic factors. Therefore, further investigations are needed to elucidate the contribution of pharmacogenomics to the efficacy and safety of antihypertensive therapy.

Background: Typical lung diseases are pneumonia, asthma, sleep apnea syndrome (SA), interstitial pneumonia (IP), lung cancer, and chronic obstructive pulmonary disease (COPD). Coronavirus disease 2019 (COVID-19) is a type of viral pneumonia. Many researchers have reported that phytochemicals (chemical compounds produced by plants) and vitamin D are useful in stimulating our immunity. This review discusses the alleviation of lung diseases by grape phytochemicals and vitamin D. Discussion: Pneumonia is an acute inflammation caused by the infection of pathogens; the worst case is a fatal cytokine storm in the lung. In asthma, allergens, tobacco smoke, or air pollution may cause seizures. Lung diseases caused by lung fibrosis may manifest chronic inflammation, progress into alveolar fibrosis, and cause respiratory malfunction. SA is a lifestyle disease related to obesity and metabolic syndrome. To alleviate these symptoms, changing the eating habit is one of the strategies. Improvement in the daily lifestyle reduces the risk of lung cancer. Self-management, including nutritional management and exercise, is very important for COPD patients in addition to pharmacotherapy. Conclusion: The intake of grape phytochemicals and vitamin D prevents the progress of lung diseases. Both phytochemicals and vitamin D prevent the production of proinflammatory cytokine, TNF-α, that is responsible for inflammation and lung diseases. Daily intake of grape phytochemicals is important. The optimum vitamin D level in serum is > 30 ng/mL. For the prevention of lung diseases, upregulating immunity and maintaining good gut microbiota are important because gut microbiota change depending on what we eat.

Objective: The objective of this literature review is to explore how depression and inflammatory conditions relate to gender among nurses working shifts. Methods: Relevant studies available on the PubMed database over the past decade were consulted. The main keywords were: “shift nurses”, “depression”, “gender Shift Nurses”, “Gender Role”, “shift nurse”, “gender roles”, “Inflammation” and then, free terms were combined with the Boolean AND operator. Inclusion and exclusion criteria had been formerly identified, and then, all the selected studies were assessed according to the following criteria, good description, and appropriateness of study design (objective and method), sample (sufficiently numerous, clarity of treatment allocation criteria, absence of important bias), intervention, outcomes, statistical analysis, and clinical relevance. Results: 61 titles concerning research on inflammation were found. 28 titles were not taken into account as doubles whilst 33 were selected by title and abstract; in addition, 28 were discarded because they were not relevant to the objective or because they did not meet the inclusion criteria. Out of the remaining 5, a further 2 were also discarded upon a careful analysis of the whole text: they did not prove relevant to the research question. As for the research related to depression, the research strategy highlighted 186 articles in the first place and then eliminated 165 of them either because they were duplicates or on the grounds that they did not answer the research questions; 21 texts were thoroughly analyzed and, after a careful read, 4 studies were eventually incorporated in this review. Conclusion: Since data available in the literature were inconsistent, it was difficult to establish that all depression conditions could be associated with an increase in inflammation and vice versa and that this condition was strictly connected to the female gender.

Aim: The present study aimed to assess any association existing between insomnia according to sex, work experience, shift and BMI values in Italian nurses. Methods: An “ad hoc” questionnaire was created and administered online in October 2020. Data collected included: sex, years of work experience, shift work per day, BMI values, and insomnia levels. Findings: A total of 341 Italian nurses were enrolled. Of these, 277 (81.23%) were females and n=64 (18.77%) males. No significant differences were assessed between ISI levels and sex, BMI scores, work experience and shift (p=.098; p=.978; p=.561; p=.222, respectively). Significant and inverse correlation was assessed between ISI values and sex (p=.019), BMI values (p=.033). While, no significant correlations were assessed between ISI levels and work experience (p=.805) and shift (p=.962), respectively. However, work experience reported significant correlations between BMI classes (p>.001) and shift (p<.001). Conclusion: Data suggested potential health risk factors for the nursing workforce, associated with weight gain and developing Metabolic Syndrome. Therefore, the essence of the nursing profession could affect work performance and cause problems in the family and social life, as well as stress, anxiety, depression, fatigue, and irregular sleep patterns.

Background: The discharge from the hospital of insulin-treated hyperglycemic patients is always challenging. This is even more so in patients requiring glucocorticoid treatment, such as those with COVID-19. Patients and Methods: A retrospective monocentric study of 23 inpatients was conducted with newly diagnosed or already known diabetes mellitus (DM) who were naïve to insulin treatment, and who were hospitalized with COVID-19 in non-critical settings and then discharged. Patients were followed up for one month after discharge for the management of insulin treatment by a multi-professional team through phone consultations. Results: Insulin prescriptions at discharge were 24.6 ± 14 U/day injected in 2 ± 1.5 daily shots. A mean of three phone consultations was required. One month later, the mean insulin reduction was 1.5 ± 1.3 shots and 6 ± 5 U/day. All patients reached their glycemic target without hypoglycemic events, drop-outs, or readmissions. Conclusion: This study demonstrates the feasibility, efficacy, and safety of a multi-professional approach through telemedicine for managing DM patients after discharge during COVID-19.

Background: Cardiovascular prevention and rehabilitation programmes (CVPRP) are a preventive tool, which can reverse unhealthy behaviours and improve risk factor management. They have been successfully implemented in a variety of settings in patients with coronary heart disease (CHD). Objective: The objective of this study is to evaluate an interdisciplinary and nurse-led cardiovascular prevention and rehabilitation programme in patients with coronary heart disease. Methods: Six pairs of hospitals were randomised between intervention (INT) and usual care (UC) patients. The interdisciplinary team in the intervention hospital carried out a 16-week CVPRP to reach European risk factor goals. The trial is registered as ISRCTN 71715857. Results: The proportion of patients achieving European cardiovascular recommendations in Spain increased in the intervention hospital, mainly regarding fruit and vegetable consumption (INT 98% vs. UC 53%, p<0.001), oily fish consumption (INT 42% vs. UC 19.5%, p<0.001), self-reported physical activity (INT 31% vs. UC 12.4%, p=0.04), blood pressure (INT 69% vs. UC 47.1%) p< 0.05) and LDL concentrations (INT 86.1% vs. UC 67.6%, p=0.04). Conclusion: The EUROACTION nurse-led model of CVPR programme has shown that therapeutic goals in cardiovascular disease prevention are affordable and sustainable in everyday clinical practice. EUROACTION model adapted in Spain has produced a healthier lifestyle.