Irish Journal of Medical Science最新文献

Aim: This study was conducted to reveal the effectiveness of telemedicine applications in mental health services.

Material method: For this meta-analysis study, data were obtained by searching PubMed, Web of Science, EBSCOhost, Google Scholar, and YÖK Thesis Center databases for the last 5 years in September-December 2023. After the review, 24 studies were included.

Findings: In this meta-analysis, it was found that telemedicine interventions in mental health services decreased the depression level of individuals (SMD - 0.168, 95% CI - 0.315 to - 0.021; Z =  - 2.243; p < .05). In addition, it was determined that the duration of the intervention played a role in the effectiveness of telemedicine interventions applied to individuals. In addition, it was determined that the type of intervention, the country where the research was conducted, and the patient group did not play a role in the effectiveness of telemedicine interventions applied to individuals.

Conclusion: Telemedicine applications in mental health services can play an effective role in reducing the burden of chronic mental illness and improving patient outcomes.

Background: With the global population aging, the number of individuals over 60 is expected to double by 2050. Brain volume increases until age 13, stabilizes between 18 and 35, then declines by 0.2% annually. Magnetic resonance imaging (MRI) studies highlight significant gray matter atrophy, necessitating differentiation between normal aging and neurodegeneration.

Aims: This study assessed the impact of aging on subcortical gray matter in healthy males to identify biomarkers of physiological aging.

Methods: A retrospective study of 106 healthy males who underwent brain MRI from 2012 to 2016, divided into two age groups: younger and older than 35 years. MRI scans were performed using a 3 T machine, and volumetric analysis was conducted with VolBrain software. Subcortical gray matter volumes were compared between groups. The Shapiro-Wilk test evaluated normality. Student's t-test and Mann-Whitney U test were used for statistical analysis, with significance defined as p < 0.05.

Results: Total intracranial volume was comparable between age groups (p = 0.527). Significant volume reductions (p < 0.05) were observed in subcortical gray matter structures, including the nucleus accumbens, caudate nucleus, globus pallidus, putamen, thalamus, and ventral diencephalon, particularly on the right side in the elderly group.

Conclusions: Subcortical gray matter volume in healthy males shows significant differences between older and younger individuals (p < 0.05), with asymmetrical reduction and certain structures on the right aging more rapidly. These findings are significant for distinguishing healthy aging from neurodegeneration.

Background: COVID-19 pandemic and mental health of people are related to each other.

Aims: To assess the relationship between fear of COVID-19 (FCOV) and the psychological status of medical students of Bangladesh.

Methods: A total of 967 medical students and intern doctors of Sher-E-Bangla Medical College participated in this cross-sectional study. FCOV was measured using the Fear of COVID-19 Scale (FCV-19S). Mental health status was assessed using the Depression Anxiety Stress Scale (DASS-21). Correlation between these two variables was done followed by general linear model to assess the relationship of other covariates with mental health.

Results: FCOV had a highly significant relationship with mental health (DASS-21 and all its components, p < 0.001 for all). Females suffered more from fear than males except the interns. Clinical students, students with middle income groups, students residing with the families, and students having family members in health services exhibited more FCOV compared to their counterparts. When we looked at the DASS-21 and its components, females suffered more from stress. Having family members in health services was related to higher anxiety and stress with higher DASS-21 scores as well. Students who expressed their lives to be affected by COVID-19 had higher DASS-21 and its components compared to those whose lives were not affected as such. Students residing with their families revealed increased stress. FCOV and life affected by COVID-19 were constantly related to DASS-21 and its components (p < 0.001), adjusted for other variables.

Conclusions: Fear of COVID-19 is associated with poor mental health of medical students.

Objective: To systematically evaluate the efficacy and safety of norepinephrine in the treatment of septic shock.

Methods: Literature retrieval of eligible randomized controlled trials (RCTs) on norepinephrine in the treatment of septic shock was performed in three English databases including PubMed, Web of Science, and Medline from database establishment to October 1, 2023. The Cochrane risk bias tool was used to evaluate the quality of the included literature. RevMan 5.3 software was used for meta-analysis.

Results: A total of 14 RCTs were included in this study, and the risk of bias was low. Our meta-analysis showed that the norepinephrine group had significantly better outcomes in reducing the 28-day mortality rate (RR = 0.92; 95% CI, 0.86 ~ 0.99; P = 0.03), the incidence of arrhythmia (RR = 0.54; 95% CI, 0.45 ~ 0.64; P < 0.0001), and the length of stay in intensive care unit (ICU) (MD =  - 1.03; 95% CI, - 1.85 to approximately - 0.21; P = 0.01) than those of the control group. However, there were no statistically significant differences in in-hospital mortality rate (RR = 0.97; 95% CI, 0.90 ~ 1.04; P = 0.4), the 90-day mortality rate (RR = 1.07; 95% CI, 0.97 ~ 1.18; P = 0.15), length of hospital stay (MD = 0.03; 95% CI, - 1.13 ~ 1.18; P = 0.96), and the rate of achieving target MAP (RR = 1.27; 95% CI, 0.72 ~ 2.26; P = 0.41) between the norepinephrine group and the control group.

Conclusion: Norepinephrine has the advantages of improving 28-day mortality, shortening ICU hospitalization time, and reducing the incidence of arrhythmia. It is a more effective choice for the treatment of septic shock than other vasopressors, and the incidence of arrhythmia is low.