Journal of Medicine and Life最新文献

Armed conflict is a prevalent global issue that affects both the socioeconomic aspects of society and has profound psychological consequences for those directly involved. This cross-sectional comparative study explored the impact of armed conflict on the self-esteem of nursing students in Sudan and Saudi Arabia. In total, 308 nursing students provided data. The Rosenberg Self-Esteem Scale (RSES) was used to evaluate nursing students' self-esteem. The findings demonstrated that nursing students who were exposed to armed conflict had lower self-esteem than those who were not. However, based on sex, marital status, and age, no statistically significant differences were observed in the nursing students' self-esteem. The current findings indicate that nursing students exposed to armed conflict have low self-esteem. Interventions providing mental health support are essential for improving their self-esteem. Further research should explore other factors that could impact the self-esteem of nursing students.

Cardiovascular complications represent a significant health concern for individuals with diabetes mellitus. The relationship between diabetes and cardiovascular diseases is complex and multifaceted, involving a variety of pathophysiological mechanisms. This study aimed to investigate the potential role of the cardiothoracic ratio as a prognostic tool for cardiovascular disorders in patients with diabetes. A retrospective case-control study of 530 adult patients referred to a tertiary care hospital in Saudi Arabia was conducted. Medical records, including chest X-rays, were analyzed to determine the cardiothoracic ratio. Patients diagnosed with diabetes who experienced cardiac disorders had significantly higher cardiothoracic ratios compared to patients with diabetes alone and controls. HbA1c was significantly elevated among patients with diabetes and cardiovascular disorders (mean = 71.5 ± 25.43 mmol/mol) compared to the other patients. There was a significant positive correlation between the duration of diabetes and the cardiothoracic ratio (r = 0.64, P < 0.001). Furthermore, the cardiothoracic ratio above 0.51 was a good discriminator of cardiovascular disorders in patients with diabetes, with an area under the curve of 0.737, sensitivity of 97.1%, and specificity of 87.2%. This study provided comprehensive evidence supporting the association between cardiothoracic ratio and subsequent cardiovascular adverse outcomes in patients with diabetes. We recommend adopting the cardiothoracic ratio as a valuable prognostic tool for risk stratification among people with diabetes.

This study aimed to identify and analyze factors associated with a higher risk of 3-year mortality in patients with Parkinson's disease (PD) within a Romanian cohort, focusing on individuals with more advanced disease stages as indicated by the Hoehn and Yahr scale. We conducted a cross-sectional observational study on 42 patients with PD treated at the Neurology Clinic I, Cluj-Napoca County Emergency Clinical Hospital, between October 2019 and January 2021. All participants were at stages 2.5 or 3 on the Hoehn and Yahr scale at baseline. Various clinical, neuropsychological, and neurophysiological assessments were performed, including evaluations for motor and non-motor symptoms such as anhedonia (via the Snaith-Hamilton Pleasure Scale - SHAPS) and cognitive impairment. The use of antiparkinsonian medications and antidepressants was also recorded. Factors associated with higher mortality risk included a higher anhedonia score (SHAPS > 34; P = 0.03), higher levodopa doses (cutoff = 937.5 mg; P = 0.001), and the administration of mirtazapine (P = 0.04). These findings indicate that non-motor symptoms like anhedonia, along with higher medication doses and specific treatments, play a significant role in influencing mortality risk in advanced PD. This study highlights the multifaceted nature of mortality risk in patients with PD, particularly emphasizing the role of non-motor symptoms and pharmacological treatment. Tailored therapeutic strategies, including closer monitoring of anhedonia and careful management of medication dosages, may be essential in reducing mortality and improving patient outcomes in advanced stages of PD.

