Junwei Xu, Jianpeng Li, Hao Zhang, Yang Gao, Qiming Dai
Background
There is growing evidence that platelet-related parameters can influence a wide range of cardiovascular diseases. However, the effect of platelet-related parameters on cardiac hypertrophy is unknown. To verify this, the present study proposes to use Mendelian randomization (MR) to explore bidirectional causality between multiple platelet-related parameters and cardiac hypertrophy and to assess the potential mediating role of plasma metabolites.
Methods
Single-nucleotide polymorphisms (SNPs), the instrumental variable required for the study, were obtained through the public genome-wide association study (GWAS) database, and samples were obtained from European populations. We obtained summary statistics of cardiac hypertrophy (4113 cases, 839,403 controls) after GWAS meta-analysis of two independent datasets. In this study, we mainly used the inverse variance weighted (IVW) method to assess the causal effect; two-step MR analysis was used to assess the mediating effect.
Results
MR analysis showed a positive causal relationship between mean platelet volume (MPV) and the risk of cardiac hypertrophy (odds ratio, 1.72 for cardiac hypertrophy per one-standard-deviation increment in MPV; 95% confidence interval, 1.24 to 2.38; p = 0.001). Multivariate MR showed that the risk role of MPV in promoting cardiac hypertrophy persisted after adjustment for other platelet parameters. Mediation analysis via two-step MR showed that this effect was partially mediated by vanillic acid glycine levels, with a mediation ratio of 20.4% (95% confidence interval, 3.7% to 40.7%).
Conclusions
This study revealed a positive causal relationship between MPV and cardiac hypertrophy risk, partly mediated by plasma vanillic acid glycine levels.
{"title":"Relationship Between Mean Platelet Volume and Cardiac Hypertrophy and Mediating Effect of Vanillic Acid Glycine Levels in Plasma Metabolites: A Mendelian Randomization Study","authors":"Junwei Xu, Jianpeng Li, Hao Zhang, Yang Gao, Qiming Dai","doi":"10.1155/ijcp/7734971","DOIUrl":"https://doi.org/10.1155/ijcp/7734971","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>There is growing evidence that platelet-related parameters can influence a wide range of cardiovascular diseases. However, the effect of platelet-related parameters on cardiac hypertrophy is unknown. To verify this, the present study proposes to use Mendelian randomization (MR) to explore bidirectional causality between multiple platelet-related parameters and cardiac hypertrophy and to assess the potential mediating role of plasma metabolites.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Single-nucleotide polymorphisms (SNPs), the instrumental variable required for the study, were obtained through the public genome-wide association study (GWAS) database, and samples were obtained from European populations. We obtained summary statistics of cardiac hypertrophy (4113 cases, 839,403 controls) after GWAS meta-analysis of two independent datasets. In this study, we mainly used the inverse variance weighted (IVW) method to assess the causal effect; two-step MR analysis was used to assess the mediating effect.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>MR analysis showed a positive causal relationship between mean platelet volume (MPV) and the risk of cardiac hypertrophy (odds ratio, 1.72 for cardiac hypertrophy per one-standard-deviation increment in MPV; 95% confidence interval, 1.24 to 2.38; <i>p</i> = 0.001). Multivariate MR showed that the risk role of MPV in promoting cardiac hypertrophy persisted after adjustment for other platelet parameters. Mediation analysis via two-step MR showed that this effect was partially mediated by vanillic acid glycine levels, with a mediation ratio of 20.4% (95% confidence interval, 3.7% to 40.7%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study revealed a positive causal relationship between MPV and cardiac hypertrophy risk, partly mediated by plasma vanillic acid glycine levels.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/7734971","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145407249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rebecca Day Benfield, Andrew Thomas Reyes, Huaxin Song, Reimund Serafica, Alicia Brown, Catherine Dingley
<div> <section> <h3> Introduction</h3> <p>Posttraumatic stress disorder (PTSD) is prevalent among military veterans around the world, with many remaining symptomatic despite standard therapies. We hypothesized that warm water immersion might have a positive therapeutic effect on veteran’s mood, anxiety, and pain.</p> </section> <section> <h3> Methods</h3> <p>This clinical trial used a mixed methods approach: a quantitative single case design with repeated measures followed by a qualitative descriptive semistructured interview of participant perceptions and experiences to examine the effects of warm water immersion on improving mood, anxiety, and pain. Veterans with PTSD symptoms and comorbid depression, anxiety, and pain were immersed to the chest in 33°C water for 45 min. Repeated measures of the Multidimensional Mood State Questionnaire and the visual analog scales for anxiety and pain were taken at dry baseline and at 15 and 45 min of immersion, followed by a semistructured interview.