P. Di Micco, F. F. Bernardi, Giovanni Maria Fusco, Alessandro Perrella
Artificial intelligence (AI) was introduced in medicine to make some difficult decision-making regarding diagnostics and/or treatments easy. Its application derives from the improvement of information obtained with computer sciences and informatics, in particular with information derived by algorithms obtained with special informatics support as machine learning. The scenario of hospital changes induced by the COVID-19 pandemic makes easy the application of AI for some clinical updates. Being lung failure with pulmonary embolism is the most common cause of death for inpatients with COVID-19, some biomarkers such as the d-dimer are constantly used associated with other clinical features in order to improve medical assistance. For this reason, d-dimer during the pandemic changed its traditional use for predictive negative value in patients with suspected pulmonary embolism and took relevance for its values giving the chance to change the intensity of anticoagulation for several inpatients. In most cases, according to data reported from several cohorts, these changes improved the morbidity and mortality of a significant percentage of inpatients with COVID-19. The International medical prevention registry on venous thromboembolism and d-dimer and modified sepsis-induced coagulopathy scores were the most used scores derived from AI and dedicated to these clinical aspects in inpatients with COVID-19. Therefore, this review was dedicated to flexible changes that we can use after d-dimer values in different clinical scenarios that vary from disseminated intravascular coagulation to pulmonary embolism to COVID-19.
{"title":"How artificial intelligence during the pandemic modified the role of a biomarker as d-dimer","authors":"P. Di Micco, F. F. Bernardi, Giovanni Maria Fusco, Alessandro Perrella","doi":"10.4081/itjm.2023.1656","DOIUrl":"https://doi.org/10.4081/itjm.2023.1656","url":null,"abstract":"Artificial intelligence (AI) was introduced in medicine to make some difficult decision-making regarding diagnostics and/or treatments easy. Its application derives from the improvement of information obtained with computer sciences and informatics, in particular with information derived by algorithms obtained with special informatics support as machine learning. The scenario of hospital changes induced by the COVID-19 pandemic makes easy the application of AI for some clinical updates. Being lung failure with pulmonary embolism is the most common cause of death for inpatients with COVID-19, some biomarkers such as the d-dimer are constantly used associated with other clinical features in order to improve medical assistance. For this reason, d-dimer during the pandemic changed its traditional use for predictive negative value in patients with suspected pulmonary embolism and took relevance for its values giving the chance to change the intensity of anticoagulation for several inpatients. In most cases, according to data reported from several cohorts, these changes improved the morbidity and mortality of a significant percentage of inpatients with COVID-19. The International medical prevention registry on venous thromboembolism and d-dimer and modified sepsis-induced coagulopathy scores were the most used scores derived from AI and dedicated to these clinical aspects in inpatients with COVID-19. Therefore, this review was dedicated to flexible changes that we can use after d-dimer values in different clinical scenarios that vary from disseminated intravascular coagulation to pulmonary embolism to COVID-19.","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":"40 6","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139255018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction. Adaption and adoption of a healthy lifestyle remain challenging worldwide. An unhealthy diet is the core risk of lifestyle illnesses. However, the status of a healthy diet and its predictors were not assessed in Nekemte town targeting middle-aged adulthoods. The study was designed to assess healthy diet, prevalence and factors associated among middle-aged adults in Nekemte town from January 15, 2019, to February 30, 2019. Materials and Methods. A descriptive epidemiological study design typically cross-sectional analysis was applied in Nekemte town on middle-aged adults. Primary data was gathered by using a questionnaire and checked for its normality. Factors associated with dependent variables were analyzed with logistic regressions and their significance was determined at P<0.05. Results. The status of dieting practice was 73.31% (unhealthy) and 26.69% (healthy), respectively. This study showed that being low income (P=0.001), not married (P=0.001), and daily meal frequency [adjusted odds ratio (AOR): 1.91, 95% confidence interval (CI): [1.04, 2.71]) are associated with unhealthy diets. The odds of having an unhealthy diet were almost 3 times (AOR=3.20, [95% CI: (2.04, 5.98) higher for illiterate compared to literate participants. In addition, an unhealthy diet was nearly 5 times (AOR: 4.87, 95% CI: [3.23, 7.65]) higher for having poor knowledge of healthy diet compared to alert participants. Conclusions. The researchers identified unhealthy diets practiced highly by the study samples of the populations.
