SAGE Open Medicine最新文献

Background: Despite multiple studies, less recent literature and data regarding the mortality associated with hip fractures in the elderly population are available.

Objectives: To assess the mortality data and functional outcomes of patients who underwent cemented and uncemented hemiarthroplasty in femoral neck fractures. To evaluate if preoperative (minimum 2 months) calcium and vitamin D supplement intake in patients affects postoperative mobilization with or without walker support.

Methods: All patients aged 65 and above who underwent hemiarthroplasty for femoral neck fractures in our tertiary care center were included. Postoperative functional outcomes were determined using the Modified Harris Hip score and Oxford Hip score at 3, 6, and 12 months. The mortality of the procedures was assessed at 3, 6, and 12 months. Individuals who took both calcium and vitamin D supplements for at least 2 months before surgery were divided into two groups: those who did not take supplements and those who did.

Results: We studied 110 patients above the age of 65 years. The postoperative mortality rate at 3, 6 months and 1 year postoperatively was found to be 3.6%, 4.7%, and 15.5% respectively. Functional outcomes were assessed at 3, 6, and 12 months postoperatively using modified Harris Hip score and Oxford Hip score and were found to be identical in both cemented and uncemented hemiarthroplasty groups. Patients who took calcium and vitamin D supplements preoperatively (minimum 2 months) could walk without support at the end of 1-year post-surgery.

Conclusion: Early surgery and early mobilization should be the main aim of treatment for femoral neck fractures.

Background: Studies across the extant literature suggest that less-experienced healthcare workers are more likely to experience adverse outcomes such as burnout, sick leaves, or intend to leave the profession. Thus, one's readiness to practice is an important element that requires more attention. While extensive research exists on the readiness of certain professions like nurses, a notable gap remains concerning other healthcare workers.

Purpose: This study sought to explore studies examining readiness to practice among various underrepresented healthcare workers.

Methods: We conducted a scoping review to determine the available research related to clinical and nonclinical areas related to the readiness to practice of healthcare workers, excluding physicians and nurses. We examined three databases, MEDLINE, CINAHL, and PsycINFO, from 1 January 2000 to 31 December 2023. Our search focused on readiness to practice among various healthcare professions, whether clinically focused or broadly related to professionalism.

Results: Our search identified 41 articles meeting the inclusion criteria from several professions, including but not limited to physiotherapists and occupational therapists, pharmacists, osteopaths/chiropractors, and social workers. Overall, studies differed in assessing readiness to practice with a broad range of identified clinical competencies that varied between professions and regions. Nonclinical skills, such as communication, conflict management, and cultural competence, were common barriers across professions.

Conclusion: Despite the heterogeneity in job roles, work settings, and geographical reasons, there is evidence to suggest that new healthcare professionals may be clinically adept but may be lacking in other nonclinical skills that could affect their work and well-being. With early-career healthcare workers particularly vulnerable to adverse outcomes in the workplace, future research should standardize core competencies, including nonclinical skills and well-being-related activities, as a prevention method across various health groups.

Background: The mental burden faced by university students in their early years is not frequently reported in the literature.

Objectives: The aim of this study is to investigate the prevalence and predictors of depression among preparatory (first) year university students using a predictive test developed from general health and well-being questionnaires.

Methods: A cross-sectional study was conducted among university students in the eastern region of Saudi Arabia from March 2023 to June 2023. A self-administered electronic general health and well-being questionnaire was implemented. Written informed consent was obtained from the participants after explaining the study's purposes. The questionnaire consisted of three parts. Part I described the objective of the study and maintained the confidentiality of the data, part II contained questions about demographic data, and part III contained the scales of the items to assess the physical and psychological health.

Results: The findings demonstrated a significant positive correlation between depressive symptoms and both perceived stress (r = 0.444, p < 0.01) and perceived burdens (r = 0.735, p < 0.01). In addition, there were significant negative correlations between the depressive symptoms and gender (r = -0.144, p < 0.05), economic level (r = -0.178, p < 0.05), and social support (r = -0.312, p < 0.01). Furthermore, the results revealed that body mass index (b = 0.272, t(146) = 4.636, p < .001), perceived stress (b = 0.182, t(146) = 2.910, p < 0.01), and perceived burdens (b = 0.593, t(146) = 9.507, p < .001) were significant predictors of depressive symptoms among Saudi university junior students.

Conclusion: Our findings emphasize the need for tailored mental health support services to address depression and its predictors, especially during critical transition periods like the early stages of university life, as early detection and intervention can lead to improved management and better control of the depression.