</p> </section> <section> <h3> Results</h3> <p>A mixed regression model (Holm–Bonferroni adjusted <i>p</i> values), controlling for veteran participants’ (<i>N</i> = 13; mean age = 31 years; male = 9, female = 4) PTSD symptoms, depression status, and combat score, revealed significant improvements compared to baseline. At 15 min, scores improved for good mood (<i>B</i> = 3.85, SE = 1.21, <i>t</i> = 3.18, <i>p</i> = 0.016), calmness (<i>B</i> = 8.15, SE = 1.57, <i>t</i> = 5.19, <i>p</i> < 0.001), and anxiety (<i>B</i> = −10.92, SE = 4.53, <i>t</i> = −2.41, <i>p</i> = 0.048). At 45 min, improvements were observed in good mood (<i>B</i> = 6.38, SE = 1.21, <i>t</i> = 5.27, <i>p</i> < 0.001), calmness (<i>B</i> = 11.38, SE = 1.57, <i>t</i> = 7.25, <i>p</i> < 0.001), and anxiety (<i>B</i> = −23.69, SE = 4.53, <i>t</i> = −5.23, <i>p</i> < 0.001). Pain scores also improved significantly at 45 min (<i>B</i> = −17.69, SE = 4.42, <i>t</i> = −4.00, <i>p</i> = 0.003). Veterans described the experience as relaxing, calming, pain-relieving, and promoting mental rest as they actively engaged with the properties of the water.</p> </section> <section> <h3> Conclusion</h3> <p>Warm water immersion provides an effective, fast-acting, low-risk, nonstigmatizing, accessible adjunct therapy for veterans experiencing PTSD symptoms and comorbid depression, anxiety, and pain. A comparison of the same participants’ responses on the psychosocial instruments with qualitative themes yields similar results, providing additional credence for immersion effectiveness.</p> </section>
创伤后应激障碍（PTSD）在世界各地的退伍军人中普遍存在，尽管有标准的治疗方法，但许多人仍然有症状。我们假设温水浸泡可能对退伍军人的情绪、焦虑和疼痛有积极的治疗作用。方法本临床试验采用混合方法：定量单例设计，重复测量，然后对参与者的感知和经历进行定性描述性半结构化访谈，以检验温水浸泡对改善情绪、焦虑和疼痛的影响。将有PTSD症状并伴有抑郁、焦虑和疼痛的退伍军人浸泡在33°C的水中45分钟。多维情绪状态问卷和焦虑和疼痛的视觉模拟量表在干基线和浸泡15和45分钟时进行重复测量，随后进行半结构化访谈。结果采用混合回归模型（Holm-Bonferroni调整p值），控制了退伍军人（N = 13，平均年龄= 31岁，男= 9，女= 4）PTSD症状、抑郁状态和战斗得分，与基线相比有显著改善。好心情在15分钟,分数提高(B = 3.85, = 1.21, t = 3.18, p = 0.016),冷静(B = 8.15, = 1.57, t = 5.19, p & lt; 0.001),和焦虑(B =−10.92,SE = 4.53, t =−2.41,p = 0.048)。在45分钟,观察改进好心情(B = 6.38, = 1.21, t = 5.27, p & lt; 0.001),冷静(B = 11.38, = 1.57, t = 7.25, p & lt; 0.001),和焦虑(B =−23.69,SE = 4.53, t =−5.23,p & lt; 0.001)。疼痛评分在45 min时也有显著改善（B = - 17.69, SE = 4.42, t = - 4.00, p = 0.003）。老兵们将这种体验描述为放松、平静、缓解疼痛，并在他们积极参与水的特性时促进精神休息。结论温水浸泡是一种有效、快速、低风险、无污名化、可及的辅助治疗方法，可用于治疗退伍军人PTSD症状及伴随的抑郁、焦虑和疼痛。同样的参与者对具有定性主题的心理社会工具的反应的比较也产生了类似的结果，为沉浸式的有效性提供了额外的证据。试验注册ClinicalTrials.gov标识符：NCT0530903
{"title":"The Positive Effects of Water Immersion for Symptoms of PTSD in Veterans: A Mixed Methods Study","authors":"Rebecca Day Benfield, Andrew Thomas Reyes, Huaxin Song, Reimund Serafica, Alicia Brown, Catherine Dingley","doi":"10.1155/ijcp/1369052","DOIUrl":"https://doi.org/10.1155/ijcp/1369052","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Posttraumatic stress disorder (PTSD) is prevalent among military veterans around the world, with many remaining symptomatic despite standard therapies. We hypothesized that warm water immersion might have a positive therapeutic effect on veteran’s mood, anxiety, and pain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This clinical trial used a mixed methods approach: a quantitative single case design with repeated measures followed by a qualitative descriptive semistructured interview of participant perceptions and experiences to examine the effects of warm water immersion on improving mood, anxiety, and pain. Veterans with PTSD symptoms and comorbid depression, anxiety, and pain were immersed to the chest in 33°C water for 45 min. Repeated measures of the Multidimensional Mood State Questionnaire and the visual analog scales for anxiety and pain were taken at dry baseline and at 15 and 45 min of immersion, followed by a semistructured interview.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A mixed regression model (Holm–Bonferroni adjusted <i>p</i> values), controlling for veteran participants’ (<i>N</i> = 13; mean age = 31 years; male = 9, female = 4) PTSD symptoms, depression status, and combat score, revealed significant improvements compared to baseline. At 15 min, scores improved for good mood (<i>B</i> = 3.85, SE = 1.21, <i>t</i> = 3.18, <i>p</i> = 0.016), calmness (<i>B</i> = 8.15, SE = 1.57, <i>t</i> = 5.19, <i>p</i> < 0.001), and anxiety (<i>B</i> = −10.92, SE = 4.53, <i>t</i> = −2.41, <i>p</i> = 0.048). At 45 min, improvements were observed in good mood (<i>B</i> = 6.38, SE = 1.21, <i>t</i> = 5.27, <i>p</i> < 0.001), calmness (<i>B</i> = 11.38, SE = 1.57, <i>t</i> = 7.25, <i>p</i> < 0.001), and anxiety (<i>B</i> = −23.69, SE = 4.53, <i>t</i> = −5.23, <i>p</i> < 0.001). Pain scores also improved significantly at 45 min (<i>B</i> = −17.69, SE = 4.42, <i>t</i> = −4.00, <i>p</i> = 0.003). Veterans described the experience as relaxing, calming, pain-relieving, and promoting mental rest as they actively engaged with the properties of the water.