{"title":"Healthy diet, prevalence and factors associated among adults of Nekemte dwellers, Oromia State, Western Ethiopia","authors":"Alemu Adeba, Dessalegn Tamiru, T. Belachew","doi":"10.4081/itjm.2023.1630","DOIUrl":"https://doi.org/10.4081/itjm.2023.1630","url":null,"abstract":"Introduction. Adaption and adoption of a healthy lifestyle remain challenging worldwide. An unhealthy diet is the core risk of lifestyle illnesses. However, the status of a healthy diet and its predictors were not assessed in Nekemte town targeting middle-aged adulthoods. The study was designed to assess healthy diet, prevalence and factors associated among middle-aged adults in Nekemte town from January 15, 2019, to February 30, 2019. Materials and Methods. A descriptive epidemiological study design typically cross-sectional analysis was applied in Nekemte town on middle-aged adults. Primary data was gathered by using a questionnaire and checked for its normality. Factors associated with dependent variables were analyzed with logistic regressions and their significance was determined at P<0.05. Results. The status of dieting practice was 73.31% (unhealthy) and 26.69% (healthy), respectively. This study showed that being low income (P=0.001), not married (P=0.001), and daily meal frequency [adjusted odds ratio (AOR): 1.91, 95% confidence interval (CI): [1.04, 2.71]) are associated with unhealthy diets. The odds of having an unhealthy diet were almost 3 times (AOR=3.20, [95% CI: (2.04, 5.98) higher for illiterate compared to literate participants. In addition, an unhealthy diet was nearly 5 times (AOR: 4.87, 95% CI: [3.23, 7.65]) higher for having poor knowledge of healthy diet compared to alert participants. Conclusions. The researchers identified unhealthy diets practiced highly by the study samples of the populations.","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139255178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Suhaila A. Ali, Ahmad Y. Alqassim, Fatmah O. Alshekh, Atheer M. Alshammakhi, Rawan N. Omar, Roaa A. Areeshi, Roaa Alhazmi, Lamees A. Zaalah, Mohammed A. Muaddi, Abdullah A. Alharbi
The global prevalence of COVID-19 has necessitated the use of personal protective equipment, particularly face masks, amongst healthcare workers (HCWs). However, extended face mask usage has led to adverse health effects. This cross-sectional study investigates the relationship between prolonged surgical mask-wearing and the development of adverse effects among 500 HCWs in Jazan, Saudi Arabia. The study utilized an anonymous questionnaire distributed across multiple departments in Jazan and Sabya Hospitals. The results indicated that most participants believed that wearing face masks for extended periods led to adverse skin and respiratory effects. The primary respiratory complaints were difficulty breathing and nasal itching, while skin-related issues included sweating, itching, and acne. Therefore, this study concludes that extended surgical mask usage during the COVID-19 pandemic could potentially lead to adverse health implications among HCWs in Jazan. Further research into this correlation is needed.