Breast tuberculosis is a rare extrapulmonary manifestation of Mycobacterium tuberculosis, representing less than 0.1% of all breast pathologies in developed countries. However, in regions with high tuberculosis prevalence, such as India and Africa, its incidence is higher. The disease poses diagnostic challenges due to its ability to mimic breast carcinoma, leading to potential misdiagnosis and unnecessary surgical interventions. This study investigates the clinical and imaging characteristics of breast tuberculosis in a large cohort, with a specific focus on a rare case in a postmenopausal woman. A retrospective observational study was conducted on 1704 women who presented for mammography at the Alessandrescu-Rusescu National Institute for Mother and Child Health between 2019 and 2021. Clinical presentation, imaging results, and histopathological findings were analyzed to identify cases of breast tuberculosis. The study includes a comparative analysis with other granulomatous diseases and malignant breast conditions to highlight key diagnostic features. Among the 1704 patients, 714 (41.9%) presented with symptoms such as pain (35.4%), palpable lumps (13.2%), nipple discharge (4.3%), and breast appearance changes (2.1%). A rare case of primary breast tuberculosis was identified in a 69-year-old postmenopausal woman, presenting with a painless, palpable mass in the upper outer quadrant. Imaging demonstrated a hypoechoic mass with fine granular content and posterior acoustic enhancement, categorized as BIRADS 4A. The biopsy confirmed the diagnosis of breast tuberculosis. This study underscores the diagnostic complexity of breast tuberculosis, particularly in its ability to mimic malignancy. Through detailed imaging and clinical analysis, we emphasize the importance of biopsy in differentiating tuberculosis from breast cancer. Given the potential for misdiagnosis, clinicians should consider breast tuberculosis in differential diagnoses, especially in regions with high tuberculosis prevalence. Further research is needed to develop specific imaging criteria for earlier and more accurate diagnosis.

Individuals entering incarceration are at high risk for infectious diseases, other ill conditions, and risky behavior. Typically, the status of active pulmonary tuberculosis (PTB) is not known at the time of admission. Early detection and treatment are essential for effective TB control. So far, no study has compared the diagnostic accuracy of various TB screening tools in detention using a network meta-analysis (NMA). We aimed to investigate the diagnostic accuracy of active PTB screening tests upon detention admission. We searched PubMed, Global Index Medicus, the Cochrane Library electronic databases, and grey literature for publications reporting detention TB entry screening in March 2022 and January 2024. Inclusion was non-restrictive regarding time, language, location, reference standards, or screening tests. Eligible study designs comprised comparative, observational, and diagnostic studies. Publications had to report TB screening of individuals entering confinement and provide data for diagnostic accuracy calculations. The QUADAS-2 tool was designed to assess the quality of primary diagnostic accuracy studies. This systematic review was registered with PROSPERO (CRD42022307863) and conducted without external funding. We screened a total of 2,455 records. Despite extensive searching, no studies met our inclusion criteria. However, we identified evidence revealing key differences in screening algorithm application. In conclusion, more diagnostic accuracy data on TB screening algorithms for detention admission worldwide needs to be collected. We recommend that global TB initiatives set up multi-site studies to investigate the diagnostic accuracy of TB screening on admission in low- and high-prevalence criminal justice systems. Further network meta-analyses of these studies could inform policymakers and public health experts to establish or fine-tune TB control in detention settings.

The presence of intact arachnoid membranes between skull base meningiomas and critical neurovascular structures is crucial for predicting surgical outcomes, understanding tumor development and growth, and planning the feasibility of tumor resection or the need for adjuvant treatments. While neurosurgeons often utilize the subarachnoid cisterns to enhance access to these tumors and facilitate their removal, a comprehensive review aimed at health professionals involved in the diagnosis and treatment of this complex pathology, including radiologists, neurologists, oncologists, ophthalmologists, and neurosurgeons is still lacking. This study aims to summarize the interaction between skull base meningiomas, subarachnoid cisterns, and arachnoid membranes, emphasizing their significance in both the diagnosis and treatment of this pathology. By conducting a thorough radiological assessment of skull base meningiomas, correlating these findings with intraoperative observations, and reviewing relevant literature, we summarize the critical relationship between skull base meningiomas and the surrounding subarachnoid spaces. We concisely describe how arachnoid structures influence tumor growth and interaction with neurovascular elements. We advocate for the inclusion of tumor-arachnoid relationships in the medical literature concerning the treatment of these tumors. A better understanding and description of the interaction between tumors and neurovascular structures will aid in planning and attempting safer treatments, minimizing surgical risks, predicting potential tumor progression, and the need for adjuvant treatments.