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Warm water immersion provides an effective, fast-acting, low-risk, nonstigmatizing, accessible adjunct therapy for veterans experiencing PTSD symptoms and comorbid depression, anxiety, and pain. A comparison of the same participants’ responses on the psychosocial instruments with qualitative themes yields similar results, providing additional credence for immersion effectiveness.</p>\u0000 </section>\u0000 ","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/1369052","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145407147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The 2020/2021 National Heart Failure Audit found prescribing rates of beta-blockers, angiotensin-converting enzyme inhibitors (ACEi), angiotensin receptor blockers (ARBs) and mineralocorticoid receptor antagonists (MRAs) were below target levels in individuals with heart failure with reduced ejection fraction (HFrEF). In Sheffield Teaching Hospitals (STH), prescribing rates of this triple therapy (TT) were below the national average. The aim of this study was to evaluate the impact of patients’ frailty and comorbidities on TT prescribing rates.
Methods
We analysed the clinical details of individuals with a diagnosis of moderate or severe HFrEF admitted to STH between May 2021 and December 2021. Patients’ electronic notes, investigations and heart failure specialist nurses’ assessments were reviewed.
Results
Electronic records of 310 patients were reviewed. About 45.5% were discharged on appropriate TT, compared to 52% nationally. Prescribing rates were 84.2% for beta-blockers and 61.3% for ACE-i/ARB/ARNIs, compared to national levels of 91% and 84%, respectively. The prescribing rate for MRA was 63.4%, which is higher than the national average (61%). About 92.6% of those not on TT had a documented clinical reason, with the commonest being ‘poor renal function’ (45.6%) and ‘low systolic blood pressure’ (25.5%). Those not on TT had a greater mean clinical frailty score (4.4 vs. 3.0, p < 0.001), were older (78.4 vs. 67.1, p < 0.001) and had worse 12-month readmission (p < 0.001) and mortality rates (p < 0.001).
Conclusions
Patients’ frailty and comorbidities play a significant role in HFrEF-prescribing patterns. Identifying and addressing the barriers to optimal HFrEF treatment may improve prescribing rates and patient outcomes.
{"title":"Barriers to Optimising Medication for Patients With Heart Failure With Reduced Ejection Fraction (HFrEF)","authors":"Omar Dirir, Ishika Prachee, Narjes Maasoumi, Abdallah Al-Mohammad","doi":"10.1155/ijcp/3468060","DOIUrl":"https://doi.org/10.1155/ijcp/3468060","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The 2020/2021 National Heart Failure Audit found prescribing rates of beta-blockers, angiotensin-converting enzyme inhibitors (ACEi), angiotensin receptor blockers (ARBs) and mineralocorticoid receptor antagonists (MRAs) were below target levels in individuals with heart failure with reduced ejection fraction (HFrEF). In Sheffield Teaching Hospitals (STH), prescribing rates of this triple therapy (TT) were below the national average. The aim of this study was to evaluate the impact of patients’ frailty and comorbidities on TT prescribing rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analysed the clinical details of individuals with a diagnosis of moderate or severe HFrEF admitted to STH between May 2021 and December 2021. Patients’ electronic notes, investigations and heart failure specialist nurses’ assessments were reviewed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Electronic records of 310 patients were reviewed. About 45.5% were discharged on appropriate TT, compared to 52% nationally. Prescribing rates were 84.2% for beta-blockers and 61.3% for ACE-i/ARB/ARNIs, compared to national levels of 91% and 84%, respectively. The prescribing rate for MRA was 63.4%, which is higher than the national average (61%). About 92.6% of those not on TT had a documented clinical reason, with the commonest being ‘poor renal function’ (45.6%) and ‘low systolic blood pressure’ (25.5%). Those not on TT had a greater mean clinical frailty score (4.4 vs. 3.0, <i>p</i> < 0.001), were older (78.4 vs. 67.1, <i>p</i> < 0.001) and had worse 12-month readmission (<i>p</i> < 0.001) and mortality rates (<i>p</i> < 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Patients’ frailty and comorbidities play a significant role in HFrEF-prescribing patterns. Identifying and addressing the barriers to optimal HFrEF treatment may improve prescribing rates and patient outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/3468060","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145406828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study aimed to elucidate the regulatory role of circadian rhythm–related genes (CRGs) in immune cell function and their potential contribution to vitiligo pathogenesis. Characterizing the crosstalk between CRGs and immune cells may yield novel insights into the immune dysregulation underlying vitiligo development.