{"title":"Correlation between extended surgical mask usage and adverse health effects during the COVID-19 pandemic among healthcare personnel in Jazan, Saudi Arabia","authors":"Suhaila A. Ali, Ahmad Y. Alqassim, Fatmah O. Alshekh, Atheer M. Alshammakhi, Rawan N. Omar, Roaa A. Areeshi, Roaa Alhazmi, Lamees A. Zaalah, Mohammed A. Muaddi, Abdullah A. Alharbi","doi":"10.4081/itjm.2023.1636","DOIUrl":"https://doi.org/10.4081/itjm.2023.1636","url":null,"abstract":"The global prevalence of COVID-19 has necessitated the use of personal protective equipment, particularly face masks, amongst healthcare workers (HCWs). However, extended face mask usage has led to adverse health effects. This cross-sectional study investigates the relationship between prolonged surgical mask-wearing and the development of adverse effects among 500 HCWs in Jazan, Saudi Arabia. The study utilized an anonymous questionnaire distributed across multiple departments in Jazan and Sabya Hospitals. The results indicated that most participants believed that wearing face masks for extended periods led to adverse skin and respiratory effects. The primary respiratory complaints were difficulty breathing and nasal itching, while skin-related issues included sweating, itching, and acne. Therefore, this study concludes that extended surgical mask usage during the COVID-19 pandemic could potentially lead to adverse health implications among HCWs in Jazan. Further research into this correlation is needed.","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":"132 6","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139257928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background. Panic disorder is a debilitating condition characterized by severe symptoms and social avoidance. Due to insufficient knowledge, this study examined the effectiveness of brief cognitive behavioral therapy (CBT) on symptom severity and social avoidance in patients with panic disorder. Patients and Methods. In this randomized controlled trial (RCT), 44 patients were included in the Brief CBT group or the control group after addressing issues related to lost-to-follow-up. Panic disorder symptom severity (PDSS) and the work and social adjustment scale (WSAS) were used to assess symptom severity and social adjustment, respectively. Results. After one month of treatment, the total PDSS scores (1.79 vs. 4.47; P=0.0409) and WSAS scores (2.97 vs. 7.41; P=0.0015) in the brief CBT group were significantly lower compared to the control group. The study revealed that in the brief CBT group, the mean score of PDSS and WSAS significantly decreased from 21.53 to 1.79 (P<0.0001) and from 24.63 to 2.95 (P<0.0001), and in the control group from 19.59 to 4.47 (P<0.0001) in PDSS and from 22.18 to 7.41 (P<0.0001) in WSAS, respectively. Furthermore, the change in WSAS scores in the brief CBT group was independent of the decrease in PDSS. Conclusions. This study demonstrated that the application of brief CBT is an effective technique for reducing symptom severity and social avoidance in patients with panic disorder.
背景。惊恐障碍是一种虚弱的疾病，其特征是严重的症状和社交回避。由于缺乏足够的知识，本研究考察了短暂认知行为疗法(CBT)对恐慌症患者症状严重程度和社交回避的有效性。患者和方法。在这项随机对照试验(RCT)中，44名患者在解决了与失访相关的问题后被纳入简短CBT组或对照组。分别用惊恐障碍症状严重程度量表(PDSS)和工作与社会适应量表(WSAS)评估症状严重程度和社会适应程度。结果。治疗1个月后，两组总PDSS评分(1.79 vs 4.47;P=0.0409)和WSAS评分(2.97 vs. 7.41;P=0.0015)，与对照组相比显著降低。研究发现，在简短CBT组中，PDSS和WSAS的平均得分分别从21.53降至1.79 (P<0.0001)和24.63降至2.95 (P<0.0001)，而在对照组中，PDSS和WSAS的平均得分分别从19.59降至4.47 (P<0.0001)和22.18降至7.41 (P<0.0001)。此外，短暂CBT组WSAS评分的变化与PDSS的下降无关。结论。本研究表明，应用简短的CBT是一种有效的技术，以减轻症状严重程度和社会回避的恐慌症患者。
{"title":"Effectiveness of brief cognitive behavior therapy on symptoms severity in relation to social avoidance among patients with panic disorder: a randomized controlled trial","authors":"Rasoul Sabri Piro, Perjan Hashim Taha","doi":"10.4081/itjm.2023.1664","DOIUrl":"https://doi.org/10.4081/itjm.2023.1664","url":null,"abstract":"Background. Panic disorder is a debilitating condition characterized by severe symptoms and social avoidance. Due to insufficient knowledge, this study examined the effectiveness of brief cognitive behavioral therapy (CBT) on symptom severity and social avoidance in patients with panic disorder. Patients and Methods. In this randomized controlled trial (RCT), 44 patients were included in the Brief CBT group or the control group after addressing issues related to lost-to-follow-up. Panic disorder symptom severity (PDSS) and the work and social adjustment scale (WSAS) were used to assess symptom severity and social adjustment, respectively. Results. After one month of treatment, the total PDSS scores (1.79 vs. 4.47; P=0.0409) and WSAS scores (2.97 vs. 7.41; P=0.0015) in the brief CBT group were significantly lower compared to the control group. The study revealed that in the brief CBT