Infectious diseases are among the most frequent causes of hospital admission and a substantial contributor to morbidity and mortality. These diseases pose a persistent concern, particularly within the pediatric population, where delays or inappropriate management can result in serious harm. Additionally, infectious diseases contribute to overcrowding in pediatric emergency departments (EDs). This study aimed to explore the epidemiology, clinical presentation, diagnostics, outcome, and social and behavioral impacts of infectious diseases on child health. We conducted a retrospective, single-hospital study at a tertiary care center that is publicly funded and owned to serve the entire community. Pediatric patients with at least one or more chief complaints related to the respiratory system or infectious etiology were included. Data analysis was performed using SPSS to assess relationships between variables. A total of 15,106 patients were included, with a mean age of 3.80 years. The largest age group was toddlers (42.8%). Most cases (71.9%) were classified as urgent (Priority 3). Regarding patient outcomes, 76.1% were discharged after receiving appropriate treatment in the ED, and 22.9% required admission for further management. Nearly 38% of patients presented with a single complaint. Fever was the most frequent complaint across all groups. In summary, this study provides insights into the presentation of pediatric respiratory infectious diseases in the emergency room. The study revealed that toddlers were the most affected age group, with fever and cough being the common symptoms.

This study presents an improved method for obtaining spheroids microwell arrays for histological processing and analysis, focusing on glioblastoma (U87 MG) and breast adenocarcinoma (MCF-7) tumor models. By transitioning from traditional 2D cell cultures to 3D systems, this approach overcomes the limitations of 2D cultures by more accurately replicating the tumor microenvironment. The method consists of producing homotypic and heterotypic spheroids using low-adherence agarose-coated wells, embedding these spheroids in agarose microwell arrays, and conducting immunohistochemistry (IHC) to analyze cellular and molecular profiles. Morphological analyses were performed using OrganoSeg software, and IHC staining confirmed marker expressions consistent with respective tumor types. The study details the workflow from 2D cell culture to IHC analysis, including agarose well coating, spheroid embedding, and IHC staining for markers such as EMA, p53, Ki-67, ER, PR, and HER2. Results demonstrated compact, round U87 MG spheroids and fibroblast-stabilized MCF-7 spheroids, with both types exhibiting specific marker expressions. This innovative approach significantly enhances the efficiency of producing and analyzing large volumes of spheroids, making it both quick and cost-effective. It offers a robust drug screening and cancer research platform, maintaining spheroid traceability even in bulk workflow conditions. Furthermore, this methodology supports advances in personalized medicine by providing a more physiologically relevant model than 2D cultures, which is crucial for investigating tumor behavior and therapeutic responses through IHC.

Hirschsprung's disease is a congenital disorder characterized by the absence of ganglion cells in the myenteric and submucosal plexuses of the colon, resulting in impaired peristalsis and functional intestinal obstruction. This condition affects approximately 1 in 5,000 newborns, with a higher prevalence in boys. Although first identified in the 17^th century, its connection to chronic constipation was clearly established by Harald Hirschsprung in 1886. Contemporary treatment strategies emphasize early diagnosis, surgical excision of the aganglionic segment, and specialized postoperative care to restore normal colonic function and improve the quality of life for affected individuals. This article reviews current therapeutic strategies, highlighting advanced surgical techniques, diagnostic methods, and postoperative management. Two clinical cases illustrate the impact and treatment of the disease. The first case involves a 5-month-old male with severe malnutrition, dehydration, and acute enterocolitis, who underwent a right-side colostomy and later a Duhamel-type extramucosal sphincter-rectal-myotomy, showing favorable progress. The second case is a 1.5-year-old patient with a history of colostomy and ileostomy, requiring further surgery. Histopathological examinations in both cases revealed the absence of ganglion cells, confirming the diagnosis of Hirschsprung's disease.