Methods
We integrated expression quantitative trait loci (eQTL) data from the eQTLGen and GTEx projects to analyze 2091 CRGs comprehensively. Summary data–based Mendelian randomization (SMR) and heterogeneity in dependent instruments (HEIDI) analyses were performed to identify key CRGs associated with vitiligo. Colocalization analysis and single-cell RNA sequencing data were used to assess CRG expression in immune cells of vitiligo patients.
Results
Nine key CRGs were identified, showing significant associations with vitiligo in both eQTL datasets. USP40, PEBP, NPM, FBXL1, and GCLC exhibited negative correlations with vitiligo risk, while RPTO, FAM228B, DPH, and CHST1 were positively correlated. Single-cell analysis revealed reduced CRG expression in vitiligo patients, particularly in natural killer (NK)/T cells, naive T cells, and monocytes. This CRG downregulation correlated with impaired immune cell functionality, implicating circadian dysregulation in the aberrant immune responses characteristic of vitiligo pathogenesis.
Conclusion
The results demonstrate that CRGs constitute potential regulatory components in vitiligo pathogenesis through their modulation of immune cell function. The identification of both protective and risk-associated CRGs, coupled with evidence of circadian–immune crosstalk disruption in affected tissues, establishes a new mechanistic framework for understanding vitiligo etiology. These findings not only advance our knowledge of the circadian–immune axis in autoimmune skin disorders but also highlight CRGs as promising therapeutic targets for precision medicine approaches in vitiligo treatment.
{"title":"Analysis of the Correlation Between Circadian Rhythms and Immune Regulation Mechanisms in Vitiligo: Evidence From Summary Data–Based Mendelian Randomization Combined With Single-Cell Analysis","authors":"Fang Miao, Xiaohui Li, Ying Shi","doi":"10.1155/ijcp/9296851","DOIUrl":"https://doi.org/10.1155/ijcp/9296851","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to elucidate the regulatory role of circadian rhythm–related genes (CRGs) in immune cell function and their potential contribution to vitiligo pathogenesis. Characterizing the crosstalk between CRGs and immune cells may yield novel insights into the immune dysregulation underlying vitiligo development.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We integrated expression quantitative trait loci (eQTL) data from the eQTLGen and GTEx projects to analyze 2091 CRGs comprehensively. Summary data–based Mendelian randomization (SMR) and heterogeneity in dependent instruments (HEIDI) analyses were performed to identify key CRGs associated with vitiligo. Colocalization analysis and single-cell RNA sequencing data were used to assess CRG expression in immune cells of vitiligo patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Nine key CRGs were identified, showing significant associations with vitiligo in both eQTL datasets. <i>USP40</i>, <i>PEBP</i>, <i>NPM</i>, <i>FBXL1</i>, and <i>GCLC</i> exhibited negative correlations with vitiligo risk, while <i>RPTO</i>, <i>FAM228B</i>, <i>DPH</i>, and <i>CHST1</i> were positively correlated. Single-cell analysis revealed reduced CRG expression in vitiligo patients, particularly in natural killer (NK)/T cells, naive T cells, and monocytes. This CRG downregulation correlated with impaired immune cell functionality, implicating circadian dysregulation in the aberrant immune responses characteristic of vitiligo pathogenesis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The results demonstrate that CRGs constitute potential regulatory components in vitiligo pathogenesis through their modulation of immune cell function. The identification of both protective and risk-associated CRGs, coupled with evidence of circadian–immune crosstalk disruption in affected tissues, establishes a new mechanistic framework for understanding vitiligo etiology. These findings not only advance our knowledge of the circadian–immune axis in autoimmune skin disorders but also highlight CRGs as promising therapeutic targets for precision medicine approaches in vitiligo treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/9296851","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145406630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mohammad Abdi, Ali Norouzi, Mahboobeh Khabaz Mafinejad
Background
Attitude toward medical law reasoning is the first step in improving medical law reasoning skills in physicians. Despite its importance, no validated instrument currently exists to assess it. This study aimed to develop and validate a Medical Law Reasoning Attitude Questionnaire (MLRAQ) in medical students.
Methods
The MLRAQ was developed based on the seven steps of AMEE Guide No. 87, related to designing questionnaires for educational research. In the first step, relevant articles were extracted through a systematic search. In the second step, medical law micro-skills were explored through a qualitative study by conducting 20 interviews. In the third and fourth steps, the identified medical law micro-skills were compared conceptually with previous studies, and the MLRAQ items were developed. Finally, content validity, cognitive interview, exploratory factor analysis, confirmatory factor analysis, and reliability analysis were performed in the fifth to seventh steps.
Results
MLRAQ consists of five factors and 24 items. The validation results showed that the content validity index (CVI) and content validity ratio (CVR) were greater than 0.90. Five subscales (prerequisites, problem identification, application of rule, analysis, and conclusion) explained 67.26% of the variance in exploratory factor analysis. Cronbach’s alpha = 0.894, indicating high internal consistency. ICC = 0.771–0.942, demonstrating strong reliability across measurements. In confirmatory factor analysis, SRMR and RMSEA were 0.078 and 0.058, respectively. GFI was 0.880, and CFI was 0.901, indicating acceptable fit indices.
