Health Science Reports最新文献

Background and Aims

A retrospective analysis was conducted on the clinical, pathological, and imaging features of 471 cases of pilomatrixoma, aiming to enhance clinicians' understanding of pilomatrixoma.

Methods

A total of 471 cases of pilomatrixoma diagnosed and surgically treated in the Affiliated Hospital of Southwest Medical University from August 1999 to July 2024 were retrospectively analyzed. Some cases were also diagnosed through preoperative fine needle aspiration, as well as ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI).

Results

Of these 471 patients, 224 (47.6%) were male, and 247 (52.4%) were female. Their ages ranged from 8 months to 90 years, with an average age of 18.2 years. The highest incidence of pilomatrixoma was observed in patients aged between 0 and 10 years, accounting for 46.5% (219/471). The most common site of pilomatrixoma is the face, followed by the neck. The most common area of the face is the parotid gland region, accounting for 24.8% (61/246) of facial cases. Histology and cytopathology revealed that the tumor cells usually consisted of basaloid cells and eosinophilic shadow cells, and inflammatory cells, foreign body giant cells, and calcifications were seen. Additionally, the ultrasonography showed a mass with calcification, a strong echo band, and parenchyma without calcification. The pilomatrixoma should be considered when the tumor presents as soft-tissue density with varying degrees of calcification, well-defined oval or circular nodules on CT, and characteristic reticular and annular hypersignal on T2WI and T2WI + FS on MRI.

Conclusion

Pilomatrixoma is commonly found on the face and neck of adolescent females. Cytopathology, ultrasound, and imaging features can provide clinical clues, and histopathology can make the final diagnosis. Complete surgical resection is the preferred treatment.

Background

Pregnancy-related anxiety and fear of childbirth are common in primiparous women and contribute to high cesarean section rates. Few interventions specifically target emotion regulation skills.

Objective

To evaluate the efficacy of a brief, midwife-led, group-based counseling program grounded in Gross's emotion regulation model in reducing pregnancy-related anxiety and fear of childbirth.

Methods

Pragmatic randomized controlled trial in Hamadan, Iran, 2023. Seventy primiparous women (28–33 weeks gestation) were allocated (1:1) to 6 weekly emotion regulation counseling sessions or routine prenatal care. Primary outcomes were post-intervention scores on the Persian Pregnancy-Related Anxiety Questionnaire (PRAQ) and Childbirth Attitudes Questionnaire (CAQ), analyzed by ANCOVA adjusting for baseline scores.

Results

Adjusted mean PRAQ scores were 36.65 (SE 2.74) vs. 66.41 (SE 2.74) (adjusted difference –29.76, 95% CI −37.28 to −22.24, Cohen's d = 1.95, p < 0.001). Adjusted mean CAQ scores were 25.51 (SE 1.07) vs. 35.99 (SE 1.07) (adjusted difference −10.48, 95% CI −13.48 to –7.48, Cohen's d = 1.71, p < 0.001). Effects remained robust after adjustment for insurance status.

Conclusion

This brief emotion regulation intervention produced large reductions in pregnancy-related anxiety and fear of childbirth. Findings are preliminary due to single-center design, lack of blinding, and subjective outcomes. Larger multicenter trials with attention controls and long-term follow-up are needed before routine implementation.

Trial Registration: IRCT20230115054147N1.

Background and Aims

Neonatal units can be stressful for pre-term infants at a time of rapid brain growth and plasticity, which may contribute to poorer developmental outcomes. Environmental modification to protect against negative sensory experiences and provide positive caregiver stimuli is the standard of care, but little is known about practices in low-income settings. We aimed to determine knowledge and practice relating to developmentally-supportive-care in Uganda.

Methods

A quantitative survey on knowledge and practice of developmentally-supportive-care was conducted with 135 health workers in four neonatal units. In addition, observations of practices and sound measurements were conducted.

Results

Only 36% of respondents reported that stress, and 21% that parental interaction can affect brain development, and knowledge of stress reduction was limited. 84% of respondents reported actions to protect infants from excessive light in their unit, 33% from excessive sound, and 69% from sleep disruption. The main perceived benefit of family involvement in care was to reduce parental stress levels (67%), with infection risk perceived as the main negative (71%). Workers at the largest volume facility had the lowest knowledge and practice, with wide variations across facilities. All units had sound readings over recommended levels.

Conclusion

Knowledge and practice of DSC in this setting were low and needs to be improved to ensure that pre-terms in this setting both survive and thrive.

Background and Aims

Clinical education is a fundamental component of medical training that faced numerous challenges during the COVID-19 pandemic. Understanding faculty members' experiences and strategies can inform plans for enhancing educational quality during future health crises. This study aimed to explore faculty members' experiences in delivering clinical education during the pandemic.

Methods

This qualitative study used a conventional content analysis approach. Data were collected through semi-structured interviews employing purposive sampling. Interviews continued until data saturation was achieved. In total, 14 participants were interviewed. The credibility of the findings was assessed using the criteria proposed by Guba and Lincoln.