group, the mean score of PDSS and WSAS significantly decreased from 21.53 to 1.79 (P<0.0001) and from 24.63 to 2.95 (P<0.0001), and in the control group from 19.59 to 4.47 (P<0.0001) in PDSS and from 22.18 to 7.41 (P<0.0001) in WSAS, respectively. Furthermore, the change in WSAS scores in the brief CBT group was independent of the decrease in PDSS. Conclusions. This study demonstrated that the application of brief CBT is an effective technique for reducing symptom severity and social avoidance in patients with panic disorder.","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":"36 22","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136347946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Francesca Romana Ponziani, Cristiano Caruso, Ilaria Baglivo, Francesco Macagno, Antonio Gasbarrini, Francesco Santopaolo, Maria Cristina Giustiniani, Stefania Colantuono, Maurizio Pompili
Inflammatory tissue damage plays a role in the onset, progression, and exacerbation of various chronic autoimmune and metabolic diseases such as autoimmune hepatitis. Here we present a case of autoimmune hepatitis with liver eosinophilic infiltrate in a severe eosinophilic asthma patient who failed conventional immunosuppressive treatment and showed improvement in gastrointestinal symptoms after anti-interleukin-5 receptor treatment. Our case highlights the potential role of eosinophils in initiating or worsening liver inflammation in autoimmune liver disease. The link between eosinophilic inflammation, barrier damage, and chronic autoimmune diseases should be considered in clinical practice.
{"title":"Autoimmune hepatitis with eosinophilic infiltration responsive to anti-interleukin-5 receptor treatment: a case report and literature review","authors":"Francesca Romana Ponziani, Cristiano Caruso, Ilaria Baglivo, Francesco Macagno, Antonio Gasbarrini, Francesco Santopaolo, Maria Cristina Giustiniani, Stefania Colantuono, Maurizio Pompili","doi":"10.4081/itjm.2023.1619","DOIUrl":"https://doi.org/10.4081/itjm.2023.1619","url":null,"abstract":"Inflammatory tissue damage plays a role in the onset, progression, and exacerbation of various chronic autoimmune and metabolic diseases such as autoimmune hepatitis. Here we present a case of autoimmune hepatitis with liver eosinophilic infiltrate in a severe eosinophilic asthma patient who failed conventional immunosuppressive treatment and showed improvement in gastrointestinal symptoms after anti-interleukin-5 receptor treatment. Our case highlights the potential role of eosinophils in initiating or worsening liver inflammation in autoimmune liver disease. The link between eosinophilic inflammation, barrier damage, and chronic autoimmune diseases should be considered in clinical practice.","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":"19 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135871115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose. To investigate a cohort of young Italian nurses to identify whether the body mass index (BMI) and eating flexibility differed and were associated according to the basic characteristics of sex, smoking behavior, or shift activity, the levels of neutrophils, lymphocytes, or platelets in blood, and the psychological conditions of anxiety, depression, stress, or insomnia. Materials and Methods. The data include sex, BMI, smoking behavior, shift activity, neutrophil, lymphocyte, and platelet levels, eating flexibility [measured using the eating disorder flexibility index (EDFLIX) and the subdimensions EDFLIX-GF for general flexibility, EDFLIX-FoEx for food and exercise flexibility, and EDFLIX-WeSh for weight and shape flexibility], and mental health [assessed using the depression, anxiety, and stress scale (DASS-21) and the insomnia severity index (ISI)]. Results. Differences in BMI with shift work (P=0.042) and anxiety with total EDFLIX (P<0.001), EDFLIX-GF (P<0.001), and EDFLIX-WeSh (P=0.044) scores were significant. Having depression was associated with significant differences in total EDFLIX (P<0.001), EDFLIX-GF (P=0.005), and EDFLIX-WeSh (P<0.001) scores. Nurses with moderate stress reported high total EDFLIX (P<0.001), EDGLIX-FoEx (P<0.001), and EDFLIX-WeSh (P=0.013) scores. Nurses with mild stress reported high EDFLIX-GF scores (P<0.001). Nurses without insomnia symptoms reported significantly high EDFLIX- FoEx scores (P<0.001). Associations between lymphocyte levels and EDFLIX-FoEx (β=-0.264; P=0.003), stress and EDFLIX-total (β=-0.436; P<0.001), EDFLIX-GF (β=-0.466; P<0.001) and EDFLIX-WeSh (P=0.022), and also between insomnia and EDFLIX-FoEx (β=-0.245; P<0.001) were significant. Conclusions. Nurses, from the beginning of their careers, should be monitored and encouraged to avoid adverse health practices that negatively influence their quality of life.