Conclusion
The MLRAQ demonstrated valid and reliable evidence. Therefore, this instrument can assess attitudes toward medical law reasoning.
{"title":"Development and Psychometric Validation of a Questionnaire to Assess Attitudes Toward Medical Law Reasoning (MLRAQ)","authors":"Mohammad Abdi, Ali Norouzi, Mahboobeh Khabaz Mafinejad","doi":"10.1155/ijcp/5167920","DOIUrl":"https://doi.org/10.1155/ijcp/5167920","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Attitude toward medical law reasoning is the first step in improving medical law reasoning skills in physicians. Despite its importance, no validated instrument currently exists to assess it. This study aimed to develop and validate a Medical Law Reasoning Attitude Questionnaire (MLRAQ) in medical students.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The MLRAQ was developed based on the seven steps of AMEE Guide No. 87, related to designing questionnaires for educational research. In the first step, relevant articles were extracted through a systematic search. In the second step, medical law micro-skills were explored through a qualitative study by conducting 20 interviews. In the third and fourth steps, the identified medical law micro-skills were compared conceptually with previous studies, and the MLRAQ items were developed. Finally, content validity, cognitive interview, exploratory factor analysis, confirmatory factor analysis, and reliability analysis were performed in the fifth to seventh steps.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>MLRAQ consists of five factors and 24 items. The validation results showed that the content validity index (CVI) and content validity ratio (CVR) were greater than 0.90. Five subscales (prerequisites, problem identification, application of rule, analysis, and conclusion) explained 67.26% of the variance in exploratory factor analysis. Cronbach’s alpha = 0.894, indicating high internal consistency. ICC = 0.771–0.942, demonstrating strong reliability across measurements. In confirmatory factor analysis, SRMR and RMSEA were 0.078 and 0.058, respectively. GFI was 0.880, and CFI was 0.901, indicating acceptable fit indices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The MLRAQ demonstrated valid and reliable evidence. Therefore, this instrument can assess attitudes toward medical law reasoning.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/5167920","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145367008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Betânia Ferreira Leite, Dalila Fernandes Gomes, Gustavo Laine Araújo de Oliveira, Roberta Borges Silva, Cecília Menezes Farinasso, Tania Sales de Alencar Fidelix, Virgínia Fernandes Moça Trevisani
Background
Osteoarthritis (OA) is a common illness that is widespread globally, especially among individuals aged 65 and older. Since 2019/2020, the OARSI and ACR recommendations have included the use of medicines such duloxetine, which function as analgesics for pain patients including central sensitization. Recent studies have assessed duloxetine as an adjunctive treatment in decreasing OA pain.
Objective
Assess the effectiveness and safety of duloxetine in treating OA pain in adults aged 40 and above.
Methods
We conducted a systematic review and meta-analysis of randomized clinical trials. The scientific evidence search was conducted in the following databases: MEDLINE via PubMed, Cochrane Library, Embase, LILACS, Web of Science, Scopus, CINAHL, ProQuest, SciELO, and Google Scholar.
Findings
The systematic review comprised nine randomized controlled trials (RCTs). The studies showed that using duloxetine for OA treatment was more effective than a placebo in achieving a 50% pain reduction (RR = 1.57, 95% CI = 1.31; 1.89) and a 30% pain reduction (RR = 1.41; 95% CI = 1.29; 1.55). This improvement was observed in pain, physical function, and stiffness as measured by the WOMAC subscales, as well as in the CGI-SEVERITY scale and the AUSCAN functional index. Duloxetine was found to be more effective than gabapentin and acetaminophen in treating moderate to severe knee OA, as it decreased ratings on the whole WOMAC scale and its subscales for pain, physical function, and stiffness. There was no statistically significant difference in adverse events between duloxetine and gabapentin, both of which were more effective than acetaminophen, which did not cause any adverse events.
Conclusion
This systematic review indicates that duloxetine is an effective treatment for pain in OA in adult patients over 40 years old, with a reasonable level of safety when compared to other centrally acting medications and placebo.