Atherosclerosis is a chronic inflammatory disease affecting the vascular system, characterised by the accumulation of modified lipoproteins, immune cell aggregation and the development of fibrous tissue within blood vessel walls. As atherosclerosis impacts blood vessels, its adverse effects may manifest across various tissues and organs. In this review, we examine the association of atherosclerosis with Alzheimer's disease, stroke, pancreatic and thyroid dysfunction, kidney stones and chronic kidney diseases. In several cases, the reciprocal causative effect of these diseases on the progression of atherosclerosis is also discussed. Particular attention is given to common risk factors, biomarkers and identified molecular mechanisms linking the pathophysiology of atherosclerosis to the dysfunction of multiple tissues and organs. Understanding the role of atherosclerosis and its associated microenvironmental conditions in the pathology of multi-organ disorders may unveil novel therapeutic avenues for the prevention and treatment of cardiovascular and associated diseases.

Objectives: Our study aimed to identify the complex interplay between self-efficacy, self-care practice, and glycaemic control among people with type 2 diabetes mellitus (PWDs) to inform the design of more targeted and effective behavioural interventions in primary care.

Methods: A cross-sectional descriptive study was performed with 294 PWDs managed in primary care. The Diabetes Management Self-Efficacy Scale (DMSES) and Summary of Diabetes Self-Care Activities (SDSCA) questionnaire measured patients' self-efficacy and self-care practice. Multivariate logistic regression models were developed to explore how SDSCA, DMSES, and their combined effect relate to glycaemic control, adjusting for patient characteristics. Network analysis in R software examined relationships between self-efficacy and self-care dimensions across glycaemic control subgroups using a Gaussian graphical model with the extended Bayesian information criterion.

Results: Half the PWDs (50.7%) had suboptimal glycaemic control. Better glycaemic control was consistently associated with higher self-efficacy (odds ratio (OR) = 0.76, 95% confidence (CI) (0.60, 0.97), p = 0.03), shorter duration of diabetes (OR = 1.89, 95% CI (1.08, 3.31), p = 0.03), normal waist circumference (OR = 1.76, 95% CI (1.02, 3.05), p = 0.04), absence of diabetes complications (OR = 2.09, 95% CI (1.10, 3.98), p = 0.02), and treatment with oral hypoglycaemic agents (OR = 3.05, 95% CI (1.53, 6.09), p < 0.01). Network analysis among people with well-controlled HbA1c revealed that diet adherence and self-efficacy had the most robust connection, with diet self-efficacy strongly associated with most self-efficacy dimensions. Self-efficacy in exercise, blood glucose monitoring, and foot care are the most central factors in the network structures for PWDs with suboptimal glycaemic control.

Conclusions: Our study highlights the critical role of self-efficacy in diabetes primary care. For people with optimal glycaemic control, prioritising self-efficacy in diet adherence is crucial for sustaining glycaemic outcomes and supporting other self-care behaviours. Among those with suboptimal glycaemic control, enhancing self-efficacy in exercise, blood glucose monitoring, and foot care is essential. Targeted education programs, personalised counselling, and E-health tools can further empower patients to manage their diabetes more effectively.

Introduction: Polycystic ovary syndrome is a common chronic condition characterized by insulin resistance and hyperandrogenism, leading to significant health risks and impaired quality of life. Sodium-glucose transporter type 2 inhibitors have shown promise in improving the metabolic profile of women with polycystic ovary syndrome. However, their impact on hormonal parameters and cycle disorders remains uncertain.

Methods: This systematic review analyzed randomized clinical trials published up to 1 December 2023, comparing sodium-glucose transporter type 2 inhibitors to metformin, other antidiabetic agents, or placebo in women with polycystic ovary syndrome. The primary outcomes were changes in total testosterone, free androgen index, dehydroepiandrosterone sulfate, delta-4 androstenedione, and cycle disorders.

Results: Five randomized studies were included, evaluating canagliflozin, dapagliflozin, licogliflozin, or empagliflozin against metformin, exenatide, or placebo, with a total of 214 participants. Improvements in total testosterone and dehydroepiandrosterone sulfatewere observed in some studies, but the effects were inconsistent across drugs and outcomes. Additionally, two studies reported beneficial effects on cycle disorders.

Conclusions: Sodium-glucose transporter type 2 inhibitors appear to have a potential but variable impact on hormonal parameters in women with polycystic ovary syndrome. However, larger and longer-duration studies are needed to fully elucidate their long-term efficacy in addressing hyperandrogenism and improving overall outcomes in these patients.

Background/objectives: As people with human immunodeficiency virus experience longer life expectancy, other causes of morbidity and mortality are being increasingly identified. The incidence of non-alcoholic fatty liver disease has recently been on the rise in Indonesia. People with human immunodeficiency virus on antiretroviral therapy are also at an increased risk of having non-alcoholic fatty liver disease. The study aimed to define the prevalence and factors associated with non-alcoholic fatty liver disease in people with human immunodeficiency virus on stable antiretroviral therapy.