{"title":"Body mass index conditions and eating attitudes in young nurses: a pilot psycho-immune-endocrine investigation","authors":"Yun-Chen Chang, Elsa Vitale","doi":"10.4081/itjm.2023.1654","DOIUrl":"https://doi.org/10.4081/itjm.2023.1654","url":null,"abstract":"Purpose. To investigate a cohort of young Italian nurses to identify whether the body mass index (BMI) and eating flexibility differed and were associated according to the basic characteristics of sex, smoking behavior, or shift activity, the levels of neutrophils, lymphocytes, or platelets in blood, and the psychological conditions of anxiety, depression, stress, or insomnia. Materials and Methods. The data include sex, BMI, smoking behavior, shift activity, neutrophil, lymphocyte, and platelet levels, eating flexibility [measured using the eating disorder flexibility index (EDFLIX) and the subdimensions EDFLIX-GF for general flexibility, EDFLIX-FoEx for food and exercise flexibility, and EDFLIX-WeSh for weight and shape flexibility], and mental health [assessed using the depression, anxiety, and stress scale (DASS-21) and the insomnia severity index (ISI)]. Results. Differences in BMI with shift work (P=0.042) and anxiety with total EDFLIX (P<0.001), EDFLIX-GF (P<0.001), and EDFLIX-WeSh (P=0.044) scores were significant. Having depression was associated with significant differences in total EDFLIX (P<0.001), EDFLIX-GF (P=0.005), and EDFLIX-WeSh (P<0.001) scores. Nurses with moderate stress reported high total EDFLIX (P<0.001), EDGLIX-FoEx (P<0.001), and EDFLIX-WeSh (P=0.013) scores. Nurses with mild stress reported high EDFLIX-GF scores (P<0.001). Nurses without insomnia symptoms reported significantly high EDFLIX- FoEx scores (P<0.001). Associations between lymphocyte levels and EDFLIX-FoEx (β=-0.264; P=0.003), stress and EDFLIX-total (β=-0.436; P<0.001), EDFLIX-GF (β=-0.466; P<0.001) and EDFLIX-WeSh (P=0.022), and also between insomnia and EDFLIX-FoEx (β=-0.245; P<0.001) were significant. Conclusions. Nurses, from the beginning of their careers, should be monitored and encouraged to avoid adverse health practices that negatively influence their quality of life.","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":"71 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135273402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In this study, we analyzed long-term sequelae in patients hospitalized at Montichiari Hospital (Brescia, Italy) during the COVID-19 acute phase, who needed a high-flow oxygen treatment. The follow-up evaluation has been performed after more than one year from discharge through a quality-of-life phone interview, standard laboratory tests, chest computed tomography, and global spirometry with an evaluation of the diffusing capacity of the lungs for carbon monoxide (DLCO). In our analysis, we found that patients who needed high FiO2 support during the acute phase, independently from the device used to administer it, showed a long-term heavy burden of pulmonary consequences: more than half of patients presented radiological alterations and persistent dyspnea or DLCO alterations; about 17% of them had alterations compatible with pulmonary fibrosis. Further analysis included a comparison of long-term consequences in patients treated with different devices. An interesting result was that prolonged positive pressure ventilation treatment didn’t seem to cause persistent pulmonary damage and thus could be considered a safe approach. In conclusion, this study confirms the heavy quality-of-life impact of moderate to severe COVID-19 and highlights the importance of recognizing patients who will benefit from rehabilitative programs and customized follow-up depending on the acute phase disease severity.