Results

The analysis yielded three main themes. The first theme, challenge-based experience, consisted of subcategories including intrapersonal psychological challenges, environmental misinformation, and systemic management deficiencies. The second theme, change-based experience, comprised subcategories such as shifts in protective roles, modifications in clinical education environments, changes in patient collaboration, heightened attention to professionalism, and strengthened role modeling. The third theme, problem-solving-based experience, encompassed subcategories such as an emphasis on feedback, clinical education strategies, educational equity approaches, systemic solutions, exploration of international approaches, and comprehensive assessment strategies.

Conclusion

The study delineates a three-phase adaptation trajectory—through confronting challenges, navigating changes, and implementing problem-solving strategies—that enabled faculty to sustain clinical education during the pandemic. These experiences yield critical, actionable recommendations for future crisis preparedness. We recommend that institutions integrate hybrid clinical training models and develop formal faculty development programs focused on digital pedagogy and crisis management. Embedding these evidence-based strategies into medical education policy is crucial for building a resilient and equitable clinical education system capable of withstanding future disruptions.

Background

Vitamin D deficiency is highly prevalent among children on regular dialysis, affecting approximately 90% of patients. This deficiency (serum 25-hydroxyvitamin D < 50 nmol/L or 20 ng/mL) is associated with various complications, including skeletal problems, increased infection risk, arterial stiffness, vascular calcification, and higher cardiovascular mortality. Severe deficiency (< 30 nmol/L) particularly increases mortality risks.

Method

In this cross-sectional retrospective study, we examined 53 pediatric patients (28 boys, 25 girls) undergoing regular dialysis (hemodialysis and peritoneal dialysis) at a children's medical center from 2018 to 2020. The mean age was 8.21 years, with 71.7% aged 2–12 years, 20.8% adolescents, and 7.5% under 2 years. The mean vitamin D level was 23.51 ng/mL.

Results

Results showed that 26.41% of patients died, with mortality analysis revealing a hazard ratio of 3.2 for patients with vitamin D levels below 15 ng/mL. The mortality rate was 64.7% in severe deficiency (< 15 ng/mL), 18.8% in moderate deficiency (15–30 ng/mL), while patients with sufficient levels (> 30 ng/mL) recorded no deaths. Additionally, 11.32% developed skeletal disorders, including two cases of spinal fracture. Vitamin D levels showed significant positive correlations with calcium (r = 0.6) and years under dialysis (r = 0.52) (p > 0.05). Associations were found between vitamin D levels and phosphorus, PTH, and mortality rates. However, no significant relationships were observed with dialysis frequency, age, weight, gender, underlying disease, dialysis type, or hypertension.

Conclusion

In conclusion, children with end-stage renal disease undergoing dialysis face increased risks of vitamin D deficiency due to impaired kidney function. This deficiency significantly impacts survival rates and contributes to poor outcomes. Regular monitoring and management of vitamin D levels are crucial for improving survival in pediatric dialysis patients.

Background and Aims

Acne vulgaris is a frequent skin disorder, affecting a large part of the population worldwide, and strongly influencing not only the physical but also the mental aspects of health. The choice of therapy for acne vulgaris is a very difficult one because the multifactorial causality of the disease and interindividual variability in response to treatment should be considered. This article aims to provide a comprehensive review of the drugs used in the treatment of acne vulgaris, along with their chemical structure.

Methods

A comprehensive search of relevant databases (PubMed, Google Scholar, Web of Science, and Scopus) was conducted using keywords such as “acne vulgaris”, “chemical structure”, “mode of action”, and “structure–activity relationship”. We reviewed articles published up to 2025. The authors reviewed articles that discussed the chemical structure and structure–activity relationships of drugs used in the treatment of acne vulgaris. In addition, articles on acne vulgaris pharmacotherapy were also reviewed.

Results

In this review, all the current modalities for the management of acne vulgaris are presented and grouped according to their chemical nature, including topical applications and systemic administration. In this light, we go further into the mechanism of action of each treatment, its efficacy and safety, and possible side effects. New therapeutic agents targeting the skin microbiome, inflammation, and hormonal imbalance are also a focus. We finally propose one step for choosing an optimum therapy based on the subject's constitution, the severity of post-acne scarring, and associated comorbidities.

Conclusion

The present review would benefit general physicians in adapting their management to treat zits and pimples for the improvement of their patients, with particular importance given to the knowledge of the chemical structures of various drugs.

Background and Aims

An infant born before 37 weeks of gestation is called a preterm infant. In the Neonatal Intensive Care Unit (NICU), occupational therapists provide essential therapeutic interventions, including those for social-emotional development, the promotion of parent-infant attachment and interactions, and the developmental assessment of preterm infants. This research aimed to explore the effects of maternal massage training combined with verbal contact with preterm infants on maternal attachment and infant motor performance.

Methods

84 preterm infants in the NICU were assigned to intervention and control groups. The infants in the control group underwent standard interventions, while the mothers of the infants in the intervention group gave their babies a massage for 15 min daily over 5 days and talked to their babies during the massage. Maternal Postnatal Attachment Scale (MPAS) and the Test of Infant Motor Performance (TIMP) were utilized for assessment and the data were analyzed using SPSS version 27.