骨关节炎（OA）是一种全球普遍存在的常见病，尤其是在65岁及以上的人群中。自2019/2020年以来，OARSI和ACR的建议包括使用度洛西汀等药物，这些药物可作为疼痛患者的镇痛药，包括中枢致敏。最近的研究评估了度洛西汀作为减轻OA疼痛的辅助治疗。目的评价度洛西汀治疗40岁及以上成人OA疼痛的有效性和安全性。方法对随机临床试验进行系统评价和荟萃分析。在以下数据库中进行科学证据检索：MEDLINE通过PubMed、Cochrane Library、Embase、LILACS、Web of Science、Scopus、CINAHL、ProQuest、SciELO和谷歌Scholar。本系统综述包括9项随机对照试验（RCTs）。研究表明，使用度洛西汀治疗OA比安慰剂更有效，疼痛减轻50% (RR = 1.57, 95% CI = 1.31; 1.89)，疼痛减轻30% （RR = 1.41, 95% CI = 1.29; 1.55）。通过WOMAC亚量表以及cgi -严重性量表和AUSCAN功能指数测量，疼痛、身体功能和僵硬度均有改善。度洛西汀比加巴喷丁和对乙酰氨基酚在治疗中重度膝关节炎方面更有效，因为它降低了整个WOMAC量表及其子量表对疼痛、身体功能和僵硬的评分。度洛西汀与加巴喷丁的不良事件发生率无统计学差异，均优于对乙酰氨基酚，对乙酰氨基酚无不良事件发生。结论本系统评价表明，度洛西汀是治疗40岁以上成年OA患者疼痛的有效药物，与其他中枢作用药物和安慰剂相比具有合理的安全性。
{"title":"Efficacy and Safety of Duloxetine for the Treatment of Osteoarthritis: Systematic Review and Meta-Analysis","authors":"Betânia Ferreira Leite, Dalila Fernandes Gomes, Gustavo Laine Araújo de Oliveira, Roberta Borges Silva, Cecília Menezes Farinasso, Tania Sales de Alencar Fidelix, Virgínia Fernandes Moça Trevisani","doi":"10.1155/ijcp/4976407","DOIUrl":"https://doi.org/10.1155/ijcp/4976407","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Osteoarthritis (OA) is a common illness that is widespread globally, especially among individuals aged 65 and older. Since 2019/2020, the OARSI and ACR recommendations have included the use of medicines such duloxetine, which function as analgesics for pain patients including central sensitization. Recent studies have assessed duloxetine as an adjunctive treatment in decreasing OA pain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Assess the effectiveness and safety of duloxetine in treating OA pain in adults aged 40 and above.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a systematic review and meta-analysis of randomized clinical trials. The scientific evidence search was conducted in the following databases: MEDLINE via PubMed, Cochrane Library, Embase, LILACS, Web of Science, Scopus, CINAHL, ProQuest, SciELO, and Google Scholar.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>The systematic review comprised nine randomized controlled trials (RCTs). The studies showed that using duloxetine for OA treatment was more effective than a placebo in achieving a 50% pain reduction (RR = 1.57, 95% CI = 1.31; 1.89) and a 30% pain reduction (RR = 1.41; 95% CI = 1.29; 1.55). This improvement was observed in pain, physical function, and stiffness as measured by the WOMAC subscales, as well as in the CGI-SEVERITY scale and the AUSCAN functional index. Duloxetine was found to be more effective than gabapentin and acetaminophen in treating moderate to severe knee OA, as it decreased ratings on the whole WOMAC scale and its subscales for pain, physical function, and stiffness. There was no statistically significant difference in adverse events between duloxetine and gabapentin, both of which were more effective than acetaminophen, which did not cause any adverse events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This systematic review indicates that duloxetine is an effective treatment for pain in OA in adult patients over 40 years old, with a reasonable level of safety when compared to other centrally acting medications and placebo.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/4976407","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145367009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Metabolic dysfunction–associated fatty liver disease (MAFLD) is the most common chronic liver condition with a bidirectional relation with multimetabolic disorders. By considering lifestyle interventions as the approved treatment strategy, several herbal products have been examined as conjugated therapy in the prevention/treatment of the disease. The annual herbaceous plant known as Salvia hispanica L. (chia) is an ancient grain trending in modern diets. Chia seeds are not only an excellent source of nutrients and bioactive compounds but also have shown effectiveness in the management of a number of metabolic disorders. However, studies on MAFLD are limited and mainly include animal models. Moreover, the exact molecular mechanisms by which chia influences MAFLD-related outcomes remain inadequately investigated. Hence, the aim of the present comprehensive review is to explore the effectiveness of chia supplementation in MAFLD by various forms (seeds, oil, and flour) with a view point on molecular pathways, metabolic regulation, and clinical outcomes.
{"title":"A Comprehensive Review on the Therapeutic Effects of Salvia hispanica L. (Chia) on Metabolic Dysfunction–Associated Fatty Liver Disease: Special Focus on Pathogenesis","authors":"Maryam Parimi, Sara Arefhosseini, Helda Tutunchi, Seyed Rafie Arefhosseini, Mehrangiz Ebrahimi-Mameghani","doi":"10.1155/ijcp/8660821","DOIUrl":"https://doi.org/10.1155/ijcp/8660821","url":null,"abstract":"<p>Metabolic dysfunction–associated fatty liver disease (MAFLD) is the most common chronic liver condition with a bidirectional relation with multimetabolic disorders. By considering lifestyle interventions as the approved treatment strategy, several herbal products have been examined as conjugated therapy in the prevention/treatment of the disease. The annual herbaceous plant known as <i>Salvia hispanica</i> L. (chia) is an ancient grain trending in modern diets. Chia seeds are not only an excellent source of nutrients and bioactive compounds but also have shown effectiveness in the management of a number of metabolic disorders. However, studies on MAFLD are limited and mainly include animal models. Moreover, the exact molecular mechanisms by which chia influences MAFLD-related outcomes remain inadequately investigated. Hence, the aim of the present comprehensive review is to explore the effectiveness of chia supplementation in MAFLD by various forms (seeds, oil, and flour) with a view point on molecular pathways, metabolic regulation, and clinical outcomes.</p>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/8660821","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145366398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The present study is a retrospective analysis of the activities of a tertiary stroke center (SC) operating on the basis of Akzhan Clinic in Karaganda Region during the year 2024. The primary objective of this study was to examine the epidemiological features, the structure of stroke morbidity, and the efficacy of thrombolytic therapy (TLT) in patients with ischemic stroke (IS). The study included data from a total of 585 patients, out of which 437 had been hospitalized with acute cerebrovascular disorders, and 104 of these patients had received TLT for IS. The analysis revealed a high level of utilization of TLT (23.8%), which was significantly higher than the average regional and national figures, owing to the efficient organization of prehospital and in-hospital stages, availability of skilled personnel, and a state-of-the-art technical infrastructure. Additionally, mechanical thrombectomy (MT) was performed in 100 instances, further confirming the high level of adoption of advanced treatment modalities. The proportion of hemorrhagic transformations (7.69%) and mortality (6.7%) was comparable to or lower than international benchmarks. The results demonstrate the high effectiveness of the performance of the SC “Akzhan” and the need for the further expansion of similar facilities in order to improve the accessibility and quality of stroke treatment in Kazakhstan.