{"title":"Long-term impact of COVID-19 requiring elevated oxygen support and safety of prolonged positive pressure ventilation","authors":"Francesca Salvotti, Riccardo Pellegrinelli, Veronica Geroldi, Francesca Leidi, Vittorio Scipione, Gigliola Flamminio, Antonella Pastori, Claudia Agabiti-Rosei, Carolina De Ciuceis, Damiano Rizzoni, Gianluca Edoardo Mario Boari","doi":"10.4081/itjm.2023.1641","DOIUrl":"https://doi.org/10.4081/itjm.2023.1641","url":null,"abstract":"In this study, we analyzed long-term sequelae in patients hospitalized at Montichiari Hospital (Brescia, Italy) during the COVID-19 acute phase, who needed a high-flow oxygen treatment. The follow-up evaluation has been performed after more than one year from discharge through a quality-of-life phone interview, standard laboratory tests, chest computed tomography, and global spirometry with an evaluation of the diffusing capacity of the lungs for carbon monoxide (DLCO). In our analysis, we found that patients who needed high FiO2 support during the acute phase, independently from the device used to administer it, showed a long-term heavy burden of pulmonary consequences: more than half of patients presented radiological alterations and persistent dyspnea or DLCO alterations; about 17% of them had alterations compatible with pulmonary fibrosis. Further analysis included a comparison of long-term consequences in patients treated with different devices. An interesting result was that prolonged positive pressure ventilation treatment didn’t seem to cause persistent pulmonary damage and thus could be considered a safe approach. In conclusion, this study confirms the heavy quality-of-life impact of moderate to severe COVID-19 and highlights the importance of recognizing patients who will benefit from rehabilitative programs and customized follow-up depending on the acute phase disease severity.","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135888701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background. Burnout syndrome may threaten medical students’ professional life through negative effects on their academic work and personal life. Therefore, it is very important to identify the risk and protective factors of burnout syndrome in this group of subjects. The present study aimed to determine the association of socio-demographic characteristics, current substance/medication abuse, and personality dimensions with academic burnout among medical students, and examine physical activity as a potential moderator of the personality dimensions-academic burnout relationship. Materials and Methods. In this cross-sectional study, a total of 400 medical students from the four courses of basic sciences, physiopathology, stagers, and internship (100 people at each course) in Zahedan, Iran, in 2018, were selected by stratified sampling method and evaluated using the socio-demographic information form, Baecke physical activity questionnaire, Temperament and character inventory, and Breso’s academic burnout questionnaire. Finally, descriptive statistical methods, the Kruskal-Wallis test, Spearman’s rank correlation coefficient, and hierarchical linear regression were implemented for data analysis. Results. The participants included 156 men and 244 women. The overall frequencies for current substance/medication abuse, exhaustion, cynicism, inefficacy, and academic burnout were reported to be 27.5, 10.3, 12.3, 6.5, and 25.8 percent, respectively. The study results showed that physical activity, persistence, and cooperativeness were negative, and the years in medical school, current substance/medication abuse, and novelty seeking were positively associated with academic burnout. Also, the regression analysis results revealed the moderating effect of physical activity in the novelty-seeking-academic burnout link. Conclusions. These findings are an important contribution to the current literature on academic burnout as they can provide a meaningful guide to integrating treatment protocols designed to reduce both frequency and severity of this syndrome among medical students. However, the etiology of academic burnout among this highly sensitive group should be further investigated in depth.