Methods: A cross-sectional study of people with human immunodeficiency virus, on antiretroviral therapy, age younger than 18 years old, and without hepatitis co-infection was conducted at the human immunodeficiency virus Integrated Clinic Cipto Mangunkusumo Hospital, Jakarta, Indonesia. Non-alcoholic fatty liver disease was diagnosed using transient elastography with associated controlled attenuation parameter examination (diagnostic cutoff: 238 db/m). A logistic regression test with Poisson regression was used to evaluate factors associated with non-alcoholic fatty liver disease.

Results: One hundred and five people with human immunodeficiency virus were included, with a median age of 39 years and 65.7% were men. The prevalence of non-alcoholic fatty liver disease was 52.4%. Factors related to non-alcoholic fatty liver disease were hypertension (aPR: 1.49, 95% CI: 1.03-2.14, p = 0.033) and triglyceride levels (aPR: 1.001, 95% CI: 1.000-1.002, p = 0.024). No human immunodeficiency virus-specific variables were associated with non-alcoholic fatty liver disease.

Conclusions: More than half of Indonesian people with human immunodeficiency virus on antiretroviral therapy in this study were found to have non-alcoholic fatty liver disease. Hypertension and increased triglyceride levels were related to non-alcoholic fatty liver disease. Screening for non-alcoholic fatty liver disease should be implemented as a means of early intervention and to prevent complications.

Background and aim: Mindfulness meditation has been inadequately used in patients with end-stage renal disease although it has been effective in reducing pro-inflammatory biomarkers in patients with chronic illnesses. Thus, this study examined mindfulness meditation effect on pro-inflammatory biomarkers and C-reactive protein in patients with end-stage renal disease.

Materials and methods: Repeated measures, randomized, control experimental design was used. A convenience sampling technique was used to select the sample from a hospital located in northern Jordan. The participants were randomly distributed into experimental (n = 31) and control (n = 31) groups. During hemodialysis sessions, the group of experiment participants practiced 30 min of the Attentional behavioral cognitive theory version of mindfulness meditation; 3 times a week for 8 weeks). The inflammatory biomarkers including C-reactive protein, tumor necrosis factor-alpha, and interleukine-6 were measured by collecting peripheral blood through venipuncture. These biomarkers were analyzed using the enzyme-linked immunosorbent assay (ELISA) protocol after 5 weeks of the intervention, and at its end (8 weeks). An Excel sheet was used to collect data for participants.

Results: Compared to the control condition, mindfulness meditation led to statistically significant reductions in C-reactive protein and tumor necrosis factor over time but a nonsignificant effect on interleukine-6.

Conclusion: Study's results support the evidence-based practice recommendation of adding mindfulness meditation as a complementary treatment to the nurse's care plans for patients with end-stage renal disease.

Trial registration: Clinical trial.gov; ID: NCT06064708; Date: 09/26/2023.

Background: To analyze the characteristics and factors influencing the diagnosis of unilateral isolated fungal sphenoid sinusitis.

Methods: A retrospective analysis was conducted on the clinical data of patients who underwent surgery for unilateral isolated sphenoid sinusitis between June 2020 and May 2023. Data collected included variables such as gender, age, side of the specimen, symptoms, sinus computed tomography findings, pathological results, and complications. The patients were categorized into two groups: the sphenoid sinusitis group and the fungal sphenoid sinusitis group.

Results: Among the 84 cases studied, there were 19 males (22.6%) and 65 females (77.4%). Inflammation was observed in 11 patients (13.1%), while fungi were detected in 73 patients (86.9%). Headache was reported in 74 cases (88.1%). Sinus computed tomography findings revealed calcified plaques/spots in 51 cases (60.7%), hyperosteogeny in 75 cases (89.3%), and bone destruction in 11 cases (13.1%). The thickness of the sinus wall ranged from 0.92 to 7.35 mm. The thickness ratio of the bilateral sinus walls ranged from 0.80 to 6.78. The chi-square test indicated significant differences between the two groups in terms of calcified plaques/spots, hyperosteogeny, the thickness of the lesion-side sinus wall, and the ratio of bilateral sinus walls (p < 0.05). Diagnostic tests using the ROC curve demonstrated that calcified plaques/spots, the thickness of the lesion-side sinus wall, and the ratio of bilateral sinus walls had moderate accuracy in diagnosing fungal sphenoid sinusitis.

Conclusion: While headache is not a specific symptom of fungal sphenoid sinusitis, sinus computed tomography findings such as calcified plaque/spots, the thickness of the lesion-side sinus wall, and the thickness ratio of bilateral sinus walls are valuable for diagnosis.