{"title":"Evaluation of Stroke Care Delivery: 12-Month Experience of a Tertiary Stroke Center in Central Asia","authors":"Marina Grigolashvili, Dmitriy Klyuyev, Dmitry Kasatkin, Sharbanu Battakova, Yelena Shayakhmetova, Mira Beisembayeva, Shynar Muratbekova, Alina Koshelyuk, Yessenbay Baituyak, Ivan Turkevich, Alexey Dey","doi":"10.1155/ijcp/8109173","DOIUrl":"https://doi.org/10.1155/ijcp/8109173","url":null,"abstract":"<p>The present study is a retrospective analysis of the activities of a tertiary stroke center (SC) operating on the basis of Akzhan Clinic in Karaganda Region during the year 2024. The primary objective of this study was to examine the epidemiological features, the structure of stroke morbidity, and the efficacy of thrombolytic therapy (TLT) in patients with ischemic stroke (IS). The study included data from a total of 585 patients, out of which 437 had been hospitalized with acute cerebrovascular disorders, and 104 of these patients had received TLT for IS. The analysis revealed a high level of utilization of TLT (23.8%), which was significantly higher than the average regional and national figures, owing to the efficient organization of prehospital and in-hospital stages, availability of skilled personnel, and a state-of-the-art technical infrastructure. Additionally, mechanical thrombectomy (MT) was performed in 100 instances, further confirming the high level of adoption of advanced treatment modalities. The proportion of hemorrhagic transformations (7.69%) and mortality (6.7%) was comparable to or lower than international benchmarks. The results demonstrate the high effectiveness of the performance of the SC “Akzhan” and the need for the further expansion of similar facilities in order to improve the accessibility and quality of stroke treatment in Kazakhstan.</p>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/8109173","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145317609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Binali Firinci, Cetin Aydin, Dilek Yunluel, Ozgur Caglar, Mehmet Dumlu Aydin, Ali Ahiskalioglu
Objectives
Circumcision has been used for thousands of years with the belief that it is beneficial for sexual health and on religious grounds. The histopathological results regarding the neurobiological damage of this procedure have been rarely investigated. This study aimed to examine the potential adverse effects of circumcision, particularly the use of monopolar electrocautery, on pudendal nerve ganglia, Onuf’s nucleus, and the myenteric plexus (Auerbach’s ganglia) of the colon in rabbits.
Methods
Eighteen male rabbits were allocated to a control group (Group I, n = 5), and groups where circumcisions were performed without (Group II, n = 5) and with (Group III, n = 8) using monopolar electrocautery. The rabbits were followed up for 3 weeks and then sacrificed under general anesthesia. Penile tissues, Onuf’s nucleus and pudendal fiber origin complexes, dorsal root ganglion at sacral 3 level, and neurons in the myenteric plexus of Auerbach in rectum were examined using stereological methods. Degenerated neuron densities (n/mm3) of S3 ganglia, ganglia of Auerbach’s plexus, and Onuf’s nuclei of male rabbits were compared.
Results
Degenerated neuron intensities (n/mm3) in pudendal ganglia, Onuf’s nucleus, and myenteric ganglia were 9 ± 3, 3 ± 1, and 7 ± 2 in GI; 17 ± 5, 7 ± 2, and 11 ± 3 in GII; and 89 ± 13, 24 ± 5, and 45 ± 8 in GIII. There were no statistically significant differences between the control group (GI) and the sham surgical circumcision group (GII) (p > 0.05). However, both GI and GII showed significantly lower levels of neuronal degeneration when compared to the electrocautery group (GIII) (p < 0.005 for GII vs. GIII; p < 0.00001 for GI vs. GIII).
Conclusions
Denervation of the pudendal nerve ganglia and Onuf’s nucleus caused by surgical removal of the foreskin may also lead to neurodegeneration in the ganglia of Auerbach’s plexus in the rectum innervated by this denervated network.