{"title":"Factors affecting medical students’ academic burnout: a moderation analysis","authors":"Mohsen Khosravi","doi":"10.4081/itjm.2023.1659","DOIUrl":"https://doi.org/10.4081/itjm.2023.1659","url":null,"abstract":"Background. Burnout syndrome may threaten medical students’ professional life through negative effects on their academic work and personal life. Therefore, it is very important to identify the risk and protective factors of burnout syndrome in this group of subjects. The present study aimed to determine the association of socio-demographic characteristics, current substance/medication abuse, and personality dimensions with academic burnout among medical students, and examine physical activity as a potential moderator of the personality dimensions-academic burnout relationship. Materials and Methods. In this cross-sectional study, a total of 400 medical students from the four courses of basic sciences, physiopathology, stagers, and internship (100 people at each course) in Zahedan, Iran, in 2018, were selected by stratified sampling method and evaluated using the socio-demographic information form, Baecke physical activity questionnaire, Temperament and character inventory, and Breso’s academic burnout questionnaire. Finally, descriptive statistical methods, the Kruskal-Wallis test, Spearman’s rank correlation coefficient, and hierarchical linear regression were implemented for data analysis. Results. The participants included 156 men and 244 women. The overall frequencies for current substance/medication abuse, exhaustion, cynicism, inefficacy, and academic burnout were reported to be 27.5, 10.3, 12.3, 6.5, and 25.8 percent, respectively. The study results showed that physical activity, persistence, and cooperativeness were negative, and the years in medical school, current substance/medication abuse, and novelty seeking were positively associated with academic burnout. Also, the regression analysis results revealed the moderating effect of physical activity in the novelty-seeking-academic burnout link. Conclusions. These findings are an important contribution to the current literature on academic burnout as they can provide a meaningful guide to integrating treatment protocols designed to reduce both frequency and severity of this syndrome among medical students. However, the etiology of academic burnout among this highly sensitive group should be further investigated in depth.","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136294849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dear Editor, The sudden and unexpected loss of an infant in the first months of life is a heartbreaking and devastating experience for any parent. Understandably, it can be an extremely distressing time for the mother, who may often find herself unfairly burdened with guilt. When this tragic event occurs, a thorough investigation becomes necessary to determine the cause of death and also absolve the mother of any responsibility. [...]
{"title":"Sudden infant death syndrome: revealing this mystery is possible","authors":"Luca Roncati, Francesco Piscioli","doi":"10.4081/itjm.2023.1651","DOIUrl":"https://doi.org/10.4081/itjm.2023.1651","url":null,"abstract":"Dear Editor, The sudden and unexpected loss of an infant in the first months of life is a heartbreaking and devastating experience for any parent. Understandably, it can be an extremely distressing time for the mother, who may often find herself unfairly burdened with guilt. When this tragic event occurs, a thorough investigation becomes necessary to determine the cause of death and also absolve the mother of any responsibility. [...]","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":"251 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136352427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We present the case of an 84-year-old female patient admitted to the Internal Medicine Ward for atypical chest pain and laboratory findings of severe pancytopenia. Past medical history was remarkable for an episode of myocardial infarction approximately 4 weeks prior to the current hospitalization which had required angioplasty + drug-eluting stent and dual antiplatelet therapy with acetylsalicylic acid and clopidogrel. Some rare cases of clopidogrel-induced pancytopenia are described in scientific literature, therefore, after excluding infectious, vitamin deficiencies, and autoimmune causes, we modified the antiplatelet therapy by replacing clopidogrel with ticagrelor, obtaining complete leukocyte recovery within a few days. Since clopidogrel is an antiplatelet drug still used in clinical cardiological practice, the knowledge of this rare side effect may lead the clinician to suspect hematological toxicity which, if recognized promptly, may suggest modification of antiplatelet therapy and limit any possible infectious complications for the care of the patient.
{"title":"Rare but possible: clopidogrel-induced pancytopenia","authors":"Pietro Bocchi, Pasquale Gianluca Giuri, Achiropita Bovino, Alessia Casola, Simona Detrenis, Marcello Bertorelli, Michele Meschi, Giancarlo Mangè","doi":"10.4081/itjm.2023.1660","DOIUrl":"https://doi.org/10.4081/itjm.2023.1660","url":null,"abstract":"We present the case of an 84-year-old female patient admitted to the Internal Medicine Ward for atypical chest pain and laboratory findings of severe pancytopenia. Past medical history was remarkable for an episode of myocardial infarction approximately 4 weeks prior to the current hospitalization which had required angioplasty + drug-eluting stent and dual antiplatelet therapy with acetylsalicylic acid and clopidogrel. Some rare cases of clopidogrel-induced pancytopenia are described in scientific literature, therefore, after excluding infectious, vitamin deficiencies, and autoimmune causes, we modified the antiplatelet therapy by replacing clopidogrel with ticagrelor, obtaining complete leukocyte recovery within a few days. Since clopidogrel is an antiplatelet drug still used in clinical cardiological practice, the knowledge of this rare side effect may lead the clinician to suspect hematological toxicity which, if recognized promptly, may suggest modification of antiplatelet therapy and limit any possible infectious complications for the care of the patient.","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136353549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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