Results

In both groups, MPAS and TIMP post-test scores increased compared to pre-test scores, although the increase in scores was significantly greater in the intervention group than in the control group (95% CI [−6.96, −1.73], p = 0.001% and 95% CI [−0.93, −0.14], p = 0.009, respectively). However, no statistically significant weight gain was observed in either the intervention or control groups (95% CI [−186.14, −129.14], p = 0.720).

Conclusion

Massage along with verbal contact by mothers of premature infants enhances maternal attachment and the infants' motor performance, yet it does not significantly affect the infants' weight gain. Consequently, given the difficulties these babies and their caregivers encounter, massage and verbal contact may serve as a safe and economical approach.

Background and Aims

Out-of-hospital cardiac arrests (OHCAs) remain a critical challenge in emergency care, as CPR effectiveness heavily relies on precise chest compressions. We propose a novel CPR guidance system using computer vision to track rescuer motion in real time. This study aims to evaluate the system's efficacy in improving CPR performance, particularly its adaptability to both adult and pediatric populations.

Methods

We evaluated a novel CPR navigation system integrated into an Automated External Defibrillator (AED), termed HeartSave M650, which utilizes computer vision to guide CPR quality. A prospective, randomized, crossover trial was conducted comparing HeartSave M650 against the traditional HeartSave M600. In total, 81 volunteers (41 CPR-trained; 40 untrained) stratified into adult (n = 61) and pediatric (n = 20) cohorts were assigned via computer-generated block randomization (block size = 4; stratified by training status) to perform simulated CPR using either: (1) Experimental intervention: HeartSave M650 AED; (2) Control intervention: Conventional HeartSave M600 AED. Participants crossed over after a 15-min washout period. Outcome assessors were masked to device assignment. Participants were not blinded due to visible device differences. The primary outcome was the proportion of compressions within guideline-recommended depth, measured by manikin sensors with video validation.

Results

The primary outcome demonstrated that the M650 significantly improved optimal-depth compressions in adults (60.38% vs. 29.54%, p < 0.001) and pediatric (73.44% vs. 40.96%, p < 0.001), while reducing excessive depth compressions in adults (17.60% vs. 53.97%, p < 0.001) and in pediatric (13.96% vs. 26.11%, p = 0.007).

Conclusion

HeartSave M650 improves compression depth accuracy, more than doubling correct performance compared to conventional AEDs. Its ability to reduce over-depth compressions further supports its clinical value in standardizing CPR quality.

Background and Aim

This study aims to retrospectively assess the point-light display (PLD) action observation methodology, in order to explore the effect of action observation treatment (AOT) for locomotion rehabilitation in aged patients at risk of falling.

Methods

The results of 30 patients were assessed with 10 patients benefiting from conventional rehabilitation program, 10 patients receiving an AOT program involving the observation of PLD representing a young actor, and 10 patients receiving an AOT program involving the observation of PLD representing an old actor (PLD-O).

Results

The analysis revealed more progress for patients who benefited from AOT observation compared to conventional therapy on standardized tests measuring daily life actions (Bartel index) and disability in the lower limbs (Short Physical Performance Battery) but only when PLD represented an old actor.

Discussion

These results suggest that an AOT program involving the observation of PLDs is a promising approach for rehabilitating patients at risk of falling in a clinical context but matching the motor repertoire seems a crucial factor for optimizing the effects.

Background

Type 2 diabetes mellitus (T2DM) is increasingly seen as a chronic inflammatory state, with the neutrophil-to-lymphocyte ratio (NLR) studied as a new biomarker of systemic inflammation. Evidence links NLR to glycemic control, but its consistency and strength vary. This review summarizes data on NLR's relationship with glycemic indicators, such as hemoglobin A1c (HbA1c), across different T2DM glycemic states.

Methods

A systematic literature search was carried out in PubMed/MEDLINE, Scopus, Web of Science, and Embase through November 2025 to find studies that reported both NLR and glycemic control indicators in adults with T2DM. Data were systematically extracted based on predefined criteria. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were combined using random-effects models. Heterogeneity was measured using the I² statistic, and robustness was assessed using sensitivity analyses. Publication bias was investigated using Begg's and Egger's tests, trim-and-fill analysis, and funnel plot examination. All statistical analyses were conducted using STATA 18 (StataCorp, College Station, TX, USA).

Results

The meta-analysis consisted of 27 studies (37 comparisons) with a total of 48,714 individuals from 11 nations. NLR demonstrated a stepwise gradient with deteriorating glycemic control: poorly controlled T2DM (HbA1c >  7%) had higher NLR than well-controlled T2DM (HbA1c ≤  7%) (p <  0.001), prediabetes (HbA1c 5.7–6.4%) (p <  0.001), and normoglycemia (HbA1c ≤  5.7%) (p =  0.037).

Conclusions

NLR rises progressively with deteriorating glycemic control and is markedly raised in poorly controlled T2DM. These observations endorse NLR as an inexpensive, widely available inflammatory biomarker that can augment conventional glycemic measures in the clinical setting.