{"title":"Neurodegenerative Effects of Monopolar Electrocautery on Myenteric Ganglia During Penile Surgery: A Preliminary Experimental Rabbit Study","authors":"Binali Firinci, Cetin Aydin, Dilek Yunluel, Ozgur Caglar, Mehmet Dumlu Aydin, Ali Ahiskalioglu","doi":"10.1155/ijcp/8849240","DOIUrl":"https://doi.org/10.1155/ijcp/8849240","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Circumcision has been used for thousands of years with the belief that it is beneficial for sexual health and on religious grounds. The histopathological results regarding the neurobiological damage of this procedure have been rarely investigated. This study aimed to examine the potential adverse effects of circumcision, particularly the use of monopolar electrocautery, on pudendal nerve ganglia, Onuf’s nucleus, and the myenteric plexus (Auerbach’s ganglia) of the colon in rabbits.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Eighteen male rabbits were allocated to a control group (Group I, <i>n</i> = 5), and groups where circumcisions were performed without (Group II, <i>n</i> = 5) and with (Group III, <i>n</i> = 8) using monopolar electrocautery. The rabbits were followed up for 3 weeks and then sacrificed under general anesthesia. Penile tissues, Onuf’s nucleus and pudendal fiber origin complexes, dorsal root ganglion at sacral 3 level, and <i>neurons</i> in the myenteric plexus of <i>Auerbach</i> in rectum were examined using stereological methods. Degenerated neuron densities (n/mm<sup>3</sup>) of S3 ganglia, ganglia of Auerbach’s plexus, and Onuf’s nuclei of male rabbits were compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Degenerated neuron intensities (n/mm<sup>3</sup>) in pudendal ganglia, Onuf’s nucleus, and myenteric ganglia were 9 ± 3, 3 ± 1, and 7 ± 2 in GI; 17 ± 5, 7 ± 2, and 11 ± 3 in GII; and 89 ± 13, 24 ± 5, and 45 ± 8 in GIII. There were no statistically significant differences between the control group (GI) and the sham surgical circumcision group (GII) (<i>p</i> > 0.05). However, both GI and GII showed significantly lower levels of neuronal degeneration when compared to the electrocautery group (GIII) (<i>p</i> < 0.005 for GII vs. GIII; <i>p</i> < 0.00001 for GI vs. GIII).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Denervation of the pudendal nerve ganglia and Onuf’s nucleus caused by surgical removal of the foreskin may also lead to neurodegeneration in the ganglia of Auerbach’s plexus in the rectum innervated by this denervated network.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/8849240","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145317124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To investigate the effects of dark chocolate consumption on anxiety and pain levels in patients undergoing thyroid fine needle aspiration biopsy (FNAB).
Materials and Methods
This was a single-center, randomized controlled study conducted between June 2024 and October 2024; local ethical approval was obtained. Patients who met the inclusion criteria were randomly divided into two groups: Group 1 received two squares of dark chocolate around 30 min before the procedure, while Group 2 did not. Anxiety levels were assessed using the State-Trait Anxiety Inventory (STAI), and pain levels were measured using the Visual Analog Scale (VAS) method. Anxiety levels were assessed before and after the procedure using the STAI, while pain levels were measured only after the procedure using the VAS.
Results
Of the 99 patients included, 82 (82.8%) were female, with a mean age of 47.61 ± 11.32 years. There were no demographic differences between Groups 1 and 2. Significant differences were found between the groups, with Group 1 reporting lower scores for both postprocedural anxiety adjusted for baseline Group STAI score and VAS scores (p < 0.05).
Conclusion
Dark chocolate consumption prior to thyroid FNAB may be an effective intervention for reducing both anxiety and pain in patients. Further studies with larger samples are recommended to confirm these findings.
{"title":"Dark Chocolate as a Preprocedure Intervention for Anxiety and Pain Reduction in Thyroid FNAB: A Prospective Randomized Controlled Study","authors":"Servan Yaşar","doi":"10.1155/ijcp/5687455","DOIUrl":"https://doi.org/10.1155/ijcp/5687455","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the effects of dark chocolate consumption on anxiety and pain levels in patients undergoing thyroid fine needle aspiration biopsy (FNAB).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This was a single-center, randomized controlled study conducted between June 2024 and October 2024; local ethical approval was obtained. Patients who met the inclusion criteria were randomly divided into two groups: Group 1 received two squares of dark chocolate around 30 min before the procedure, while Group 2 did not. Anxiety levels were assessed using the State-Trait Anxiety Inventory (STAI), and pain levels were measured using the Visual Analog Scale (VAS) method. Anxiety levels were assessed before and after the procedure using the STAI, while pain levels were measured only after the procedure using the VAS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 99 patients included, 82 (82.8%) were female, with a mean age of 47.61 ± 11.32 years. There were no demographic differences between Groups 1 and 2. Significant differences were found between the groups, with Group 1 reporting lower scores for both postprocedural anxiety adjusted for baseline Group STAI score and VAS scores (<i>p</i> < 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Dark chocolate consumption prior to thyroid FNAB may be an effective intervention for reducing both anxiety and pain in patients. Further studies with larger samples are recommended to confirm these findings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/5687455","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145317125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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